Lamictal and acne
Red writes in with a common complaint about Lamictal . . .
I’m a 29 y/o female. I started Lamictal July of 07 (150mgs) and since then I have developed horrible acne along my jawline that takes weeks to clear up and new pimples develop every other day. They are painful. I also have pimples on my chest. I’ve never had bad skin in my life. I also noticed that I have more peach fuzz on the sides of my face and the hair on my head seems to be thinning as well. This really sucks for me because the Lamictal is the first thing that has helped to get me out of depression. Im also taking Lexapro 10mgs. I want to get off the Lamictal to see if these nasty side effects subside, but Im also scared to be on an emotional roller coaster again. I stopped birth control (Yaz) about 7 months ago and thought that if I start back on it again, it may help with the acne? It is supposed to be FDA approved for bc, acne, and PMDD symptoms, so maybe my answer lies in that. Before making my decision to stop the lamictal, I’ll see my Pdoc and my dermatologist. Mental health issues are a big pain in the butt to deal with!!!!!!
With the huge increase in use of Lamictal comes the inevitable huge increase in complaints about Lamictal. No . . . nothing can ever be easy! For most folks who take it, Lamictalis wonderfully helpful and has minimal side effects. Acne, as described above, is one of the more common complaints for those who do experience difficulties. It then leaves you with the dilemma of choosing whether you feel good . . . or look good. Most people choose to look good. More on that in another blarticle. From your description of your situation, there are a number of options available for you.
1. Birth Control Pills–As you mention, some of the newer birth control agents can be helpful for a variety of issues. As with mental health medicines . . . it is always a bit of a guess . . . might help . . . might not . . . won’t know till you try. If you were on it before and it was helpful, it is certainly worth a try. Especially if your acne only emerged after you stopped the Yaz.
2. Don’t stop the Lamictal . . . just lower the dose–The dose of Lamictal you are taking (150 mg) is a good solid dose. You might not need that much, especially since you are doing better. It is common to need less of a medicine to sustain improvements after an acute episode of difficulty. The decrease should occur slowly. Skin takes a while to heal and adjust to medication changes. I would recommend decreasing to 100 mg for a few months and then, if needed, more cautious tapering (eg by 25 mg every month or two). You are really balancing how you feel with improvements in your skin condition. One way of enhancing your mood as you lower the Lamictal is to maximize the Lexapro you are taking. For example, you may only need 100 mg of Lamictal when you are on 20 of Lexapro and your skin might be better. If, as you decrease the Lamictal dose, your acne remains bad and your mood begins to become more depressed . . . you have a difficult choice to make.
3. Other options–The fact that the addition of a mood stabilizer to an antidepressant has helped your mood opens the door to other mood stabilizer options, namely Abilify. Recent work (and my clinical experience) shows that the addition of Abilify to an antidepressant can be helpful in improving mood. Abilify comes with its own side effect difficulties, but at least it does no cause acne.
Remember, no medication changes should take place without a consultation with your psychiatrist. Make sure that you tell your doc about any over-the-counter agents you are taking as well as any herbal supplements. I’m also glad to hear that you are seeing a dermatologist. There are many new products for acne and choosing which one will help can be quite difficult. Also, you should have hormonal studies done to make sure that there are not underlying reasons for your hair and skin difficulties. As you so eloquently summed it up in your last sentence . . . mental health issues are a big pain in the butt!!! Make sure you are working actively with a psychiatrist and make your changes in a slow and methodical fashion. It increases the chance that you will ultimately find the combination of medicines that work effectively for you.
–Dan Hartman, MD
Tags: Abilify, acne, alopecia, Bipolar, depression, dermatology, Hartman, lamictal, Philadelphia, Psychiatrist
May 16, 2008 at 1:00 am
Great tips, thanks! By the way, I don’t recommend anyone using ProActiv for treating acne… I just tried it last month, and it really irritated and dried out my skin.
May 16, 2008 at 6:40 am
Really good advice. I feel the same as the woman. Mental issues are a pain in the butt. I’ve had severe depression problems my entire life and have recently found the courage to get help. I was also put on Lamictal and Lexapro about 7 or 8 weeks ago. I’ve had a range of side effects. The psych. wanted me to go up to 100mg/day of Lamictal, but am afraid to do it given the current side effects, and that I have Thalassemia (spelling?). I’ve kept myself on 50mg/day and haven’t yet discussed it with the doc because I haven’t yet gone back since she said to increase it after the 5th week.
Side effects: lumps in my throat, cyst-like lumps that I’m concerned about (could be lymph node enlargement from the drug, could be from Hashimoto hypothyroidism…not sure) I’ve never felt these fairly large sized lumps before, so it’s a concern; some acne problems on the lower jaw; blurred vision (on occasion); fever and flu like symptoms for a week (never get sick, so could have just been me getting sick, but a weird coincidence); dry mouth; difficulty swallowing; weight gain (could not be related, but it’s irritating non the least); sleepy; waking up in middle of the night with difficulty returning to sleep.
Is it worth it? I’m struggling with this because I do feel so much better, but I still have zero energy and am really concerned about having a blood disorder taking this drug and just worried about a lot of the side effects I’ve been having.
Any advice? I will speak with my psych. and I also have an appointment with my primary care doc to discuss all, but any additional advice from any experts would be appreciated. Thanks.
May 22, 2008 at 4:35 am
Vicki–Wierd bunch of side effects. Problem with starting two meds at once is that you never know which caused problems if they do arise. There should be no difficulties with Lamictal and the Thalassemia. The presence os what seems like a low grade infectious process is concerning. Not likely due to the meds but you never know. I hope that you went to your family doc. If not . . . get there. If the doc does not find any other cause for your medical issues, I would suggest stopping the Lamictal first. It can be a messy med for some people . . . much less likely with the Lexapro.
–DH MD
June 24, 2008 at 5:19 pm
hi,
I was on Lamictal for a long time….i stopped takin it about 4 motnhs ago when i realized i didn’t need it. I am also Bi-Polar and have depression….my doctors decided to put me on Wellbutrin….which has helped me morre then anything….hope this helps some
Jessi
http://www.cindycut.com
July 4, 2008 at 3:49 am
I suffer from bipolar disorder and I was put on lamictal 100mg and geodon 20mg. It seemed to work great for my mood. However, my face has suffered because of the lamictal. The acne along my jawline and cheeks is gross. I went to see my psychiatrist and he suggested that I get off it and go on topamax. Lamictal works well, but the acne it causes made me feel bad. I tried proactive and other expensive acne products but the acne kept coming. I’m also going back on Yaz because that helped with my mood too and it helps with acne.
July 13, 2008 at 1:50 pm
Nat– Sorry to hear about the acne. As you can read, it is a big problem for many people. Lowering the dose may help, especially with the addition of the Yaz if that was previously helpful. I am not a big Topamax fan, only because in my limited use of it, I have not had great success (but no crash and burn failures, either). Sounds like you have a doc who is listening and willing to try options . . . keep trying your options . . . there is likely a solution for your mood issues that will not require such a difficult trade off.
–DH MD