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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by SLS on December 13, 2005, at 22:25:49
Lamictal has earned some respect for use as an adjunct to lithium in the prophylaxis and stabilization of bipolar I disorder, and also in the treatment of rapid cycling presentations. However, as an antidepressant, it seems to disappoint more often than it does lead to remission.
I would like to hear from people whom have had treatment successes and treatment failures with Lamictal. It would be helpful to know what other drugs were being taken at the time as well as a given diagnosis or description of symptomology.
I think the success rate of using Lamictal for both unipolar and bipolar depression might depend on what other drugs are to be taken along with it.
-----------------------------------
For now, I would not be without Lamictal. I take 150mg per day in divided doses. In combination with the four other drugs I am taking, it provides mild relief from a severe and anergic bipolar depression. By itself, Lamictal is of no value to me. It is not without side effects. Although not as profoundly as some other drugs, it does effect deleteriously memory (particularly short-term memory) and cognition. It is also blunts to some degree motivation and affect.Currently:
Lamictal 150mg
Parnate 80mg
nortripyline 100mg
Abilify 10mg
Keppra 750mg
- Scott
Posted by theo on December 13, 2005, at 22:48:39
In reply to Lamictal: A disappointing drug for depression., posted by SLS on December 13, 2005, at 22:25:49
Lamictal for me was an endless chase. With each titration I would feel good for about a week, then the effects would diminish. When I reached 150mg, memory loss was bad along with acid reflux so I discontinued it completely. I also had this warm feeling in my brain like it was soaking in warm water, really weird. It is a very inconsistant med, brief moments of clarity would occur, only to be followed by long periods of nothing.
Posted by Phillipa on December 13, 2005, at 23:00:17
In reply to Re: Lamictal: A disappointing drug for depression. » SLS, posted by theo on December 13, 2005, at 22:48:39
So are you saying it's not that good for depression? Thought it was better than trileptal? Fondly, Phillipa
Posted by Racer on December 14, 2005, at 0:37:20
In reply to Re: Lamictal: A disappointing drug for depression., posted by Phillipa on December 13, 2005, at 23:00:17
Well, after two experiences with it, a year and a half apart, I can safely say that I'm not one that it's helped.
The first time was miserable -- I don't think I got beyond 50mg. The 25mg was OK, didn't seem to do much of anything, but within days of starting the 50mg, I couldn't sleep, racing thoughts, anxiety through the roof (including the sort of emotional anxiety that I don't usually get) -- basically, I was on the very edge of hysteria. And, of course, couldn't get through to Dr EyeCandy to get any help. The clerk called back, after several hours and at least two telephone calls, to say that "doctor says the drugs have been working, so keep taking them." ?? That was when I stopped all drugs last year, cold turkey, and went through benzo withdrawal complete with technicolor effects.
At that time, I was taking Lamictal, 100mg Zoloft, and 4mg Xanax each night, in one dose, for sleep.
Then I tried it again this year, with slightly better results. At that time, I was taking Cymbalta, Wellbutrin XL, and the Lamictal, and got up to 200mg. There was nothing good happening with it, until I got to 150mg -- which good lasted three days. Then, again, at 200mg, I had about two good days before it faded.
Side effects were basically feeling as though I might as well be dead. I could hardly move, no motivation, no energy, didn't want to talk -- GG can tell you that we went into withdrawal from our chats during that time -- just generally lay on the sofa and didn't even bother to change the TV channels. I could have been watching the test patterns for all I was aware. It was really terrible for me. And it was terribly constipating.
Once I got back to the bad days, after that little good blip at 200mg, I called and told the doctor I was stopping it, that I was stopping it RIGHTAWAY, that I was not willing to discuss continuing to a higher dosage because I was so miserable. He wasn't awfully pleased about it. He kept telling me he had great results with it. Which is fine -- it still wasn't working for me.
Interesting thread, Scott. I look forward to reading what other people have to say.
Posted by blueberry on December 14, 2005, at 6:20:23
In reply to Lamictal: A disappointing drug for depression., posted by SLS on December 13, 2005, at 22:25:49
I took lamictal about 5 years ago along with 20mg prozac and 15mg remeron. Though I wasn't depressed, lamictal was added to see if it could work on the persistent anhedonia.
