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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by zenhussy on December 2, 2003, at 23:34:51
Okay folks,
How does one get to target dosage for supplemental depression usage of Lamictal?
It is incredibly slow in tritration and just what is the target dosage for adjunct med. therapy with mood stabilizers for treatment resistant depression?
I guess the cocktail is necessary for serious responses to this inquiry:
300 mg Wellbutrin XL
60 mg buspirone (Buspar)
1 mg clonazepam (Klonopin)
and now 25 mg Lamictal (lamotrigine) after two weeks at 12.5 mg/day
.5 mg alprazolam(Xanax) as needed for anxiety and panic (approx. 2-4x/wk)There are a couple of other regular things that go along with that cocktail but I don't think they are relevant to this at this time.
Thanks if anyone has any advice.
I've read the archives on lamotrigine but wonder if anyone currently reading has personal experience to offer using this for adjunct unipolar depression therapy. It isn’t likely that I will be dropping the wellbutrin anytime soon from this jolly little med mix I have going.
zenhussy
Brief rundown of symptoms: PTSD with heavy dissociation when confronting the issues surrounding the traumas, depressive episodes with lack of sense of future, very sudden sucidal thoughts beginning in October of this year with the setting of a death date in my mind for early next year, robotic feeling of going through the motions of life while not really experiencing it.
Posted by fallsfall on December 3, 2003, at 8:48:38
In reply to Lamictal (lamotrigine) and how do you get there?, posted by zenhussy on December 2, 2003, at 23:34:51
Zen, be on the lookout for a rash from the Lamictal. A friend in my support group developed something called [some reasonably common last name]-Jackson Syndrome. I can get the name if you want it. Causes a rash and sores that don't go away (and she thinks that it is not a temporary problem). Lamictal is a good med for lots of people. Just be on the lookout for rashes so if you do get them you can stop the med quickly.
Posted by mags on December 3, 2003, at 10:48:58
In reply to Lamictal (lamotrigine) and how do you get there?, posted by zenhussy on December 2, 2003, at 23:34:51
Target dose is different for everone. I personally felt great at 50 Mg! Others need much more...As fallfalls said the slow titration is because of the rash which can be very serious! so you have to watch out for it! otherwise you could bump it way faster..if it works for you this med is great..but only time and unfortunately patience will tell....good luck
Posted by Penny on December 4, 2003, at 8:55:00
In reply to Lamictal (lamotrigine) and how do you get there?, posted by zenhussy on December 2, 2003, at 23:34:51
ZH,
There is a blood test your pdoc can do to check the serum levels of lamotrigine. My doc checked my levels frequently when I was taking it, and there's a target range that has been shown to be effective. It differs for everyone - I got as high as 225/225 on lamotrigine and was still only mid-range, whereas someone else might take a much lower dose and be at the top of the range. Just depends on how quickly your body metabolizes it. You might ask your doc about a serum level test.
P
Posted by zenhussy on December 5, 2003, at 2:22:49
In reply to Re: Lamictal (lamotrigine) and how do you get there? » zenhussy, posted by fallsfall on December 3, 2003, at 8:48:38
Thanks Fallsfall,
I've read up on this med and seen all the horror pics of SJS from lamotrigine. It isn't common but certainly not a se I'd want to endure.
I'm mainly wondering the eternal when...when will this one work? Ya know?
zh
Posted by zenhussy on December 5, 2003, at 2:30:43
In reply to Re: Lamictal (lamotrigine) and how do you get there?, posted by mags on December 3, 2003, at 10:48:58
> Target dose is different for everone. I personally felt great at 50 Mg! Others need much more...As fallfalls said the slow titration is because of the rash which can be very serious! so you have to watch out for it! otherwise you could bump it way faster..if it works for you this med is great..but only time and unfortunately patience will tell....good luck
mags,
How long did you take to get up to the 50 mg? And if you don't mind my asking what other medications are you taking it with?
I'm just feeling so funky and since this is the only med being tweaked in my cocktail currently I feel like every brain fart and space out are somehow connected to this med. Nutty I know. No rash or other obvious se's.
By the time I see my pdoc next week I will have been at the 25 mg for eleven days (working up from fourteen days at 12.5 mg). I'm not sure just what this doc's idea of target dose is anyway.
Guess that's where the 'we're all individual' part comes in, eh?
Thank you for the support. Time and patience are oh so hard to achieve when one doesn't have control over one's own thoughts. Sigh.
I'm hoping I'll be like you and feel fantastic when I get to 50 mg. Here's hoping!
zenhussy
Posted by zenhussy on December 5, 2003, at 2:36:16
In reply to Re: Lamictal (lamotrigine) and how do you get there? » zenhussy, posted by Penny on December 4, 2003, at 8:55:00
> ZH,
> There is a blood test your pdoc can do to check the serum levels of lamotrigine. My doc checked my levels frequently when I was taking it, and there's a target range that has been shown to be effective. It differs for everyone - I got as high as 225/225 on lamotrigine and was still only mid-range, whereas someone else might take a much lower dose and be at the top of the range. Just depends on how quickly your body metabolizes it. You might ask your doc about a serum level test.
