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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Geezer on November 13, 2001, at 10:35:36
I am 57 newly diagnosed Bipolar II after 30 years of treatment for MAJOR DEPRESSION.
Current Meds.: Depakote 750mg., Wellbutrin 200mg., Zoloft 25mg., Visteril 50mg., Klonopin 1mg., and Ambien 10 mg.,(all total daily dosages at devided intervals). QUESTION: Is there any danger with the addition of Lamictal (I understand 1/2 dose slow titration with Depakote to avoid rash). My concern is interation with Lam.+Well+Zo. Found one study (2 patients) indicating 33% increase of Lam. level with combined use of Zo. Thanks to all-been monotoring for 6 months - your a good group.
Geezer
Posted by Hattree on November 13, 2001, at 14:57:21
In reply to Add Lamictal to current cocktail!!, posted by Geezer on November 13, 2001, at 10:35:36
Don't know about the rest of your combo, but no problem here with lamictal and zo.
> I am 57 newly diagnosed Bipolar II after 30 years of treatment for MAJOR DEPRESSION.
> Current Meds.: Depakote 750mg., Wellbutrin 200mg., Zoloft 25mg., Visteril 50mg., Klonopin 1mg., and Ambien 10 mg.,(all total daily dosages at devided intervals). QUESTION: Is there any danger with the addition of Lamictal (I understand 1/2 dose slow titration with Depakote to avoid rash). My concern is interation with Lam.+Well+Zo. Found one study (2 patients) indicating 33% increase of Lam. level with combined use of Zo. Thanks to all-been monotoring for 6 months - your a good group.
> Geezer
Posted by JohnX2 on November 13, 2001, at 15:01:54
In reply to Add Lamictal to current cocktail!!, posted by Geezer on November 13, 2001, at 10:35:36
damn, I lost my 1st post because I forgot to
hit the confirmation button, if I had a dime
for every time I did that!Anyways, Depakote will have an interaction with
Lamictal. It will approximately double the levels
of lamictal in your body. This is from the top of
my head, please check with your doctor.Sorry about the late bpii diagnosis. bpii can
be a sneaky s.o.b. Anyways Lamictal is generally
a good med if *dosed carefully* and maybe
with it you can back off some of your other meds.good luck,
john> I am 57 newly diagnosed Bipolar II after 30 years of treatment for MAJOR DEPRESSION.
> Current Meds.: Depakote 750mg., Wellbutrin 200mg., Zoloft 25mg., Visteril 50mg., Klonopin 1mg., and Ambien 10 mg.,(all total daily dosages at devided intervals). QUESTION: Is there any danger with the addition of Lamictal (I understand 1/2 dose slow titration with Depakote to avoid rash). My concern is interation with Lam.+Well+Zo. Found one study (2 patients) indicating 33% increase of Lam. level with combined use of Zo. Thanks to all-been monotoring for 6 months - your a good group.
> Geezer
Posted by jazzdog on November 13, 2001, at 17:26:47
In reply to Re: Add Lamictal to current cocktail!!, posted by Hattree on November 13, 2001, at 14:57:21
> Don't know about the rest of your combo, but no problem here with lamictal and zo.
>
Hi Hattree -I'm also on zoloft and lamictal - 50 mg. zoloft and just starting lamictal at 12.5 mg. I noticed in an earlier post you mentioned ADD without hyperactivity. I have trouble with foggy-mindedness, inattention, dreaminess and derealization. Did the lamictal help you to concentrate and focus? How did it affect your wake/dream/sleep cycles? At what dosage did you start to feel the effects?
Thanks a lot - Jane
Posted by Hattree on November 14, 2001, at 8:38:36
In reply to Re: Add Lamictal to current cocktail!! » Hattree, posted by jazzdog on November 13, 2001, at 17:26:47
I can't say that Lamictal has particularly helped me focus. (I also take stimulants and that has its pros and cons--they do help me focus on tasks like crazy, but they don't keep me from losing my keys.) It helped my mood quickly, though, possibly at as little as 25mg.
> > Don't know about the rest of your combo, but no problem here with lamictal and zo.
> >
> Hi Hattree -
>
> I'm also on zoloft and lamictal - 50 mg. zoloft and just starting lamictal at 12.5 mg. I noticed in an earlier post you mentioned ADD without hyperactivity. I have trouble with foggy-mindedness, inattention, dreaminess and derealization. Did the lamictal help you to concentrate and focus? How did it affect your wake/dream/sleep cycles? At what dosage did you start to feel the effects?
>
> Thanks a lot - Jane
Posted by jazzdog on November 14, 2001, at 15:08:34
In reply to Re: Add Lamictal to current cocktail!! » jazzdog, posted by Hattree on November 14, 2001, at 8:38:36
> I can't say that Lamictal has particularly helped me focus. (I also take stimulants and that has its pros and cons--they do help me focus on tasks like crazy, but they don't keep me from losing my keys.) It helped my mood quickly, though, possibly at as little as 25mg.
