|
Q: Anticonvulsants & Itching
I have recentlly been told by a new psychiatrist that he suspects
that I have bipolar II disorder. I had been previouslly treated for unipolar
depression with out much success. I was started on Lamictal 25mg bid and
increased to 50mg bid. I noticed a huge difference in mental clarity and affect.
Unfortunately I began itching and scratching around my feet, legs, arms and
neck(not the trunk). This itching was not associated by a fever. I took some
benadryl and applied hydrocortisone cream to affecteced areas with mild relief.
When the situation became unbearble I notified my psychiatrist eventhough I
doubted it was Steven's Johnsons syndrome. I was told to quit taking lamictal
and was to start on Depakote. I insisted on a wash out period of a week in which
the itching eased, but never fully went away. I started on Depakote 250mg 1 tab
in am and 250mg 2 tabs at night. In one weeks time my itching has started back
to the point that I have taken 100mg of hydroxyzine and 50mg of benadryl along
with Allegra 180mg, 10mg of Singulair to no avail. I've bathed with coal tar
shampoo and rubbed aveeno on itchy areas. I'm not one to practice pollypharmacy,
but at this point I'd rather deal with ideations of suicide than be a scratching
fool. I know that it's time to see a dermatologist. I haven't been exposed to
any patients with scabies or dermatological conditions. I guess my question is
this. Have you ever heard of a patient being overly sensitive to anticonvulsants
in respect to itching?
Yours Sincerely,
Dear S' --
I haven't heard people warn about starting Depakote on the heels of this kind of
experience with lamotrigine. I certainly would worry about starting the other
commonly used anticonvulsants (carbamazepine and oxcarbazepine, close cousins,
both known to cause rash rather often). But as you've probably already
discovered, Stevens-Johnson and other such skin reactions are listed as
potential side effects of Depakote so I hope by now you and your doc' have taken
you off the Depakote too, or come up with some other way to manage it.
Dr. Phelps
Published February, 2005
|