> PPenny,
Thank you ever so much for this information. After living as a human pin cushion earlier this year having to do much blood work I'm not keen on the idea of blood draws again. However my peace of mind literally and figuratively are worth giving up a bit more blood.
Do you know if the serum level check is more common when lamotrigine is used for bp instead of as an adjunct to major depression?
>when I was taking it....
Did you stop taking lamotrigine? Stopped working? Or have you found the magic potion? ; )
Thanks for your feedback and helpful information.
zenhussy
Posted by Penny on December 5, 2003, at 8:07:04
In reply to Re: Lamictal (lamotrigine) serum levels » Penny, posted by zenhussy on December 5, 2003, at 2:36:16
> Do you know if the serum level check is more common when lamotrigine is used for bp instead of as an adjunct to major depression?
I can't say - I'm diagnosed "Mood Disorders NOS", so not bp and not just depression, but the lamotrigine was used more as an augmentor for my antidepressant than as a mood stabilizer. My pdoc is a neuropsychiatrist and just happens to be pretty thorough.
>
> >when I was taking it....
>
> Did you stop taking lamotrigine? Stopped working? Or have you found the magic potion? ; )I stopped taking it for a while, then started again, but right now I'm only taking 25 mgs in the morning. And, believe it or not, I can tell a difference between taking that small dose and not taking any. I have yet to find any magic potion :( unfortunately, and thought the lamictal had stopped working, along with other things, but now I'm not so sure that was my problem...
>
> Thanks for your feedback and helpful information.
>
> zenhussy
>No problem. Good luck with this.
P
Posted by Flipsactown on December 5, 2003, at 11:40:34
In reply to Lamictal (lamotrigine) and how do you get there?, posted by zenhussy on December 2, 2003, at 23:34:51
I am currently on 300mgs of lamictal, along with 100mgs prozac and 90mgs of remeron, and I am depression free. I was diagnosed with clinical depression (unipolar, no mania) over 12 years ago after I suffered chronic low back pain from a traffic accident. I have been on ADs even since and have tried elavil, effexor, celexa, paxil, wellbutrin, etc. These were either ineffective or I was unable to tolerate the S/E's.
Because of the Steven-Johnson syndrome, in which one can suffer from a rare but sometimes fatal rash, pdoc's prescribe lamictal on low dosages and titrate slowly. I started on 25mgs and with much patience, in my 6th week I was up to 200mgs and experienced dramatic lifting of depression. The only other time I experienced dramatic results was when I first took prozac over 12 years ago. As you probably have read in this forum or others online, prozac along with other A/D's lose their effectiveness or "poops out" after long term use.
Research has shown that lamictal is an effective med in treating both bipolar and unipolar depression when taken with other A/Ds. Also, in the higher dosages 300 to 500mgs, lamictal is effective on its own as an A/D. I have had no noticeable S/E from lamictal other then a slight headache in the first week.
Bottomline, in my experience, with some patience, lamictal has been effective in treating unipolar depression when taken with other A/Ds. Eventually, my goal is to be on only lamictal. Time will tell. Hope this info has been helpful to you.
Flipsactown
Okay folks,
>
> How does one get to target dosage for supplemental depression usage of Lamictal?
>
> It is incredibly slow in tritration and just what is the target dosage for adjunct med. therapy with mood stabilizers for treatment resistant depression?
>
> I guess the cocktail is necessary for serious responses to this inquiry:
>
> 300 mg Wellbutrin XL
> 60 mg buspirone (Buspar)
> 1 mg clonazepam (Klonopin)
> and now 25 mg Lamictal (lamotrigine) after two weeks at 12.5 mg/day
> .5 mg alprazolam(Xanax) as needed for anxiety and panic (approx. 2-4x/wk)
>
> There are a couple of other regular things that go along with that cocktail but I don't think they are relevant to this at this time.
>
> Thanks if anyone has any advice.
>
> I've read the archives on lamotrigine but wonder if anyone currently reading has personal experience to offer using this for adjunct unipolar depression therapy. It isn’t likely that I will be dropping the wellbutrin anytime soon from this jolly little med mix I have going.
>
> zenhussy
>
> Brief rundown of symptoms: PTSD with heavy dissociation when confronting the issues surrounding the traumas, depressive episodes with lack of sense of future, very sudden sucidal thoughts beginning in October of this year with the setting of a death date in my mind for early next year, robotic feeling of going through the motions of life while not really experiencing it.
>
Posted by zenhussy on December 5, 2003, at 14:42:34
In reply to Re: Lamictal (lamotrigine) and how do you get there?, posted by Flipsactown on December 5, 2003, at 11:40:34
Thank you Flipsactown. Your information has been most helpful. I am appreciative to hear first hand experience when it comes to adding something new in my med mix. I'm crossing my fingers that I could be on the lower end of the dose for feeling therapeutic benefits. But if it takes me a while to get to a level that works I'm willing as long as the se's stay at bay.
At least I'm using words like hope, eh?
Thanks again.
zenhussy
Posted by zenhussy on December 5, 2003, at 14:43:22
In reply to Re: Lamictal (lamotrigine) serum levels » zenhussy, posted by Penny on December 5, 2003, at 8:07:04
This is the end of the thread.
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