Posted by Ellen S. on October 21, 2002, at 18:15:26
In reply to Re: Adverse effects from abruptly quitting Lamictal? » Ellen S., posted by SLS on October 21, 2002, at 0:38:20
> Hi Ellen.
>
> > My teenage son has been taking Lamictal (400 mg daily), in addition to Eskalith, Celexa, and Geodon.
>
> What is he being treated for?Good question to ask [sigh....].
His current psychiatrist is treating him for bipolar disorder (apparently "mixed-state"), although we (and other professionals who have had more direct contact with him than this psychiatrist has) have serious doubts about that diagnosis. His issues definitely include anxiety and depression, seasoned with a strong pinch of oppositional behavior (but never conduct disorder). "School avoidance" (apparently due to a mixture of social anxiety and anxiety about academic performance) is an enduring behavioral theme. There have been several episodes in which he was desperately ill (with psychosomatic ailments at younger ages and with depression more recently) during the school term and got miraculously better for a weekend, holiday, or vacation period.
Lamictal was added to his "cocktail" several months ago to combat what the doctor interpreted to be a cycle of treatment-resistant bipolar depression. We think this episode of depression was triggered by despair that he was failing several courses because he had missed many classes, was behind in the make-up work, and was being given "zeroes" for work not completed. At the time, he was denying that his behavior and worries were a major contributor to his symptoms, and he liked having a doctor tell him that his symptoms were due to a biological illness (BPD) and could be resolved by medication. He did get better while he was taking Lamictal, but only after a plan was worked out that would allow him to salvage the school year. He also finally started to agree with his therapist about the role of his feelings and behaviors in causing other problems, and he is now *working* at recovery instead of waiting for meds to do everything. He thinks he has benefited from the other meds, but not Lamictal. Therefore, he told the psychiatrist that he wanted to stop the Lamictal because he thought it was hurting more than helping, but the doctor told him "No -- maybe later, but not yet."
> > He doesn't think the Lamictal ever had any positive effect, and we also didn't notice that it helped him any. However, he thinks that it caused irritability and insomnia, so he secretly stopped taking it a few days ago. He says he is feeling better without it.
>
> Whether or not he responded to Lamictal, it seems that many people experience a TEMPORARY antidepressant effect from LOWERING the dosage.
>Interesting.... My son says he has not experienced depression in several months. His feeling "better" without the Lamictal means it's been easier to get to sleep at night, which is a good thing. Difficulties getting to sleep at night and then waking up the next morning have been interfering with his goal of successfully leading a normal life. The pdoc thinks these are symptoms of depression (meaning a need for increased medication), but we think they are medication side effects.
>
> > I am concerned about the possible consequences of suddenly quitting...
>
> Whether or not someone has a seizure disorder, abruptly discontinuing any anticonvulsant by anyone can potentially produce seizures. However, I don't know the propensity of Lamictal to do this. My guess is that it is quite a bit lower than the old mainstream anticonvulsants (phenobarbital, phenytoin, valproate, carbamazepine, etc.) Anxiety and heart-palpitations might be among the withdrawal symptoms. Just another guess.
>
> Sorry I couldn't be more helpful.Thanks for sharing what you DO know, Scott. I guess I'm going to hope for the best at this point... It's been long enough (6 days) since he quit that his body probably has cleared most of the Lamictal, so it's probably too late to try to taper off....
-- Ellen
poster:Ellen S.
thread:124239
URL: http://www.dr-bob.org/babble/20021019/msgs/124562.html