I had sleep troubles on lamictal and could not get above 125mg. It had no effect on anhedonia or anything else that I remember. It was fairly invisible in terms of effects or side effects. I weaned off after 6 months of realizing that I was takinig a risky expensive medicine that was doing nothing for me except ruining sleep.
Posted by banga on December 14, 2005, at 10:08:39
In reply to Re: Lamictal: A disappointing drug for depression., posted by blueberry on December 14, 2005, at 6:20:23
Lamictal alone did nothing for me (depression/anxiety).
When I was taking it in combo with desipramine, abilify, luvox, and adderall, I was not sure it added anything. I dropped it when I got pregnant...my mood did slip a little and I am not sure, perhaps it did help a tad? Hard to tell...but in any case it did not add much.
Posted by gardenergirl on December 14, 2005, at 10:20:16
In reply to Lamictal: A disappointing drug for depression., posted by SLS on December 13, 2005, at 22:25:49
I'm taking 75 mg Lamictal with 60 mg Nardil, and at the moment (fingers and toes crossed), I'm depression-free for the first time in forever. It's been so long, I worried I was hypomanic, but it's really just me feeling not depressed.
gg
Posted by zenhussy on December 14, 2005, at 12:04:52
In reply to Lamictal: A disappointing drug for depression., posted by SLS on December 13, 2005, at 22:25:49
our experience with lamotrigine (Lamictal in USA)
lamotrigine as adjunct for unipolar depression (from post in first link below: Brief rundown of symptoms: PTSD with heavy dissociation when confronting the issues surrounding the traumas, depressive episodes with lack of sense of future, very sudden sucidal thoughts beginning in October of this year with the setting of a death date in my mind for early next year, robotic feeling of going through the motions of life while not really experiencing it. Dec 02, 2003 )
Dec 2, 2003 http://www.dr-bob.org/babble/20031202/msgs/286102.html
Dec 8, 2003 discouraged by titration http://www.dr-bob.org/babble/20031208/msgs/287712.html
Dec 13, 2003 four weeks on lamotrigine problems with sudden sleepiness http://www.dr-bob.org/babble/20031213/msgs/289481.html
Dec 15, 2003 at the 25 mg level http://www.dr-bob.org/babble/20031213/msgs/290101.html
Dec 18, 2003 at 37.5 mg lamotrigine http://www.dr-bob.org/babble/20031213/msgs/291404.html
Dec 30, 2003 http://www.dr-bob.org/babble/20031225/msgs/294548.html
Jan 03, 2004 last babble post re: lamotrigine trial before discontinuing lamotrigine in Feb/Mar 2004 http://www.dr-bob.org/babble/social/20031229/msgs/296149.html
mid November 2003-February or March 2004 from 12.5 mg to 50 mg w/o ability to go higher w/o significant SEs. four months with little to no "real" lifting of depressive symptoms.
have heard it works well for some. lucky them!! turned us into equivalent of doorknob for brains and butterfingers for dexterity.
Posted by SLS on December 14, 2005, at 20:26:09
In reply to Lamictal: A disappointing drug for depression., posted by SLS on December 13, 2005, at 22:25:49
With Lamictal, I've noticed:
1. One will have a robust, but brief response early in treatment at dosages of 25-50mg.
2. This response fades but is recaptured upon subsequent dosage increases, whereupon it is soon lost again.
3. Some people retain a mild response at higher dosages that remains inadequate.
4. Reducing the dosage produces a rebound depression that is not to be confused with a relapse.
- Scott
Posted by Phillipa on December 14, 2005, at 20:39:39
In reply to Re: Lamictal: A disappointing drug for depression., posted by banga on December 14, 2005, at 10:08:39
Hi Banga it's been a long time since I've seen a post from you. So have you had a baby? Fondly, Phillipa
Posted by SLS on December 14, 2005, at 20:45:04
In reply to Re: Lamictal: A disappointing drug for depression., posted by SLS on December 14, 2005, at 20:26:09
> With Lamictal, I've noticed:
>
> 1. One will have a robust, but brief response early in treatment at dosages of 25-50mg.
>
> 2. This response fades but is recaptured upon subsequent dosage increases, whereupon it is soon lost again.
>
> 3. Some people retain a mild response at higher dosages that remains inadequate.
>
> 4. Reducing the dosage produces a rebound depression that is not to be confused with a relapse.Also:
5. Reducing the dosage produces a temporary improvement in some people that is not to be confused with a true antidepressant response.
