![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 13 to 37 of 37. Go back in thread:
Posted by jazzdog on January 15, 2002, at 16:39:17
In reply to Re: Lamictal worked great, pooped out » Hattree, posted by cindylou on January 15, 2002, at 15:25:10
Sorry to hear Lamictal isn't working for both of you - you were my Lamictal models! I found a brief, two-day effect at 12.5 mg, then that effect dissipated. However, although I don't feel any dramatic effect at 100 mg, I do find that I am much more easygoing than I used to be. Things that would get me very riled up just don't seem to get to me. I've heard that the brief initial effect is very common, then if fades until you hit 150 to 300 mg and reach a therapeutic dose. I've also heard that this therapeutic dose can take a month to six weeks to kick in. So I'm a long way from giving up on this drug yet - at least six months, since I'm aiming at 250 mg. I'll keep you both posted, and I'll follow both your progress with interest.- Jane
Posted by Krazy Kat on January 15, 2002, at 17:05:01
In reply to Please don't ruin my thread, posted by jaby on January 15, 2002, at 13:21:58
jaby:
I understand - it is frustrating when threads change direction, but they inevitably do.
if anything further comes up for me not re: LAmictal, I'll start another thread.
BTW, I'm having a terrible time starting up Lamictal right now.
Depakote worked best for me, but I did gain weight on it.
- KK
Posted by jaby on January 15, 2002, at 18:58:28
In reply to Re: Please don't ruin my thread » jaby, posted by Krazy Kat on January 15, 2002, at 17:05:01
KK,
Thanks for your kind words. I had trouble with L after the first few days. Things got easier after a week or two and the I experienced side effects after 150mg+
> jaby:
>
> I understand - it is frustrating when threads change direction, but they inevitably do.
>
> if anything further comes up for me not re: LAmictal, I'll start another thread.
>
> BTW, I'm having a terrible time starting up Lamictal right now.
>
> Depakote worked best for me, but I did gain weight on it.
>
> - KK
Posted by Krazy Kat on January 15, 2002, at 21:25:35
In reply to Re: Please don't ruin my thread, posted by jaby on January 15, 2002, at 18:58:28
jaby:
I'm stopping L. per my pdoc's advice. It's all so frustrating, isn't it?
- KK
Posted by Dinah on January 15, 2002, at 22:37:00
In reply to Re: Please don't ruin my thread, posted by Krazy Kat on January 15, 2002, at 21:25:35
> jaby:
>
> I'm stopping L. per my pdoc's advice. It's all so frustrating, isn't it?
>
> - KKI'm sorry it didn't work out for you, Kat. Could any part of this be Depakote withdrawal? What is your pdoc thinking of trying next?
I hope you feel better soon.
Dinah
Posted by JohnX2 on January 16, 2002, at 1:00:30
In reply to Re: Lamictal worked great, pooped out, now what? » JohnX2, posted by Krazy Kat on January 15, 2002, at 9:40:44
I felt the board was an excellent place
to be around, specifically to ask Cam a question
about Zyprexa, but he is banned , and I don't
agree with the rational for it , and I feel it
was a bad trade-off to ban him in favor of the
policy.Thanks for your concern,
John> John:
>
> You banned yourself because you had problems with the board - I'm just concerned that someone who is very much against pbabble, who then comes on and gives advice as a "freebie", is going to have another agenda at hand.
>
> This is still the best board I've found - every board is going to have some things one doesn't like about it.
>
> I'd much rather you re-evaluate your concerns and stay. But if you find yourself in a position where you feel the board is a bad place to be, then I wouldn't even visit the site.
>
> - KK
Posted by JohnX2 on January 16, 2002, at 1:02:25
In reply to Please don't ruin my thread, posted by jaby on January 15, 2002, at 13:21:58
Point well taken.
Many apologies.Good luck with your medicines.
-john
> Please don't use my thread to vent your frustrations with one another. I really just want to hear from people responding to my situation and don't want it to get lost as a result of someone's problems with eachother. Thanks!
