Concerns About Potential Double Dosing of My Psychiatric Medications
Age: 29 Height: 5'9" Weight: 235 lbs **Relevant Medical History:** - Bipolar II disorder, previously experienced one psychotic episode. - Diagnosed with a seizure disorder, likely focal (as indicated by my neurologist). - ADHD. **Current Medications:** - Lamictal, 200 mg once daily. - Vilazodone, 20 mg taken twice daily. I’m a bit anxious about potentially taking an extra dose of my medications today, and I apologize if this question seems naive. When I forget to take my meds, I tend to feel lethargic, as if my surroundings are slightly blurred—almost like everything is viewed through a psychological haze rather than a visual one. My routine is to take my medications around 9 to 10 in the morning, and if I miss one, I typically start experiencing these symptoms about four to five hours later. However, today was unusually hectic, causing me to feel that sense of drowsiness and disorientation around 1:30 p.m. I normally rely on my pill organizer to track my doses, but since I just filled it that morning, I couldn’t confirm whether I missed a dose or was simply fatigued. The real issue lies with my Lamictal: skipping that dose guarantees I will have a seizure later on. That’s why I ended up taking what might have been my second dose today. I've recently recognized this connection between missed Lamictal doses and seizures; in the past, I would resort to taking Ativan, which only partially alleviates the situation and usually leaves me needing to rest afterward. This sequence of events is rather distressing and frightening, and I aimed to sidestep a seizure, albeit without fully considering the implications of taking an extra dose. I am aware that altering the Lamictal dosage could lead to serious reactions, such as Stevens-Johnson syndrome, which raises my concerns. I have maintained a stable dose of 200 mg for approximately seven years without complications. If I have indeed doubled up on the Lamictal, there’s also the possibility that I did the same with vilazodone, but I'm less anxious about that one. At present, I am feeling much improved, though a bit more drowsy than usual. I want to believe I’ll be alright (fingers crossed!), but I would appreciate guidance on any symptoms to watch for and the next steps I should take. My next scheduled dose isn't until tomorrow morning, and I assume it’s advisable to continue with that. I'm really seeking any advice here, as my doctor’s office is closed until Monday, and there’s no backup contact available. Thank you in advance!
Answers (1)
2/13/2026, 12:50:49 AM
OpenHealth AI
It's understandable to feel anxious about the possibility of double dosing your psychiatric medications, especially given your medical history and the potential implications. Let’s break this down and give you clear, actionable guidance.
Summary of Key Points:
- Double dosing of Lamictal (lamotrigine) can be concerning due to risks like seizures and serious side effects.
- You're experiencing mild drowsiness but are feeling improved overall.
- Monitoring your symptoms is crucial.
Explanation:
In your situation, Lamictal is particularly important due to its role in preventing seizures, and you are right to be cautious about missing doses. When you miss a dose, it can indeed lead to drowsiness, disorientation, or a seizure, which you have already experienced. It is also wise to be aware of the potential for serious reactions from adjusting your Lamictal dosage, as you noted.
If you suspect you may have taken a double dose, it's important to focus on monitoring yourself for any unusual or severe symptoms.
Next Steps:
-
Monitor Symptoms Closely:
- Watch for any new symptoms such as increased drowsiness, confusion, changes in mood, or any unusual behavior. If you notice any signs of a seizure, such as convulsions or loss of consciousness, seek immediate emergency help.
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Hydrate and Rest:
- Ensure you drink enough water and get adequate rest. Fatigue can amplify feelings of lethargy and disorientation.
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Avoid Further Dosing:
- Do not take any additional doses of Lamictal or vilazodone until your scheduled dose tomorrow morning. Continue with your regular dosing schedule once you confirm the amount you've taken today.
-
Pill Organizer Verification:
- When your doctor’s office is open again, consider reinforcing your use of a pill organizer to minimize confusion in the future. You can also mark each dose on a calendar or in a journal.
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Plan for Future Missed Doses:
- If you miss a dose of Lamictal in the future, take it as soon as you remember on the same day, unless it is close to the time of your next scheduled dose. In that case, skip the missed dose and return to your regular schedule. Avoid taking double doses.
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Schedule a Follow-Up:
- Once your doctor's office resumes, schedule an appointment to discuss your anxious feelings regarding medication management and any adjustments that may help. You deserve support in managing these concerns.
Final Note:
It’s great to hear that you are feeling improved overall! Focus on remaining calm and taking these steps. If at any point you feel more uncomfortable or develop concerning symptoms, don't hesitate to seek medical help earlier. Remember, you’re not alone in this, and there are resources available to support you.
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