6. Lamictal can precipitate mania.
- Scott
Posted by SLS on December 14, 2005, at 20:56:13
In reply to Re: Lamictal: A disappointing drug for depression., posted by Phillipa on December 13, 2005, at 23:00:17
> So are you saying it's not that good for depression? Thought it was better than trileptal? Fondly, Phillipa
The easy way out of responding to your question is to say that we are all different and that some people respond favorably to Lamictal. However, I am under the impression that Lamictal is not a potent antidepressant by itself and might not be a universal augmentor, even for bipolar disorder. Trileptal is a potentially useful drug when treating unequivocal bipolar disorder. Like its cousin, Tegretol, I think it can produce a robust and stable antidepressant response as well as being an antimanic for those people whose biology it complements, along with long-term mood stabilization. For true unipolar depression, Lamictal is probably more useful than Trileptal.
- Scott
Posted by Phillipa on December 14, 2005, at 21:56:53
In reply to Re: Lamictal: A disappointing drug for depression. » Phillipa, posted by SLS on December 14, 2005, at 20:56:13
Scott thanks. My old pdoc had wanted to rx lamictal and when I mentioned a rash she said then try trileptal. Waiting for next Thursday. Fondly, Phillipa
Posted by ExcellentCamper on December 14, 2005, at 22:10:11
In reply to Re: Lamictal: A disappointing drug for depression., posted by blueberry on December 14, 2005, at 6:20:23
Lamictal is great for my rumination. It pretty much eliminates it. When I miss doses for a couple of days, I fall into a self-loathing rut. I've had no side-effects at 150mg, which is amazing for me.
When I first started it, I had this incredible response to it interacting with my Wellbutrin. For a couple of weeks, I felt great ... like a veil had dropped, and I could see everything so vividly. Even a coal-burning power plant looked positively beautiful to me. But that faded, and I was never able to recapture it. I dropped the Wellbutrin several months ago and had just been taking Lamictal.
Recently I added Selegiline at 10mg per day, with DLPA 1000mg in the morning. No real difference so far. (See above post.) I'm trying to target dopamine.
Good luck with your search,
Will
Posted by Peter S. on December 14, 2005, at 23:02:33
In reply to Re: Lamictal: A disappointing drug for depression., posted by ExcellentCamper on December 14, 2005, at 22:10:11
Lamictal has been the most effective uni-polar anti-depressant med for me and has worked for the last 2 years. There is a caveat in that it gives me a mood boost about an hour after I take it in the morning which then goes away after about 5 hours. I take 50mg and have noticed that increasing the dose doesn't really make a huge difference. I also take Neurontin and Cymbalta which both help as well.
I am by no means depression free but without the Lamictal I would be a lot less productive in the morning! It really helps at work.
Posted by blueberry on December 15, 2005, at 4:49:00
In reply to Re: Lamictal: A disappointing drug for depression., posted by SLS on December 14, 2005, at 20:26:09
It's just my own theory, but I think the initial good effects that then fade are related to dopamine. I've read in several places that when dopamine depleting drugs are used, lamictal prevents the dopamine depletion. A former pcod of mine told me that lamictal has considerable action on dopamine (after I told him lamictal increased my libido). So maybe the initial good response is due to enhanced dopamine function, which then fades as tolerance rapidly sets in. As is noticed with most dopamine enhancing drugs, tolerance sets in very fast and the intial good effects are lost.
This theorized dopamine effect I believe would be independent of the other actions that lamictal has.
> With Lamictal, I've noticed:
>
> 1. One will have a robust, but brief response early in treatment at dosages of 25-50mg.
>
> 2. This response fades but is recaptured upon subsequent dosage increases, whereupon it is soon lost again.
>
> 3. Some people retain a mild response at higher dosages that remains inadequate.
>
> 4. Reducing the dosage produces a rebound depression that is not to be confused with a relapse.
