Posted by Mondeo on April 14, 2002, at 23:26:36
In reply to Re: high-dose Lamictal: why not? » Zo, posted by Elizabeth on April 11, 2002, at 8:37:29
HI,Elizabeth,
as a Lamictal user(since a couple of months,for BP2),I agree totally with your opinion,being a courageous one,mainly because of the so little professional info.about this promising med,in general and its proposed dosages,in special ; I myself,on my own,have had to go up and up,for the time being up to 400mg(taken in 2 partial dosages each 12 hours) ; there are very few docs taking the responsability advising and ACCEPTING (without too much hesitation)such higher dosages administration
My opinion as a BP2 sufferer since 1972 !(normally and as usually,I haven't been aware of this dx for so many years and as always,resuming myself thenjust to different AD'S,the best PARTIAL results being obtained then,with Celexa ) ; so MY opinion is that Mood Stabilizers are indeed important or even obligatory(not only for BP1,BP2 etc.,but also for UP's) and the most difficult questions are just arising from this point on:
a)which Mood Stabilizer? the old traditional ones with all of their shortcomings,or the newest generation,though lacking info.about
b)which should be the MAXIMAL dosage worth to be checked,tried(normally,presuming no serious side effects encountered ),before deciding(without any doubt) that a specific Mood S.(Lamictal etc.)isn't efficient enaough(or at all)even at that (?)higher dosage
c)should Mood S.be used as a monotherapy(even if still facing mild depr.breakthroughs)or as an adjunctive to the best AD ?
I myself(again almost on my own)consider that the correct steps should be according to the 3 ones(the same order)as mentioned above ; Probably,permitting ourselves even dosages high as 500-600mg Lamictal(already acceptable for Epilepsy)before switching to another one and starting the "testings"with another one.
I do hope that such correspondence between us,may overcome the professional shortage I have been referring to; so,let's go ahead and exchange further on as much "trial and error" experiences(sometimes very difficult ones)
best luck for ALL of us looking for the BEST solution,on our own
Mondeo
> > Yes-- but I think the inability to tolerate is, unfortunately, quite confusing. One must sort out, while in a confused and confusing state, whether this is due to drug or dose, whether these side effets will or will not go away.
>
> What I mean by "as tolerated" is that one should increase the dose only if:
>
> 1) you haven't yet reached the target dose (or an effective dose)
>
> 2) the side effects are at worst mild and easily tolerated.
>
> I *don't* mean that you should just put up with any side effect you get and hope that it will go away!
>
> Anyway, I think that a month or so is enough time to reach a highish dose of Lamictal, assuming that the side effects don't get bad (i.e., that you tolerate the dose you're at). If you do have trouble with side effects, of course, you can and should drop back to a dose that is tolerated.
>
> For example, the first time I went from 300 to 375 mg/day of Effexor, I got jittery, so I dropped back to 337.5 mg, where the jitters were at worst mild. I took the 337.5 for a few days, then increased to 375 again, this time without difficulty.
>
> > n general, I think that creeping up on doses is the only rational way to get on a med and be also capable of making these crucial decisions as symptoms occur.
>
> The question is, how slow do you have to creep if you're tolerating the drug? I think that, up to the target dose, it's usually fine to increase every few days (obviously there's some variation depending on the specifics of the drug).
>
> -elizabeth
poster:Mondeo
thread:100086
URL: http://www.dr-bob.org/babble/20020408/msgs/103090.html