Psycho-Babble Medication Thread 63935

Shown: posts 1 to 18 of 18. This is the beginning of the thread.

 

ssri to Lamictal?

Posted by chloe on May 22, 2001, at 18:53:02

Can lamictal be used as an AD for unipolar depression?

I don't think I am bipolar, but when I go on an SSRI, like prozac, zoloft, and now celexa, I get so revved up and pressured, irritable and at times "high", until the med poops out. I have also been on Wellbutrin and Serzone with no success.

I get alot of relief from anger and mood swings with the mood stabilizers. But they never seem to address my depression. But when I add an AD I tend to get the hypomania thing.

Does anyone know how Lamictal works as an AD? Does it work on Seratonin, or some other pathway? Any info would be appreciated. I really hate the edgy, rushed feeling I always have on these AD. But I do something to keep the negative thoughts away.

TIA
Chloe

 

Re: ssri to Lamictal? chloe

Posted by JahL on May 22, 2001, at 19:13:22

In reply to ssri to Lamictal?, posted by chloe on May 22, 2001, at 18:53:02

> Can lamictal be used as an AD for unipolar depression?

Rarely is, but yes.

> I don't think I am bipolar, but when I go on an SSRI, like prozac, zoloft, and now celexa, I get so revved up and pressured, irritable

Me too. Become hostile. According to my oh-so-knowledgable pdoc it is 'pharmacologically (big word for him) impossible' for this reaction to occur. Guess we know different, huh?

> I get alot of relief from anger and mood swings with the mood stabilizers.

Me too.

>But they never seem to address my depression.

Same.

> But when I add an AD I tend to get the hypomania thing.

Me too; euthymia (briefly) also. I've been dx'd unipolar but I'm *certain* I'm Bipolar III (if you accept this nebulous classification) due to having some of the reactions you describe & more.

> Does anyone know how Lamictal works as an AD? Does it work on Seratonin, or some other pathway? Any info would be appreciated. I really hate the edgy, rushed feeling I always have on these AD. But I do something to keep the negative thoughts away.

No idea how it works but wld be interested to know. Not sure anyone is clear on its precise mode of action.

fwiw, I'm taking Lamictal 350mg. Removes suicidal ideation, as with all mood-stabilizers, & has the added bonus of discernably improving cognition (others report this). Doesn't touch depression tho'. That said *some* report excellent results from Lamictal monotherapy (I've just added Gabapentin to little effect).

Good luck,
J.

 

Re: ssri to Lamictal?

Posted by chloe on May 22, 2001, at 20:17:32

In reply to Re: ssri to Lamictal? chloe, posted by JahL on May 22, 2001, at 19:13:22

J,
I really enjoyed your post. I added gabapentin to help with the raciness and insomnia with Celexa. I find it a rather "weak" drug, however. I am still racy and irritable, but just feel more sleepy during the day.

I also take Trileptal (cleaner form of Tegretol) for mood stabilization. It works great, but I have terrible dry skin, itching, painful scalp (folliculitis), and photosensitivity that makes me stay inside until the sun goes down. So, I can't go up anymore on that one, unfortunately...

So, I was hoping that the Lamictal could take the place of both Trileptal and Celexa. How is that for optimism??? But I am so sensitive to meds, I often can't get to a therapuetic dose. So perhaps I won't be able to get the benefits of lamictal. Did I mention I get hypomanic on 4 mgs of Celexa!

If you don't mind me asking, do you find Lamictal helpful for anger and irritability? Or just S.I.?

Again, thanks for your informative post.
Chloe

 

Re: ssri to Lamictal? chloe

Posted by JahL on May 22, 2001, at 21:10:21

In reply to Re: ssri to Lamictal?, posted by chloe on May 22, 2001, at 20:17:32

> I added gabapentin to help with the raciness and insomnia with Celexa. I find it a rather "weak" drug, however.

My impression also. Can't say it's doing anything. No real side-effects at least.

> I am still racy and irritable, but just feel more sleepy during the day.

Same.

> I also take Trileptal (cleaner form of Tegretol) for mood stabilization. It works great, but I have terrible dry skin, itching, painful scalp (folliculitis), and photosensitivity that makes me stay inside until the sun goes down. So, I can't go up anymore on that one, unfortunately...

That's something I'm interested in. Probably only available in the US tho'. Also, a cleaner version of Carbamazepine (Oxymazapine?) that Elizabeth mentioned. Can't wait for Preglabin (sp?) either.

> Did I mention I get hypomanic on 4 mgs of Celexa!

I became (mildly) hypomanic on a similarly miniscule dose; my pdoc didn't believe my rpts of euthymia/hypomania until I paid him an unexpected visit whilst on the Celexa. He was shocked at how much more well-adjusted, lucid &, well, more intelligent I seemed.

> If you don't mind me asking, do you find Lamictal helpful for anger and irritability? Or just S.I.?

What's S.I.?
None of the AEDs help with irritabity/restlessness. In fact I find 'homocidal' thoughts are, for me, the next step up from suicidal thoughts, which AEDS vanquish. I am annoyed by everything (esp. people) & often harbour v. 'dark' thoughts concerning certain individuals deserving of my wrath. Too depressed to do anything about the urges tho' :-) . Also, for the life of me I cannot sit my ass down for so much as a minute. There are furrows in my carpet where I pace up & down!

Are you sure you've no Bipolar tendencies?

J.

 

Re: ssri to Lamictal? JahL

Posted by JahL on May 22, 2001, at 21:22:32

In reply to Re: ssri to Lamictal? chloe, posted by JahL on May 22, 2001, at 21:10:21


> What's S.I.?

Suicidal Ideation, silly.
(right?)

 

Re: ssri to Lamictal?

Posted by missliz on May 23, 2001, at 0:59:57

In reply to ssri to Lamictal?, posted by chloe on May 22, 2001, at 18:53:02

> Can lamictal be used as an AD for unipolar depression?
>
> I don't think I am bipolar, but when I go on an SSRI, like prozac, zoloft, and now celexa, I get so revved up and pressured, irritable and at times "high", until the med poops out. I have also been on Wellbutrin and Serzone with no success.
>
> I get alot of relief from anger and mood swings with the mood stabilizers. But they never seem to address my depression. But when I add an AD I tend to get the hypomania thing.
>
> Does anyone know how Lamictal works as an AD? Does it work on Seratonin, or some other pathway? Any info would be appreciated. I really hate the edgy, rushed feeling I always have on these AD. But I do something to keep the negative thoughts away.
>
> TIA
> Chloe

Uhhh, everything you describe is pretty typical symptoms and drug reactions of bipolar. Lamictal is an anti-convulsant that's starting to be used as a mood stabilizer in bipolar illness, not an anti depressent. It may have anti depressant qualities as a function of the mood stabilization. You sound like you need a big chunk of mood stabilizer to me, Cloe, and then an anti depressent . The mood stabilizers will help with the irritable mania you describe and keep it from returning when the anti depressant starts to flip you. The symptoms you describe from anti depressants are all classic bipolar stuff. Have you tried lithium? (Depakote, Tegretol, Topomax?) Have you tried a not SSRI anti depressant? Lamictal is the latest thing but it's relatively unproven and not the first thing to try. I have support group friends with problems like yours that did ECT with lithium and are doing great. I take a cocktail of stuff including a neuraleptic, which keeps the franticness at bay. I also know that therapy does a lot for depression; all bipolar folks have a few issues, from the illness at least. We also don't handle a lot of stuff in general too well. Something to think about. You have a lot of options to try and you might want to see a psychopharmacologist if there's one in your area. You probably need more than one drug.

 

Re: ssri to Lamictal?-missliz

Posted by chloe on May 23, 2001, at 9:51:52

In reply to Re: ssri to Lamictal?, posted by missliz on May 23, 2001, at 0:59:57

I have always had "major depression", but now my illness seems to be taking a new turn. I am not able to tolerate the AD's anymore without great irritability and raciness. This is something i have been discussing with my pdoc. I think she is a bit bewildered. I used to be so dark and dramatic all the time. Now I get wildly optimistic and talkative for brief periods.

I have always been on some mood stabilizer over the last 10 years or so. They work for a while, then I have to change to another because I can't take side effects any longer (depakote-flat mood and major hair loss, tegretol-horrible GI discomfort, pain.) Trileptal is working well for me now. I just can't go any higher on this med either due to adverse effects. So I don't think I get the full benefit of the med. I was on Lithium years ago. All I remember is the hand tremor. I was so shaky and never in therapuetic range on my blood tests.

