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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by Whit_in_Texas on March 30, 2006, at 7:32:01
This is my third time to try lamictal because my pdoc thinks it will help, but every time I get to a certain point, I feel more depressed and fatigued. I am taking most of it at night now, but I thought it was supposed to be activating?
I am up to 125mg now.
Posted by SLS on March 30, 2006, at 7:59:36
In reply to Lamictal causing depression?, posted by Whit_in_Texas on March 30, 2006, at 7:32:01
> This is my third time to try lamictal because my pdoc thinks it will help, but every time I get to a certain point, I feel more depressed and fatigued. I am taking most of it at night now, but I thought it was supposed to be activating?
>
> I am up to 125mg now.Hmm. That is certainly an atypical reaction to Lamictal, but I doubt it is unique. When it comes to psychotropics, there is great variability between individuals as to how one reacts to a given drug. Not that it would make any difference, but I find that splitting up my dosage to twice a day works better than taking it all at once.
In what ways are you more depressed?
What is your current diagnosis?
I'm sure some others whom have had the same reaction as yours will reply to your post. If I were in your position, I would find it difficult to justify the continuation of treatment.
- Scott
Posted by Sobriquet Style on March 30, 2006, at 8:16:45
In reply to Lamictal causing depression?, posted by Whit_in_Texas on March 30, 2006, at 7:32:01
>This is my third time to try lamictal
Its my second.
>but every time I get to a certain point, I feel more depressed and fatigued.
This has happened to me too, in a similar way. At first I feel an 'ok' antidepressant response. Also my sleep doesn't improve, but I need less of it which I think helps the antidepressant effect. Overtime, and its been afew weeks, my mood remains stable in some respects, however I begin to flat and slowly the antidepressant effects where off.
>I am up to 125mg now.
I'm using 12.5mg, soon to be 6.25mg and then then nothing. :-(
If my mood feels little differnece from using nothing, i'm not going to continue with Lamictal, if theres the slightest chance it was better with the drug, i'll use it again in very low dosages. Anything above 25mg for me clearly doesn't help, strangely enough it is a very low dosage but I know of others who use a very small dosage too.
Like me, you may find smaller dosages will bring more benefits compared to lower ones, but obviously everyone is different etc.
~
Posted by Whit_in_Texas on March 30, 2006, at 8:33:14
In reply to Re: Lamictal causing depression? » Whit_in_Texas, posted by SLS on March 30, 2006, at 7:59:36
> Hmm. That is certainly an atypical reaction to >Lamictal, but I doubt it is unique. When it >comes to psychotropics, there is great >variability between individuals as to how one >reacts to a given drug. Not that it would make >any difference, but I find that splitting up my >dosage to twice a day works better than taking >it all at once.I tried that, but then I am sleepy all day so I take most at night.
>
> In what ways are you more depressed?
>
Mainly anhedonia. I was taking Adderall to combat that, but the lamictal seems to be canceling it out. I am now trying to get off Adderall completely for different reasons (the rollercoaster ride of tolerance and drug holidays is becoming too frequent and maddening).> What is your current diagnosis?
Bipolar 2
> I'm sure some others whom have had the same reaction as yours will reply to your post. If I were in your position, I would find it difficult to justify the continuation of treatment.
>
Pdoc said to try to ride it out until I reach the therapeutic dosage so I am trying. I am so desperate for something to work.
Posted by maryhelen on March 30, 2006, at 8:59:10
In reply to Lamictal causing depression?, posted by Whit_in_Texas on March 30, 2006, at 7:32:01
> This is my third time to try lamictal because my pdoc thinks it will help, but every time I get to a certain point, I feel more depressed and fatigued. I am taking most of it at night now, but I thought it was supposed to be activating?
>
> I am up to 125mg now.I am also on my third trial of Lamitcal. I took it three years ago and it worked. It was astonishing not to be depressed. The problem was that the response lasted for only 6 weeks and then over the next 2 weeks my mood kept slipping until I was back into my disabling depression. We tried it again after a year of tryng other meds, to no avail. Without going into my long 25 years of trying just about everything to blast ( pdoc's word) this depression out of me, I guess my psych doc decided that another trial of Lamitcal, along with Lithium and Cipralex (SSRI) is worth giving a try.