>
>
> > John:
> >
> > You banned yourself because you had problems with the board - I'm just concerned that someone who is very much against pbabble, who then comes on and gives advice as a "freebie", is going to have another agenda at hand.
> >
> > This is still the best board I've found - every board is going to have some things one doesn't like about it.
> >
> > I'd much rather you re-evaluate your concerns and stay. But if you find yourself in a position where you feel the board is a bad place to be, then I wouldn't even visit the site.
> >
> > - KK
Posted by Krazy Kat on January 16, 2002, at 8:35:19
In reply to Re: Stopping Lamictal » Krazy Kat, posted by Dinah on January 15, 2002, at 22:37:00
Dinah:
Thanks!
- KK
Posted by Hattree on January 16, 2002, at 9:09:14
In reply to Lamictal - Hattree, CindyLou, posted by jazzdog on January 15, 2002, at 16:39:17
I haven't given up on Lamictal yet--it may be premature to say that it has pooped out, but in the beginning I was positively cheerful and that has not lasted. Gradually my old dysthymic self has been resurfacing.
I decided to stick with 100 for awhile. I realized that holidays and weather had derailed my exercize routine, and that I should get back to that before messing with my meds.
Also, Jane's anecdote that the initial burst of good feeling is common and then you need to go much higher discourages me from dropping back down.
Keep me posted, guys--hope it works for you.
>
> Sorry to hear Lamictal isn't working for both of you - you were my Lamictal models! I found a brief, two-day effect at 12.5 mg, then that effect dissipated. However, although I don't feel any dramatic effect at 100 mg, I do find that I am much more easygoing than I used to be. Things that would get me very riled up just don't seem to get to me. I've heard that the brief initial effect is very common, then if fades until you hit 150 to 300 mg and reach a therapeutic dose. I've also heard that this therapeutic dose can take a month to six weeks to kick in. So I'm a long way from giving up on this drug yet - at least six months, since I'm aiming at 250 mg. I'll keep you both posted, and I'll follow both your progress with interest.
>
> - Jane
Posted by cindylou on January 16, 2002, at 13:20:20
In reply to Re: Lamictal - Jane, CindyLou, posted by Hattree on January 16, 2002, at 9:09:14
I met with my pdoc today thinking that we would decide to get off of the Lamictal (I started decreasing the dose before I met with her, and do seem to feel a bit better on 75 mg than I did at 100).
Anyway, she really insisted that I look and come across to her much better than I have in previous visits. She said that before I was more "distraught," but I seem much more at ease now. I trust her opinion greatly -- she's seen me for over a year now and has always been open to my suggestions. So I am definitely open to her opinion and suggestions as well.
She also seems to think that a lot of my depression and fatigue as of late may be due more to emotional/cognitive reasons than chemical, which could very well be true.
We decided to stay on the 75 mg of Lamictal (plus the 75 mg of Serzone which seems to take the edge off agitation, even at that low of a dose). We are also going to try to add a low dose of Prozac for 2 weeks on, 2 weeks off each month to see if it will keep me from crashing on it, and also to see if it will help during PMS.
So, that's the scoop. Looks like the three of us (Hattree, Jane and me) aren't giving up the Lamictal ship yet!
Keep me posted and I'll do the same,
cindy
> I haven't given up on Lamictal yet--it may be premature to say that it has pooped out, but in the beginning I was positively cheerful and that has not lasted. Gradually my old dysthymic self has been resurfacing.
>
> I decided to stick with 100 for awhile. I realized that holidays and weather had derailed my exercize routine, and that I should get back to that before messing with my meds.
>
> Also, Jane's anecdote that the initial burst of good feeling is common and then you need to go much higher discourages me from dropping back down.
>
> Keep me posted, guys--hope it works for you.
>
>
>
> >
> > Sorry to hear Lamictal isn't working for both of you - you were my Lamictal models! I found a brief, two-day effect at 12.5 mg, then that effect dissipated. However, although I don't feel any dramatic effect at 100 mg, I do find that I am much more easygoing than I used to be. Things that would get me very riled up just don't seem to get to me. I've heard that the brief initial effect is very common, then if fades until you hit 150 to 300 mg and reach a therapeutic dose. I've also heard that this therapeutic dose can take a month to six weeks to kick in. So I'm a long way from giving up on this drug yet - at least six months, since I'm aiming at 250 mg. I'll keep you both posted, and I'll follow both your progress with interest.
