side effects, dosage, how to take & discontinue, uses, pros & cons, and more
MultiPageMedicationArticle Article Index | Approved & Off-label Uses ›
Learn More about Taking and Discontinuing MultiPageMedicationArticle
Brand & Generic Names; Drug Class
MultiPageMedicationArticle’s Approved & Off-Label Uses (Indications)
US FDA Approved Treatment(s)
Explaining the pages of a multi-page medication article
Popular Off-Label Uses
If you read the page on one-page med articles, you’ll probably notice a lot of copy & paste repetition. Not all of it on this page, though.
- FDA-approved uses/indications will be listed here.
- If a drug has multiple forms the different forms will often have different approvals.
- There usually won’t be anywhere near as much detail in any of these fields as on the one-page articles. That’s what the other pages are for!
- Wanna know more about MultiPageMedicationArticle’s drug classes and names? Click on the link to the MultiPageMedicationArticle’s Generic & Worldwide Availability above.
- How about its approved and off-label uses? Click on the link to MultiPageMedicationArticle’s Approved & Off-label Uses below.
- Sorry about all the bullshit “Learn more about” and whatnot. I was desperately trying to get these pages back into the top ten search results. I’ll think of something better.
Learn More about MultiPageMedicationArticle’s Approved & Off-label Uses
How Long Until MultiPageMedicationArticle Starts Working (Onset of Action)
Isn’t this one of the most important question your doctor or pharmacist should be able to answer? Yes, it is. Did you remember to ask them that?
The short answer will be here. The standard “3–4 weeks for most SSRIs, up to 6 weeks for Prozac, while Lexapro can start working in two weeks or less.”
Longer answers will be on the Efficacy and Comparisons with Other Meds Page.
Likelihood of Working
Same as with how long it takes to work. With more detail, off-label uses, and comparisons with other meds.
Learn how MultiPageMedicationArticle Compares with Other Drugs
How to Take MultiPageMedicationArticle
Taking a med is something your doctor and/or pharmacist should explain to you. In case you didn’t quite understand it, or want to get an idea of what it’s like, we’ll summarize both the manufacturer’s guidelines from the prescribing information (PI) and, since we often disagree, our suggestion to talk to your doctor about.
The Taking and Discontinuing Page will have excerpts from the PI and details of our suggestions.
How to Stop Taking MultiPageMedicationArticle (Discontinue, Withdrawal)
How you stop taking a drug can be just as, if not more important than how you take it.
As with titration, if the PI has it, we’ll summarize it here and quote the whole thing on the Taking and Discontinuing Page. The same goes for our suggestions.
MultiPageMedicationArticle’s Pros and Cons
- A short list of why this might be the drug for you.
- Why it’s better for its approved & off-label uses than other medications that treat the same things.
- And/or why it sucks less than those meds.
- A short list of why this might not be the drug for you.
- Why it’s not as good for its approved & off-label uses than other medications that treat the same things.
- And/or why it sucks more than those meds.
Interesting Stuff your Doctor Probably didn’t Tell You about MultiPageMedicationArticle
- “Interesting” is really subjective.
- Sometimes it can mean “important.”
- Either way, it’s only the highlights here.
- More pros, cons, and interesting stuff if any, will be on the In-Depth Pros & Cons page.
- As will more details about them.
Best Known for
There’s usually one, sometimes two, things a drug is known for. Lamictal has The Rash. Effexor has the discontinuation syndrome from hell. Topamax will make you skinny and stupid.
Originally this was going to be an entire page itself. That didn’t work.
In-Depth Pros & Cons
MultiPageMedicationArticle’s Potential Side Effects (Adverse Reactions)
Typical Side Effects
- Side effects are divided into three categories: Typical, Uncommon, and Freaky Rare.
- Typical/common side effects (“adverse reactions” in doctorese) are those that practically everyone who takes a medication is going to get.
- On a medication page this part invariably starts with “The usual for [the class of the med]…”.
- For SSRIs, SNRIs, and TCAs that can be most, if not all of the typical side effects.
- The main difference for each med in those classes is how long the typical side effects will last.
- Most common side effects either go away or subside to something you can live with in two to four weeks.
- A lot of the good stuff, like how to deal with side effects, will be on the Side Effects page.
Uncommon Side Effects
- These are the side effects that happen, but not all that often.
- File under “don’t be surprised if you get one or more of these.”
- How long they can last is highly variable, from a few days to as long as you’re taking the drug.