>
>
Hi Hattree - thanks for your quick answer. I'm having trouble posting this, so I'll try again. I wonder if a higher dose is needed for clearing up cognition. The Maudsley depersonalization unit recommends 250 mg. Has anyone else had success with cognitive problems by using lamictal?
Thanks, Jane
Posted by VMBW on November 14, 2001, at 19:31:07
In reply to Lamictal and cognition - Hattree and others, posted by jazzdog on November 14, 2001, at 15:08:34
> >Hi Jane,
Lamictal has been a tremendous find for me after years of different ADs. "Cognitive" can be a rather broad term but it definitely has helped bring me out of the up and down cycle. My moods are MUCH more consistent which in turn allows me to concentrate etc. without fearing the next down turn - so I guess you could say that my cognition has improved, certainly the depression has lifted. I've been on 400mgs for nearly 6 months and there was not a noticeable difference for me until around 300mgs. Also,no noticeable side effects. Good Luck
I can't say that Lamictal has particularly helped me focus. (I also take stimulants and that has its pros and cons--they do help me focus on tasks like crazy, but they don't keep me from losing my keys.) It helped my mood quickly, though, possibly at as little as 25mg.
> >
> >
> Hi Hattree - thanks for your quick answer. I'm having trouble posting this, so I'll try again. I wonder if a higher dose is needed for clearing up cognition. The Maudsley depersonalization unit recommends 250 mg. Has anyone else had success with cognitive problems by using lamictal?
> Thanks, Jane
Posted by jazzdog on November 16, 2001, at 10:34:47
In reply to Re: Lamictal and cognition - Hattree and others, posted by VMBW on November 14, 2001, at 19:31:07
> > >Hi Jane,
>
> Lamictal has been a tremendous find for me after years of different ADs. "Cognitive" can be a rather broad term but it definitely has helped bring me out of the up and down cycle. My moods are MUCH more consistent which in turn allows me to concentrate etc. without fearing the next down turn - so I guess you could say that my cognition has improved, certainly the depression has lifted. I've been on 400mgs for nearly 6 months and there was not a noticeable difference for me until around 300mgs. Also,no noticeable side effects. Good Luck
>
> I can't say that Lamictal has particularly helped me focus. (I also take stimulants and that has its pros and cons--they do help me focus on tasks like crazy, but they don't keep me from losing my keys.) It helped my mood quickly, though, possibly at as little as 25mg.Hi VMBW -
Thanks for replying. Do you take any ssri's with the lamictal? A study I read suggests that ssri's potentiate lamictal to the extent of doubling the blood levels. Maybe that's why Hattree and others taking an ssri feel the effect at a lower dose? Just a possibility.
- Jane
Posted by VMBW on November 16, 2001, at 17:24:56
In reply to Re: Lamictal and cognition - Hattree and others » VMBW, posted by jazzdog on November 16, 2001, at 10:34:47
> > >Yes Jane, in fact 150mgs Effexor. Effexor alone had seemingly limited effect, but the addition of the Lamictal resulted in a very noticeable difference. Thinking about going off effexor to attempt monotherapy but I'm a little apprhensive. I had an incredible experience prior to the Effexor - hospitalization where I had to be carried out, deep desire to die. I have not had that feeling at all since adding the lamictal but I'm suspecting that the combo is what is working. Anyway, give it a shot - I don't see any downsides if you increase slowly. Take Care.
>Hi Jane,
> >
> > Lamictal has been a tremendous find for me after years of different ADs. "Cognitive" can be a rather broad term but it definitely has helped bring me out of the up and down cycle. My moods are MUCH more consistent which in turn allows me to concentrate etc. without fearing the next down turn - so I guess you could say that my cognition has improved, certainly the depression has lifted. I've been on 400mgs for nearly 6 months and there was not a noticeable difference for me until around 300mgs. Also,no noticeable side effects. Good Luck
> >
> > I can't say that Lamictal has particularly helped me focus. (I also take stimulants and that has its pros and cons--they do help me focus on tasks like crazy, but they don't keep me from losing my keys.) It helped my mood quickly, though, possibly at as little as 25mg.
>
> Hi VMBW -
>
> Thanks for replying. Do you take any ssri's with the lamictal? A study I read suggests that ssri's potentiate lamictal to the extent of doubling the blood levels. Maybe that's why Hattree and others taking an ssri feel the effect at a lower dose? Just a possibility.
>
> - Jane
Posted by Hattree on November 16, 2001, at 20:32:45
In reply to Re: Lamictal and cognition - Hattree and others » jazzdog, posted by VMBW on November 16, 2001, at 17:24:56
Seems like I saw a post here (Cam?) about why Lamictal monotherapy wouldn't work as well as L and SSRI...didn't see it until after I tried to drop my Zoloft and crashed.
> > > >Yes Jane, in fact 150mgs Effexor. Effexor alone had seemingly limited effect, but the addition of the Lamictal resulted in a very noticeable difference. Thinking about going off effexor to attempt monotherapy but I'm a little apprhensive. I had an incredible experience prior to the Effexor - hospitalization where I had to be carried out, deep desire to die. I have not had that feeling at all since adding the lamictal but I'm suspecting that the combo is what is working. Anyway, give it a shot - I don't see any downsides if you increase slowly. Take Care.
