Mary is a 34 yr. old female who is being treated for Bipolar…
Mary is a 34 yr. old female who is being treated for Bipolar Type II. She has just been prescribed Lamictal (lamotrigine) by her Psychiatric Mental Health Nurse Practitioner for the management of her depression in the context of Bipolar Disorder. Due to the potential risk for Stephen Johnson’s Syndrome, this medication needs to be titrated slowly. This is especially the case if the patient is also on other antiepileptic medication. Mary’s other medication is Carbamazepine (Tegretol) 200mg PO twice a day. The following table is the recommended dosage escalation for patients over the age of 12. She is scheduled to return to follow up with the Nurse Practitioner in 6 weeks. Based on this table, what would you anticipate is the instructions you would provide as her nurse as to how to take the medication, Lamictal 25mg tablets to get her up to the prescribed target dose of 100mg po daily? In patients taking Depakote In patients not taking Tegretol, Depakote or Dilantin In patients taking Tegretol, or Dilantin but not taking Depakote Week 1 and 2 25mg every other day 25mg every day 50mg every day Week 3 and 4 25mg every day 50mg every day 100mg every day in two divided doses Week 5 and onward 100mg to 400mg per day with Valproate alone Increase by 50mg per day every one to two weeks Increase by 100mg per day every one to two weeks
Read Details