- The most frustrating is “You’ll know it’s a temporary side effect when it stops.”
- Unfortunately there are a very few side effects where that timeline applies even after you stop taking the med.
Freaky Rare Side Effects
- My favorite type of side effect, only because one person’s misfortune1 is another person’s comedy. Sometimes.
- The key words here are:
- “Rare”, which, depending on the popularity of the med and nature of the available side effects, is in the neighborhood of fewer than one person in 10,000 to fewer than one person in 100,000.
- And “freaky,” which isn’t as subjective as it seems
- The Side Effects page will have things like excerpts from case reports
Learn More about MultiPageMedicationArticle’s Side Effects.
TMI at times
What You Really Need to be Careful About
If a drug has a “Black Box Warning” - something potentially bad enough that it is the first thing in the PI, written in a bold and larger typeface, all caps, and printed/displayed within a black box - that will be summarized here.
If there is one, the entire black box warning will be on the Warnings and Noted Traits Page
MultiPageMedicationArticle’s Black Box and Other Warnings, Pregnancy Category, etc.
longmed’s Half-Life & How Long Until It Clears Your System
Plasma half-life: About all the pharmacokinetics 99% of Crazymeds readers want. It can be total information overload on the PK page.
longmed’s Pharmacokinetics Information Overload
Half-life is the average time it takes for you to process half of the drug’s active ingredient. If a drug has a half-life of around 24 hours and you take a dose of 100mg, you’ll have roughly the equivalent a 50mg dose after one day, a 25mg dose after two days, and so on. The rule of thumb is: multiply the half-life by five and you get how long it is for the dose you took to be cleared from your bloodstream, so there’s nothing swimming around to attach itself to your brain and start doing stuff2. That’s called “plasma clearance.” Complete clearance is a complex equation based on a lot of factors which may or may not: be published in the PI sheet, include personal data like your weight, or even completely figured out by corporate and independent researchers. It usually winds up being 2–5 days after plasma clearance no matter what3, but can take weeks. Sometimes a drug will clear from your brain and other organs before it clears from your blood. If we’ve found the complete clearance, or how to calculate it if it requires things like your weight and what your piss looks like, you’ll find that on longmed’s pharmacokinetics page.
How longmed Works
the current best guess at any rate
The keyword here is “brief”. We try to make it as brief and understandable as possible, and put the pharmacology student-level details on the Pharmacodynamics Page.
Learn More than You Probably Ever Wanted to Know about How longmed Works
AKA mechanism/method of action, pharmacodynamics
Ratings, Reviews, Comments, PI Sheet, and More
- This will often be the personal experiences of the author.
- Even though there’s an entire page for extended comments, it’s rarely used.
- In fact, with all the other pages for extended attributes, the comments section for a lot of meds are blank!
- A couple more things to cover about these articles:
- Ratings. Anyone can rate the med and the article.
- The way the wiki software is written you can’t rate both at the same time. It’s pick one, click submit, scroll back down, pick the other, click submit.
- Don’t blame me, I didn’t write it.
- Please rate this guide. I have no idea how much good any of this crap does.
- I know there is way too much in the way of ads for Amazon and CafePress crap. Sorry.
- I’m sure I’ll come up with more.
As if I didn’t go on long enough already.
Give your overall impression of MultiPageMedicationArticle on a scale of 0 to 5.
Get all critical about MultiPageMedicationArticle
Everybody hates me.
Rate this article
If you’re still feeling judgmental as well as just mental4, please boost or destroy my self-confidence by honestly (and anonymously) rating this article on a scale of 0 to 5. The more value-judgments the better, even if you can criticize my work only once.
Get all judgmental about the MultiPageMedicationArticle (longmed) Overview
Everybody hates me.
Pages and Forum Topics Google Thinks are Relevant to Your Mental Health
It’s always a good idea to check for drug-drug interactions yourself. Just because most people in the crazy meds business know about really important interactions (e.g. MAOIs and a lot of stuff, warfarin and everything on the planet) doesn’t mean the person who prescribed your meds told you about them, or the pharmacist has all the meds you take at their fingertips like they’re supposed to. Or they have the time to do their jobs properly when not dealing with complete idiots or playing Angry Farmers on the Faecesbooks.
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- MultiPageMedicationArticle’s Full US Prescribing Information
- Faught, Edward. “Topiramate in the treatment of partial and generalized epilepsy.” Neuropsychiatric disease and treatment 3.6 (2007): 811-821.