So the search goes on for the right cocktail. But, as a post says above, this maybe as good as it gets...

Thanks for you post.
Chloe

 

Re: ssri to Lamictal?-missliz chloe

Posted by Mitch on May 23, 2001, at 12:50:42

In reply to Re: ssri to Lamictal?-missliz, posted by chloe on May 23, 2001, at 9:51:52

Chloe,

You just mentioned something very interesting. You said that you are taking some Trileptal now, right? By the way, did you start having the mood cycling about the time you started the Trileptal? My pdoc has tried it on several bipolar patients (most were trying to switch from Tegretol to Trileptal) and it made them manic. I have tried it, but it makes me nauseous and I noticed getting "amped-up" from it, too. That *could* be your culprit.

 

Re: ssri to Lamictal?-Mitch

Posted by chloe on May 23, 2001, at 18:00:21

In reply to Re: ssri to Lamictal?-missliz chloe, posted by Mitch on May 23, 2001, at 12:50:42

Mitch,
I never even consider that Trileptal could be a culprit. I switched from Tegretol to Trileptal about two months ago, when I was not on any AD. When I added Celexa about a three weeks ago, I had my first hypomanic reaction to an AD. So you may be on to something...Now my wheel are turning.

Perhaps, the Trileptal isn't the best mood stabilizer for me to be on. My mood has been all over the map the last few days. From unable to move and depressed, to bursting with excitement all in one day. It is becoming quite debilitating.

Thanks alot Mitch.
C

 

Re: ssri to Lamictal?-Mitch chloe

Posted by Mitch on May 23, 2001, at 23:09:00

In reply to Re: ssri to Lamictal?-Mitch, posted by chloe on May 23, 2001, at 18:00:21

Chloe, I know this is kind of like getting painted into a corner and stepping your way out of it. I have also been on Celexa, too. I quit it completely just a few days ago. The Celexa could be the culprit, but I also retried Trileptal a few days ago (as an add-on)and just a few days of it and I noticed an increased agitation and my thoughts seemed "louder"-I stopped it-ain't takin' it again. It would be tough to switch back to Tegretol just like that for you.
How about this:
The last thing you did was add the Celexa. You have got to retrace your steps backward.... You said this was the first time you experienced hypomania on an AD right? Well, question one is: Is this the first time that you have tried Celexa? IF SO,
then stop the Celexa and just take the Trileptal or if you were taking a *different* AD before the Celexa-go back on that one and see if you see all of this turbulence subside. If after doing that it doesn't help-I would suggest switching back to the Tegretol and then go from *there*.

Mitch

> Mitch,
> I never even consider that Trileptal could be a culprit. I switched from Tegretol to Trileptal about two months ago, when I was not on any AD. When I added Celexa about a three weeks ago, I had my first hypomanic reaction to an AD. So you may be on to something...Now my wheel are turning.
>
> Perhaps, the Trileptal isn't the best mood stabilizer for me to be on. My mood has been all over the map the last few days. From unable to move and depressed, to bursting with excitement all in one day. It is becoming quite debilitating.
>
> Thanks alot Mitch.
> C

 

Had it with the ssri-

Posted by chloe on May 26, 2001, at 10:26:45

In reply to Re: ssri to Lamictal?-Mitch chloe, posted by Mitch on May 23, 2001, at 23:09:00

I have had it with Celexa and the intense anxiety. The hypomania, and all the short term joys I experienced with it are LONG gone. I am now just a knot of anxiety and morbid thoughts.
I have been on Celexa about a month, and I have had so many mood flips.
1st week- hypomania, insomnia,- added neurontin
2nd week- tired and blah, but with bubbles of optimism
3rd week tired, blah with bubbles of anxiety
4th week- so anxious, I am out of breath sitting down and my body is rigid. I am scared, agraphobic, anxious, anhedonic and sluggish. And have suicidal thoughts, THAT I DIDN'T HAVE BEFORE I STARTED THE CELEXA.

I haven't been able to reach the pdoc, but I have an appointment next Wednesday. God, I hope I can hold on...Why do I always crash on a holiday weekend?
I am hoping pdoc with subscribe Lamictal and it will help. But I am very pessimistic about this...
I am not hearing any miracle stories about Lamictal for unipolar depression...But I am all ears if any one will share!
C

 

Re: Had it with the Celexa?

