To take my medication 'instructions' to the gp?

[BrittaPerry]

Recently i went to the gp as i was feeling overwhelmingly tired, and every now and again would be staggering and unco ordinated as if i was drunk, with the odd random spasm. They sent me for blood tests, which came back as slightly anemic, but not really enough to cause the symptoms that i had. She put me on iron solution stuff anyway and told me to come back if symptoms didn't sort out within 3 months.

Anyway, two and a half months later, I am still getting some symptoms, so i was starting to worry that i had some kind of major health issue. While I was taking my medication tonight, i had a read of the side effects.

More than one in ten experience drowsiness, up to one in ten experience ataxia, up to one in a hundred experience anemia and/or muscle spasms.

The medication is life changing - i would rather have the side effects than not have the medication. But, still, would have been nice for the gp to mention it. Not sure they would have done any different treatment even, but i just feel a bit weird that she obviously didnt even look it up. Maybe there are different treatments for the side effects? I will be on this medication forever, so it would be nice to minimise side effects really.

Or am i being silly?

(medication is 250mg Lamotrigine, for bipolar, if that means anything to anyone)

Should add, the drowsiness etc is only every now and again - not enough to stop me living m life, but enough to make the odd day a lot harder. I had also fallen asleep while in charge of tge kids a couple of times, but i just fill myself with caffiene and berrocca if i feel that happening (and get really twitchy, lol)

Absolutely wonderful, undreamt of, lifestyle compared to what it was like on all the other meds i have tried though.

So not wanting to stop the medication, or even reduce it, as i tried lower doses. Just, well, if i have to have a supplement of some kind to keep well, i am happy to do that forever too, but would like to know.

It is up to the patient to read the details. The doc can't read every possible side affect to every patient. They won't even know the side effects for many meds. There are thousands of need and hundereds of side effects. Does it say to contact gp if you are having side effects?

if I'm taking medication for the first time I check side effects before I take any. I don't expect the GP to run down a list of them. Sometimes the list is quite long.

You may need to check with your GP if you;re getting drowsiness whether that's going to effect your driving licence/insurance. (assuming you drive) I think our insurance says we need to tell them if we're on regular medication.

Turns out every medication has loads of side effects. Nothing just does what we want it to do. Problem is if you mention all the side effects, each appointment would be much longer and you'd start getting psychosomatic symptoms too. It's more a case of warn of anything major "This may cause, birth defects" or "If you experience this symptom, go to hospital and take the packaging as a matter of urgency"

In most cases it's about how happy you are with the medication, what may be an acceptable side effect to you may not be to someone else. Also, there is a certain element of you being expected to read the packaging or to return to doctors sharpish if you're not happy with the side effects.

In your case, you're happy with the medication, go and tell your GP this but ask if there's anything that can be done to counteract the side effects. Mention you're caring for children, so what can be done? There may be another medication that doesn't have drowsiness, but odds are that will have a different side effect, otherwise they'd all use the non drowsy one IYSWIM.

You need to see the doctor ASAP. Please book an appointment tommorrow. I know bipolar is very distressing and you worry about moods changing but you old be put onto a different medication. Are you seeing a conultant?

Or a different mix of medication.

Go to a local pharmacy for a medication review. I find pharmacists much more clues up about side effect of thing than GPs, simply because they are experts in medication and GPs are not. The pharmacist should be able to gouge you clearer advice that you can take back to your GP, who will then, if needed, review your prescription.

Not all pharmacies have this service, but it's fairly common so I'm sure it won't be hard for you to find one that does. I think Lloyds do.

It's unusual for a GP to start a patient on lamotrigine , usually it is started by a psychiatrist and it would be their job to discuss the side effects, although I agree only the main ones are usually discussed. Generally if a patinet starts a new tab and develops side efeects you'd expect the patient to say "I wonder if this medicine is giving me side effects".
Nearly every medication lists tiredness as a side effect. If you were also iron deficient and your mood was stable on the lamotrigine it's not unreasonable that your GP tried correcting the iron deficiency first. I agree if 2 months of iron hasn't helped then it's time to look at other options.