> >
> > - Jane
Posted by JahL on January 16, 2002, at 16:02:28
In reply to Re: Lamictal worked great, pooped out, posted by Hattree on January 15, 2002, at 14:32:32
> Same problem here, great results at first w/Lamictal at 25mg, basically the same respose at 100mg for awhile, then poopout. Going back down hasn't made a big differnce. What a drag--I was depression free for six months, a record.
Snap. This pattern seems very common. I've been on 400mg for about 6 months (at the behest of ignorant, by-the-book pdocs) and I can't say there's any improvement over say, 100mg. I had the euthymic/hypomanic reaction at about 25mg and it faded over about 6 weeks.
Interestingly the first true hypomanic episode was precipitated by the addition of 0.25mg/Klonopin, which seemed to 'kickstart' the Lamictal benefits.
I continue to take up to 1mg of Klonopin (against pdoc's advice) daily with my Lamictal and I can state with certainty that, for myself at least, a special synergy exists btwn the 2 meds. Neither works by themselves but together they do help fairly significantly (chronically suicidal vs acutely so). Curiously, my brother, who has a milder form of my BPII, only seems to benefit from Zyprexa+Klonopin. Neither works alone. Of course both are purported to have mood-stabilizing qualities.
*Have any of you considered augmenting Lamictal before giving up on it (if you're at that stage)? The consensus amongst pdocs I have spoken to is that Lamictal is very amenable to augmentation, VPA notwithstanding. I have just had Celexa and L-Tryptophan (available only on special licence) added to augment Lamictal's supposed S-reuptake inhibition characteristics.
Best,
J.
Posted by Hattree on January 16, 2002, at 17:41:35
In reply to Re: Lamictal augmentation?, posted by JahL on January 16, 2002, at 16:02:28
I augment with Zoloft and Amphetamines (I don't get the jitters from Lamictal at all), plus sleep aids. Tried dropping the Zo but no luck.
> > Same problem here, great results at first w/Lamictal at 25mg, basically the same respose at 100mg for awhile, then poopout. Going back down hasn't made a big differnce. What a drag--I was depression free for six months, a record.
>
> Snap. This pattern seems very common. I've been on 400mg for about 6 months (at the behest of ignorant, by-the-book pdocs) and I can't say there's any improvement over say, 100mg. I had the euthymic/hypomanic reaction at about 25mg and it faded over about 6 weeks.
>
> Interestingly the first true hypomanic episode was precipitated by the addition of 0.25mg/Klonopin, which seemed to 'kickstart' the Lamictal benefits.
>
> I continue to take up to 1mg of Klonopin (against pdoc's advice) daily with my Lamictal and I can state with certainty that, for myself at least, a special synergy exists btwn the 2 meds. Neither works by themselves but together they do help fairly significantly (chronically suicidal vs acutely so). Curiously, my brother, who has a milder form of my BPII, only seems to benefit from Zyprexa+Klonopin. Neither works alone. Of course both are purported to have mood-stabilizing qualities.
>
> *Have any of you considered augmenting Lamictal before giving up on it (if you're at that stage)? The consensus amongst pdocs I have spoken to is that Lamictal is very amenable to augmentation, VPA notwithstanding. I have just had Celexa and L-Tryptophan (available only on special licence) added to augment Lamictal's supposed S-reuptake inhibition characteristics.
>
> Best,
> J.
Posted by Blue Cheer 1 on January 16, 2002, at 19:52:30
In reply to Lamictal worked great, pooped out, now what?, posted by jaby on January 14, 2002, at 14:13:17
> After dealing with anxiety/depression/fibromyalgia for 5 years now, I was throw absolutely back to my normal healthy self for the first 3 days I used lamictal. I was cured! Since then I had tried to chase that experience uping the dose as directed, but never found it again-only side effects. I have used all of the SSRI's, effexor, remeron, trilpetal, trazadone, welbutrin (maybe a few more). I currently take 2600 mg. neurontin, 2.5 mg valium. Anyone have any ideas? All input is much appreciated!