>
> >Hi Jane,
> > >
> > > Lamictal has been a tremendous find for me after years of different ADs. "Cognitive" can be a rather broad term but it definitely has helped bring me out of the up and down cycle. My moods are MUCH more consistent which in turn allows me to concentrate etc. without fearing the next down turn - so I guess you could say that my cognition has improved, certainly the depression has lifted. I've been on 400mgs for nearly 6 months and there was not a noticeable difference for me until around 300mgs. Also,no noticeable side effects. Good Luck
> > >
> > > I can't say that Lamictal has particularly helped me focus. (I also take stimulants and that has its pros and cons--they do help me focus on tasks like crazy, but they don't keep me from losing my keys.) It helped my mood quickly, though, possibly at as little as 25mg.
> >
> > Hi VMBW -
> >
> > Thanks for replying. Do you take any ssri's with the lamictal? A study I read suggests that ssri's potentiate lamictal to the extent of doubling the blood levels. Maybe that's why Hattree and others taking an ssri feel the effect at a lower dose? Just a possibility.
> >
> > - Jane
Posted by Cindylou on November 20, 2001, at 12:37:24
In reply to Add Lamictal to current cocktail!!, posted by Geezer on November 13, 2001, at 10:35:36
Hello,
I'm a bit late responding to your post; haven't checked in for awhile ...I can't say much here, althought Lamictal + Klonapin + Serzone are causing no problems for me. My pdoc feels confident combining other meds with Lamictal. I know Depakote + Lamictal is a popular combo, but like you said, you need to titrate even more slowly on the Lamictal.
Good luck,
cindy> I am 57 newly diagnosed Bipolar II after 30 years of treatment for MAJOR DEPRESSION.
> Current Meds.: Depakote 750mg., Wellbutrin 200mg., Zoloft 25mg., Visteril 50mg., Klonopin 1mg., and Ambien 10 mg.,(all total daily dosages at devided intervals). QUESTION: Is there any danger with the addition of Lamictal (I understand 1/2 dose slow titration with Depakote to avoid rash). My concern is interation with Lam.+Well+Zo. Found one study (2 patients) indicating 33% increase of Lam. level with combined use of Zo. Thanks to all-been monotoring for 6 months - your a good group.
> Geezer
Posted by Cindylou on November 20, 2001, at 12:42:38
In reply to Re: Lamictal and cognition - Hattree and others, posted by Hattree on November 16, 2001, at 20:32:45
Interesting ... Lamictal alone actually seemed to make me worse once I got to 50 mg -- MORE irritable and MORE tired ... I kept thinking I just had to keep increasing it to get the real benefits ... but at 62.5 the anxiety was so severe I could barely function. Even Klonapin couldn't help.
So I added Serzone. I just started a week ago at 100 mg. a day. The anxiety practically vanished after the first day. I just increased Lamictal to 75 mg. and the anxiety is (so far) under control. I'm not sure whether to keep increasing the Serzone or stay where I'm at ... think I'll start another thread on that one.
> Seems like I saw a post here (Cam?) about why Lamictal monotherapy wouldn't work as well as L and SSRI...didn't see it until after I tried to drop my Zoloft and crashed.
>
> > > > >Yes Jane, in fact 150mgs Effexor. Effexor alone had seemingly limited effect, but the addition of the Lamictal resulted in a very noticeable difference. Thinking about going off effexor to attempt monotherapy but I'm a little apprhensive. I had an incredible experience prior to the Effexor - hospitalization where I had to be carried out, deep desire to die. I have not had that feeling at all since adding the lamictal but I'm suspecting that the combo is what is working. Anyway, give it a shot - I don't see any downsides if you increase slowly. Take Care.
> >
> > >Hi Jane,
> > > >
> > > > Lamictal has been a tremendous find for me after years of different ADs. "Cognitive" can be a rather broad term but it definitely has helped bring me out of the up and down cycle. My moods are MUCH more consistent which in turn allows me to concentrate etc. without fearing the next down turn - so I guess you could say that my cognition has improved, certainly the depression has lifted. I've been on 400mgs for nearly 6 months and there was not a noticeable difference for me until around 300mgs. Also,no noticeable side effects. Good Luck
> > > >
> > > > I can't say that Lamictal has particularly helped me focus. (I also take stimulants and that has its pros and cons--they do help me focus on tasks like crazy, but they don't keep me from losing my keys.) It helped my mood quickly, though, possibly at as little as 25mg.
> > >
> > > Hi VMBW -
> > >
> > > Thanks for replying. Do you take any ssri's with the lamictal? A study I read suggests that ssri's potentiate lamictal to the extent of doubling the blood levels. Maybe that's why Hattree and others taking an ssri feel the effect at a lower dose? Just a possibility.
> > >
> > > - Jane
This is the end of the thread.
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