Posted by Mitch on May 27, 2001, at 16:21:14

In reply to Had it with the ssri-, posted by chloe on May 26, 2001, at 10:26:45

Chloe-

Back up to the point where your pdoc recommended some Celexa.

1)Were you taking an AD at that time? What was it and how much did you take?

2)If you were taking an AD then, why did you want to switch it? Was it lack of efficacy or intolerable side effects? Or are you STILL taking the other AD??

3)Was there any other change in meds that happened at the *SAME* time that you started the Celexa, i.e. started/stopped/changed a benzo or mood stabilizer or something?

4)If ALL he did was ADD some Celexa or switch you to Celexa from something else, would you consider yourself to be in better shape at the time immediately before the Celexa came on board?

5) If you felt better then than you do now and all that happened was a switch to or an addition of Celexa, I would suggest tapering it away and consider something else.

Hope this helps, I have been going through some very unstable times lately myself-esp. with 3-week rapid cycling and a major seasonal depressive episode coming up in about a month.
Good luck,

Mitch

> I have had it with Celexa and the intense anxiety. The hypomania, and all the short term joys I experienced with it are LONG gone. I am now just a knot of anxiety and morbid thoughts.
> I have been on Celexa about a month, and I have had so many mood flips.
> 1st week- hypomania, insomnia,- added neurontin
> 2nd week- tired and blah, but with bubbles of optimism
> 3rd week tired, blah with bubbles of anxiety
> 4th week- so anxious, I am out of breath sitting down and my body is rigid. I am scared, agraphobic, anxious, anhedonic and sluggish. And have suicidal thoughts, THAT I DIDN'T HAVE BEFORE I STARTED THE CELEXA.
>
> I haven't been able to reach the pdoc, but I have an appointment next Wednesday. God, I hope I can hold on...Why do I always crash on a holiday weekend?
> I am hoping pdoc with subscribe Lamictal and it will help. But I am very pessimistic about this...
> I am not hearing any miracle stories about Lamictal for unipolar depression...But I am all ears if any one will share!
> C

 

I think Celexa makes me worse.

Posted by chloe on May 27, 2001, at 18:22:07

In reply to Re: Had it with the Celexa?, posted by Mitch on May 27, 2001, at 16:21:14

> Chloe-
>
> Back up to the point where your pdoc recommended some Celexa.
>
> 1)Were you taking an AD at that time? What was it and how much did you take?
>
> 2)If you were taking an AD then, why did you want to switch it? Was it lack of efficacy or intolerable side effects? Or are you STILL taking the other AD??
>
> 3)Was there any other change in meds that happened at the *SAME* time that you started the Celexa, i.e. started/stopped/changed a benzo or mood stabilizer or something?
>
> 4)If ALL he did was ADD some Celexa or switch you to Celexa from something else, would you consider yourself to be in better shape at the time immediately before the Celexa came on board?
>
> 5) If you felt better then than you do now and all that happened was a switch to or an addition of Celexa, I would suggest tapering it away and consider something else.
>
> Hope this helps, I have been going through some very unstable times lately myself-esp. with 3-week rapid cycling and a major seasonal depressive episode coming up in about a month.
> Good luck,
>
> Mitch
>
>
>
Mitch,
The long story is:
I had been on Zoloft for about 4 years and it had long pooped out and was making me edgy and anxious. (That seems to be a theme with me and SSRI's. I had the same problem with Prozac.) So I tried Serzone for 8 weeks and all I got were side effects, hot flashes/chills, sedation, anger, but not relief from depression. So I went without an AD for 2 and 1/2 months. I was ok for about 6 weeks. Then my energy level started to wane, and I wasn't able to do much exact the minimum. But at least I was stable! But, every once in a while, for a brief moment, I would passively wish I were dead. Nothing to worry about really, compared to now.

So for a couple months I did well on a mood stabilizer (Trileptal) and a benzo. But to prevent "spiraling down," my pdoc added Celexa, first 2mgs, then after a week up to 4 (I am extremely sensitive to meds). The first week was wonderful with positive thoughts and unbounding energy. But soon I crashed. And never really recovered. I only became plagued with anxiety. And the suicidal feelings became very strong. So three days ago, I pushed the Celexa up to 5 mgs, and that was it. After two days on 5, I was a rigid, tremulous, suicidal, hopeless wreck. But also very tired and foggy.

