Posted by SLS on April 3, 2001, at 9:02:17
In reply to Re: treatment resistant depression , posted by sweetmarie on April 2, 2001, at 13:52:20
Hi Anna.
> I thought that you were gradually increasing the Lactimal - you seem to be saying that you are on 300 mg. Have you been on it before, or have you pushed yourself up to this dosage? Or have I got the wrong end of the stick? You say that it has an effect - how much of an effect, and how long did it take to achieve it?
> Let me know,
O.K.
You may have seen a post in which I described the way I went about increasing the dosage of Lamictal. I have been taking 300mg for over a year.
I used the following titration schedule, although I currently see others using more gradual schedules:
25 x 2 weeks
50 x 2 weeks
100 x 1 week
add 50 x 1 weekI have used this schedule three times. It might make sense to spend a week at 75mg between 50mg and 100mg. A few times, I would feel a mild itching on my eyelids around the eyelashes on dosage increases.
* When Lamictal is being combined with Depakote, it is critical to use no more than half of the above dosages. Depakote slows down the rate at which the body eliminates Lamictal.
I am not a good person to compare notes to. The first time I tried it, I had just discontinued a combination of the antidepressants Nardil and desipramine. I often experience a brief improvement when I discontinue certain drugs, including these. It would be difficult to separate this improvement and my response to Lamictal. However, I am not surprised by some people's descriptions of feeling improvements at dosages of 50mg and lower when they are first beginning treatment. This is probably temporary in most cases. I haven't seen too many people finding 50mg to be their optimal dosage to treat depression. Dosages of between 100mg and 300mg seems to be the effective range. One person reported needing 400mg.
How long does it take to work for depression? I don't know. Like so many other drugs, I think it is variable. For me, I felt a small improvement during the first few weeks at 25mg and 50mg. that was intermittant. I would say that there was a more sustained effect when I reached 100mg. It was necessary for me to raise the dosage in order to maintain an improvement. I found that 300mg was an optimal dosage. I lose the effect if I lower the dosage. If you are tolerating the drug well, I would consider targeting 200mg and remaining there for several weeks. If you are treating a true rapid-cycling bipolar disorder, you cannot fully evaluate the effectiveness of any drug, including Lamictal, unless you take it for several months.
When I first tried Lamictal, its antidepressant effect became synergistic with the improvement I received from discontinuing the antidepressants just prior to starting it. I felt substantially improved. I found myself going out and enjoying myself. I couldn't keep myself in the house. I had no use for the T.V. There were just so many other things to do. I had no hesitency to walk into a night-club by myself and striking up conversations with anyone who's ear was close enough to hear me. What fun.
It was nice to be able to read and comprehend too. Eventually, things sought their own level and I was left with only a slight improvement. Today, I continue to take Lamictal because it does help a bit when it is combined with an antidepressant.Sooo...
You might feel a moderate improvement during the first two weeks that might or might not fade. If it fades, don't get upset. It is probably a very good sign that you will experience a long-term improvement at dosages between 100mg and 300mg. Some previous investigations studying the use of Lamictal in bipolar depression found the average effective dosage to be 187mg.
I wish I could give you more concrete answers. It makes sense for you to follow other people's experiences on Psycho-Babble to get a better idea of the range of responses that are possible with Lamictal.
Lamictal is a good drug with few side effects that is worth trying.
- Good luck.
poster:SLS
thread:55847
URL: http://www.dr-bob.org/babble/20010403/msgs/58556.html