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Dr. Bob is Robert Hsiung, MD,
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Posted by Mags on December 23, 2001, at 13:37:40
I was wondering if anyone else has found that the more they increase the dosage of Lamictal the less effective? I have been DX as possible BPII or III. I suffer from Major Depression and don't believe I have any mania.I have had some response from Prozac, a week of feeling great then crashed, initially no response to Effexor until Lithium was added and then felt great for four days and then majorly crashed. Tried Desipramine and couldn't handle the S/E's.Couldn't satnd the SE's of Lithium either.
I am now on Lamictal by itself. After about two weeks at 25mg felt FANTASTIC!! The nurses at the outpatient clinic were really concerned I was manic but my doc thinks I was just being back to me....I was feeling good most days but still had some down days. We have slowly increased the Lamictal to 50 MG and we are shooting for 100MG BUT I am feeling more down now than up. Has anyone else felt this way or can anyone explain to me what perhaps has happened?? Should I back off on doseage or keep at it? Thanks so much...
Marg
Posted by spike4848 on December 23, 2001, at 16:35:37
In reply to Increase of Lamictal dose less effective? , posted by Mags on December 23, 2001, at 13:37:40
After failing many antidepressants ..... Lamictal was recommended to me. I started at 25mg per day then ramped up to 300mg over 6 weeks. I felt a strong antidepressant effect the first two weeks .... then that gradually faded away ... til I was left with just brief rush for about 3 hours after each 100 mg dose, one dose in the morning, one dose in the afternoon. It was like a cup of coffee.
Spike
Posted by Mags on December 23, 2001, at 17:04:10
In reply to My Two Cent's, posted by spike4848 on December 23, 2001, at 16:35:37
Thanks for response Spike even tho' it is a bit discouraging..Based on what you said perhaps I should back off or do you think it was a transitory fix just like all the rest...I sure hope not..I really had my hopes up about this.....did you feel the effect of Lamictal right away? I could of sworn I felt better even at 12.5mg..perhaps it was just a placebo effect..but I want it back!!
Anyone else any thoughts??
Mags
Posted by spike4848 on December 23, 2001, at 17:14:31
In reply to Re: My Two Cent's » spike4848, posted by Mags on December 23, 2001, at 17:04:10
Sorry Mags, I didn't mean to discourage you ... I have very atypical depression with panic disorder. I am definately not the normal individual with depression. So please don't get discouraged on my account ... I got to keep my mouth shut sometimes.
I have heard of several individuals would have done excellent with lamictal. I think "SalArmy" has done very well with it. "Sal" are you there?
Spike
Posted by jazzdog on December 23, 2001, at 17:32:54
In reply to Can I take it back?, posted by spike4848 on December 23, 2001, at 17:14:31
Apparently it's very common with this drug to feel an immediate effect after starting it, which then fades until a therapeutic dose (at least 150 mg) is reached. It's also common for the true therapeutic reaction to take over a month at a therapeutic dose to kick in. I started lamictal several weeks ago, and felt a very encouraging response which quickly faded. Now I'm titrating up to 250 mg, but I'm still only at 75 mg. This drug seems to require more than ordinary amounts of patience, but a lot of people swear by it once the therapeutic effects begin. Good luck -
- Jane
Posted by Cindylou on December 23, 2001, at 20:04:04
In reply to Increase of Lamictal dose less effective? , posted by Mags on December 23, 2001, at 13:37:40
Hi Mags,
I am currently up to 100 mg of Lamictal, and like you, I thought I felt quite a bit better right away, at 12.5 and then 25 mgs. However, after 25 mg., each time I titrated up I went through a week of agitation and exhaustion -- the opposite effect of what a mood stabilizer is supposed to do. After about a week, I would start to level off. I kept it up, because my pdoc said there really isn't much of a therapeutic reaction until 100 mg.Now, at 100 mg, I still have the depression, but it feels like I have a "safety net" that keeps me from hitting those all-time lows where I don't see the purpose in living. My anxiety is more under control as well. My pdoc describes me as not having the desperation and urgency as I did before.
