Q: Leg Weakness, Could
It Be the Meds?
diagnosed with bi-polar 4 years ago. I am on a combination of Lamictal, Trileptal
and Wellbutrin XL. I have been experiencing a problem with leg weakness that
sometimes results with a fall. It seems to occur in the right leg and comes and
goes. Could the combination of these drugs cause something like this to happen?
Thank you so much for your response.
Dear Ms. Gí Ė
A general principle, as
phrased by a doctor friend of mine: "Medications are guilty until proven
innocent." On that basis, one has to presume that it is possible that any of
these medications are causing the problem. On the other hand, if you were
taking some subset of them with no problems for a long time, and then a third
one was headed and only after that did the problem emerge, then obviously, only
the third one is really likely to be the problem.
What about a problem due to
the combination, not due to any one alone? That is even harder to figure out.
Fortunately, this does not seem to be an issue very commonly, and not at all, to
my knowledge, with these three medications -- except for one thing.
Because Lamictal (lamotrigine)
and Trileptal (oxcarbazepine) are both anti-seizure medications, sometimes it
seems that when they are combined, it is just a little too much for the central
nervous system. People are more likely to get side effects from the
oxcarbazepine, like dizziness and balance problems, than they do when it is used
alone (lamotrigine rarely causes side effects, but it too, especially at high
doses like 300-400 mg, can also cause balance problems).
So, summarizing the above,
unfortunately I think the conclusion is "possible, but not likely"; and "the
only way to really know is to try to subtract something very cautiously" (only
under the very direct supervision of your psychiatrist, of course).
However, there is one more
thing: for this to occur only in one leg, and not the other, makes it much less
likely to be a medication problem. The other way to cope with this question,
rather than considering which medication you might try to take her to figure it
out (and I cannot stress enough the importance of doing this in discussion with
your doctor, not on your own; you could end up in a terrible place trying to do
this by yourself), would be to continue investigations of the right leg problem
on a presumption that there is a physical explanation, as opposed to a chemical
(medicines) explanation. Some old injury, perhaps, or a spinal cord/nerve root
pinch; something like that.
Not much in there you hadnít
figured out already, Iíll bet. Sorry itís not more concrete than that. Good luck
getting that figured out.
Published May, 2009