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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Bekka H. on March 18, 2002, at 15:52:37
Hi everyone. Lamictal is an anti-folate compound. It interferes with the synthesis of folate (folic acid is an important vitamin). I'd like to know whether any Lamictal users take extra folic acid? I've just started on Lamictal and I think I should be taking extra folic acid. I understand that, in the United States, any vitamin with more than a certain amount of folic acid requires a prescription because folic acid can mask a vitamin B12 deficiency. I don't know how much extra folic acid to take. Do you?
Posted by OldSchool on March 18, 2002, at 19:21:08
In reply to Lamictal and Folic Acid, posted by Bekka H. on March 18, 2002, at 15:52:37
> Hi everyone. Lamictal is an anti-folate compound. It interferes with the synthesis of folate (folic acid is an important vitamin). I'd like to know whether any Lamictal users take extra folic acid? I've just started on Lamictal and I think I should be taking extra folic acid. I understand that, in the United States, any vitamin with more than a certain amount of folic acid requires a prescription because folic acid can mask a vitamin B12 deficiency. I don't know how much extra folic acid to take. Do you?
Bekka, it is true that all of these anticonvulsants deplete folic acid and if you are to be on one longterm it is probably wise to take a supplement. This would be a question for your doctor really. However, I do know you arent supposed to take supplements of individual B vitamins such as folic acid supplements. What you are supposed to do is take a B-50 or B-100 complex vitamin. A B-100 complex vitamin contains 100 mg of all the B vitamins, except for folic acid. If I remember correctly, the maximum any OTC vitamin has in folic acid is only 400 micrograms. A little of that stuff goes a long way evidently and its easy to overdo folic acid.
Dont forget plain old Centrum multivitamins contain 400 mcg in folic acid. Might be as good as anything to take.
Old School
Posted by IsoM on March 18, 2002, at 19:52:16
In reply to Re: Lamictal and Folic Acid, posted by OldSchool on March 18, 2002, at 19:21:08
B complex vitamin supplements sold as B-50 or B-100 aren't good to take. You'll end up showing deficiencies of some of the individual B vitamins if you take these supplements regularly, long-term.
The reason being that in nature & as needed by our bodies, the amounts of the B vitamins needed aren't all the same. Something like trying to make spaghetti using equal amounts of meat, tomato sauce, salt, garlic, onions, herbs, water, & pasta - it would be pretty loathsome.
If you take this type of B complex, the large amounts of those that should be less than the others, will end up causing a deficiency of the ones that should be higher. Better to take an anti-stress B complex supplement. You'll notice the levels of the different B vitamins have a far better ratio to each other. In Canada, more folic acid is allowed than the States. The regulation against more folic acid came about due to the fact that folic acid could mask the symptoms of pernicious anemia (in those who lack the intrinsic factor in their stomach).
Posted by Bekka H. on March 18, 2002, at 22:11:32
In reply to Re: Lamictal and Folic Acid, posted by OldSchool on March 18, 2002, at 19:21:08
Hi Old School.
Thank you for your reply. Centrum sounds like a good idea, and I will speak with my pdoc about any other supplements. I'm wondering whether taking folic acid (in a multivitamin, B vitamin complex or just in food) might interfere with the mechanism of action of the anticonvulsants? I mean, is the depletion of folate that is caused by anticonvulsants just a side effect, or could it be an essential "ingredient" in its therapeutic action?
Bekka
Posted by Bekka H. on March 18, 2002, at 22:16:40
In reply to Lamictal and Folic Acid for Bekka and Old School, posted by IsoM on March 18, 2002, at 19:52:16
Hi IsoM,
Thank you for your reply. I will start with good old Centrum and/or a B complex formula. That's interesting that Canada allows a larger amount of folic acid without a prescription. Yes, come to think of it, I do remember reading that the B vitamins should be taken in certain proportions to eachother for optimal absorption, etc.
Bekka
Posted by Bill L on March 19, 2002, at 11:48:03
In reply to Re: Lamictal and Folic Acid -- IsoM, posted by Bekka H. on March 18, 2002, at 22:16:40
Bekka - All women who have any possiblility of becoming pregnant should be taking folate supplements. They help prevent neural tube defects. The amount to take is 800 units per day.
Folate is more easily absorbed by the body in supplement form than in food form for 2 reasons:
1) the folate in food can become denatured before you eat it
2) folate in enteric capsules or pills bypasses the stomach and is better absorbed in the duodenum
Posted by paulb on March 19, 2002, at 20:56:38
In reply to Lamictal and Folic Acid, posted by Bekka H. on March 18, 2002, at 15:52:37
I queried my psychiatrist about this when i was taking lamotrigine. His response was that he had done several tests for folate levels in persons taking lamotrigine and did not find one one that was severely depressed. Taking it as a supplement would be sensible though just check up on toxicity levels.
