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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Rachel Terese on May 3, 2004, at 20:22:54
I have been taking Lamictal for three weeks now. Am up to 100mg/day. I am more depressed than I've ever been. I can't stop crying and am very irritable. I feel way worse than I did before I started taking it. I think the only difference is that I'm not moody... not as much back and forth. But at least before I was happy sometimes. I don't care about anything anymore. I can't make any decisions. I fall asleep in the middle of the day and am restless at night. I don't know what to do. I'm supposed to go up to 200mg/day, but want to give in right now. I want to be happy again, but not so crazy back and forth between extreme irritability/moodiness and too hypomanic. Any advice?
Posted by chemist on May 4, 2004, at 12:02:14
In reply to question for chemist: lamictal and depression, posted by Rachel Terese on May 3, 2004, at 20:22:54
> I have been taking Lamictal for three weeks now. Am up to 100mg/day. I am more depressed than I've ever been. I can't stop crying and am very irritable. I feel way worse than I did before I started taking it. I think the only difference is that I'm not moody... not as much back and forth. But at least before I was happy sometimes. I don't care about anything anymore. I can't make any decisions. I fall asleep in the middle of the day and am restless at night. I don't know what to do. I'm supposed to go up to 200mg/day, but want to give in right now. I want to be happy again, but not so crazy back and forth between extreme irritability/moodiness and too hypomanic. Any advice?
hi rachel, your story sounds quite unpleasant...i have read and heard good things about lamictal for use in bipolar disorder (and heard/read the bad, too)...i would be remiss if, naturally, i presented a little bit of the literature to you - most of my posts tend to be wordy, and maybe even useful...i have 15 journal articles culled from my files, publication dates 2000-2003, a few of them being reviews and the rest being the studies to which the reviews refer. keeping in mind that this drug might not be right for *you* or that it is not effective *yet* or that you should not take it as monotherapy: lamictal is very, very well documented in alleviating the depressive side of the bipolar spectrum, and there are few data that support efficacy in acute mania, although all of my references (i will provide citation list to anyone interested, just ask) keep coming back to lamictal being most effective for the depression side of the spectrum. and finally, the number 200 mg/day does seem to come up quite frequently as the effective dose. which brings us to your situation: you are slowly-titrating for purposes of avoiding stevens-johnson syndrome, and i assume that you are progressing rash-free. there are a few things that may be posible in your situation. (1) you are not bipolar but unipolar and this medication is inappropriate in your case; (2) you are bipolar and are simply not feeling the full effect of lamictal at your dosage; (3) you are bipolar and happen to be particularly affected in a hypomanic/manic state, and thus the rapid onset of depression before therepeutic levels of the drug have been reached; (4) you are bipolar and lamictal is simply not going to work for you. i have to ask, are you taking it as monotherapy? you do not indicate any other meds in your post....let me know if any of this helps, and i do hope you are feeling better as soon as possible....all the best and well wishes, chemist
Posted by Rachel Terese on May 4, 2004, at 15:38:48
In reply to Re: question for chemist: lamictal and depression » Rachel Terese, posted by chemist on May 4, 2004, at 12:02:14
I'm taking Klonopin 1/2mg during the day and 1 at night for insomnia. I just talked to my nurse today (I have Kaiser and apparently cannot see a real doctor) and she put me on 10mg paxil to increase to 20mg in a week. I'm also apparently only to stay at 100mg because she doesn't think any higher dosage will help. I told her that Paxil has horrible sexual side effects and withdrawl (used to be up to 80mg/day). She was very abrupt and said she didn't think I had any other options. I know there are hundreds of drugs out there. I just cannot going on feeling this way. I've also lost 5 pounds and am down to 106 (5'5"). Sorry I rambled so much, but am very frustrated... I feel like I'm not being listened to. Thank you so much for your advice.
Posted by chemist on May 4, 2004, at 15:48:11
In reply to Re: question for chemist: lamictal and depression, posted by Rachel Terese on May 4, 2004, at 15:38:48
> I'm taking Klonopin 1/2mg during the day and 1 at night for insomnia. I just talked to my nurse today (I have Kaiser and apparently cannot see a real doctor) and she put me on 10mg paxil to increase to 20mg in a week. I'm also apparently only to stay at 100mg because she doesn't think any higher dosage will help. I told her that Paxil has horrible sexual side effects and withdrawl (used to be up to 80mg/day). She was very abrupt and said she didn't think I had any other options. I know there are hundreds of drugs out there. I just cannot going on feeling this way. I've also lost 5 pounds and am down to 106 (5'5"). Sorry I rambled so much, but am very frustrated... I feel like I'm not being listened to. Thank you so much for your advice.
hi rachel, perhaps it is the paxil that you have had such a bad history with in the past that is the cause of your problems now, in addition to being held at a less-than-therapeutic dose of lamictal...if i were you - this is my opinion, and i am a ph.d., not an m.d. - i would hold the paxil dose low while trying to find another doctor who can ramp you up on lamictal to see if it takes hold. also, you might try doing 0.5 mg of klonopin throughout the day, not loading up too heavy with 1 mg at bedtime....this will reduce the clobberring, if you will, of taking a big dose of klonopin at once and might be adding to your depression...please let me know if i can be of any help, and all the best, chemist
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