So yesterday I took 2 and 1/2 and today I took 2 mgs. And I am feeling better already. I still have anxiety and a very short fuse. But the suicidal thoughts are better. I am really wondering if the ssri's are making me worse. Or at least Celexa makes me worse. And I have no ambition to go back to Zoloft or Prozac. I hate the pressured, tense feeling on these meds. I don't know how I took it for so many years, other than I was taking Mellaril until 2 years ago. Which I think really took the edge off. All AP's are not an option for me now that I have persistant tongue movements from years of using Mellaril. It very sad. It was a very useful med. Too bad AP's are so damned dangerous when used on a regular, long term basis.

So it seems to me, that I was better off before I started the Celexa. But I do need a *little* something to enhance my mood. Or I get very dull and energyless.

So my question is, could Lamictal work as my mood stabilizer/AD? I always have a very short fuse, so I have needed a mood stabilizer to keep my anger in check. If one had the added bonus of an AD, I think I would be all set.

But I have to say again, I think I am unipolar. And I don't know how well Lamictal works for that. ANd I don't know how useful it is for anger and irritibility. I have a pdoc appointment on Wed. I hope she can answer some of my Q's. Changing meds is extremely difficult for me, so if there is little chance it will work, I am not sure I want to put my body through another change.

There has to be something better than this mix!
Thanks for asking. And I hope you can find a way to feel more stable, too!
Chloe

 

Re: I think Celexa makes me worse.

Posted by Mitch on May 28, 2001, at 1:00:33

In reply to I think Celexa makes me worse., posted by chloe on May 27, 2001, at 18:22:07

Chloe-

Experiencing similar troubles that you have described. I would try suggesting a non-SSRI AD (in LOW doses)that you haven't tried before-after stopping the Celexa. I tell you, if I could tolerate Adderall or Wellbutrin I would be GLAD to take either of those again. I had *NO CYCLING*, NO dysthymia, and plenty of energy and attentiveness, but made me too panicky (maybe if I could have stuck with them longer+CBT+benzo?)

I have and heard of others having trouble with SSRI's aggravating *dystonias* of neck/tongue/back muscles, etc. SSRI's may not be your AD of choice-you might be better off with an MAOI. I wish I could get low-dose transdermal patches (you don't have to worry about diet) of Parnate/Nardil/Marplan to try out. My pdoc is scared of all MAOI's. Fat chance of getting moclobemide from Canada...
The Lamictal could be a real good possibility, that is if you are not taking an AD and are also taking another mood stabilizer with it (esp. Neurontin or Topamax). I would be interested in ditching SSRi's and trying it as a substitute in my case. I just have a few noted skin reactions to previous other meds, though.

Good luck,
Mitch

> Mitch,
> The long story is:
> I had been on Zoloft for about 4 years and it had long pooped out and was making me edgy and anxious. (That seems to be a theme with me and SSRI's. I had the same problem with Prozac.) So I tried Serzone for 8 weeks and all I got were side effects, hot flashes/chills, sedation, anger, but not relief from depression. So I went without an AD for 2 and 1/2 months. I was ok for about 6 weeks. Then my energy level started to wane, and I wasn't able to do much exact the minimum. But at least I was stable! But, every once in a while, for a brief moment, I would passively wish I were dead. Nothing to worry about really, compared to now.
>
> So for a couple months I did well on a mood stabilizer (Trileptal) and a benzo. But to prevent "spiraling down," my pdoc added Celexa, first 2mgs, then after a week up to 4 (I am extremely sensitive to meds). The first week was wonderful with positive thoughts and unbounding energy. But soon I crashed. And never really recovered. I only became plagued with anxiety. And the suicidal feelings became very strong. So three days ago, I pushed the Celexa up to 5 mgs, and that was it. After two days on 5, I was a rigid, tremulous, suicidal, hopeless wreck. But also very tired and foggy.
>
> So yesterday I took 2 and 1/2 and today I took 2 mgs. And I am feeling better already. I still have anxiety and a very short fuse. But the suicidal thoughts are better. I am really wondering if the ssri's are making me worse. Or at least Celexa makes me worse. And I have no ambition to go back to Zoloft or Prozac. I hate the pressured, tense feeling on these meds. I don't know how I took it for so many years, other than I was taking Mellaril until 2 years ago. Which I think really took the edge off. All AP's are not an option for me now that I have persistant tongue movements from years of using Mellaril. It very sad. It was a very useful med. Too bad AP's are so damned dangerous when used on a regular, long term basis.
>
> So it seems to me, that I was better off before I started the Celexa. But I do need a *little* something to enhance my mood. Or I get very dull and energyless.
>
> So my question is, could Lamictal work as my mood stabilizer/AD? I always have a very short fuse, so I have needed a mood stabilizer to keep my anger in check. If one had the added bonus of an AD, I think I would be all set.
>
> But I have to say again, I think I am unipolar. And I don't know how well Lamictal works for that. ANd I don't know how useful it is for anger and irritibility. I have a pdoc appointment on Wed. I hope she can answer some of my Q's. Changing meds is extremely difficult for me, so if there is little chance it will work, I am not sure I want to put my body through another change.
>
> There has to be something better than this mix!
> Thanks for asking. And I hope you can find a way to feel more stable, too!
> Chloe

