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Suggest Remedies For Anxiety, Depression And Fatigue While On Lamictal

Posted on Fri, 20 Jan 2017

Question: I began processing trauma and was put on 200mg of Lamictal and 300mg Truleptal. I contend with PMDD with horrible side effects the week before my period of anxiety, depression, anger, fatigue, and shutting down. The symptoms are so severe it is negatively affecting my relationship. The first line of defense for PMDD is often birth-control, or more specifically YAZ.
My question is this; if I take Lamictal and Trileptal can I take YAZ without it being contradicted. The reviews and advice are all over the board and I'm frustrated and scared of negating meds that are positively supporting me. My second question would be my partner and I are also looking at starting a family soon. On the strength of Lamictal and Trileptal is it safe with pregnancy?

Answered by Dr. Seikhoo Bishnoi (18 minutes later)

Brief Answer:
Lamictal and Carbamazepine are safe to use

Detailed Answer:
Hi, thanks for asking from HCM

I can understand your concern. If we consider drug interactions between Lamictal or Lamotrigine with Birth control pills then in a number of studies using Birth control pills with Lamotrigine has shown to reduce the levels of later drug.

Trileptal or Carbamazepine is known to reduce the effectiveness of birth control pills.

So final decision lies on the treating doctor. Pills can be taken while on Lamictal or Trileptal without any significant adverse events.

Lamictal or Trileptal both are considered as relatively safe in pregnancy so no need to worry about that. Using Folic acid while on this drug also reduces risk of any side effects. Please discuss with your doctor before conception for best outcome.

Thanks. Take carer

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Seikhoo Bishnoi (13 hours later)

Does bio identical progesterone interfere with Lamictal and Trileptal?

Answered by Dr. Seikhoo Bishnoi (5 hours later)

Brief Answer:
Yes it will interact.

Detailed Answer:
Hello again

Trileptal will reduce the concentration of Progesterone. Lamictal effectiveness too will be reduced by progesterone.

Progesterone is metabolised by Cyt P450 enzyme which is affected.

Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Seikhoo Bishnoi (2 hours later)

My Dr isn't savy enough to know. So since they are affected do you increase the dose of all of them? Only the lamictal and trileptal? I'm so at a loss of how to handle this. I posed the question with another Dr on this site and he said they wouldn't interfere. Hence my confusion and frustration in trying to get clear answers.

Answered by Dr. Seikhoo Bishnoi (1 hour later)

Brief Answer:
No serious drug interactions will be seen

Detailed Answer:
Hello again

They would definitely interfere with levels and will alter efficacy but final decision about dose adjustments or changing depends upon treating doctor.

But if you take birth control pills with these drugs then there would not be any serious drug interactions.

Thanks

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Seikhoo Bishnoi (8 hours later)

My prescribing Dr doesn't know either. She stated they wouldn't interfere, then when I picked up my birth control from my pharmastis he said they definitely will. The consensus is so divided, but I agree with your feedback. Have you seen success for PMDD with a modality/intervention that wouldn't be contraindicated with a Lamictal and Trileptal?

Answered by Dr. Seikhoo Bishnoi (11 hours later)

Brief Answer:
SNRIs can help you.

Detailed Answer:
Hello again, I am sorry for late reply

If you have been never given SNRI drugs then that could be used. Venlafaxine or Duloxetine can be used. Both of these will not interact with Lamictal or Trileptal. Both are safe to use and are free of serious side effects. The drugs will reduce the fatigue, severe anxiety and pain and will help you. In next appointment you can talk with your doctor for that.

Apart from this vitamin supplements especially Vitamin B6 or pyridoxin containing have great roles in PMDD. Exercise daily, have good diet rich in proteins and complex carbs and low in fats. This will too help you.

Thanks. Take care

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar