Posted by sweetmarie on March 11, 2001, at 11:35:32
In reply to Re: treatment resistant depression » sweetmarie, posted by JahL on March 11, 2001, at 9:58:20
>
> > > phillybob - I checked out the thing you sent. Jah seems only to be on a small dosage of Lamotragine, and doesn`t say whether this will be increased. I wonder if it will (Jah, if you are reading this, could you let me know - cheers). I`m actually quite concerned about this huge increase; the only reason I can think of, is that they are concerned that I be kept on a high level of something whilst I undergo the transition. I am really quite ill already (immobilised by the severity of the depression much of the time) The last time I came off meds altogether, I was very nearly catatonic. This may be a factor, I don`t know. Anyway, I`ll still check it out.
>
> Hi Anna.
>
> Valproate more than doubles Lamotrigine blood levels. The increase you described previously was effectively a jump from 50mg-400mg/day in just over a week! Phillybob & I wld take *8 months* to reach 400mg on our current dosing schedule! IMO (FWIW) Lamotrigine has been recklessly prescribed to you.
>
> Phillybob is spot on when he says you must get this checked out, & dropping the dose back to say 100mg is probably good advice too.
>
> To answer your Q, I'm now on 37.5mg/day & intend titrating upwards (weekly) in 12.5mg increments to btwn 100 & 200 mg, based on response/side-effects. If yr depression is severe, the proposed (4 you) dose of 250mg sounds reasonable.>
> This slowly-slowly approach shld enable me to pin-point the optimal point of benefits against side-effects, whilst reducing drastically my chances of developing the rash.
>
> Jah.Now I`m really worried. I suppose that I`m reluctant to speak to my psychiatrist about this, as I don`t want hoer to think that I`m questioning her judgement. I guess that the other thing I could do is to take it into my own hands, and drop back to 100 mg myself. As I am seeing her in 4 weeks, this should be easy to do. In other words, I could go back to 100 mg for the next couple of weeks, and then up to 200 mg. I don`t want to take it further than that myself. The other thing is that I am juggling this increase with decreasing the Valproate. So, I`m coming off the Valproate at a rate of 200 mg per 5/6 days (I was on 1000 mg). It`s really bloody complicated I can tell you. I don`t like this set-up at all; I thought that the whole reason for my going into hospital was that this could all be managed there. Frankly, I feel too ill to be doing it myself. Still, that`s the way it is - and I`m perfectly capable of ringing my psychiatrist and asking her to spell it out more clearly for me. Or at least double check the report sent to her by the professor, and see what he actually says. I`m really confused.
Anna.
poster:sweetmarie
thread:55847
URL: http://www.dr-bob.org/babble/20010310/msgs/56203.html