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Re: HELP! Switching from Lamictal to Depakote

Posted by JohnX2 on March 30, 2002, at 22:52:13

In reply to Re: HELP! Switching from Lamictal to Depakote » Janelle, posted by Ritch on March 30, 2002, at 22:44:49

> > Well, ever since I began titrating up on the Lamictal (I'm VERY sensitive to meds, even tiny doses - argh!) I have become increasingly anxious and agitated to such an extreme point I've been scared I was going to *lose it*. Anyway, given no other changes in my meds, the pdoc thinks the Lamictal (perhaps in combo with the Effexor) may be setting me off.
> >
> > SOOOOOOOOO, I'm off the Lamictal and will start Depakote tomorrow.
> >
> > Could one/some of you brilliant people here explain the BASIC difference(s) between these two meds - how each one works, each one's side effects. I really need a comparison of the two please! Thanks very much.
>
> Hi Janelle,
>
> I suppose I could give you something to start to think about. Depakote is involved generally with GABA, while Lamictal is involved generally with NMDA. John could set you straight on the specifics. I think Effexor (IMO), is a bad med to give to bipolars (mostly based on personal bad experiences). It could be that you would be better off with Depakote+Effexor, but you could be better off with Lamictal+ (absence of Effexor or something other than Effexor). AD's can create a real chemical earthquake in susceptibles.
>
> Mitch

Yes, I agree. Its possible that being on the high dose of Effexor in the absense of the mood stabilizer is not a good situation. Generally one would like to titrate onto a mood stabilizer first (like Lamictal or Depakote) and use as much mood stabilizer as possible before throwing on ADS. But since you are already on a mid dose of Effexor, if you don't want to drop the effexor dose, it might make more sense to go with a quicker acting mood stabilizer like Depakote. I think this is the direction that your doctor is persuing. It doesn't sound like a bad idea.

The other route would be possibly to lower the effexor dose in lieu of titrating up Lamictal, but this is a much more time consuming process.

John


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poster:JohnX2 thread:100950
URL: http://www.dr-bob.org/babble/20020327/msgs/101036.html