This is new for the multi-page format. Currently the bibliography is on its own page. I’m changing that for various reasons. Until it’s filled you’re going to see "$BigBibli0" all over the place. Here’s Lamictal’s:
Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Applications (Essential Psychopharmacology Series) 3rd edition Stephen M. Stahl
Antiepileptic Drugs René H. Levy, Richard H. Mattson, Brian S. Meldrum, Emilio Perucca, et al.
U.S. Lamictal PI Sheet GlaxoSmithKline
last revised December 2011
Clinical Handbook of Psychotropic Drugs 18th edition Adil S. Virani, K. Bezchlibnyk-Butler, J. Jeffries
A Primer of Drug Action: A Comprehensive Guide to the Actions, Uses, and Side Effects of Psychoactive Drugs Robert M. Julien, Claire D. Advokat, Joseph E. Comaty
The Prescriber’s Guide (Essential Psychopharmacology Series) 3rd edition Stephen M. Stahl
Epilepsy: Patient and Family Guide Orrin Devinsky
PDR: Physicians’ Desk Reference 2010 64th edition
Mosby’s Drug Consult 2007 (Generic Prescription Physician’s Reference Book Series)
Clinical Neurology for Psychiatrists 5th edition David Myland Kaufman
Bipolar disorder and mechanisms of action of mood stabilizers Stanley I. Rapoport, Mireille Basselin, Hyung-Wook Kim, and Jagadeesh S. Rao Brain Research Reviews Volume 61, Issue 2, October 2009
Ion channels and epilepsy T.D. Graves QJM: An International Journal of Medicine Volume 99, Issue 4, April 2006
Steady‐state Pharmacokinetics of Lamotrigine when Converting from a Twice‐daily Immediate‐release to a Once‐daily Extended‐release Formulation in Subjects with EpilepsyDebra J. Tompson et al. Epilepsia Volume 49, Issue 3 Pages:410–417, 2008
Adjunctive therapy for the treatment of primary generalized tonic-clonic seizures: focus on once-daily lamotrigine
Medical Management of Bipolar Disorder: A Pharmacologic Perspective Matthew A. Fuller, PharmD, BCPS, BCPP, FASHP Annals of Clinical Psychiatry Vol. 22, No. 04 / November 2010
Pharmacotherapeutics of epilepsy: use of lamotrigine and expectations for lamotrigine extended release Mary Ann Werz Therapeutics and Clinical Risk Management 2008 October; Vol 4 Issue 5 pages: 1035–1046
Lamotrigine and therapeutic drug monitoring: retrospective survey following the introduction of a routine service Raymond G Morris et al. British Journal of Clinical Pharmacology 1998 December Volume 46 Issue 6 pages: 547–551.
Review of the available evidence on Lamotrigine for Epilepsy for the WHO Model List of Essential Medicines
Lamotrigine pharmacokinetic evaluation in epileptic patients submitted to VEEG monitoring European Journal of Clinical Pharmacology A. M. Almeida et al. 2006 Volume 62 pages: 737–742
Tobacco habits modulate autosomal dominant nocturnal frontal lobe epilepsy
Truly “Rational” Polytherapy: Maximizing Efficacy and Minimizing Drug Interactions, Drug Load, and Adverse Effects
Drug interactions involving the new second-and third-generation antiepileptic drugs
Basic mechanisms of antiepileptic drugs and their pharmacokinetic/pharmacodynamic interactions: an update
“Targets for antiepileptic drugs in the synapse” Cecilie Johannessen Landmark Medical Science Monitor Volume 13, Issue 1, January 2007
MultiPageMedicationArticle Article Index | Approved & Off-label Uses ›
1 Warning: Footnote '#rare' referenced but not defined.
2 Based on Julien's calculations from A Primer of Drug Action, the half-life multiplied by five is the generally accepted estimate of how long it takes a single dose of any given drug to be eliminated from the blood stream/plasma of someone with a normal metabolism. That's also the rough estimate for steady stage if they can't get, or won't provide a number for that.
3 For crazy meds. I have no idea what the average complete clearance is for other types of medications. For all I know there are drugs that utterly vanish from your system in under five passes, and others that won't let go of your squishy bits for years after you stop taking them.
