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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 22 to 46 of 46. Go back in thread:
Posted by BetweenDreams81 on January 18, 2011, at 18:02:50
In reply to Re: Generic Lamictal (lamotrigine) experiences?, posted by bleauberry on January 18, 2011, at 17:43:51
Thank you bleauberry for sharing your experience...I feel the same way about staying with the brand Lamictal after reading so many stories...at least to know whether it is the right thing or not...and hopefully I really do qualify for the GSK Bridges to Access program which would provide me with their brand name meds.
Now about Xanax (should mention, it is generic)
How long does one normally feel its effects? I am currently taking 0.25 mg 2x/day. I definitely notice it when it kicks in...I get uber drowsy for about 30 min, and then I'm fine...for 3-4 hours in a stressful situation or if I am particularly low or negative...longer, about 6-8 hours if I'm not stressed out to begin with. When I feel it "stop" working I automatically have a feeling like there is a hampster wheel of negative thoughts/feelings and anxiety running through my head. Sometimes, I can feel my heart rate increase...again, 30 min after I take the xanax, it's gone again.
Now I can see why this can become habit forming. I have never had an "addictive" personality so I don't 'think' I'm feeling addicted to it?? Is this an indication that I am still adjusting to it? Does this sound like it needs to be increased or XR formula? Or??? Just noticing and wondering...I want to be careful and responsible with this drug. I have e-mailed pdoc about it.
Posted by Phillipa on January 18, 2011, at 18:46:49
In reply to Now about Xanax (alprazolam) » bleauberry, posted by BetweenDreams81 on January 18, 2011, at 18:02:50
Been on it for many years and haven't increased dose. Some need regular xanax if they take the long acting. Personally it didn't work for me. Some say it doesn't release consistently. Greenstone is the only xanax I'd take. Made by manufacturer of real name brand xanax. Phillipa
Posted by BetweenDreams81 on January 18, 2011, at 19:25:03
In reply to Re: Now about Xanax (alprazolam) » BetweenDreams81, posted by Phillipa on January 18, 2011, at 18:46:49
Thanks Phillipa, What dosage do you take? (if it isn't too personal)
Posted by Phillipa on January 18, 2011, at 20:05:23
In reply to Re: Now about Xanax (alprazolam) » Phillipa, posted by BetweenDreams81 on January 18, 2011, at 19:25:03
Before any other meds and just a benzo .25 mg three times a day. Or 4 hard to remember. And now just under lmg bedtime only. Phillipa ps benzos for 40 years yes it's true
Posted by ed_uk2010 on January 19, 2011, at 16:12:24
In reply to Re: Generic Lamictal (lamotrigine) experiences?, posted by bleauberry on January 18, 2011, at 17:43:51
>You know the old saying, "you get what you pay for." I personally believe with maybe 70% of meds on the market, that is true. $4 fluoxetine is NOT the same as $100 prozac. Even the claim that the active ingredient is identical is misleading.
That's interesting, because Eli Lilly's wholesale price for branded Prozac in the UK is currently £1.28 (exc. VAT) for a pack of 30 capsules - so that's about $2. The cost of manufacturing will be a few pennies/cents per pack. Your $100 pack has several thousand percent profit margin for the manufacturer. The cost of manufacturing Prozac is very similar to the cost of manufacturing the generics. Since your knowledge of the pharmaceutical industry does not appear to be great, it might be best to avoid making such dramatic statements.
Posted by morgan miller on January 19, 2011, at 22:13:21
In reply to Re: Generic Lamictal (lamotrigine) experiences? » bleauberry, posted by ed_uk2010 on January 19, 2011, at 16:12:24
I think what BB means is that if brand truly is more effective than generic, you do have to pay quite a bit more for the brand, at least here in the U.S.
I'm sure you already know this Ed, but the cost of brand medications in the U.S. is ridiculously high.
I understand what you mean about the wholesale price and the manufacturing price.
Posted by morgan miller on January 19, 2011, at 23:31:14
In reply to Now about Xanax (alprazolam) » bleauberry, posted by BetweenDreams81 on January 18, 2011, at 18:02:50
I personally do not believe anyone that might fall within the bipolar spectrum should be taking such a strong and short lived benzo like Xanax. Because of the short life of Xanax, it can be destabilizing in the short or long run IMO. This drug is a very quick fix and does not lead to anything good in the long run. At least with mood stabilizers, there is much evidence of neuroprotective and neurogenic properties. I'm not a big fan of Lamictal and how it can potentially negatively impact the brain, but there is some evidence that it can also do some good things for the brain, two of these being increasing brain antioxidant levels and protection against glutamate toxicity.
