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What Causes Itchy Rashes All Over Body After Taking Effexor And Lamictal?

Posted on Wed, 30 Sep 2015

Question: I am elderly lady dx with Bipolar as well as my brother after age 60 but explains a lot that happened in my life ending in hospital 5 times over the years til a Dr got it right and I was put on Lamictil and effexor and have done fairly well but deal with intermittent OCD.I recently moved to new area out of state (part of what I do when going into Manic phase )about 3 0r 4 months before I left I had terrible itching rash all over my body with some bruising unknown cause so my primary sent me to dermatologist as time went on I developed open sores all over.I was sure I had bed bugs as itching was worse at night but dermotogist did scrappings and biopsy and said no bugs now that I have moved WHEN I GO TO SLEEP I WAKE UP in the middle of night with roaches crawling on me and one time a tic My family thinks I am hallucinating but it is very real to me I hired Pest control to evaluate for all bugs bedbugs and roaches and they could not find any but I continue to wake up with one or 2 roaches crawling on me and once a spider. I am now terrified to sleep and stay up all night having headackes( maybe due to fACT I SPRAY RAID on myself everynight )and intermittent overwhelming feelings of depression.I do not know what to do.I have no psych Dr here and meeting my primary tomorrow for 1st time/.Anyone else have this issue I am exhausted from no sleep and terrible headacke and depressed

Answered by Dr. Manisha Gopal (19 minutes later)

Brief Answer:
looks like delusion, treatment plan to be changed

Detailed Answer:
Hello,

I have read your query carefully and can see that you were keeping fine on meds till you developed these symptoms of rash and itch and now you have difficulty in sleeping.

1. As for the issue of rash and itch- even lamictal might give rise to this sometimes. So please check with your treating team. In that case the dosage of the drug can be decreased. I have seen this side effect in some of my patients on lamictal.

2. I think the repititive thoughts about bugs might be just your suspicion, as no one has ever seen or found them either in your house nor on your body, such delusions may happen.

Had I been treating you I would have added an antipsychotic drug for this and you would have got rid of the bugs. You need to consult a doctor for a prescription of the same.

3. You must sleep properly at night; a good night sleep is restorative in patients and I have seen good response in overall symptoms when my patient starts sleeping well.

In cases like yours when patient has difficulty with ambien, I change the drug to lorazepam, this is a prescription drug and you need to obtain this from a psychiatrist.

Please do not lose hope- yours is a common clinical presentation and will be managed.

You can discuss the above points with your treating team.

I hope the reply is helpful.
Please feel free to ask more queries for clarification.

Dr. Manisha Gopal
MD Neuropsychiatry

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Manisha Gopal (9 hours later)

Thank you very much I am a nurse of course trying to think of ways that may help and Ativan might well be the drug to use. I usually use Risperdal for psychosis issues but its rare as I said I tried it 3 nights ago and did not help but I thought Xanax or Ativan might calm me down. Part of the bug issue is I was working in home health and so many homes were so dirty and some had rats roaches and one person had body lice and that has added to my suspicion of bugs. I am also Insulin dependent Diabetic. I would love to see my old psych but she is out of state. I am seeing an internist today but will ask for referral to local psych team. Thank you again.

Answered by Dr. Manisha Gopal (11 hours later)

Brief Answer:
you are most welcome and good luck

Detailed Answer:
Hello,

Good to hear from you again. Its helpful that you are a nurse yourself and can understand the points more clearly.

May be you can first try with ativan and if that does help you in calming down - best!!

However, if the feeling or thoughts persist then I would have advised any of my similar patient- to try resperidone in a raised dosage for some days.

And to get symptoms of this severity like you have -- just one or two exposure to bugs is less....and atleast someone would be able to see them in scarping or by team of pesticide people...which wasnt the case with you..

You should discuss the points with your internist.

All the best for speedy recovery and good health!

Dr. Manisha Gopal
MD Neuropsychiatry

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

Follow up: Dr. Manisha Gopal (59 minutes later)

I GOT NO MEDICAL HELP TODAY SEEING NP FOR INTERNIST SHE DID GIVE ME NAME OF DR QUINTION PSYCHIATRIST BUT SHE CANNOT SEE ME Till JAN/2016 tHE OTHER 2 WERE NAMES OF LOCAL MENTAL health programs I CALLED Lifespring left message not sure what they do, have not heard back.IN meantime will try Ambien tonight but will be going to bed quickly or continue to up dose on RISPERODOL JUST THINKING? also will sleep in different room I am trying the best I can One more bad night I am going to a urgent care center
THANKS FOR LISTENING

Answered by Dr. Manisha Gopal (38 minutes later)

Brief Answer:
yes, the plan sounds right!

Detailed Answer:
You are welcome...
and I think that you are on the right track and have a right plan for now...

Wish you luck!
Dr. Manisha Gopal

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

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