 

Re: I think Celexa makes me worse.

Posted by chloe on May 28, 2001, at 10:53:19

In reply to Re: I think Celexa makes me worse., posted by Mitch on May 28, 2001, at 1:00:33

Mitch,
I do tend to think the SSRI's make me worse without a major tranquilizer to counter that damned edgy, pressured feeling. And I can relate to the "dystonias." I am always clenching my teeth and my tongue never rest. It is always going back and forth on my lower teeth. Very annoying (and maybe not the TD from Mellaril).

I too have tried Wellbutrin, no luck, just sweats and anxiety, Serzone, not good!, and I am very leary of Effexor and MAOI's. I am thinking maybe just a bit of SJW with the Lamictal. Maybe that would be enough to give me the positive outlook I get when my seratonin level is tweeked. Don't know if the pdoc will agree!

I too have problems with my skin. Chronic ezcema makes it hard to know what is a "rash" and what is just my skin. The reason why I can't go up on Trileptal is that is has taken all the oil out of my skin til it hurts. I feel like I have a bad sunburn. And it gives me "folliculitis" where my hair follicles are so sensitive, I can't brush my (dried out) hair, or lie on a pillow.

i think Lamictal, after the initial start up period, has a lower side effect profile than Trileptal. so if I could get on it very slowly, and avoid the rash, it might be a more tolerable mood stabilizer than Trileptal.

I am not familiar with Adderall and what is CBT?

Hang in there!
Chloe

 

Re: I think Celexa makes me worse. chloe

Posted by Mitch on May 28, 2001, at 12:24:16

In reply to Re: I think Celexa makes me worse., posted by chloe on May 28, 2001, at 10:53:19

Chloe,

1)CBT is short for cognitive-behavioural therapy (non-drug). It is used for management of anxiety/depressive disorders and can be very effective, BUT, you have to find the right therapist, spend some $$$, and do a LOT of it (close together), and it has to be structured and tailored just for the trouble that you have. If you have a lot of coexisting problems it might not work as well. I was considering it just for social anxiety/panic.

2) Adderall is an amphetamine stimulant used to treat attention deficit disorder (which I definitely DO have). If you were all uptight on Wellubtrin I doubt if this would help you much.

3) As far as dystonias go that is very interesting what you have described. Here is a list of the differing dystonic and other psuedo-parkinson type reactions from SSRI's that I have experienced:
Prozac: restlessness, choking sensations (but had the fewest extrapyramidal-like symptoms with it.
Zoloft: Jaw clenching, teeth grinding, restlessness
Celexa: restlessness and a little of the "tongue-thing" that you have described.
Paxil: HAD the WORST reaction to it of all of them-except I had trouble speaking as well.
Luvox: Bradykinesia (difficulty initiating movement) it was like taking Stellazine!!

I am VERY concerned about your skin conditions that you are describing. I would absolutely rule-out med involvement causing them before I would even consider Lamictal. You mentioned that Trileptal seemed to "take the oil out of your skin and made you feel like you had a sunburn". WOW, that is weird because I had a similar reaction to the Trileptal as well. It felt like my skin was *hot* and *dry*.

