Wtf? Sertraline with lamotrigine

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I moved to Germany and had my first appointment with local psychiatrist. I have schitzoaffective and am on lurasidone. They don’t have it Germany! I had to change antipsychotic.

but the wierdest thing was that he was shocked to see that I am on sertraline and lamotrigine together. Apparently you shouldn’t because your skin can peel off suddenly?! He couldn’t believe that my uk psychiatrist had prescribed them together. Well the plan is reduce sertraline. He was quite dramatic.

Wow! I was on both for ages!

Never heard of the combo causing this. Lamotrigine on its own is known for having a rare side effect called Steven-Johnson syndrome which is normally what people are warned about when they first start taking it.

Sertraline can (very rarely) increase the amount of Lamotragine in your blood, and that can lead to Stevens-Johnson syndrome.

Yes the psychiatrist ordered tha blood test for lamotrigine.

I've been on 400mg lamotrigine and 200mg sertraline for decades, lamotrigine is usually started gradually to reduce the small risk of Stevens–Johnson syndrome.

'Skin peeling off' is not a common complication at all and only applicable very early on in treatment.

I didn’t say anywhere it was common, and yes, normally when being titrated.

Interesting. The psychiatrist thought that it is the ultimate mistake to prescribe them together. He even said “how stupid the doctor be”.

My dc lives in France where her gp and psychiatrist are excellent.
She has HFA and a type of bipolar. She is on exactly those 2 meds, small doses, and has been well, happy and working for the last few years after having a horrific episode when a gp in UK increased her antidepressants.Thank goodness she was back in France when it happened because she received excellent in patient and follow up care.