We are going to try adding Paxil to see if it will help with my depression and social anxiety (which I think is related to my depression rather than being bonified "social phobia." I just feel so insecure, inferior, etc. around other people.)
I think we'll hold off on increasing the Lamictal until we see how the Paxil works.
Sorry for the rambling message -- I guess the bottom line is that, yes, I did feel an inital lift when I first started the Lamictal, and I don't think it was all in my head. But I'm not really discouraged that it went away, since the Lamictal does seem to be helping "stabilize" me a bit. It's just not acting as an AD right now.
Good luck! I think it's worth it to keep it up. I have had the same reactions to meds that you have -- feeling good and then CRASHING big time. It is such a discouraging feeling. I am hoping that Lamictal may help ward off that crash effect.
Keep us posted on how you are doing!
-cindy> I was wondering if anyone else has found that the more they increase the dosage of Lamictal the less effective? I have been DX as possible BPII or III. I suffer from Major Depression and don't believe I have any mania.I have had some response from Prozac, a week of feeling great then crashed, initially no response to Effexor until Lithium was added and then felt great for four days and then majorly crashed. Tried Desipramine and couldn't handle the S/E's.Couldn't satnd the SE's of Lithium either.
> I am now on Lamictal by itself. After about two weeks at 25mg felt FANTASTIC!! The nurses at the outpatient clinic were really concerned I was manic but my doc thinks I was just being back to me....I was feeling good most days but still had some down days. We have slowly increased the Lamictal to 50 MG and we are shooting for 100MG BUT I am feeling more down now than up. Has anyone else felt this way or can anyone explain to me what perhaps has happened?? Should I back off on doseage or keep at it? Thanks so much...
> Marg
Posted by Mags on December 23, 2001, at 22:15:24
In reply to Re: Increase of Lamictal dose less effective? » Mags, posted by Cindylou on December 23, 2001, at 20:04:04
Thanks to all of you for your responses including you Spike!! Don't worry I get discouraged easily and I enjoy reading all posts about lamictal. I too, as most here, don't have normal responses to drugs...I think most of us wouldn't be here if we did..we would be cured and not comparing notes....That is how we learn from reading individual responses. That is what makes this board so special. I can't get this info from my doc, only from people like you. I have been lurking here for months and have learned so much.
Jane, thanks for explanation re rapid response it is good to know about and Cindy I feel exactly the same as you every time I titrate up plus I get muscle aches and feel like I have the flu. No rash and these symptoms do go away..but I do not find this drug that activating in fact it really helps me sleep, which I haven't been able to do without Ativan for a very long time. I really miss the first few weeks tho'...I want it back...i had so much energy and was very social...now as you said Cindy, the safety net is there but I am feeling kinda blah. I will keep you all posted as to how I am doing..I am supposed to titrate up today to 75mg today but I think I will wait 'til after Xmas.
Mags
Posted by Mags on December 24, 2001, at 0:01:01
In reply to Thanks everyone!, posted by Mags on December 23, 2001, at 22:15:24
> One more question re Lamictal...when do you take it, morning or evening and do you split up the doses? I have been taking 2x25mg at bedtime. My pdoc suggested this to avoid any nausea or stomach pain as I am very succeptible to that but am wondering if splitting meds or changing time may help with my mood.Thanks!
Mags
Posted by Cindylou on December 24, 2001, at 0:17:53
In reply to When do you take lamictal?, posted by Mags on December 24, 2001, at 0:01:01
Funny that you ask that question, as it is 1 a.m. and I am WIRED. I've been taking Lamictal all at night, because when I tried to split the dose, I was very agitated throughout the day. I take Klonapin to help me sleep, since the Lamictal does activate me.
I've been trying to taper off the Klonapin (I only take about a half tablet, so I tried 1/4 tablet tonight) and I can't sleep for the life of me. I just took another half Klonapin, and I'm sure it will knock me out pretty soon.
So, I decided tonight (just before reading your post) that I am going to start trying to split the Lamcital doses again, now that I am adjusting to it. Hopefully it will help give me more energy during the day, possibly help with my mood, and/or help me sleep better.
I think the standard practice is to split the dose, half in a.m. and half in p.m. -- but there doesn't seem to be any "rule" about it like with some of the other meds. Whatever works best for each of us!