Given the skin things I really doubt if your pdoc will give you any Lamictal. He/she might want to get you off the Trileptal first (since that definitely is causing some kind of skin thing-that doesn't sound so good chloe), then after the Trileptal is washed out and your skin gets better, then maybe they can start a tiny dose of Lamictal (you said you are already taking some Neurontin+benzo-so maybe you won't get unstable from stopping the Trileptal)

Please be very careful with regards to your skin troubles,

Mitch

> Mitch,
> I do tend to think the SSRI's make me worse without a major tranquilizer to counter that damned edgy, pressured feeling. And I can relate to the "dystonias." I am always clenching my teeth and my tongue never rest. It is always going back and forth on my lower teeth. Very annoying (and maybe not the TD from Mellaril).
>
> I too have tried Wellbutrin, no luck, just sweats and anxiety, Serzone, not good!, and I am very leary of Effexor and MAOI's. I am thinking maybe just a bit of SJW with the Lamictal. Maybe that would be enough to give me the positive outlook I get when my seratonin level is tweeked. Don't know if the pdoc will agree!
>
> I too have problems with my skin. Chronic ezcema makes it hard to know what is a "rash" and what is just my skin. The reason why I can't go up on Trileptal is that is has taken all the oil out of my skin til it hurts. I feel like I have a bad sunburn. And it gives me "folliculitis" where my hair follicles are so sensitive, I can't brush my (dried out) hair, or lie on a pillow.
>
> i think Lamictal, after the initial start up period, has a lower side effect profile than Trileptal. so if I could get on it very slowly, and avoid the rash, it might be a more tolerable mood stabilizer than Trileptal.
>
> I am not familiar with Adderall and what is CBT?
>
> Hang in there!
> Chloe

 

Re: I think Celexa makes me worse.

Posted by chloe on May 29, 2001, at 19:30:51

In reply to Re: I think Celexa makes me worse. chloe, posted by Mitch on May 28, 2001, at 12:24:16

> Chloe,
>
> 1)CBT is short for cognitive-behavioural therapy (non-drug). It is used for management of anxiety/depressive disorders and can be very effective, BUT, you have to find the right therapist, spend some $$$, and do a LOT of it (close together), and it has to be structured and tailored just for the trouble that you have. If you have a lot of coexisting problems it might not work as well. I was considering it just for social anxiety/panic.
>
> 2) Adderall is an amphetamine stimulant used to treat attention deficit disorder (which I definitely DO have). If you were all uptight on Wellubtrin I doubt if this would help you much.
>
> 3) As far as dystonias go that is very interesting what you have described. Here is a list of the differing dystonic and other psuedo-parkinson type reactions from SSRI's that I have experienced:
> Prozac: restlessness, choking sensations (but had the fewest extrapyramidal-like symptoms with it.
> Zoloft: Jaw clenching, teeth grinding, restlessness
> Celexa: restlessness and a little of the "tongue-thing" that you have described.
> Paxil: HAD the WORST reaction to it of all of them-except I had trouble speaking as well.
> Luvox: Bradykinesia (difficulty initiating movement) it was like taking Stellazine!!
>
> I am VERY concerned about your skin conditions that you are describing. I would absolutely rule-out med involvement causing them before I would even consider Lamictal. You mentioned that Trileptal seemed to "take the oil out of your skin and made you feel like you had a sunburn". WOW, that is weird because I had a similar reaction to the Trileptal as well. It felt like my skin was *hot* and *dry*.
>
> Given the skin things I really doubt if your pdoc will give you any Lamictal. He/she might want to get you off the Trileptal first (since that definitely is causing some kind of skin thing-that doesn't sound so good chloe), then after the Trileptal is washed out and your skin gets better, then maybe they can start a tiny dose of Lamictal (you said you are already taking some Neurontin+benzo-so maybe you won't get unstable from stopping the Trileptal)
>
> Please be very careful with regards to your skin troubles,
>
> Mitch
>
Thanks for the post Mitch. I am starting to think you may be right about the Lamictal and my skin. But right now, Trileptal starting to scare me. I have had two terrible colds in the two+ months have been on Trileptal. I am wondering if I am having some leukopenia, or depression of my white blood cells. I haven't had a cold in 5 years until I started Trileptal. My pdoc wants me to have a CBC. But the lab is closed now.

