Epilim. Valpro, Tegretol, Lamictal (Sodium valproate, carbamazepine, lamotrigene)

These medications are intended to supplement the effectiveness of antidepressants you are taking already, and also to prevent relapse of your depressive illness.  While antidepressants work by improving the chemical transmitters in your brain, these medications work by stabilising the electrical activity in your brain.  In recent years, it has become increasingly clear from research that these medications (known as anticonvulsants), which are normally used to prevent epileptic seizures (by stabilising brain electrical activity in people suffering from epilepsy), also prevent attacks of depressive illness and other mood disorders.  These medications are sometimes very useful in treating anxiety and supplementing antidepressants.  You may also be prescribed these medications as a precaution against epileptic seizure risk if you are taking unusually high doses of antidepressants, or if your EEG shows electrical instability.

Dosage:  The medication will be started at low dose, usually taken morning and night.  The dose will gradually be increased to normal doses.  You will have blood tests from time to time to check you are receiving the correct dosage.

Blood Test:  We try to measure the lowest level of these medications in your blood stream.  If you are taking the medication at night only, have the blood test late in the afternoon.  If you are taking the medication twice a day, have the blood test in the morning, before you take the anticonvulsant.  You do not have to fast for the blood test, and you should take your other medications as prescribed.

Side Effects:  You may experience some or none of the following:

• Drowsiness or tiredness – do not drive or use machinery if you are drowsy.  Try taking less of the medication during the day, and most of the medication at night, provided you are not groggy in the morning.
• Unsteadiness or dizziness – reduce the dose of medication.
• Skin rash or itch – take one tablet less each day until you are off the medication.  This  is a sign of being allergic to this medication. In the case of Lamictal, continuing a medication to which you are allergic can cause a potentially fatal condition called the Stevens_Johnson syndrome.
• Unusual bruising – you will need a blood test in case you are having an allergic reaction affecting your blood cells.
• Less common – double vision, weight gain, hair loss, facial hair growth.

IMPORTANT –  

• DO NOT STOP THE MEDICATION SUDDENLY, or you may cause a withdrawal epileptic seizure.  If you are going to run out of medication, ask your GP or your pharmacist for more.  If you are stopping the medication, reduce by one tablet per day.
• Stop the medication (in the way described above) if you develop a rash or itchiness and do not take it again.
• Do not take these medications if you are at risk of becoming pregnant, or if breastfeeding. These medications can harm unborn babies.
• These medications (especially Tegretol) MAY MAKE THE CONTRACEPTIVE PILL INNEFFECTIVE.

Alcohol:  You can safely have a small amount of alcohol while taking these medications, but do remember one drink may have the effect of 2 or 3 drinks.

This information is intended to improve your knowledge of the treatment you are receiving.  Any further points can be discussed at your next consultation with your doctor.

Important Disclaimer:  This site is medical information only, and is not to be taken as diagnosis, advice or treatment, which can only be decided by your own doctor.