If you're going to discontinue Lamictal, it's prudent to do so in a stepwise fashion (e.g., in increments of 50 mg. every 2 weeks). Otherwise, you might find that it actually did have mood stabilizing and/or antidepressant effects after all. I discontinued Lamictal once (from 250 mg/day) over a 2 week period -- only to find that I was far more depressed off it. Then, you have to go through the slow escalation once again to regain the efficacy you thought was lost. Same goes for Trileptal d/c from a 900 mg/day dose - in two weeks. The depression (and increased anxiety) was unbearable, but with Trileptal I was able to go right back up to 900 mg/day in a week. So, by going down slowly you can better determine (and at what point) whether or not it had been working.
Posted by Dr. Bob on January 16, 2002, at 19:55:59
In reply to Re: Lamictal worked great, pooped out, now what? » Krazy Kat, posted by JohnX2 on January 16, 2002, at 1:00:30
> I felt the board was an excellent place
> to be around...This is probably understood now, and I'm glad it got worked out, but just for the record, discussion of policies and other administrative issues should be posted to Psycho-Babble Administration, thanks.
Bob
Posted by crinn on January 18, 2002, at 7:18:02
In reply to Update - Staying on Lamictal too, posted by cindylou on January 16, 2002, at 13:20:20
I've been going off Effexor XR (which I've taken for over a year) and have added Lamictal. I've been tapering up VERY SLOWLY (started @ 25 mg, moved up to 50, moved up to 100, etc.) Each time I would feel better for a few days, and then be back in a depression (I am bipolar II). My pdoc says that is very normal. I'm up to 200mg of Lamictal, down to 37.5 of effexor xr(will be off in two weeks--Hurray) and take xanax for anxiety. I also have hypothyroid so am on cytomel and synthroid. I have to say, for me, going off the Effexor XR has elimated many side effects that I had attributed to my depression. Also, the Lamictal has lifted my spirits (albeit, temporarily) like no other drug I've ever tried (and I feel like I've tried them all). Anyway, there was a lot of input to your thread, but I wanted you to hear from someone on a higher dose with some success. Good luck and best wishes--I'll keep a good thought.
> I met with my pdoc today thinking that we would decide to get off of the Lamictal (I started decreasing the dose before I met with her, and do seem to feel a bit better on 75 mg than I did at 100).
>
> Anyway, she really insisted that I look and come across to her much better than I have in previous visits. She said that before I was more "distraught," but I seem much more at ease now. I trust her opinion greatly -- she's seen me for over a year now and has always been open to my suggestions. So I am definitely open to her opinion and suggestions as well.
>
> She also seems to think that a lot of my depression and fatigue as of late may be due more to emotional/cognitive reasons than chemical, which could very well be true.
>
> We decided to stay on the 75 mg of Lamictal (plus the 75 mg of Serzone which seems to take the edge off agitation, even at that low of a dose). We are also going to try to add a low dose of Prozac for 2 weeks on, 2 weeks off each month to see if it will keep me from crashing on it, and also to see if it will help during PMS.
>
> So, that's the scoop. Looks like the three of us (Hattree, Jane and me) aren't giving up the Lamictal ship yet!
>
> Keep me posted and I'll do the same,
> cindy
>
>
> > I haven't given up on Lamictal yet--it may be premature to say that it has pooped out, but in the beginning I was positively cheerful and that has not lasted. Gradually my old dysthymic self has been resurfacing.
> >
> > I decided to stick with 100 for awhile. I realized that holidays and weather had derailed my exercize routine, and that I should get back to that before messing with my meds.
> >
> > Also, Jane's anecdote that the initial burst of good feeling is common and then you need to go much higher discourages me from dropping back down.
> >
> > Keep me posted, guys--hope it works for you.
