Posted by myclonic_jerk on December 10, 2003, at 12:20:42
In reply to Re: The Joys of Being Bipolar » SLS, posted by Ron Hill on December 9, 2003, at 13:55:27
Hi Ron,
>>> I bring all this up only to say that there is a possibility that the Lamictal rash might have been avoided if the pdoc had implemented a start low and go slow approach in the dosing. Therefore, I sometimes toy with the idea of trying Lamictal as an add-on to my Lithobid starting at about 5 mg/day and slowly titrating up trying to avoid the rash. However, my current pdoc (a good one) is of the opinion that Lamictal will cause a rash even if I go low and slow. But, I’m sure he would let me try it if I asked him to do so.
>>>I'm certain he's a good Pdoc, although in this particular instance he seems to be just erring on the side of caution.I take 350mg Lamictal, developed a (mild) rash initially on 12.5mg, but persevered with miniscule (2mg) increments.It was well worth the perseverance.Right now, if I'm feeling in a real slump, I can easily jump up by 100mg for a few days, wih no ill effects whatsoever.
If you're minded to go for a re-trial, the results can often be staggering.> > Lamictal is not a good anti manic agent per se, but is supposed to help stabilize rapid cyclicity. Lithium is a good antimanic agent, but is not usually of any value to prevent or mitigate depressive episodes, despite its occasional us as an augmentor of antidepressants. A combination of the two (Lamictal + lithium) has been shown to increase the time before relapse of both manic and depressive phases of bipolar disorder. Maybe I can dig up some of the material I came across that describes this observation.
>>>I often read of Lamictal not having mood stabilizing properties per se.All I can say is that for me at least, it most certainly does.
I was never able to tolerate any antidepressant whatsoever prior to starting Lamictal.Now I can get away with (at least)giving AD's a fair shot, for months at a time before deciding on a given med's efficacy.I'm not bipolar (although possibly type 111)if one wanted to apply a grandiose term to simple 'antidepressant intolerant')!
Lithium can complement Lamictal quite well for BP, or BP11- a very effective combo.+additional safety net with the lithium.
Its important not to stifle the Lamictal with too much lithium though, whilst maintaining just enough lith. to ensure stability.
> Yeah I hear ya, Scott. As I indicated above, I periodically toy with the idea of a trial of a Lamictal add-on to my Lithobid.>>>Go for it Ron ;)
The Jerk....
poster:myclonic_jerk
thread:287370
URL: http://www.dr-bob.org/babble/20031208/msgs/288398.html