I would have thought that me going in with a symptom would trigger her looking at my record on the computer screen or asking me what medication i am on, then having a quick scan down the sde effects to see if it was listed. Maybe i'm wrong then - it could be harder than i assummed.

I don't mean a full rundown if i'm not showing the symptom, just if somone on fairly hardcore medication goes in, have a quick look on the list, o even just ask if they had checked before alarming them. But then i get alarmed at all sorts - hence the liquid iron and not the pills.

I should learn really - i had the same happen on a different medication when i had a period for five weeks. Lots of being scared about cancer etc, ultrasounds and so on. I know they still need to check, but a quick 'btw, what medication are you on...let me look that up...oh yeah, don't worry too much, it can be a side effect'

I don't always get the instruction leaflet, and have been told not to read them unless urgent anyway because i do end up with psychosomatic symptoms. Or at least i used to, but then i used to hear voices . I did get the talk about the deadly rash that sometimes happens, which has of course led to me thinking i have the deadly rash a few times. Sigh.

Ok, IABU :-). Lesson learned - always check symptoms arent just side effects.

Still, even side effects need checking, don't they? Next time i go, should i take the leaflet with me? Like i say, they don't often leave the leaflet in the pack.

It was a psychiratrist that started me and increased the dose to this level, but they just refused to deal with 'physical' problems. I duscharged myself from them (not alarmingly so, they agreed it was probably time) because i was so sick of one lot not wanting to get involved in the other lots bits.

I really really don't want to change meds - i can live with these side effects if it is that or anti psychotics (been there, done that - lamotrigine a miracle cure for me) but obviously i would rather live without them.

I don't drive - a have a bus pass on medical grounds.

Lol, i sound terrible! You wouldn't know it to look at me though, which is down to lamotrigine too :-)

Just because the medication you are on may cause these efeects doesn't mean it is causing them. Your GP will be used to dealing with patients on a variety of medications, and most medications have huge lists of potential side effects, many of which only occur in under 1% of people taking the stuff. If you wouldn't want to stop the lamotrigine anyway it makes sense to check that nothing else is causing the tiredness and not put it all down to side effects.

I suppose she wouldn't know how anxious i get over health related stuff as up to now the cpn has been taking the brunt of it (poor woman!) and so she probably didn't realise that saying something would need further investgation would leave me thinking 'OMG I'm going to die!'

I have actually read ALL the guidelines and some medical journals on lamotrigine, but (un) fortunately that was when i was in hospital being manic, and so i have forgotten most of it now.

:-D. Again, lamotrigine here helping me to not be taking myself to a + e with feeling slightly tired...

...perspective restored... :-)

(()) Such a difficult illness to treat so I'm glad you've found something that works.

OP if it helps, I fully agree that one of the first questions should be "what medication are you on" which, in this instance, hasn't been asked? Even if not for the side effects themselves - but to then ask further to see if anything else in your lifestyle could be interacting with those medications (alcohol, diet changes, contraceptives etc) Surely that's just common sense rather than send you off for all manner of tests first? I would suggest returning to gp to discuss ongoing symptoms and mention your meds leaflet, to find out more about them and what it actually means to be one in a hundred etc. and if the dosage can be tailored to you (say a 3quarter dose? Or 5/6th?!)

YABU, you can't expect anyone to know all the side effects of all pills.

Even if they did every appointment would be at least an hour long.

The GP won't need to ask what medication a patient is on because it is there on the computer unless it's a new patient, and the GP will have had letters from the psychiatrist, had to sign repeat prescriptions etc. I doubt that the GP was unaware Britta was on lamotrigine, it's more likely that if she had been on it for a while and the symptoms were new that she thought the two were probably unrelated.

It is standard practice to ask, if not at least double check, though. (I.E. The gp doesn't know the OP is actually swallowing them, the symptoms could be withdrawal symptoms as well as anything else). From the sounds of it the avenue of meds-related symptom hasn't been explored at all (suitability, interference with other factors, side effects, dosage, withdrawal) which Britta is right to mention at her next appt imo.