I hope you can get off Xanax soon and find something that makes you more stable and helps you feel much better.
Posted by ed_uk2010 on January 20, 2011, at 16:20:51
In reply to Re: Generic Lamictal (lamotrigine) experiences? » ed_uk2010, posted by morgan miller on January 19, 2011, at 22:13:21
>I think what BB means is that if brand truly is more effective than generic....
As is often the case (in my opinion), BB made quite a number of unreasonable claims.
With respect to lamotrigine, the UK Department of Health has stated that it is not routinely necessary to prescribe by brand name (for epilepsy).
Posted by morgan miller on January 20, 2011, at 21:24:27
In reply to Re: Generic Lamictal (lamotrigine) experiences? » morgan miller, posted by ed_uk2010 on January 20, 2011, at 16:20:51
>As is often the case (in my opinion), BB made quite a number of unreasonable claims.
I understand. Though, I do believe it is very possible that people can have better responses to brands than generics.
Posted by ed_uk2010 on January 23, 2011, at 13:25:02
In reply to Re: Generic Lamictal (lamotrigine) experiences?, posted by morgan miller on January 20, 2011, at 21:24:27
>I do believe it is very possible that people can have better responses to brands than generics.
If that's the case, some people will respond better to generics than brands. Or perhaps generics which have brand names applied, as some do.
Anyway, BB's claims went far beyond that.
Posted by morgan miller on January 23, 2011, at 20:09:20
In reply to Re: Generic Lamictal (lamotrigine) experiences? » morgan miller, posted by ed_uk2010 on January 23, 2011, at 13:25:02
> >I do believe it is very possible that people can have better responses to brands than generics.
>
> If that's the case, some people will respond better to generics than brands. Or perhaps generics which have brand names applied, as some do.I think I told you about my experience with Zoloft. I switched to generic for a month and my stomach was upset along with not quite feeling as good. Now, maybe I didn't feel as good because my stomach was upset half the time. Every doctor I've spoken to admits there may be a difference in how people respond to some brand and generic psychiatric medications. I forget the explanation my last pdoc gave me. I think he also spoke of a few of his patients responding better to generics. Anyway, we've talked about this before. I understand your and others stance on the brand vs. generic issue.
Posted by gritslad on January 23, 2011, at 20:24:03
In reply to Generic Lamictal (lamotrigine) experiences?, posted by BetweenDreams81 on January 17, 2011, at 15:57:34
Take the generic. I've never used anything but and it works well for me.
Posted by ed_uk2010 on January 24, 2011, at 16:07:36
In reply to Re: Generic Lamictal (lamotrigine) experiences?, posted by morgan miller on January 23, 2011, at 20:09:20
>Every doctor I've spoken to admits there may be a difference in how people respond to some brand and generic psychiatric medications.
I think a major problem here is that most doctors don't actually know much about pharmacy and the generics industry. It is not their area of expertise.
Posted by morgan miller on January 24, 2011, at 20:21:18
In reply to Re: Generic Lamictal (lamotrigine) experiences? » morgan miller, posted by ed_uk2010 on January 24, 2011, at 16:07:36
> >Every doctor I've spoken to admits there may be a difference in how people respond to some brand and generic psychiatric medications.
>
> I think a major problem here is that most doctors don't actually know much about pharmacy and the generics industry. It is not their area of expertise.This is true. I would hope that at least a good psychiatrist would.
Posted by BetweenDreams81 on January 25, 2011, at 0:38:40
In reply to Re: Now about Xanax (alprazolam), posted by morgan miller on January 19, 2011, at 23:31:14
Holy moly! Yes, I see exactly what you mean now about the short life of the xanax, and have brought it up with doc. Especially not a great combo when another person in your life is mad manic and toxically critical/irritable at the same time.
On the other hand, do you think it is healthy to try dealing with some anxiety without popping a pill to just get rid of it?...this was an extreme situation and I think merited using something to settle my ping-pong exploding brain, but I don't want to just flat line either. I don't feel necessarily that I am flat, but it definitely is not the answer to getting to the bottom of the anxiety. Or, is it partially also a matter of the Lamictal not kicking in yet? (not expecting it to just yet, still at 25 mg)
Does Klonopin have the same effect as xanax, just longer acting? Or does it make a person flat with a sluggish mind?