>
>
> - Scott
Posted by sassie on December 17, 2005, at 17:03:41
In reply to Lamictal: A disappointing drug for depression., posted by SLS on December 13, 2005, at 22:25:49
hi im supposed to see my pdoc monday and the plan is to augment my wellbutrin sr 100 mg with either trileptal or lamictal. i have depression as well as panic attacks, and wellbutrin has helped with my depression but its increased my anxiety level and i also become hysterically upset or angry when triggered and i know thats not a normal reaction
i can't take SSRI's or SNRI's, and klonopin hasn't been enough to control my panic attacks so my pdoc recommended one of those two mood stabilizers. after reading this thread im a little bit nervous to try lamictal. would trileptal be better? any advice would be appreciated, i've had bad experiences with meds so trying a mood stabilizer for the first time is scary for me. thanks for the help
Posted by octopusprime on December 18, 2005, at 1:35:21
In reply to So Lamictal or Trileptal for depression?, posted by sassie on December 17, 2005, at 17:03:41
i just passed 65+ days with lamictal - the five week titrate up to 200 mg. it is the only drug i am taking. i am waking early again (2-3 times weekly). the sleep issue is the only really troubling symptom remaining. my concentration is good at work again. keeps the blind rages and the tears under control. etc. the pdoc is impressed with my progress, frankly i am too.
depression has not been my major problem for quite some time - rather, the hypomanic/agitated phases of bipolar 2 are more problematic for me. perhaps that explains a better response?
Posted by denise1966 on December 18, 2005, at 13:07:20
In reply to Lamictal: A disappointing drug for depression., posted by SLS on December 13, 2005, at 22:25:49
Hi Scott,
Over a period of six months I got up to 200mg of Lamictal, first with Sertraline(Zooloft) and then on its own. I don't remember it doing anything, it felt like I might as well have been taking sugar tablets.
I then went onto 40mg Seroxat after an unsuccessful Nardil trial and the Seroxat seemed to start helping but isn't anymore so it's back to the drawing board :-(
Kind Regards
Denise
Posted by Timebomb on March 25, 2015, at 13:24:58
In reply to Re: Lamictal: A disappointing drug for depression., posted by Racer on December 14, 2005, at 0:37:20
This is an INCREDIBLY old post, but I wanted to add my own experience of Lamictal side effects. I too currently feel 'dead.' Unable to function and just feel like staring at the wall. It's appalling and I can't wait to have this medication out of my body.
I was prescribed it for Derealisation and Depression. Both of which it has made worse, even with an SSRI added.
> Well, after two experiences with it, a year and a half apart, I can safely say that I'm not one that it's helped.
>
> The first time was miserable -- I don't think I got beyond 50mg. The 25mg was OK, didn't seem to do much of anything, but within days of starting the 50mg, I couldn't sleep, racing thoughts, anxiety through the roof (including the sort of emotional anxiety that I don't usually get) -- basically, I was on the very edge of hysteria. And, of course, couldn't get through to Dr EyeCandy to get any help. The clerk called back, after several hours and at least two telephone calls, to say that "doctor says the drugs have been working, so keep taking them." ?? That was when I stopped all drugs last year, cold turkey, and went through benzo withdrawal complete with technicolor effects.
>
> At that time, I was taking Lamictal, 100mg Zoloft, and 4mg Xanax each night, in one dose, for sleep.
>
> Then I tried it again this year, with slightly better results. At that time, I was taking Cymbalta, Wellbutrin XL, and the Lamictal, and got up to 200mg. There was nothing good happening with it, until I got to 150mg -- which good lasted three days. Then, again, at 200mg, I had about two good days before it faded.
>
> Side effects were basically feeling as though I might as well be dead. I could hardly move, no motivation, no energy, didn't want to talk -- GG can tell you that we went into withdrawal from our chats during that time -- just generally lay on the sofa and didn't even bother to change the TV channels. I could have been watching the test patterns for all I was aware. It was really terrible for me. And it was terribly constipating.
>
> Once I got back to the bad days, after that little good blip at 200mg, I called and told the doctor I was stopping it, that I was stopping it RIGHTAWAY, that I was not willing to discuss continuing to a higher dosage because I was so miserable. He wasn't awfully pleased about it. He kept telling me he had great results with it. Which is fine -- it still wasn't working for me.
>
> Interesting thread, Scott. I look forward to reading what other people have to say.
Posted by Lamdage22 on April 16, 2015, at 8:23:47
In reply to Re: Lamictal: A disappointing drug for depression., posted by Timebomb on March 25, 2015, at 13:24:58
Lamictal does nothing for depression for me.
Like pretty much everything else... so...
Not good
This is the end of the thread.
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