Hopefully I'll be heading off to dreamland soon ...
Take care,
cindy
> > One more question re Lamictal...when do you take it, morning or evening and do you split up the doses? I have been taking 2x25mg at bedtime. My pdoc suggested this to avoid any nausea or stomach pain as I am very succeptible to that but am wondering if splitting meds or changing time may help with my mood.Thanks!
> Mags
Posted by Mags on December 24, 2001, at 12:21:44
In reply to Re: When do you take lamictal? » Mags, posted by Cindylou on December 24, 2001, at 0:17:53
Thanks Cindy, I guess it is worth trying to split it...I will try 1/2 tonight and half in morning..will let you know if it works..if you celebrate Christmas have a great one!
Mags >Funny that you ask that question, as it is 1 a.m. and I am WIRED. I've been taking Lamictal all at night, because when I tried to split the dose, I was very agitated throughout the day. I take Klonapin to help me sleep, since the Lamictal does activate me.
>
> I've been trying to taper off the Klonapin (I only take about a half tablet, so I tried 1/4 tablet tonight) and I can't sleep for the life of me. I just took another half Klonapin, and I'm sure it will knock me out pretty soon.
>
> So, I decided tonight (just before reading your post) that I am going to start trying to split the Lamcital doses again, now that I am adjusting to it. Hopefully it will help give me more energy during the day, possibly help with my mood, and/or help me sleep better.
>
> I think the standard practice is to split the dose, half in a.m. and half in p.m. -- but there doesn't seem to be any "rule" about it like with some of the other meds. Whatever works best for each of us!
>
> Hopefully I'll be heading off to dreamland soon ...
>
> Take care,
> cindy
>
>
> > > One more question re Lamictal...when do you take it, morning or evening and do you split up the doses? I have been taking 2x25mg at bedtime. My pdoc suggested this to avoid any nausea or stomach pain as I am very succeptible to that but am wondering if splitting meds or changing time may help with my mood.Thanks!
> > Mags
Posted by Cindylou on December 25, 2001, at 7:00:55
In reply to Re: When do you take lamictal?, posted by Mags on December 24, 2001, at 12:21:44
Hi Mags,
Merry Christmas to you, too! Good news, at least for yesterday ... I took Lamictal througout the day (25 mg at 10 a.m., 25 mg at 1 p.m., and 50 mg. at 4:30 p.m.)I felt so much better! I started with just 25 mg to see if it would make me agitated, and it didn't ... but didn't give me much energy either. So I added the other 25, and I felt really pretty good! Then I took the 50 at 4:30 before going out, and it sustained me for the evening. I also slept like a rock without needing Klonapin. This morning, I am not as big of a zombie as usual.
I felt better yesterday than I have in a long time.
I hope it keeps up, and I hope it works for you too! Hopefully, since you've been taking it for awhile, your stomach will have adjusted by now and you won't have the GI distress.
Wishing the best for you,
cindy> Thanks Cindy, I guess it is worth trying to split it...I will try 1/2 tonight and half in morning..will let you know if it works..if you celebrate Christmas have a great one!
> Mags >
>
> Funny that you ask that question, as it is 1 a.m. and I am WIRED. I've been taking Lamictal all at night, because when I tried to split the dose, I was very agitated throughout the day. I take Klonapin to help me sleep, since the Lamictal does activate me.
> >
> > I've been trying to taper off the Klonapin (I only take about a half tablet, so I tried 1/4 tablet tonight) and I can't sleep for the life of me. I just took another half Klonapin, and I'm sure it will knock me out pretty soon.
> >
> > So, I decided tonight (just before reading your post) that I am going to start trying to split the Lamcital doses again, now that I am adjusting to it. Hopefully it will help give me more energy during the day, possibly help with my mood, and/or help me sleep better.
> >
> > I think the standard practice is to split the dose, half in a.m. and half in p.m. -- but there doesn't seem to be any "rule" about it like with some of the other meds. Whatever works best for each of us!
> >
> > Hopefully I'll be heading off to dreamland soon ...