> >
> >
> >
> > >
> > > Sorry to hear Lamictal isn't working for both of you - you were my Lamictal models! I found a brief, two-day effect at 12.5 mg, then that effect dissipated. However, although I don't feel any dramatic effect at 100 mg, I do find that I am much more easygoing than I used to be. Things that would get me very riled up just don't seem to get to me. I've heard that the brief initial effect is very common, then if fades until you hit 150 to 300 mg and reach a therapeutic dose. I've also heard that this therapeutic dose can take a month to six weeks to kick in. So I'm a long way from giving up on this drug yet - at least six months, since I'm aiming at 250 mg. I'll keep you both posted, and I'll follow both your progress with interest.
> > >
> > > - Jane
Posted by cindylou on January 18, 2002, at 12:25:29
In reply to Re: Update - Staying on Lamictal too, posted by crinn on January 18, 2002, at 7:18:02
Thanks for the information ... a few questions for you --
Now that you are up to 200 mg Lamictal, is the depression held at bay? Or are you still planning on titrating up? What dose to you and your pdoc hope to reach for optimum effects?
Thanks in advance for your response!
-cindy> I've been going off Effexor XR (which I've taken for over a year) and have added Lamictal. I've been tapering up VERY SLOWLY (started @ 25 mg, moved up to 50, moved up to 100, etc.) Each time I would feel better for a few days, and then be back in a depression (I am bipolar II). My pdoc says that is very normal. I'm up to 200mg of Lamictal, down to 37.5 of effexor xr(will be off in two weeks--Hurray) and take xanax for anxiety. I also have hypothyroid so am on cytomel and synthroid. I have to say, for me, going off the Effexor XR has elimated many side effects that I had attributed to my depression. Also, the Lamictal has lifted my spirits (albeit, temporarily) like no other drug I've ever tried (and I feel like I've tried them all). Anyway, there was a lot of input to your thread, but I wanted you to hear from someone on a higher dose with some success. Good luck and best wishes--I'll keep a good thought.
> > I met with my pdoc today thinking that we would decide to get off of the Lamictal (I started decreasing the dose before I met with her, and do seem to feel a bit better on 75 mg than I did at 100).
> >
> > Anyway, she really insisted that I look and come across to her much better than I have in previous visits. She said that before I was more "distraught," but I seem much more at ease now. I trust her opinion greatly -- she's seen me for over a year now and has always been open to my suggestions. So I am definitely open to her opinion and suggestions as well.
> >
> > She also seems to think that a lot of my depression and fatigue as of late may be due more to emotional/cognitive reasons than chemical, which could very well be true.
> >
> > We decided to stay on the 75 mg of Lamictal (plus the 75 mg of Serzone which seems to take the edge off agitation, even at that low of a dose). We are also going to try to add a low dose of Prozac for 2 weeks on, 2 weeks off each month to see if it will keep me from crashing on it, and also to see if it will help during PMS.
> >
> > So, that's the scoop. Looks like the three of us (Hattree, Jane and me) aren't giving up the Lamictal ship yet!
> >
> > Keep me posted and I'll do the same,
> > cindy
> >
> >
> > > I haven't given up on Lamictal yet--it may be premature to say that it has pooped out, but in the beginning I was positively cheerful and that has not lasted. Gradually my old dysthymic self has been resurfacing.
> > >
> > > I decided to stick with 100 for awhile. I realized that holidays and weather had derailed my exercize routine, and that I should get back to that before messing with my meds.
> > >
> > > Also, Jane's anecdote that the initial burst of good feeling is common and then you need to go much higher discourages me from dropping back down.
> > >
> > > Keep me posted, guys--hope it works for you.
> > >
> > >
> > >
> > > >
> > > > Sorry to hear Lamictal isn't working for both of you - you were my Lamictal models! I found a brief, two-day effect at 12.5 mg, then that effect dissipated. However, although I don't feel any dramatic effect at 100 mg, I do find that I am much more easygoing than I used to be. Things that would get me very riled up just don't seem to get to me. I've heard that the brief initial effect is very common, then if fades until you hit 150 to 300 mg and reach a therapeutic dose. I've also heard that this therapeutic dose can take a month to six weeks to kick in. So I'm a long way from giving up on this drug yet - at least six months, since I'm aiming at 250 mg. I'll keep you both posted, and I'll follow both your progress with interest.
