Posted by Maximus on March 10, 2003, at 12:18:05
In reply to Re: Lamictal and Lithium = best match-Max » Maximus, posted by colin wallace on March 10, 2003, at 11:14:32
> I like the concept of the lithium/lamictal combo.,but would be hesitant to say the least, about adding a low dose tricyclic where depression continues to slip through the net.
We have to be on the combo Lithium + Lamictal for a while BEFORE adding a TCA.
> I take 300mg of Lamictal, and will shortly be discussing adding an additional med. with a bipolar specialist psych.I may well go for lithium too.
I coudn't encourage you enough to go for Lithium + Lamictal. I don't know your DX (bipolar?) but if you are bipolar i don't understand why you are on Lamictal alone. I'm glad you're going to see a bipolar psychiatrist. You are already a winner.
> I'm guessing here that perhaps keeping the TCA dosage marginal will negate any destabilizing effect, but I can't see why this shouldn't apply to an SSRI, or indeed any other AD.
Again, it was in that context, that if the antidepressant effect of Lamictal (AND Lithium) isn't enough then and only then you can add a very small dose of TCA.
> I'd love to know the reasoning here, because if I thought it was safe, I'd opt for a low dose(noradrenergic)TCA over an SSRI anyday.
Okay i will do my best. She (bipolar psychiatrist too) explained to me that a bipolar depression is different chemically than an unipolar depression. It is more deep, more serious and more "neuro-vegetative". Yes she told me what i already knew, that a TCA was a "bigger trigger" than an SSRI. But then again, an SSRI lacks often the punch to lift up a bipolar depression. This is why it is critical and imperative to have a good anti-manic med with.
But don't worry. Most of us respond well to a Lithium + Lamictal combo or if you want to an anti-manic + Lamictal combo.
> Glad you've been kept well for 3 years too-that's good to hear.
Many thanks Colin and good luck to you!