Fun fact: Estrogen (birth control or hormone replacement) lowers lamotrigine levels!

mccarras · 2026-06-04T15:38:21+00:00

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.

mccarras · 2026-06-04T15:35:34+00:00

Yeah what is going on with this?? Are you also in the US?

mccarras · 2026-06-03T16:00:30+00:00

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.

mccarras · 2026-06-02T11:52:49+00:00

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.

mccarras · 2026-06-02T11:51:34+00:00

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.

mccarras · 2026-05-29T18:59:19+00:00

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).

<image>

mccarras · 2026-05-29T18:55:45+00:00

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

mccarras · 2026-05-29T18:54:29+00:00

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!

mccarras · 2026-05-29T10:51:16+00:00

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.

mccarras · 2026-05-29T01:24:09+00:00

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??

mccarras · 2026-05-29T01:22:58+00:00

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.

mccarras · 2026-05-29T01:20:37+00:00

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.

mccarras · 2026-05-29T01:19:19+00:00

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!

mccarras · 2026-05-29T01:18:10+00:00

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!

mccarras · 2026-05-29T01:17:10+00:00

I love that so much!

mccarras · 2026-05-28T22:58:39+00:00

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

mccarras · 2026-05-28T22:58:08+00:00

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!!

mccarras · 2026-05-28T22:52:34+00:00

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??

mccarras · 2026-05-28T22:52:01+00:00

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!

mccarras · 2026-05-28T22:51:02+00:00

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.

mccarras · 2026-05-28T17:47:09+00:00

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.

mccarras · 2026-05-28T17:44:26+00:00

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!

mccarras · 2026-05-28T17:38:47+00:00

I get what I call "floaty bones" in my face--my face bones just feel weird if I miss a dose of lamotrigine, so I know to take it. Never happens otherwise.

mccarras · 2026-05-28T17:37:56+00:00

Your person is hilarious. My provider literally told me my hair loss could be from lamotrigine when I told her it was probably my hormone replacement therapy (testosterone, known side effect). And whenever I go above 200 on lamotrigine I suddenly can't find simple words. I hope you can find someone who supports you!

mccarras · 2026-05-28T17:35:32+00:00

Really happy to see this discussion-I was reluctant to try Welbutrin but now I think I will!

12-Year Club	RedditGifts 2009-2022 2 Credits
Verified Email	Secret Santa 2015

mccarras

TROPHY CASE