Paulb
Posted by IsoM on March 19, 2002, at 22:11:15
In reply to Re: Lamictal and Folic Acid, posted by paulb on March 19, 2002, at 20:56:38
In Canada, folic acid supplements can be had in 1 mg & even 5 mg strengths. I see no reason to take more than 1 mg strength though. Folic acid is a water-soluble vitamin but why pay for vitamins to wash out in your urine?
It's for these reasons that water-soluble vitamins whould be taken with food so they don't go straight to your kidneys & then out your bladder. And fat-soluble vitamins whould be taken with a meal containing a small amount of fat at least.
Posted by Bekka H. on March 20, 2002, at 0:08:10
In reply to Re: Lamictal and Folic Acid, posted by paulb on March 19, 2002, at 20:56:38
> I queried my psychiatrist about this when i was taking lamotrigine. His response was that he had done several tests for folate levels in persons taking lamotrigine and did not find one one that was severely depressed. Taking it as a supplement would be sensible though just check up on toxicity levels.
> Paulb
***********************************************
Hi Paul,
Thanks for your help. Can you tell me a little more about your experience on lamotrigine? Did it help you? If you don't mind my asking, why did you stop? Were you taking any other meds with it?Bekka
Posted by Bekka H. on March 20, 2002, at 0:12:01
In reply to Re: Lamictal and Folic Acid -- IsoM, posted by Bill L on March 19, 2002, at 11:48:03
Hi Bill,
Thank you for the nutrition information on folic acid. It's good you told me about folate being denatured before it's eaten. I was planning on eating a lot more leafy green vegetables in order to get extra folate. I guess it's not a bad idea to eat those veggies, but I'll take a supplement just to be sure.
Bekka
Posted by btrout on July 18, 2002, at 23:20:43
In reply to Lamictal and Folic Acid, posted by Bekka H. on March 18, 2002, at 15:52:37
Hi,
I don't sleep at all and my circadium rythms ar all out of whack unless I take 5 mg folic acid twice daily. I also take a B-50 to prevent deficiency in the other b's, though the only specific danger I know of is depleting b6. The risk of covering up pernicious anemia is very low. This dose also works for my sister and another aquaintance for insomnia and anxiety during th night. I think it is conceivable that some of the insomnia from Lamictal could be from folate depletion.
Also, while Centrum is a well known multi-vitamin, it is really very poor quality. It contains the cheapest, least bio-available forms of the various nutrients and such low potencies as to be almost pointless. The multivitamins at health food stores are much higher quality.btrout
Posted by BekkaH on July 19, 2002, at 20:57:16
In reply to Re: Lamictal and Folic Acid » Bekka H., posted by btrout on July 18, 2002, at 23:20:43
> Hi,
> I don't sleep at all and my circadium rythms ar all out of whack unless I take 5 mg folic acid twice daily. I also take a B-50 to prevent deficiency in the other b's, though the only specific danger I know of is depleting b6.
I think it is conceivable that some of the insomnia from Lamictal could be from folate depletion.
> Also, while Centrum is a well known multi-vitamin, it is really very poor quality. It contains the cheapest, least bio-available forms of the various nutrients and such low potencies as to be almost pointless. The multivitamins at health food stores are much higher quality.
>
> btrout
**********************************************Hi. Thank you for that information. I had such high hopes for Lamictal, but it gave me just about the poorest sleep I've ever had in my life. It was even worse than the sleep I had (or didn't have) on Wellbutrin.
That's interesting about Centrum. May I ask where you got that information?
Bekka
Posted by McPac on July 23, 2002, at 16:24:20
In reply to Re: Lamictal and Folic Acid, posted by OldSchool on March 18, 2002, at 19:21:08
oldschool "However, I do know you arent supposed to take supplements of individual B vitamins"
>>>>>>>>Who said and Why?
Thanks!
Posted by McPac on July 23, 2002, at 16:34:17
In reply to Lamictal and Folic Acid -btrout, posted by BekkaH on July 19, 2002, at 20:57:16
Bekka
I JUST started taking Lamictal yesterday.
How long have you been on it?
Posted by BekkaH on July 23, 2002, at 22:13:12
In reply to Re: Lamictal and Folic Acid -btrout, posted by McPac on July 23, 2002, at 16:34:17
> Bekka
>
> I JUST started taking Lamictal yesterday.
> How long have you been on it?
**********************************************Hi. Unfortunately, I'm not on it. I tried it several times this spring and was unable to tolerate the poor sleep. Even tiny doses impaired my sleep and my speech! I had terrible speech blockage, almost like aphasia, but I think that my reaction was unusual. I have read more good reports about Lamictal than just about any other drug. It seems to be very effective when used to augment antidepressants. Many people have been able to drastically lower their AD dose when they add Lamictal.
Bekka
This is the end of the thread.
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