> > > >
> > > > - Jane
Posted by crinn on January 19, 2002, at 9:52:37
In reply to Re: Update - Staying on Lamictal too » crinn, posted by cindylou on January 18, 2002, at 12:25:29
I've only been on the 200mg for 2 days--plus, it is going to take me 3 weeks to get completely off the effexor XR (as I side note, I've been having those lovely brain shivers as a withdrawal side effect) My pdoc is chairman of the dept. of a major clinic, and has been very progressive and, in a conservative way, aggressive. So I would expect in 3 or 4 days with the lamictal kicks in, we'll have to see how long the effect lasts. Then, if it tapers off again, I would suspect we'll increase the dose. At one point I was on over 400mg of the Effexor XR, which from reading this board, seems to be on the high end, so I know my pdoc doesn't seem to have issues with increasing. Plus, I have had NO side effects on the lamictal :) so he would probably be more open. I keep in touch with him via e-mail, so I will keep you posted on what happens. We can only take it day by day (sometimes hour by hour). Hang in there--it's worth it!
Warmly, Crinn
> Thanks for the information ... a few questions for you --
>
> Now that you are up to 200 mg Lamictal, is the depression held at bay? Or are you still planning on titrating up? What dose to you and your pdoc hope to reach for optimum effects?
>
> Thanks in advance for your response!
> -cindy
>
> > I've been going off Effexor XR (which I've taken for over a year) and have added Lamictal. I've been tapering up VERY SLOWLY (started @ 25 mg, moved up to 50, moved up to 100, etc.) Each time I would feel better for a few days, and then be back in a depression (I am bipolar II). My pdoc says that is very normal. I'm up to 200mg of Lamictal, down to 37.5 of effexor xr(will be off in two weeks--Hurray) and take xanax for anxiety. I also have hypothyroid so am on cytomel and synthroid. I have to say, for me, going off the Effexor XR has elimated many side effects that I had attributed to my depression. Also, the Lamictal has lifted my spirits (albeit, temporarily) like no other drug I've ever tried (and I feel like I've tried them all). Anyway, there was a lot of input to your thread, but I wanted you to hear from someone on a higher dose with some success. Good luck and best wishes--I'll keep a good thought.
> > > I met with my pdoc today thinking that we would decide to get off of the Lamictal (I started decreasing the dose before I met with her, and do seem to feel a bit better on 75 mg than I did at 100).
> > >
> > > Anyway, she really insisted that I look and come across to her much better than I have in previous visits. She said that before I was more "distraught," but I seem much more at ease now. I trust her opinion greatly -- she's seen me for over a year now and has always been open to my suggestions. So I am definitely open to her opinion and suggestions as well.
> > >
> > > She also seems to think that a lot of my depression and fatigue as of late may be due more to emotional/cognitive reasons than chemical, which could very well be true.
> > >
> > > We decided to stay on the 75 mg of Lamictal (plus the 75 mg of Serzone which seems to take the edge off agitation, even at that low of a dose). We are also going to try to add a low dose of Prozac for 2 weeks on, 2 weeks off each month to see if it will keep me from crashing on it, and also to see if it will help during PMS.
> > >
> > > So, that's the scoop. Looks like the three of us (Hattree, Jane and me) aren't giving up the Lamictal ship yet!
> > >
> > > Keep me posted and I'll do the same,
> > > cindy
> > >
> > >
> > > > I haven't given up on Lamictal yet--it may be premature to say that it has pooped out, but in the beginning I was positively cheerful and that has not lasted. Gradually my old dysthymic self has been resurfacing.
> > > >
> > > > I decided to stick with 100 for awhile. I realized that holidays and weather had derailed my exercize routine, and that I should get back to that before messing with my meds.
> > > >
> > > > Also, Jane's anecdote that the initial burst of good feeling is common and then you need to go much higher discourages me from dropping back down.
