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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by farside on June 1, 2010, at 16:09:59
After starting lamictal 100 mgs, I experienced manic states for the first time in 20 years--one in January, one in March, one in June, and one in August. My doc put me on lithium to control the mania in June (600, then 900 mg). I crashed into major depression in September, so he doubled my lamictal to 200 mg. By this time, I was realizing that the medications were messing up my ability to study. I went from being an A student to failing a midterm (after studying hard.) I withdrew from the lithium quickly (about 2 weeks), but was more worried about coming off the lamictal, so I withdrew from it by 25mg per week for 8 weeks. I have now been off the lamictal for over 4 months, and I am still having some withdrawal effects--insomnia alternating with hypersomnia, tingling in my brain, and sore muscles. Can anyone tell me how long it will take to get back to normal? Is it possible I have some kind of permanent neurological damage?
Posted by morganator on June 1, 2010, at 16:33:56
In reply to Lamictal withdrawal, posted by farside on June 1, 2010, at 16:09:59
Permanent damage? Anything is possible.
It may take a very long time for your brain to heal and reach some state of homeostasis. Do you exercise? Exercise is one of the best things you can do to improve the health of your brain.
Are you taking any medications now?
Do you take fish oil? Specifically something high in DHA.
Posted by Phillipa on June 1, 2010, at 16:54:06
In reply to Re: Lamictal withdrawal, posted by morganator on June 1, 2010, at 16:33:56
So sorry to hear of the withdrawal from lamictal. Did you doc say the mania was caused by lamictal hence the lithium? Give it some time to heal. Phillipa
Posted by farside on June 2, 2010, at 9:07:24
In reply to Re: Lamictal withdrawal, posted by morganator on June 1, 2010, at 16:33:56
Thanks! I do exercise quite regularly, and I just started taking a cod liver oil supplement with 375 mg DHA. I'm not sure how much or how often to take it, though. I am not taking any medications now, but I was taking lorazepam before switching to hypnotics (lunesta and sonata) for insomnia. I just stopped taking those, because I read a post on "Beyond Meds" suggesting that meds that work on GABA receptors, like benzos (and I'm guessing, hypnotics) can screw up lamictal withdrawal. The pdoc at the depression clinic I go to is trying to persuade me to take a low dosage of seroquel for sleep, but that spooks me after my experiences with lamictal and lithium.
Posted by farside on June 2, 2010, at 10:22:43
In reply to Re: Lamictal withdrawal, posted by Phillipa on June 1, 2010, at 16:54:06
Thanks for your sympathy! My first pdoc--I have switched--said it was very unlikely that the lamictal was causing the mania. Every time I had another manic/hypomanic episode, I said, "This is really unusual for me. Could this be caused by the lamictal?" He just said no and increased the lithium. The second pdoc I consulted was willing to acknowledge that the lamictal might have caused the mania. I showed her a timeline with every possible manic event in my life compared to definite manic events during the time I was on lamictal. The sudden increase in frequency was quite striking. My decision to go off both meds was based on two considerations: the fact that my mood cycling became worse, my depression more severe after starting meds, and the fact that my cognitive impairment was so severe.
Posted by morganator on June 2, 2010, at 10:48:33
In reply to Re: Lamictal withdrawal, posted by farside on June 2, 2010, at 9:07:24
Yeah I say stay away from seroquel. Doctors love to push that sh*t.
What about taking a low dose of lithium, say 300 mg? That way you may benefit from it some without it being so toxic. Lithium can provide neuroprotection and enhance neurogenesis. It's actually a pretty amazing naturally occurring element at low doses.
Have you tried any natural sleep aids like Magnesium Glycinate, Taurine, Melatonin, GABA, and Glycine?
I think 1 gram of combined DHA and EPA from fish oil is a good start. If you want after a month or so you can try upping the dose a bit and see how you feel.
Posted by Dan_MI on June 2, 2010, at 12:34:00
In reply to Lamictal withdrawal, posted by farside on June 1, 2010, at 16:09:59
I got hypomania when I started lamictal. I also have a permanent movement disorder from taking Seroquel for less than a year. Tell your doctor to try Seroquel and come down from his or her ivory tower.
Lithium and lamictal are now my main meds and I'm getting an A in an accelerated Calculus class. I did have to overcome test anxiety.
As for not taking any meds: remember mental illness is a degenerative disease. Lithium especially is proven to slow the degeneration. And a lot can be achieved with low doses like morgneator suggested.
> After starting lamictal 100 mgs, I experienced manic states for the first time in 20 years--one in January, one in March, one in June, and one in August. My doc put me on lithium to control the mania in June (600, then 900 mg). I crashed into major depression in September, so he doubled my lamictal to 200 mg. By this time, I was realizing that the medications were messing up my ability to study. I went from being an A student to failing a midterm (after studying hard.) I withdrew from the lithium quickly (about 2 weeks), but was more worried about coming off the lamictal, so I withdrew from it by 25mg per week for 8 weeks. I have now been off the lamictal for over 4 months, and I am still having some withdrawal effects--insomnia alternating with hypersomnia, tingling in my brain, and sore muscles. Can anyone tell me how long it will take to get back to normal? Is it possible I have some kind of permanent neurological damage?
Posted by farside on June 3, 2010, at 10:37:14
In reply to Re: Lamictal withdrawal, posted by morganator on June 2, 2010, at 10:48:33
This is very helpful! Yes, I have been thinking about going back on Lithium, and my new pdoc is open to trying to find the lowest effective dosage for me. Lithium had some really positive effects for me--lower anxiety and much, much better sleep. Maybe I can figure out a way to test myself systematically for cognitive impairment as I raise the dosage. For now, I just tried my first accupuncture treatment for sleep. If that doesn't work, I'll try the natural sleep aids. Thanks!
Posted by farside on June 3, 2010, at 13:30:57
In reply to Re: Lamictal withdrawal, posted by Dan_MI on June 2, 2010, at 12:34:00
Great advice! I'm sorry to hear that Seroquel had long-term consequences for you. Thanks for the heads up. I read a long time ago that bipolar disorder is degenerative, but I don't completely understand the implications of that. I'll have to learn more about it, since both you and morganator have mentioned it. Good to hear that you are able to keep such a high level of cognitive function on lamictal and lithium. I dropped calculus this semester, because I felt too impaired to complete the course. Maybe there's hope I can function at a lower dosage.
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