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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by lawrence s. on November 1, 2002, at 1:16:49
I'm giving up on Lamictal. Like all the other mood stabilizers they take away every feeling of pleasure. They leave me feeling flat emotionally and spiritually hollow. I only made it to 50 mg. The thought of being on 200mg. or more really saddens me. Why would anyone want to feel that way? I hope it does'nt do to others what it did to me. It's probably just me. What is wrong with me?
Lawrence S.
Posted by catmint on November 1, 2002, at 1:43:29
In reply to On Lamictal and feeling really screwed up!!, posted by lawrence s. on November 1, 2002, at 1:16:49
Lawrence, I too have experienced intolerable flatness from mood stabilizers. I know exactly what you mean. I'ts like I can't even enjoy the beauty of nature. My doc says it's a trade off. The lesser of two evils. Pick one. Be flat or be moody. I hate to accept that.
So, what is working for me as far as flatness, is a low dose of Depakote, and I plan to add an AD soon. 125 mg. is enough to temper some of the manic, distorted thoughts and, I still am able to feel spiritual.Does that make sense?
Amy
Posted by chad_3 on November 1, 2002, at 4:02:16
In reply to Re: On Lamictal and feeling really screwed up!! » lawrence s., posted by catmint on November 1, 2002, at 1:43:29
Hi -
Although lamictal is one of the few mainstream meds I've not trialed (anticonvulsants aren't really recommended for my condition) - but in any case I have considered it - my understanding is that lamictal itself does not show any significant DA agonist activity, but when combined with a dopamine agonist (ie; maoi, wellbutrin, stimulant, etc...) - that lamictal preferentially augments d2 above and beyond the effect of the ajunctive dopaminergic.
Since some dopaminergics tend to target dysthymia well (nardil, dextroamphetamine, wellbutrin) - well - this is just a thought I wanted to bring up to the table ...
Chad
> Lawrence, I too have experienced intolerable flatness from mood stabilizers. I know exactly what you mean. I'ts like I can't even enjoy the beauty of nature. My doc says it's a trade off. The lesser of two evils. Pick one. Be flat or be moody. I hate to accept that.
> So, what is working for me as far as flatness, is a low dose of Depakote, and I plan to add an AD soon. 125 mg. is enough to temper some of the manic, distorted thoughts and, I still am able to feel spiritual.Does that make sense?
> Amy
Posted by lostsailor on November 1, 2002, at 7:34:34
In reply to Re: On Lamictal and feeling really screwed up!!, posted by chad_3 on November 1, 2002, at 4:02:16
For treatment of BP dis, lamictal is the only esp indicated for bp's who tend to remain treament resitant and lean twoards the depressive pole of the disorder. The flatness often associated with mood stabs often need to be seen thru the normal eye vs our own. when manic, we are high...we taste life and know it tastes better than normal....mood medsw take that from us by design
. On depecote, yrs ago i felt i had blunted affect only to realive that I had been looking thru rose colered glasses.AS for the AD, wellbuterin is ofetn indicated for us as it is less "stimulating than ssris and ssri's.
tony
Posted by lawrence s. on November 2, 2002, at 16:38:07
In reply to lamictal, posted by lostsailor on November 1, 2002, at 7:34:34
> For treatment of BP dis, lamictal is the only esp indicated for bp's who tend to remain treament resitant and lean twoards the depressive pole of the disorder. The flatness often associated with mood stabs often need to be seen thru the normal eye vs our own. when manic, we are high...we taste life and know it tastes better than normal....mood medsw take that from us by design
> . On depecote, yrs ago i felt i had blunted affect only to realive that I had been looking thru rose colered glasses.
>
> AS for the AD, wellbuterin is ofetn indicated for us as it is less "stimulating than ssris and ssri's.
>
> tonyTony,
does the flatness disappear after a while?
Larry
Posted by lawrence s. on November 2, 2002, at 23:39:42
In reply to Re: On Lamictal and feeling really screwed up!!, posted by chad_3 on November 1, 2002, at 4:02:16
Amy, I hope this does'nt upset you. I am truly sorry if I do but, what a horrible dillema! It's like choosing death by firing squad or guillutine! I wish they would find a way to stop mood swings without losing your zest for life. I played my favorite music and I did'nt enjoy it. I played with my kids, I did'nt enjoy it I used do crossword puzzles.
