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Re: scott/sls; lamictal ?'s johnLA

Posted by SLS on September 1, 2014, at 12:38:44

In reply to scott/sls; lamictal ?'s SLS, posted by johnLA on September 1, 2014, at 10:46:15

> wow scott.
> i understood about 80% of all that. and, you delivered the info in a very 'gentle' way. i appreciate that greatly.
> theory aside;
> 1. what can lamictal possibly do for a anergic depression? i have heard it can be 'pro-social' in it's action.

My depression is primarily one of anergia and cognitive impairment along with lack of interest and anhedonia. I find Lamictal to be energizing and antidepressive. At 200 mg/day, I don't think that I experience very much cognitive impairment as a side effect. Since I have been taking Lamictal for quite a few years, I cannot be absolutely sure as to the degree of residual impairments that might still exist. For me, the cost/benefit ratio leans in the direction to continue Lamictal treatment.

> 2. i have read about the 'dumbing' effect it can cause on cognitive ability. any more info on your end about this?

Cognitive impairments produced by Lamictal are dosage-dependent. It makes sense to establish the lowest effective dosage. I would set 200 mg/day as an initial target dosage to titrate up to. Most people find this to be optimal. This will take at least four weeks to attain so as to avoid the precipitation of a rash-reaction. I see most people respond robustly to a dosage range of 150 - 300 mg/day.

> 3. could you explain the sodium channel deal a bit more? you mentioned this causes cognitive impairments.

Sodium ions must be transported in and out of the neuron in order for the neuron to send its message. This is accomplished via the passage of ions through a membrane channel, and must occur rapidly and unimpeded in response to changes in voltage. When these sodium channels are blocked by anticonvulsants like Lamictal, neurons are inhibited from firing (propogating an action-potential). In this case, blocking sodium channels impairs cognitive and memory function.

> 4. lamictal; worth a try?

I think so. It can help in the treatment of both bipolar disorder and unipolar major depressive disorder. However, it seems to me that it produces better results when combined with an antidepressant, atypical antipsychotic, or another anticonvulsant.

> still, need to talk to her and my regular pdoc. i'm not too sure my regular doc will be keen to use it.

What are your doctor's objections to treating you with Lamictal?

- Scott

> thanks again so much for such a detailed reply.
> john

Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw




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