> >
> > Take care,
> > cindy
> >
> >
> > > > One more question re Lamictal...when do you take it, morning or evening and do you split up the doses? I have been taking 2x25mg at bedtime. My pdoc suggested this to avoid any nausea or stomach pain as I am very succeptible to that but am wondering if splitting meds or changing time may help with my mood.Thanks!
> > > Mags
Posted by Mags on December 25, 2001, at 19:06:59
In reply to Re: When do you take lamictal? » Mags, posted by Cindylou on December 25, 2001, at 7:00:55
> Hi Cindy
That is great news! I am so glad it worked for you....I will give it a try and let you know..I am going to up my dose today so I think I will take my 50 MG tonight as usual and another 25 mg tomorrow morning..I have my fingers crossed. Hope you had a good Christmas day....
Mags
Posted by dreamer on December 26, 2001, at 11:09:02
In reply to Re: When do you take lamictal?, posted by Mags on December 25, 2001, at 19:06:59
Posted by Cindylou on January 2, 2002, at 12:26:19
In reply to Re: Increase of Lamictal dose less effective? » Mags, posted by Cindylou on December 23, 2001, at 20:04:04
Mags,
How are you doing on the Lamictal? Unfortunately, I have to revise my answer to your post now. I increased the Lamictal up to 125 and felt much worse. I decreased back to 100, and am now wondering if I in fact WAS better off on 50 mg, even though my pdoc said there would be no effect until 100 mg.I'm interested in how you are doing, and sorry for this not-so-positive report.
cindy
> Hi Mags,
> I am currently up to 100 mg of Lamictal, and like you, I thought I felt quite a bit better right away, at 12.5 and then 25 mgs. However, after 25 mg., each time I titrated up I went through a week of agitation and exhaustion -- the opposite effect of what a mood stabilizer is supposed to do. After about a week, I would start to level off. I kept it up, because my pdoc said there really isn't much of a therapeutic reaction until 100 mg.
>
> Now, at 100 mg, I still have the depression, but it feels like I have a "safety net" that keeps me from hitting those all-time lows where I don't see the purpose in living. My anxiety is more under control as well. My pdoc describes me as not having the desperation and urgency as I did before.
>
> We are going to try adding Paxil to see if it will help with my depression and social anxiety (which I think is related to my depression rather than being bonified "social phobia." I just feel so insecure, inferior, etc. around other people.)
>
> I think we'll hold off on increasing the Lamictal until we see how the Paxil works.
>
> Sorry for the rambling message -- I guess the bottom line is that, yes, I did feel an inital lift when I first started the Lamictal, and I don't think it was all in my head. But I'm not really discouraged that it went away, since the Lamictal does seem to be helping "stabilize" me a bit. It's just not acting as an AD right now.
>
> Good luck! I think it's worth it to keep it up. I have had the same reactions to meds that you have -- feeling good and then CRASHING big time. It is such a discouraging feeling. I am hoping that Lamictal may help ward off that crash effect.
>
> Keep us posted on how you are doing!
> -cindy
Posted by Mags on January 2, 2002, at 23:56:20
In reply to Re: Increase of Lamictal dose less effective?, posted by Cindylou on January 2, 2002, at 12:26:19
> Hi Cindy,I don't see my last post so I will send this again....
Don't worry about not positive report...I feel the same. I have been trying tio ignore for days the fact that I am getting very depressed. I am also wondering if I should have left well enough alone. I am at 75 mg. I take 50 at night (midnight) and 25mg at noon. I have less energy than before amd very low. I am going to see my pdoc on the 21st. Iwill see what he says. I keep hoping I will get back the old feeling i had at 25MG.....what a drag this game is...
Mags,
> How are you doing on the Lamictal? Unfortunately, I have to revise my answer to your post now. I increased the Lamictal up to 125 and felt much worse. I decreased back to 100, and am now wondering if I in fact WAS better off on 50 mg, even though my pdoc said there would be no effect until 100 mg.
>
> I'm interested in how you are doing, and sorry for this not-so-positive report.
