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Re: lamactil for atypical bipolar disorder?

Posted by Scott L. Schofield on January 26, 2000, at 17:25:29

In reply to Re: lamactil for atypical bipolar disorder?, posted by Donald F on January 26, 2000, at 15:45:11

> > Promising evidence is coming in on Lamictal (check medline for lamotrigene). In my bipolar mind it would be the next mood stabilzer of choice (YMMV). If your doc is recommending it he must think like I do. It purportedly has some antidepressant effect, which is encouraging. I've taken it for most of the past two and one-half years with no discernable side effects. The big-bad-rare rash scares a lot of people off. I understand the risk is lessened by starting at a very low dose and titrating up very slowly. Good Luck.
> >
> > Chris A.
> My doc started me on Lamactil about 6 weeks ago for bipolar disorder. As described I started with a very low dose and titrated my way up to my present dose of 4 tabs.
> I have a type of bipolar disorder which is very long term. The intervals can take several months and primarily result in deep depression.
> I am taking Lamactil in addition to Lithium and I do believe it has had a stabalizing effect on me. Time will tell.

Lamictal (lamotrigine) is one of the few drugs capable of budging my stubbornly depressed bipolar psychobiology. It definitely does display antidepressant properties in some people. For me, it helps provide a slight, but stable improvement that allows me to indulge in such exotic and esoteric activities like reading and writing (I still have trouble adding single-digit numbers in my head, though). The average effective dosage of Lamictal in bipolar disorder seems to be around 200 mg/day. The dose range for its indicated use in epilepsy is 300 - 600 mg/day. I seem to need 300 mg/day. It is important to note that these dosages must be cut in half if Lamictal is to be used in combination with Depakote.

Some investigators assert that Lamictal is also useful when treating cases that present with rapid-cyclicity. There are similar thoughts regarding Neurontin (gabapentin).

The rash can be lethal and it is not rare.

The PDR and package-insert for Lamictal provides an excellent titration schedule.

- Scott




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