> > > >
> > > > Keep me posted, guys--hope it works for you.
> > > >
> > > >
> > > >
> > > > >
> > > > > Sorry to hear Lamictal isn't working for both of you - you were my Lamictal models! I found a brief, two-day effect at 12.5 mg, then that effect dissipated. However, although I don't feel any dramatic effect at 100 mg, I do find that I am much more easygoing than I used to be. Things that would get me very riled up just don't seem to get to me. I've heard that the brief initial effect is very common, then if fades until you hit 150 to 300 mg and reach a therapeutic dose. I've also heard that this therapeutic dose can take a month to six weeks to kick in. So I'm a long way from giving up on this drug yet - at least six months, since I'm aiming at 250 mg. I'll keep you both posted, and I'll follow both your progress with interest.
> > > > >
> > > > > - Jane
Posted by Mondeo on April 17, 2002, at 9:00:25
In reply to Re: Update - Staying on Lamictal too, posted by crinn on January 18, 2002, at 7:18:02
. I'm up to 200mg of Lamictal, Also, the Lamictal has lifted my spirits (albeit, temporarily) like no other drug I've ever tried (and I feel like I've tried them all). Anyway, there was a lot of input to your thread, but I wanted you to hear from someone on a higher dose with some success. Good luck and best wishes--I'll keep a good thought.
> >
> > > I haven't given up on Lamictal yet--it may be premature to say that it has pooped out, but in the beginning I was positively cheerful and that has not lasted. Gradually my old dysthymic self has been resurfacing.
> > >
> > > I decided to stick with 100 for awhile. I realized that holidays and weather had derailed my exercize routine, and that I should get back to that before messing with my meds.
> > >
> > > Also, Jane's anecdote that the initial burst of good feeling is common and then you need to go much higher discourages me from dropping back down.
> > >
> > > > Sorry to hear Lamictal isn't working for both of you - you were my Lamictal models! I found a brief, two-day effect at 12.5 mg, then that effect dissipated. However, although I don't feel any dramatic effect at 100 mg, I do find that I am much more easygoing than I used to be. Things that would get me very riled up just don't seem to get to me. I've heard that the brief initial effect is very common, then if fades until you hit 150 to 300 mg and reach a therapeutic dose. I've also heard that this therapeutic dose can take a month to six weeks to kick in. So I'm a long way from giving up on this drug yet - at least six months, since I'm aiming at 250 mg. I'll keep you both posted, and I'll follow both your progress with interest.
> > > >
> > > > - JaneHei,Jane
as your informative message was written in Jan.,I wonder whether you have already reached that Lamictal therapeutic dose(mentioned by you as being around 300mg)?Practically,as far as I know,there is still no exact data about its optimal dose
I am asking,since I myself,as a BP2,am already a couple of months on it,as a monotherapy(switched FROM Celexa to it)and since a couple of weeks already on an elevated dose of 450mg ! and the results are promising :no hypomany and v.mild depr.breakthroughs(fluctuations or better said,still no firm stability)
In case things won't improve even more(though it seems to),I shall certainly NOT increase anymore this already high dose,but on the contrary,I may reduce it and restart taking Celexa(at least the lower dose of 10mg)and consider then Lamictal just as an augmentation and barrier for hypomany
Paul
Posted by Mondeo on April 17, 2002, at 9:14:40
In reply to Re: Lamictal augmentation?, posted by JahL on January 16, 2002, at 16:02:28
. This pattern seems very common. I've been on 400mg for about 6 months (at the behest of ignorant, by-the-book pdocs) and I can't say there's any improvement over say, 100mg. I had the euthymic/hypomanic reaction at about 25mg and it faded over about 6 weeks.
>
> >
> *Have any of you considered augmenting Lamictal before giving up on it (if you're at that stage)? The consensus amongst pdocs I have spoken to is that Lamictal is very amenable to augmentation, VPA notwithstanding. I have just had Celexa and L-Tryptophan (available only on special licence) added to augment Lamictal's supposed S-reuptake inhibition characteristics.