A pdoc back in the early 80's told me that people who have brain damage hate lithium and it drives them crazy! Could this be what he meant? Has anyone else heard something like this? Maybe some of us are brain damaged and don't know it.
Lsrry
Posted by lawrence s. on November 3, 2002, at 0:24:22
In reply to lamictal, posted by lostsailor on November 1, 2002, at 7:34:34
> For treatment of BP dis, lamictal is the only esp indicated for bp's who tend to remain treament resitant and lean twoards the depressive pole of the disorder. The flatness often associated with mood stabs often need to be seen thru the normal eye vs our own. when manic, we are high...we taste life and know it tastes better than normal....mood medsw take that from us by design
> . On depecote, yrs ago i felt i had blunted affect only to realive that I had been looking thru rose colered glasses.
>
> AS for the AD, wellbuterin is ofetn indicated for us as it is less "stimulating than ssris and ssri's.
>
> tony
Tony, I appreciate your input about the falttening effect. Here is an interesting thing that happened to me:
About 10 years ago I was put on verapmil for a heart condition - before I ever new about the mild mood stabilizing properties of this drug. After 3 weeks on it I felt extremely screwed up. I thought for sure it was deppresion or psychosis. I finally figured out that I started feeling this way around the time I started Verapmil. Upon stopping I started to feel ok. I was again prescribed this verapamil a year or so later for the same condition but I could'nt remember why I discontinued it in the past. A short time after starting up again I remembered. It was that same scary feeling. Like I was about to loose my mind and could'nt quite explain how I felt. Not right, is the best words I could use to desribe the feeling. So I was put back on my beta blocker med. Now I read in dr. Bob how it has been used for mild mood stabilization. Go figure? Why do pdocs want to keep giving me these things? Can anyone help me out here? What is wrong with me?
I wish pdocs should warn their patients before presribing such powerfull drugs.
Larry
Posted by lostsailor on November 3, 2002, at 16:49:27
In reply to Re: lamictal, posted by lawrence s. on November 2, 2002, at 16:38:07
larry,
I am new an lmictal so i cant say..i have noticed that as reducing my neurontin, i the lamictal already lowering current mania. Much of this was thru lit and talks w/ doc about the drug. I feel much beetea than while on depacote, now, to me that's sedator. hope this helps .
~tony
Posted by Maximus on November 3, 2002, at 21:20:24
In reply to Re: lamictal, posted by lostsailor on November 3, 2002, at 16:49:27
I just want to add my knowledge here, based on my experience, reading, studies, pdoc's chat and facts.
FDA is going to approve soon Lamictal as "long-term management of ***DEPRESSIVE*** episodes in bipolar I/II disorder".
- Lamictal is NOT more effective than placebo in the prevention of mania.
- Lamictal is NOT a replacement for the classic mood stabilizers. It is an add-on. Period.
- Lamictal CAN precipitate mania like any others antidepressants.
- Lamictal is activating. You may have sometimes anxiety, insomnia, etc.
- Lamictal appears to be the only effective and useful treatment in the bipolar depression.
Moreover:
- Lithium and Valproate are NOT more effective than placebo for the treatment of bipolar depression.
- Valproate: great for ACUTE mania. It is fast and powerful. It often precipitates depression.
- Neurontin is NOT more effective than placebo in the prevention of mania.
- Lamictal and valproate have bad interactions together.
- Lamictal and Tegretol have bad interactions together.
- Topamax: inconclusive studies. Can precipitate mania.
- Tegretol: often works when everything has failed in both mania and depression.
Thus,
The new modern treatment for the bipolar condition, i.e. the bleeding cutting edge (but proved, studied and well known) meds are Lithium (mania) + Lamictal (depression) together. They are the best match but not a miracle combo.
I hope this helps.
Best regards,
Max
Posted by polarbear206 on November 4, 2002, at 8:24:38
In reply to Lamictal, **Indications**..., posted by Maximus on November 3, 2002, at 21:20:24
> I just want to add my knowledge here, based on my experience, reading, studies, pdoc's chat and facts.
