Hello everyone, I have not been on here a while, but I had my revision from lap band to RNY surgery on July 9th. I was about 280 day of surgery and left 2 days later at 287 (?). Today I'm down to 274. I was out for 5 hours, the surgeon said there was a lot of scar tissue. I thought it was kind of cool because the surgery was robot assisted, which I haven't seen used much for bariatric procedures.

Anyways, the root of my post...Lately I've been having strange dizzyness and head compression feelings. I strongly do not think this is related to the RNY because I've actually been able to get 60g protein and about 48oz of liquid per day. I've found I can drink more than 1oz per 15 minutes without feeling poorly, and my urine color is not dark yellow. BP is normal and blood sugar is normal (I checked it even though I'm not a diabetic)

Also, I've had these kinds of dizziness/pulsed-compression feelings before when I tapered onto or off of antidepressants. I'm almost positive that's what I'm feeling.

I take 75mg in the morning of lamictal for cyclothymic disorder (Essentially a version of bipolar-II where I don't have mania, but instead have atypical depression). I am on a very small dose, in the past, small doses worked very well for me. I believe the normal bipolar-2 dose is about 150mg. Anyways, I take 3x25mg tablets in the morning. I've done some reading and found that lamictal is poorly metabolized post RNY, so I was wondering if anyone here had to change theirs, and if so, by what multiple? (e.g. 4x amount, 2x, etc..). I know my psychiatrist is very willing to work with me on it, but I'd like to have a general idea before I go see him. I should have had them check for blood levels post surgery, but alas, I didn't.

I also have panic disorder/General Anxiety and that was "more or less" under control with 2x25mg Luvox in the morning and 2x25MG Luvox in the evening. Luvux is also supplied in a very small tablet. (Both Luvix and lamictal are smaller than a claratin). I haven't seen much on Luvox directly since it is an older SSRI that everyone has pretty much forgot about, but for me it worked much better than the newer ones like Lexapro. Typically, with me, I get abnormal yawning reflexes when my Serotonin is being affected by an SSRI, and I'm not seeing it, so I suspect the metabolism of the lamictal is more the culprit (Although the wierd dizziness happens with SSRI taper as well).

My doc told me that I did not need to crush any tablets smaller than an M&M, so I have not been crushing them.

Thanks for any thoughts and I'm excited to be part of the RNY club.

Chiming in here so go see your doc lamictal is a very tricky med my mother in law who has been practicing for 35 years barely prescribes it because of the very high chance of Steven Johnson syndrome. Up until this time you were fine but just go. Also you might want to try trileptal it’s the same mechanism in the brain and safer for rny patients.

Thank you all for all of your help. Newmebithebypass, thank you I was completely unaware of trileptal. My doctor did explain the serious rash/death side effects that sometimes can happen to people, but he said it was that or seroquil, and that the people that could tolerate lamictal were very happy with the med and were not overly drowsy, brain fog, or weight gain.

I am seeing your post after my visit, but he put me on a single 100mg sublingual dose in the morning. He gave me the option of the chewables and even if I wanted to adjust the dosage, but I am the "slow and steady" type personality when it comes to mental medications. He explained that lamictal originally came out as a sublingual, and that sublingual was the best way to get the medication into the blood. He did say (And expect) some flack from my insurance company, so it might take a week or two before I start it (My pharmacy is small and usually has to order out-of-the-ordinary meds). I will update this thread once I get on the sublingual ones.