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Re: Does Lamictal have therapeutic value

Posted by blueboy on July 28, 2008, at 11:21:27

In reply to Does Lamictal have therapeutic value, posted by tedrew on July 27, 2008, at 9:34:46

> I started on Lamictal in early June for ongoing depression/anxiety. I am up to 100mgs a day.Does this med even work for depression/anxiety.

AFAIK, Lamictal is only approved (as a psychoactive) for prevention of depressive episodes in bipolar patients. It may have some effect on prevention of mania. I have never heard of it preventing anxiety as such.

There are off-label reports of Lamictal being effective in drug-resistant unipolar depression, but I think the general practice is to exhaust other possibilities first. The beauty of Lamictal is that it can stabilize mood in bipolar conditions with a low degree of side effects. It is particularly effective in preventing or easing the depressive phase of a bipolar cycle.

However, I haven't seen any research that would show Lamictal effectively treating a depressive episode. Certainly the official story is that it only useful for preventing depression, i.e. if taken before the episode starts. It prevents, but does not cure. It's more like a vaccine.

One possibility is that success with "treatment resistant" unipolar depression is because such depression is actually a bipolar cycle with minimal hypomania. Very often, bipolar II patients will complain only of depression because hypomania feels "normal" or even great. (Whereas Bipolar I patients will typically go "nuts" and engage in really bizarre behavior.)

> I went through the bad stress of a separation in early July but I would have expected Lamictal to have had some therapeutic effect by now. They say that the target dose for depression is maybe 200 mgs, but I am already starting to get some cognitive blunting and many people supposedly do well at 100mgs so whats up.

Again, the official line on Lamictal is that it is ineffective, or its effectiveness is not proven, to bring a patient out of a depressive episode. I am not a doctor, and if I were a doctor I wouldn't diagnose you over the internet, so please take anything I say with a healthy dose of skepticism. But to me, you don't sound like someone that would be expected to respond to Lamictal.


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