>
> FDA is going to approve soon Lamictal as "long-term management of ***DEPRESSIVE*** episodes in bipolar I/II disorder".
>
> - Lamictal is NOT more effective than placebo in the prevention of mania.
>
> - Lamictal is NOT a replacement for the classic mood stabilizers. It is an add-on. Period.
>
> - Lamictal CAN precipitate mania like any others antidepressants.
>
> - Lamictal is activating. You may have sometimes anxiety, insomnia, etc.
>
> - Lamictal appears to be the only effective and useful treatment in the bipolar depression.
>
> Moreover:
>
> - Lithium and Valproate are NOT more effective than placebo for the treatment of bipolar depression.
>
> - Valproate: great for ACUTE mania. It is fast and powerful. It often precipitates depression.
>
> - Neurontin is NOT more effective than placebo in the prevention of mania.
>
> - Lamictal and valproate have bad interactions together.
>
> - Lamictal and Tegretol have bad interactions together.
>
> - Topamax: inconclusive studies. Can precipitate mania.
>
> - Tegretol: often works when everything has failed in both mania and depression.
>
> Thus,
>
> The new modern treatment for the bipolar condition, i.e. the bleeding cutting edge (but proved, studied and well known) meds are Lithium (mania) + Lamictal (depression) together. They are the best match but not a miracle combo.
>
> I hope this helps.
>
> Best regards,
>
>
> Max
>
>Max,
I hope this holds true for others. Lamictal has given me my life back after 13 years of various mood stablizers and antidepressants. I have cyclothymia which is depression dominated.
Laura.
Posted by colin wallace on November 4, 2002, at 9:09:15
In reply to Re: Lamictal, **Indications**...MAX, posted by polarbear206 on November 4, 2002, at 8:24:38
Hi Laura,
Glad you're success with Lamictal is holding- mine is too (unless I'm foolish enough to take a sip of alcohol with it!)
Aren't you taking Neurontin aswell? I ask because I tried it briefly, and don't quite know what to make of it.I took one 100mg pill late one evening, and the following day I drove a route I'd taken countless times before, and took every wrong turn possible.I also wandered around putting plates etc. in the wrong cupboards!
I couldn't decide whether I felt irritable, or more relaxed.Strange sensation- very odd.
It did seem to take the 'sharp' and zippy edge from the Lamictal, but that edge is what gave me back my mental faculties.
Does the blunted alertness thing subside with time? I wanted to try it to help with relaxation, and to eventually kick my benzo., but I can easily make do without it.
Any thoughts?Col.
PS. If you're not taking Neurontin, just ignore me!!!
Posted by Maximus on November 4, 2002, at 12:08:21
In reply to Re: Lamictal, **Indications**...MAX, posted by polarbear206 on November 4, 2002, at 8:24:38
> I hope this holds true for others. Lamictal has given me my life back after 13 years of various mood stablizers and antidepressants. I have cyclothymia which is depression dominated.
>
> Laura.Hi Laura,
Thank you for your reply. Yes as a **general rule**, (because there are always some exceptions), Lamictal is finaly the answer for the bipolar depression.
I'm glad it works for you :-)
Max
Posted by Maximus on November 4, 2002, at 12:28:34
In reply to Re: Lamictal, **Indications**.Laura » polarbear206, posted by colin wallace on November 4, 2002, at 9:09:15
Hi Colin,
You mention in your above post that you're taking Neurontin. Althought Neurontin is useless as mood stabilizer, it is a great anti-anxiety med. The usual dosage to get off of these benzos is 300 mg x 3, or 400 mg x 3 a day. The initial side effects, somnolence, dizzness, will go away within a week.
You also said you were feeling anxious/irritable on Lamictal, isn't it? If that edgy feeling does not stop, try a small dose (300 to 450 mg) of Lithium. It will zapp away the residual anxiety, preoccuption or even irritability.
Lamotrigine and Lithium are made to work together.
Bye
Max
Posted by Peter S. on November 5, 2002, at 19:56:29
In reply to Re: Lamictal, **Indications**.Laura » polarbear206, posted by colin wallace on November 4, 2002, at 9:09:15
Hey Colin,
I've had some bizarre disociative experiences with Neurontin. The experience is like being somewhat removed from what I'm doing. I've driven like this and it's pretty scary. Generally when this happens my mood is excellent.