I still have my appointment tomorrow with the pdoc, but I am sick with a cold, and so confused, I am not sure what good the appointment will do. I also went back up on the Celexa (God, I don't know why!!!) so I wouldn't be totally off it when I see her. She didn't give me the go ahead to completely quit it. So now I am so clenchy, edgy, and short tempered and have a chest full of phlegm. Great. what a mess I am!

The slightest change sends me over the edge. That is why I am wonderin how I could go off Trileptal without something to replace it. I am only taking 200 neurontin. More than 200 seems to make me revved up. Do you have that experience? Under 200 it's rather calming for me.

It is so interesting that you have had similar responses to Trileptal. I guess we both have to be cautious about our skin and "rashes".

Thanks, Mitch for the info and warning!
All the best,
Chloe

 

Re: I think Celexa makes me worse.

Posted by Mitch on May 30, 2001, at 1:21:16

In reply to Re: I think Celexa makes me worse., posted by chloe on May 29, 2001, at 19:30:51

> Thanks for the post Mitch. I am starting to think you may be right about the Lamictal and my skin. But right now, Trileptal starting to scare me. I have had two terrible colds in the two+ months have been on Trileptal. I am wondering if I am having some leukopenia, or depression of my white blood cells. I haven't had a cold in 5 years until I started Trileptal. My pdoc wants me to have a CBC. But the lab is closed now.

Get the CBC since it will chill-out your pdoc and yourself, but I don't think the Trileptal is *causing* your cold-I really think it is probably coincidental. BTW-most people don't have five year lapses between colds! The advantage to taking Trileptal over Tegretol was supposed to be the elimination of dangerous blood disorders that Tegretol can rarely cause. Is it correct that you were on Tegretol and switched to Trileptal? If so, how long were you taking Tegretol before you made the switch? If you had NEVER taken Tegretol before and NOW you are on Trileptal and having the skin things-you may just be hypersensitive to the common chemical structure of these two meds (skinwise). In the monograph for Trileptal it does mention that people who have had skin reactions to Tegretol will have a higher than normal propensity to have the same skin reactions reoccur with Trileptal.

> The slightest change sends me over the edge. That is why I am wonderin how I could go off Trileptal without something to replace it. I am only taking 200 neurontin. More than 200 seems to make me revved up. Do you have that experience? Under 200 it's rather calming for me.

I *suspect* that Trileptal could (probability-wise) be destabilizing you (not helping)and the skin reaction seems to be fairly pinpointed as well. In that case tapering it away would be helpful not hurtful. Also, when you say "the slightest change in my meds sends me over the edge", are the "over the edge" situations tend to involve antidepressants?? You must realize that for bipolarII or III? folks that AD's are like plastic explosive (depending on which one and how much). Interestingly I have found that when I started taking (even low doses) Neurontin that it seemed to *amplify* SSRI, stims, all sorts of AD's.
As far as Neurontin goes-it is a really *weird* med. All I know is that if I take less than 300mg/day (100mg/3x), I get more depressed, tired, and inattentive. So that is my minimum dose. You must realize that this stuff washes out of your system really fast-so some of the phenomena surrounding it (I believe) may relate to the *withdrawal* from it. I am now taking 400mg/day (100/4x), and I feel a *lot* better. I just have trouble taking 300mg doses (they wallop me).
Oh, just an FYI-you mentioned and I have personaly noticed how the Trileptal "took" the oil out of your skin? Well, I have noticed (quite obviously) that Neurontin seems to *add* colllagen or oil into my skin (without acne). Go figure! I don't know if that would be helpful for you or not.
You said you are taking a benzo (Klonopin?), you may consider upping it a notch or two (instead of the Neurontin for now), if you start tapering away the Trileptal.

> It is so interesting that you have had similar responses to Trileptal. I guess we both have to be cautious about our skin and "rashes".

I don't think you (or myself) should write-off the Lamictal just because of the rash thing. Just because you have a skin reaction to one med doesn't mean that you will have one with another-and you don't want to exclude a med that could be very helpful for you (especially to get off AD's that are causing cycling!).
You mentioned that you had eczema-are you seeing a dermatologist for it fairly regularly? If so, maybe when you get the Trileptal washed out of your system (and your skin gets better), and are ready to withdraw the Celexa (so you can start slowly bringing in Lamictal) you could have your derm doc. in with your pdoc as a team. That would be a great way to proceed.
Good luck!

>
> Thanks, Mitch for the info and warning!
> All the best,
> Chloe


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