Posted by Hombre on January 25, 2011, at 7:03:45
In reply to Re: Now about Xanax and ? about Klonopin » morgan miller, posted by BetweenDreams81 on January 25, 2011, at 0:38:40
Since I feel like we have some symptoms in common, namely anxiety, insomnia, and late-night racing thoughts (correct if I'm wrong about this), you might want to look into Seroquel at a pretty low dose, like 25mg to start, as a possible plan B or C. It's predictable with inducing sleep onset and it acts all day to calm anxiety.
The thing with benzos especially is that you don't know you need one until you are already pretty uncomfortable. I found myself carrying a few .5mg lorazepam pills on me "just in case". That's no way to live. With one dose of Seroquel at night, as long as I don't overdo the caffeine I am mellow. It also has a definite antidepressant effect, which is probably enhanced by my taking antidepressants.
Don't be frightened by the "antipsychotic" label or anything else you might here. Just keep it as an option, that's all.
Posted by BetweenDreams81 on January 25, 2011, at 7:44:54
In reply to Re: Now about Xanax and ? about Klonopin, posted by Hombre on January 25, 2011, at 7:03:45
Thank you Hombre, I really appreciate you input...yes, I do feel I have very similar symptoms that you have described...here and on the other forum. I will mention the Seroquel to pdoc and see what he thinks.
What you describe about keeping the lorazepam on hand wherever you are...that is exactly what I have been doing lately, and while it is fairly quick acting...it would be nice to not have several reminders everyday that I am only calm and not spinning my top off just because I am taking a med...and once a day would be quite convenient.
I am not generally turned off by the "titles" things are given...if they work, they work. Hell, Lamictal is an anti-convulsant lol.
Posted by morgan miller on January 25, 2011, at 14:01:38
In reply to Re: Now about Xanax and ? about Klonopin » morgan miller, posted by BetweenDreams81 on January 25, 2011, at 0:38:40
>Especially not a great combo when another person in your life is mad manic and toxically critical/irritable at the same time.
Are you speaking of your mother? This is likely one of the two main reasons why you developed any mental health issues that have interfered with your ability to live a full productive life. Our environment plays just as big a role if not bigger for most of us as our genetics in what we struggle with mentally in adulthood. Which is why I put so much emphasis on therapy.
I do think klonopin is the best option for benzos in most cases. It should at least be the first one that doctors try on their patients. I don't think klonopin was any more flattening than Xanax, at least not for me. Klonopin has an 8 to 12 hour half life and is much smoother in it's effects IMO. I would try a very low dose of klonopin, just enough to make your anxiety manageable, not enough to wipe it out. Wiping out anxiety should not really be the goal with most medications anyway. It's making things very manageable so that we function well and do all the other good things in life that make us feel good and relieve our anxieties. I think if a medication wipes out all anxiety, we are too medicated at that point, in a way that we lose the "good" anxiety that gives us a sense of urgency to do the things we need to do to both survive and thrive.
Posted by morgan miller on January 25, 2011, at 14:03:05
In reply to Re: Now about Xanax and ? about Klonopin » morgan miller, posted by BetweenDreams81 on January 25, 2011, at 0:38:40
Hopefully you can ween off benzos over the next few months as you begin to stabilize on Lamictal and feel better through exercise and other lifestyle changes.
Posted by BetweenDreams81 on January 25, 2011, at 14:51:12
In reply to Re: Now about Xanax and ? about Klonopin, posted by morgan miller on January 25, 2011, at 14:01:38
Oh gawwd, how did you guess! lol I am fortunate to have a very supportive sister whom allowed me vent about the immediate situation.
Oh yes, and anxiety while on the extreme (as this was) is really tough to deal with (and often counter productive) it can definitely be a motivator to get as far away from a particular situation as possible...I just don't want to make stupid, rash decisions where I end up worse off than started. But hey, this time I ended up focusing my negative energy into positive by working like a fien on my website/facebook business page (til 3 AM grr). And, I'll be in FL for business by the end of the week (for 2 months) anyway; where I am optimistic that I will be able to build my business back up again and not have to return to the state I have been in for the past year+.
Meditation and Esther/Jerry Hicks works ("new age" type spirituality/thought) have been a big help, and my current method of self therapy. Once back on my feet, I am all for therapy...I do have family issues...I think most people do, just many are not as sensitive to the anxieties/issues that arise from it, perhaps not as aware that there is something to actually 'deal' with.