I've noticed that it happens if I take 600mg at one time.Is this similar to your feeling?
Pete
> Hi Laura,
>
> Glad you're success with Lamictal is holding- mine is too (unless I'm foolish enough to take a sip of alcohol with it!)
> Aren't you taking Neurontin aswell? I ask because I tried it briefly, and don't quite know what to make of it.I took one 100mg pill late one evening, and the following day I drove a route I'd taken countless times before, and took every wrong turn possible.I also wandered around putting plates etc. in the wrong cupboards!
> I couldn't decide whether I felt irritable, or more relaxed.Strange sensation- very odd.
> It did seem to take the 'sharp' and zippy edge from the Lamictal, but that edge is what gave me back my mental faculties.
> Does the blunted alertness thing subside with time? I wanted to try it to help with relaxation, and to eventually kick my benzo., but I can easily make do without it.
> Any thoughts?
>
> Col.
>
> PS. If you're not taking Neurontin, just ignore me!!!
Posted by BarbaraCat on November 7, 2002, at 1:36:29
In reply to Re: lamictal, posted by lostsailor on November 3, 2002, at 16:49:27
I'm having great response to lamictal. Now up to 100mg after 4 weeks and its the first med in a long time to lift me out of the deep black despair of a mixed states bipolar depression. No flatness at all. It's added a smooth sparkle that peaks at the 3 hour mark, at which time I take the next half of my dose.
I'm very grateful to Max for his input. Even though Lamictal is tackling the depression, it does nothing for anxiety. I was planning to discontinue my lithium and tapered way down, but have reconsidered. BTW, I'm taking Neurontin as well, although tapering off it since I wasn't noticing much of an effect one way or the other. One major help to me has been taking tryptophan (yes, the stuff of scares a few years ago). I'll be posting a separate thread on this eventually, but I do believe it's turning out to be a miracle in many ways for me.
Posted by polarbear206 on November 7, 2002, at 8:12:56
In reply to Re: lamictal, posted by BarbaraCat on November 7, 2002, at 1:36:29
> I'm having great response to lamictal. Now up to 100mg after 4 weeks and its the first med in a long time to lift me out of the deep black despair of a mixed states bipolar depression. No flatness at all. It's added a smooth sparkle that peaks at the 3 hour mark, at which time I take the next half of my dose.
>
> I'm very grateful to Max for his input. Even though Lamictal is tackling the depression, it does nothing for anxiety. I was planning to discontinue my lithium and tapered way down, but have reconsidered. BTW, I'm taking Neurontin as well, although tapering off it since I wasn't noticing much of an effect one way or the other. One major help to me has been taking tryptophan (yes, the stuff of scares a few years ago). I'll be posting a separate thread on this eventually, but I do believe it's turning out to be a miracle in many ways for me.Hi Barbara,
What antidepressant are you taking along with the mood stabilizers? I'm just wondering if you would try to slowly lower you a/d, it just might help with the lingering anxiety your still having. I'm so glad the lamictal is working for you. The lamictal has been a very good a/d for me. I can't believe how low of the dose I got down to on the paxil. Only on this with the lamictal now. Things just keep getting better with this drug!!!
Laura.
Posted by BarbaraCat on November 7, 2002, at 17:04:17
In reply to Re: lamictalB Cat, posted by polarbear206 on November 7, 2002, at 8:12:56
Hi Laura,
I'm on a smidge of Remeron, 1/4 of 30mg tablet. I've tried discontinuing altogether but get that jangled feeling of stopping an AD. I recently went back to work after 1-1/2 years off and didn't want to risk getting too stressed by stopping my AD. But maybe it's time. I just want that drug out of my system. My poor brain gets confused by all these substances and greatly desires some simplicity.It's interesting how so many people don't respond well to Lamictal. It seems to be custom made for bipolar mixed states depression but not good for other kinds. Just like we don't do well with SSRI's but other depressed people do. Very indicative of our many varied chemistries. I'm very grateful to you, Laura, for steering me in this direction. I just hope it lasts and doesn't peter out on me like all the other meds have. But that's just my anxiety talking. - Barbara
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