Posted by SLS on April 3, 2001, at 21:36:12
In reply to Re: treatment resistant depression » SLS, posted by lois on April 3, 2001, at 12:59:14
Hi Lois.
> How can you tell if you have too *much* lamictal aside from being manic?In general, Lamictal will not produce a manic reaction. There have been a few reports, but it seems to occur infrequently. I guess what I'm trying to say is that mania is not to be expected as the result of taking too much Lamictal.
> I worked up to 400 mgs and had slight improvement in depression each time I upped by 25 mgs for about 4 days and then pooped out, only to improve again after another increase of 25 mgs.
This is similar to my own experience. Since Lamictal has shown itself to be capable of producing any improvement in your condition, I would consider optimizing the dosage and continue taking it as you try adding other drugs to it. I think this makes sense if you are bipolar. Lamictal can be combined with just about any drug. However, it is important that when combining Lamictal with Depakote, the dosage of Lamictal be reduced by half. The reason for this is that Depakote hinders the body from eliminating it. Blood levels of Lamictal will remain the same.
> Now on 400 mgs for about 2 weeks I stopped noticing improvement and seem more anxious and fatigued (depressed?) Hard for me to tell whether I am borderline agitated manic or borderline agitated depressed).
When I tried taking 400mg of Lamictal, I experienced significant problems with memory. I don't recall if I felt fatigued, but sleepiness and dizziness are listed as possible side-effects. I guess fatigue is possible, but you probably won't be sure until you reduce the dosage. Based upon what I see here on Psycho-Babble, my guess is that you won't need to take more than 300mg. You and your doctor will need to evaluate the desirability of continuing with Lamictal. If your case involves a stubborn mixed-state (depression + mania together), combining mood stabilizers may be necessary. Such cases are usually thought of as being the bipolar II subtype. Depakote is usually thought of as the first choice of mood stabilizer. You could try adding Neurontin to Lamictal first because it is the easiest and has few side effects. Unless you have already had a negative experience with Depakote, I would consider combining it with Lamictal with the understanding that you will need to reduce the dosage of Lamictal.
> Any thoughts? I just don't want to keep going up and up and up.Any thoughts about what too much might feel like? I see my p doc tomorrow.
I hope I gave you some relevant information to work with. I will be interested to see what decision you and your doctor arrive at.
Good luck.
- Scott
I hope this stuff helps.
poster:SLS
thread:55847
URL: http://www.dr-bob.org/babble/20010403/msgs/58590.html