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Too high of a dose of lamotrigine?
its_sara posted:
Hello everyone! This is my first post so bear with me. I was recently with bipolar disorder and was out on 25mg of generic lamictal then gradually increased to 150mg. My pharmacist gave me the generic brand and didn't think much of it until I started taking 200mg. I started to cry more often, before VERY agitated and had very little self esteem. I became paranoid and suspicious of everyone, including people close to me. I did not feel this way when I took the 150mg. Could it possibly be the dosage that is creating all of these problems or the generic brand? I'm also on 5mg of Abilify once a day. Any advice or input would be great! Thanks all
Joseph F Goldberg, MD responded:
Dear Sara,

For the FDA to approve a drug as a generic, its manufacturer only has to show that it reaches 80-120% of the blood level of the brand-name version. Studies of safety or efficacy (or side effects) are not required. So it is possible that a switch from a brand-name version to a generic could produce a different result. Usually the easiest way to find out is to go back on the brand (a doctor can usually pursuade an insurance company to pay for brand if the brand was known to help and a generic produced an undesirable effect); if the problem is solved, there is your answer. If not, then the symptoms you describe may very likely just be illness features that Lamictal alone cannot adequately treat. A higher dose of generic could be 20% more or less than the brand, so resuming brand at 150 mg would provide a more level starting point from which to judge this.

Dr. G.

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