4 Thank you! I'll be here all weak. Be sure to tip your content provider. And don't try the veal, it's cruelicious!
5 These include: Canada's Product Monographs (PM), New Zealand's Medicine Data Sheets (MDS), the EU's European Public Assessment Reports (EPAR), and the Summary of Product Characteristics (SPC) used in Britain, Ireland, and many other places.
If you have any questions not answered here, please see the Crazymeds MultiPageMedicationArticle discussion board. We welcome criticisms of the articles, notifications of bad links, site problems, consumer experiences with medications, etc. I’m not always able to write back. Hence I never answer questions about meds via e-mail that are answered by this or other articles. Especially if they have been repeatedly asked on the forum. That’s why we write these damn things. Questions about which meds are best for your condition should also be asked on the forum; because this is a free site, so the price of admission is making things easier for somebody else searching for the same answer. We don’t deal with children on the forum or in private because after doing this for ten years I don’t have the emotional stamina to deal with kids who have brain cooties. How to contact Crazymeds. — Jerod Poore, CME, Publisher Crazymeds (crazymeds.net)
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MultiPageMedicationArticle, and all other drug names on this page and used throughout the site, are a trademark of someone else. MultiPageMedicationArticle’s PI Sheet will probably have the name of the manufacturer and trademark owner (they’re not always the same company) at or near the very bottom. Or ask Google who the owner is. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of the trademark may have changed without my noticing. It may of changed hands by the time you finished reading this article.
Page design and explanatory material by Jerod Poore, copyright © 2003 - 2015. All rights reserved.
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Almost all of the material on this site is by Jerod Poore and is copyright © 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, and 2015 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and something along the lines of following disclaimer, I’m usually cool with it.
All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
The information on Crazymeds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else. Plus we are big pottymouths and talk about S-E-X a lot.
Know your sources!
Nobody on this site is a doctor, a therapist, or a pharmacist. We don’t portray them either here or on TV. Only doctors can diagnose and treat an illness. While it’s not as bad as it used to be, some doctors still get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don’t be a cyberchondriac, thinking you have every disease you see a website about, or that you’ll get every side effect from every medication1. Self-prescribing is as dangerous as buying meds from fraudulent online pharmacies that promise you medications without prescriptions.
All information on this site has been obtained from the medications’ product information / summary of product characteristic (PI/SPC) sheets and/or medication guides - which is all you get from sites like WebMD, RxList,
NAMBLA NAMI, etc., the sources that are referenced throughout the site, our personal experience and the experiences family, friends, and what people have reported on various reputable sites all over teh intergoogles. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or medication guide/patient information leaflet (PIL) that comes with your medications and never ever throw them away. OK, you can throw away duplicate copies, but keep at least one, as that’s your proof of purchase of having taken a med in case a doctor doubts your medical history. Plus they take up less space than a bottle, although keeping one inside of a pill bottle is even better.
Crazymeds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
Crazymeds is optimized for ridiculously large screens and browsers that don’t block ads. I use Firefox and Chrome, running under Windows 72. On a computer that sits on top of my desk. With a 23 inch monitor. Hey, at least you can make the text larger or smaller by clicking on the + or - buttons in the upper right hand corner. If you have Java enabled. Like 99% of the websites on the planet, Crazymeds is hosted on domain running an open source operating system with a variety of open source applications, including the software used to display what you’ve been reading. As such Crazymeds is not responsible for whatever weird shit your browser does or does not do when you read this site3.
No neurologists, psychiatrists, therapists or pharmacists were harmed in the production of this website. Use only as directed. Void where prohibited. Contains nuts. Certain restrictions may apply. All data are subject to availability. Not available on all mobile devices, in the 12 Galaxies Guiltied to a Zegnatronic Rocket Society, or in all dimensions of reality. Hail Xenu!
‘Everything is true, nothing is permitted.’ - Jerod Poore
1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.
2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.
3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?* I don’t even need my big-ass rant any more. Heartbleed has made my case for me. And that’s just the one that got all the media attention. The very nature of an open source operating system makes security as much of an illusion as anonymity on teh Intergoogles. Before you flip out too much: the domain Crazymeds is hosted on uses a version of SSL that is not affected by the Heartbleed bug. That’s one of the many reasons why I pay a lot of money and keep this site on Lunarpages.
* Yes, I know I’m using open source browsers. I also test the site using the now-defunct IE and Safari browsers. Their popularity - and superiority - killed IE and Safari, so that’s why I rely on the open source browsers. It’s like brand vs. generic meds. Sometimes the generic is better than the brand.
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