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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]The doctor said there were studies showing it worked well with ASD kids. And his genetic testing shows he wouldn’t react well with an ssri ([/quote]

that seems really questionable. lamictal has a list of side effects a mile long and the the genetic tests are unproven. 2nd opinion. [/quote]

My ASD kid had really bad reactions to SSRIs and we used genetic testing to guide us. Following this advice could save you lots of heartache. Best to heed your doctor. Good for them for doing the genetic testing. My kid takes lamictal. Switched to it from Abilify. It’s a bit sedating. There’s a random rare rash side effect that’s supposed to be serious keep an eye out for that. [/quote]

The bad reactions to Lamictal are much worse than the bad reactions to SSRIs. I’m glad you found a med that worked, but those genetic tests just are not reliable yet. To start with a riskier class of drugs based on the genetic test seems really questionable.

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Realistically speaking, the worst thing that can happen with lamictal that doesn't happen with SSRIs is you get a bad rash that needs to be treated in the hospital and you stop taking it. It can be deadly but that's only if the rash gets insanely bad and you don't get treatment for it, and it almost always happens when you first start taking the medication so you'll know within 8 weeks if it's bad.

And it's definitely not always better to start out with SSRIs. I assume OP's child doesn't have bipolar disorder, but if someone with bipolar disorder takes SSRIs it can make their bipolar disorder worse. This happens quite a bit.

Of course this is so specific to the individual and it's really ahrd to find the right thing. But lamictal is perfect for me.  [/quote]

“Realistically speaking”?? No, Stevens-Johnson is very serious, it’s not “just a rash.” And there are other very serious side effects of Lamictal as well. It’s just objectively a more risky medication. OP should seek out a second opinion because it does not make sense to go straight to the riskier drug on the basis of extremely thin evidence (the genetic test). [/quote]

Yes, realistically speaking, that is the worst that can happen. I never said it wasn't serious but it's manageable with prompt medical attention. Have you taken lamictal? When I started, my doctor told me over and over again to be on the lookout for rashes and immediately stop taking it and seek medical care if I got red spots. With this rash, first it presents as red spots, then after a couple of days to a several weeks it becomes a rash. If you stop taking lamictal after you get red spots or even after a mild rash, you are going to be totally fine.

When considering the rash, yes, lamictal is more risky. But I still wouldn't call it a "risky" medication. I am so glad I accepted the risk of the rash and started with lamictal instead of an SSRI. I, like 99.9% of individuals who take lamictal, have not had a rash from it and I never had to deal with any of the SSRI side effects (not relevant for children, but I've never had a reduction in libido, weight gain, increased medication tolerance necessitating a bump in dosage, or emotional blunting). I also went from experiencing suicidal ideation every day to never having suicidal thoughts, and that was pretty great too.

I think a second opinion is a great idea and it might very well be that an SSRI is better for OP's kid than lamictal, but a lot of people seriously overstate the risk of the lamictal rash. [/quote]

the point remains that lamictal poses much more serious risks - it’s not even a question. of course it’s the right med for some people, but there’s no justification for trying it FIRST for irritability or depression in autism. [/quote]

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