Posted by morgan miller on January 25, 2011, at 17:41:32
In reply to Re: Now about Xanax and ? about Klonopin » morgan miller, posted by BetweenDreams81 on January 25, 2011, at 14:51:12
>I think most people do, just many are not as sensitive to the anxieties/issues that arise from it, perhaps not as aware that there is something to actually 'deal' with.
I totally agree. Most everyone out there could benefit from therapy.
I'm also not sure how much people are aware of the impact nurture or lack of nurture during development has on the development of mental illness in childhood, adolescence, and adulthood.
If you can get on a 4 to 5 day a week exercise program I think it would help you tremendously. There is evidence that permanent changes take place in the brain over time with regular exercise that improve the brain's response to anxiety and stress. I prefer 20 minutes of moderate to intense cardiovascular exercise, moderate to heavy resistance weight training, and a long thorough meditative stretch, but that's just me.
Posted by BetweenDreams81 on January 28, 2011, at 23:14:38
In reply to Re: Now about Xanax and ? about Klonopin, posted by morgan miller on January 25, 2011, at 17:41:32
So, today was the first day of 50mg of Lamictal. I took the whole 50mg ODT and then thought to myself...'did doc say to take 1/2 am and 1/2 pm for the first week of 50mg?' I didn't think too much about it because, I couldn't do anything about it if that's what I was 'supposed' to do or not...it was already in my system. Well, about 2-3 hours later I felt really feverish and got the chills, aching all over like I had the flu...and actually did have a fever around 101.4. I think the fever is mostly gone now, but the chills and hot flashes are annoying.
There are a few other things that may have played a part of this though...gotta love playing 'sleuth! lol...
1.) I was maybe stupid yesterday. I NEEDED to have more get up and go, a good bit more motivation cause I'm packing and getting ready for a 2 month relocation, and the drive there is 18hrs. So, I re-looked up several times to make sure there were no interactions with adderall and the other things I'm rx'd. I took a small 2.5mg adderall, but it was at the same time I took the alprazolam. Holy moly, when I was taking a shower 20-30 min later, I got chills, felt dizzy, nauseous and if water hadn't been running over me, I would have been washed-out anyway. I 'think' it was because of this combo...the adderall possibly making the xanax work overtime throwing my body off. but maybe it was already the early signs of a reaction to Lamictal? The incident was also around 2-3 hours after taking Lamictal.
2.) Since Monday I have been having a really sore back and tight muscles...I did help pull out 2- 800# round bales from a truck bed, but I've done it several times before, and never had this type of pain before. ie: I don't take pain meds unless I REALLY need them...I'm taking naproxen every time it wears off.
3.) I suppose it is possible I just had a 'bug'...but I don't think it would run its course this quickly?? I still have slightly swollen lymph nodes on the right side of my neck, but most other sympoms are gone, save body ache and chills/hot flashes.
Taking half of the 50mg tab tomorrow AM & PM to see if that helps. Has anyone had this type of reaction w/ Lamictal before??
Posted by morgan miller on January 29, 2011, at 0:22:13
In reply to Update: and possible side effects of Lamictal??, posted by BetweenDreams81 on January 28, 2011, at 23:14:38
I think those side effects are not uncommon for Lamictal or other medications like SSRIs. If they are Lamictal side effects they are likely transient and will go away. It was your first day at a higher dose so some adverse effects can be expected..very common.
Posted by morgan miller on February 3, 2011, at 23:25:36
In reply to Update: and possible side effects of Lamictal??, posted by BetweenDreams81 on January 28, 2011, at 23:14:38
BD, how are you doing?
Posted by BetweenDreams81 on February 4, 2011, at 8:04:27
In reply to Re: Update, How's it going on Lamictal? » BetweenDreams81, posted by morgan miller on February 3, 2011, at 23:25:36
Well, the day after I posted that I was feeling better, I got a rash all across my chest, abdomen, shoulders and the front of my thighs. Very mild, but it was there, so I stopped taking it immediately and let the doc know. :( I was really hopeful for it to work, I was finally really feeling the benefits of it...so not sure where we're going next. Doc wanted to wait until all signs of rash were gone before starting something else...and that is probably today. BUT I am now 1200 miles away! What awaits around the next bend? Your guess is better than mine.
Good things...it is warmer here, lots of sun, eating healthy, making myself get sleep and keeping around lots of optimistic people
This is the end of the thread.
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