>
> Best,
> J.
YES,AS BEING ON A DOSE OF 450mg for a while,without really obtaining a full stability
(some milder depr.breakthroughs,even between a couple of hours during a day),I am dwelling on either to insist on this dose further on,OR reducing a little,at least to 300mg and augmenting with Celexa(at least 10mg)
Posted by Ponder on April 19, 2002, at 10:18:16
In reply to Re: Update - Staying on Lamictal too, posted by Mondeo on April 17, 2002, at 9:00:25
19 April 2002
Third generation anticonvulsants 'fill unmet need' in bipolar disorder
The third generation anticonvulsant lamotrigine could fill an unmet need in the treatment of bipolar depression and rapid-cycling bipolar disorder, say researchers.Lakshmi Yatham (University of British Columbia, Vancouver, Canada) and colleagues comment that as many patients are unresponsive to lithium and most bipolar patients cannot be managed with monotherapy, the third generation anticonvulsants could prove effective options.
The team, therefore, carried out a review of studies and case reports on the efficacy of third generation anticonvulsants.
Overall, lamotrigine seemed the most useful anticonvulsant for bipolar depression and disorder, as a monotherapy or in combination with other mood stabilizers. It was also effective in prophylaxis of patients with bipolar I disorder. However, the drug did not appear to be specifically effective in treating acute mania.
Being less likely to induce a manic switch than antidepressants, the researchers recommend its use as a first-line agent for treating bipolar depression in patients with a history of severe and refractory manic episodes.
Gabapentine failed to show efficacy in treating patients with acute mania or in refractory bipolar disorder, and so is unlikely to be considered as a monotherapy for acute mania, bipolar depression, or bipolar disorder. Nevertheless, the researchers highlight its effectiveness in social phobia and possibly panic disorder.
Another potential adjunctive treatment for refractory mania and in ultrarapid or ultradian cycling disorder was topiramate, which in also potentially causing weight loss may make it an attractive add-on treatment.
The study is published in the Journal of Clinical Psychiatry.
J Clin Psychiatry 2002; 63: 275–283
Posted by E on September 17, 2002, at 19:44:08
In reply to Re: Lamictal worked great, pooped out, now what? » jaby, posted by JohnX2 on January 14, 2002, at 16:29:59
My daughter was taking lamictal for depression.
Now has twitching of muscles. Is this a side
effect? She has quit taking lamictal, but still
has twitches after one week.
Posted by shurtlaj on May 30, 2003, at 17:56:33
In reply to Re: Lamictal worked great, pooped out, now what? » Krazy Kat, posted by JohnX2 on January 16, 2002, at 1:00:30
Posted by maryhelen on June 1, 2003, at 14:00:58
In reply to Coming off Effexor, starting Lamictal (nm), posted by shurtlaj on May 30, 2003, at 17:56:33
shurlaj:
I don't know about you but I feel pretty discouraged by the earlier posts.
I have been on Lamitcal for a month now, up to 100 mg. I am augmenting it with 90 mg of Parnate.
I have never felt better in my life. Now I am so scared it is going to poop out. I have just returned to work and I cannot bear to go into that depression again.
I wish we could here more positive results with Lamitcal.
maryhelen
Posted by LindaAnn on June 4, 2003, at 5:35:31
In reply to Lamictal First Line for Bipolar, posted by Ponder on April 19, 2002, at 10:18:16
I am having such difficulty finding the newest threads to psychobabble. I posted and got some returned threads (which I found) but now I am having difficulties just looking at newer threads.
Can someone HELP!!!!!!!!!!!!!
Posted by Dr. Bob on June 4, 2003, at 18:34:40
In reply to Re: Difficulties getting into threads, posted by LindaAnn on June 4, 2003, at 5:35:31
> I am having such difficulty finding the newest threads to psychobabble.
I think this might be the same problem other people have reported. I'm still trying to figure out what the problem is. Maybe you can help? Please see:
http://www.dr-bob.org/babble/admin/20030508/msgs/229189.html
Bob
This is the end of the thread.
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