>
> cindy
>
> > Hi Mags,
> > I am currently up to 100 mg of Lamictal, and like you, I thought I felt quite a bit better right away, at 12.5 and then 25 mgs. However, after 25 mg., each time I titrated up I went through a week of agitation and exhaustion -- the opposite effect of what a mood stabilizer is supposed to do. After about a week, I would start to level off. I kept it up, because my pdoc said there really isn't much of a therapeutic reaction until 100 mg.
> >
> > Now, at 100 mg, I still have the depression, but it feels like I have a "safety net" that keeps me from hitting those all-time lows where I don't see the purpose in living. My anxiety is more under control as well. My pdoc describes me as not having the desperation and urgency as I did before.
> >
> > We are going to try adding Paxil to see if it will help with my depression and social anxiety (which I think is related to my depression rather than being bonified "social phobia." I just feel so insecure, inferior, etc. around other people.)
> >
> > I think we'll hold off on increasing the Lamictal until we see how the Paxil works.
> >
> > Sorry for the rambling message -- I guess the bottom line is that, yes, I did feel an inital lift when I first started the Lamictal, and I don't think it was all in my head. But I'm not really discouraged that it went away, since the Lamictal does seem to be helping "stabilize" me a bit. It's just not acting as an AD right now.
> >
> > Good luck! I think it's worth it to keep it up. I have had the same reactions to meds that you have -- feeling good and then CRASHING big time. It is such a discouraging feeling. I am hoping that Lamictal may help ward off that crash effect.
> >
> > Keep us posted on how you are doing!
> > -cindy
Posted by Hattree on January 3, 2002, at 9:34:10
In reply to Re: Increase of Lamictal dose less effective?, posted by Mags on January 2, 2002, at 23:56:20
Cindy,
I am up to 100mg Lamictal and also think I may have been doing better on 50. Keep us posted.
--hat> > Hi Cindy,I don't see my last post so I will send this again....
> Don't worry about not positive report...I feel the same. I have been trying tio ignore for days the fact that I am getting very depressed. I am also wondering if I should have left well enough alone. I am at 75 mg. I take 50 at night (midnight) and 25mg at noon. I have less energy than before amd very low. I am going to see my pdoc on the 21st. Iwill see what he says. I keep hoping I will get back the old feeling i had at 25MG.....what a drag this game is...
> Mags,
> > How are you doing on the Lamictal? Unfortunately, I have to revise my answer to your post now. I increased the Lamictal up to 125 and felt much worse. I decreased back to 100, and am now wondering if I in fact WAS better off on 50 mg, even though my pdoc said there would be no effect until 100 mg.
> >
> > I'm interested in how you are doing, and sorry for this not-so-positive report.
> >
> > cindy
> >
> > > Hi Mags,
> > > I am currently up to 100 mg of Lamictal, and like you, I thought I felt quite a bit better right away, at 12.5 and then 25 mgs. However, after 25 mg., each time I titrated up I went through a week of agitation and exhaustion -- the opposite effect of what a mood stabilizer is supposed to do. After about a week, I would start to level off. I kept it up, because my pdoc said there really isn't much of a therapeutic reaction until 100 mg.
> > >
> > > Now, at 100 mg, I still have the depression, but it feels like I have a "safety net" that keeps me from hitting those all-time lows where I don't see the purpose in living. My anxiety is more under control as well. My pdoc describes me as not having the desperation and urgency as I did before.
> > >
> > > We are going to try adding Paxil to see if it will help with my depression and social anxiety (which I think is related to my depression rather than being bonified "social phobia." I just feel so insecure, inferior, etc. around other people.)
> > >
> > > I think we'll hold off on increasing the Lamictal until we see how the Paxil works.
> > >
> > > Sorry for the rambling message -- I guess the bottom line is that, yes, I did feel an inital lift when I first started the Lamictal, and I don't think it was all in my head. But I'm not really discouraged that it went away, since the Lamictal does seem to be helping "stabilize" me a bit. It's just not acting as an AD right now.
> > >
> > > Good luck! I think it's worth it to keep it up. I have had the same reactions to meds that you have -- feeling good and then CRASHING big time. It is such a discouraging feeling. I am hoping that Lamictal may help ward off that crash effect.
> > >
> > > Keep us posted on how you are doing!
> > > -cindy
This is the end of the thread.
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