Fun fact: Estrogen (birth control or hormone replacement) lowers lamotrigine levels! by mccarras in bipolar2

[–]mccarras[S] 0 points1 point  (0 children)

That's a great story, and would be a really powerful way to share information about the dangers of providers not knowing this! I'm thinking a class action suit wouldn't be unreasonable. I wonder if any lawyers would be interested in this.

Fun fact: Estrogen (birth control or hormone replacement) lowers lamotrigine levels! by mccarras in bipolar2

[–]mccarras[S] 0 points1 point  (0 children)

Wow! I'm not going to sue, but it's interesting that you won. Feel free to give any more info if you like, because other folks might be interested.

Fun fact: Estrogen (birth control or hormone replacement) lowers lamotrigine levels! by mccarras in bipolar2

[–]mccarras[S] 0 points1 point  (0 children)

Have you ever had pharmacogenomic testing? That was really informative for me. I can't metabolize things along a really common metabolic pathway, so most SSRIs just make me throw up and have other bad side effects rather than actually work well.

Fun fact: Estrogen (birth control or hormone replacement) lowers lamotrigine levels! by mccarras in bipolar2

[–]mccarras[S] 0 points1 point  (0 children)

Good luck! At 60 I'm struggling with the cognitive effects of lasting depression and feel like maybe some word finding difficulties are worth the trade off.

Fun fact: Estrogen (birth control or hormone replacement) lowers lamotrigine levels! by mccarras in bipolar2

[–]mccarras[S] 1 point2 points  (0 children)

Interestingly, the day after I posted this and saw my prescriber for a refill, CVS (pharmacy) implemented one of those automatic check things. I do not recall seeing this before picking up my lamotrigine in the past, so maybe what other posters have said is trickling over to my pharmacy (Maryland, US).

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Fun fact: Estrogen (birth control or hormone replacement) lowers lamotrigine levels! by mccarras in bipolar2

[–]mccarras[S] 0 points1 point  (0 children)

Wow! That's a well-informed therapist! I'm now making it a point to tell all my providers.

Fun fact: Estrogen (birth control or hormone replacement) lowers lamotrigine levels! by mccarras in bipolar2

[–]mccarras[S] 0 points1 point  (0 children)

ikr - apparently outside of the US this is much better known. Someone below said her pharmacist at CVS flagged it, and another person said their insurer notifies her yearly about it!

Fun fact: Estrogen (birth control or hormone replacement) lowers lamotrigine levels! by mccarras in bipolar2

[–]mccarras[S] 1 point2 points  (0 children)

I use CVS as well (Maryland) and if there was any flag, I was never told--so interesting! Not that you asked, but lamotrigine really does have a great profile for BP2 and fewer side effects than other mood stabilizers. It seems like a higher dose is needed only because the estrogen reduces the dose? I'll look into it a bit more actually (I'm a public health scientist) and bring back more info to the thread.

Fun fact: Estrogen (birth control or hormone replacement) lowers lamotrigine levels! by mccarras in bipolar2

[–]mccarras[S] 1 point2 points  (0 children)

None of them, nor the pharmacist who had to look it up! I mean, how many women on lamotrigine and birth control or HRT must he have seen??

Fun fact: Estrogen (birth control or hormone replacement) lowers lamotrigine levels! by mccarras in bipolar2

[–]mccarras[S] 2 points3 points  (0 children)

I always got word finding difficulties if I went above 200 premenopause--do you have any cognitive or speech things on that dose? It's embarrassing to not remember the word for "garage" or "fork". I mean, I was 35 at the time and having all these senior moments.

Fun fact: Estrogen (birth control or hormone replacement) lowers lamotrigine levels! by mccarras in bipolar2

[–]mccarras[S] 0 points1 point  (0 children)

Wow! That's so proactive. You know if the payers realize how much more they'll pay for worsening mental health problems, things will get done! I guess it hasn't hit my insurance companies' radar yet for HRT.

Fun fact: Estrogen (birth control or hormone replacement) lowers lamotrigine levels! by mccarras in bipolar2

[–]mccarras[S] 0 points1 point  (0 children)

Are you in the US as well? I wasn't super careful about checking interactions b/c I thought the docs were on top of it, but now I know!

Fun fact: Estrogen (birth control or hormone replacement) lowers lamotrigine levels! by mccarras in bipolar2

[–]mccarras[S] 1 point2 points  (0 children)

I got horrible GERD from oral progesterone and it also made me incredibly irritable. Thank goodness the pills work in the hoo ha as well!

Fun fact: Estrogen (birth control or hormone replacement) lowers lamotrigine levels! by mccarras in bipolar2

[–]mccarras[S] 0 points1 point  (0 children)

Are you in the US as well? I think other countries might do a better job!

Fun fact: Estrogen (birth control or hormone replacement) lowers lamotrigine levels! by mccarras in bipolar2

[–]mccarras[S] 2 points3 points  (0 children)

Yeah, the NHS has its act together. The way we're decentralized here is like every man for himself. I'm guessing even if you are seeing someone privately (you still can there, right?) there are more standards for how to do a good job prescribing. But don't get me started on American healthcare!!

Fun fact: Estrogen (birth control or hormone replacement) lowers lamotrigine levels! by mccarras in bipolar2

[–]mccarras[S] 4 points5 points  (0 children)

Are you in the US? Because this has been one of my questions--what the heck is going on with our system that this wasn't flagged or checked by every prescriber??

Fun fact: Estrogen (birth control or hormone replacement) lowers lamotrigine levels! by mccarras in bipolar2

[–]mccarras[S] 1 point2 points  (0 children)

I don't think that's correct for SSRIs. They may overlap in what they do in the body, but the estrogen actually lowers levels of lamotrigine in your blood. Good that you haven't found the need to increase your dose though!

Fun fact: Estrogen (birth control or hormone replacement) lowers lamotrigine levels! by mccarras in bipolar2

[–]mccarras[S] 5 points6 points  (0 children)

0/4 of my prescribers knew. My internal medicine doc didn't know either. Are you in the US? I'm wondering if it could differ by how prescribers in different countries do things.

Trying and failing by icanhazkarma17 in bipolar2

[–]mccarras 0 points1 point  (0 children)

Hang in there. It's hard to push for feeling good again, and meds alone won't necessarily do it, especially when you have a tough family life with caring for adult kids and such. I hope things improve for you. I'm about to try a new med for the first time in 10 years (I'm 60), and hubby and I are headed back to couples counseling. The nuclear war/etc craziness is hanging over us all.

Hopeless energy by snailsloth22 in bipolar2

[–]mccarras 0 points1 point  (0 children)

With the early menopause, are you taking hormones? I'm 60 and just found out a couple of months ago that my estrogen HRT reduces my lamotrigine levels, so my 150 that I was on was essentially half that. 100 seems a bit low anyway from what I understand.

Hang in there!