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Q: Tatoos & Mood Stabilizers : Lamictal & Watching for a Rash
My son is 23 he just started on Lamictil today. I tried to get him to
start on 12.5 but the Dr was no help, in fact she got annnoyed because I knew
about mood stabilizers. She said start at 25, He is also on 20 mgs of Prozac. He
was taking Seroqule that was prescribed in the hopital but he hated it and had a
lot of the side affects, he doesn't want to take any anti psychotics. We have a
few questions. His first question is can he get tattooed. He is a tattooist and
has many tattoos and plans on getting many more. The Dr said something about low
platelets and not to get tattooed. He said then forget it I don't wanna take the
Lamactil and she said all mood stabilzers will make it dangerous to get
tattooed. She would not give us much info as she thought getting tattooed is
something to give up for meds. But he is not willing to do that. I wanted to know
how long should we watch for a rash? The whole time he is on it? Is this
medicine safe? I am worried about the rash. He just started today. I have been
to your website and spent hours on it. I like how honest you are and I respect
your advice. Thank you for any information you can give me.
Dear D' --
Sorry you had that experience over the 12.5 mg dose. The 25 mg dose really is
standard, I'm just ultra-ultra-cautious with my dosing when I have the option to
be.
As for tatoo's, it's true that Depakote can interfere
with platelets and cause bleeding to be a little prolonged; and can occasionally
even drop the platelet count below normal. And Depakote interacts very directly
with lamotrigine. So if Depakote was in the mix of medications, she might have
something there. If it's not, I don't get the hesitation regarding tatoos. I
can understand the notion of giving them up in favor of medications, but I hear
that in this young man's case, that ain't gonna happen right now.
Just to make sure I reviewed the product information on
lamotrigine; did a PUB MED lit search (lamotrigine platelets; lamotrigine
bleeding) and a Google search -- and found no connection between lamotrigine and
bleeding problems.
How long to watch for a rash? The problem usually
occurs, if it's going to occur, in the first 2-8 weeks, and once you're past 2
months at full dose, you're probably not going to see a problem. But there have
been some rare cases occurring after more than 6 months of treatment, so you can
never completely relax about the rash-risk. It's definitely a risk with this
medication, but so it having symptoms, in many cases. The risk of rash is not
one that keeps me from using this medication, even using it first, before
other medications like lithium and Depakote, in many cases -- in other words,
the risk from this one, compared to its potential benefits for some people, is
in the same ballpark as the alternatives when you take all factors into account,
in my opinion.
Dr. Phelps
Published March, 2004
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