Given that this is the third trial of Lamitcal, why does your doctor feel that it is a going to help you this time? Before you get to the where you feel more depressed and fatigued, are you getting a good response to the depression? Is the doctor going to try a higher dose? I am just trying to understand why he would give you a drug for the third time when you end up feeling the way you do. How long do you think you will keep taking it?
I have heard that others get a good response from Lamitcal and then it poops out, like I experienced, and yet others do not get the poop out. It is all so darned frustrating!
I do not remember if Lamitcal was activating for me or not. I am and have always been and very tired and fatigued person. Although, it may have been because I had just returned to work after 2 years and was able to even work overtime. I really don't know.
Others should be able to answer your question better than I. I just wanted to share with you that I am also on my third trial. I am at 75mg. now and have gone as high as 400 mg on the second trial.
Good luck!
maryhelen
Posted by Whit_in_Texas on March 30, 2006, at 9:02:42
In reply to Re: Lamictal causing depression?, posted by maryhelen on March 30, 2006, at 8:59:10
>
> Given that this is the third trial of Lamitcal, why does your doctor feel that it is a going to help you this time?I never got up to a therapeutic dosage before...quit because I didn't like the side effects.
Before you get to the where you feel more depressed and fatigued, are you getting a good response to the depression?
not really
Is the doctor going to try a higher dose? I am just trying to understand why he would give you a drug for the third time when you end up feeling the way you do. How long do you think you will keep taking it?
I planned to reach the therapeutic dose and stay there for a couple of weeks to see if it helped.
>
> I have heard that others get a good response from Lamitcal and then it poops out, like I experienced, and yet others do not get the poop out. It is all so darned frustrating!
>
I seem to poop out on everything,too.
Posted by SLS on March 30, 2006, at 9:32:10
In reply to Re: Lamictal causing depression?, posted by Whit_in_Texas on March 30, 2006, at 8:33:14
> > I'm sure some others whom have had the same reaction as yours will reply to your post. If I were in your position, I would find it difficult to justify the continuation of treatment.
> Pdoc said to try to ride it out until I reach the therapeutic dosage so I am trying. I am so desperate for something to work.You have plenty of support here if things get rough. People often don't get the maximum effect of Lamictal until they reach dosages of between 200-300mg.
Good luck.
- Scott
Posted by RetiredYoung on March 30, 2006, at 9:34:11
In reply to Re: Lamictal causing depression?, posted by Whit_in_Texas on March 30, 2006, at 9:02:42
Lamictal seemed to cause my depression to get worse. I tried adding it to my Prozac/Zyprexa mix and within the first couple of days, I felt more depression so immediately abandoned the Lamictal. In retrospect, I wish that I would have tried sticking it out a little longer to see if things improved, but I don't usually make very sound decisions when I'm feeling depressed.
Jim
Posted by Maxime on March 30, 2006, at 10:36:53
In reply to Lamictal causing depression?, posted by Whit_in_Texas on March 30, 2006, at 7:32:01
I took lamictal and up to 75 mg it had no effect on me. 100 -125 mg made me more depressed. I went off it and switched to Trileptal.
Maxime
> This is my third time to try lamictal because my pdoc thinks it will help, but every time I get to a certain point, I feel more depressed and fatigued. I am taking most of it at night now, but I thought it was supposed to be activating?
>
> I am up to 125mg now.
Posted by blueberry on March 30, 2006, at 17:39:07
In reply to Lamictal causing depression?, posted by Whit_in_Texas on March 30, 2006, at 7:32:01
I took 100mg lamictal for about 6 months. Not much effect really, other than some general dulling effects. I did feel some increase of depression with each dose increase, which then settled after a few days. But when I tried to go from 100mg to 125mg, depression got a lot worse. I said forget it. Tapered off.
I hate it when docs say "therapeutic dose". Therapeutic dose for who? Someone else? All I care about is MY therapeutic dose, which is probably dramatically lower or higher than the general population. I'm not a statistic ya know?
Anyway, yeah, lamictal was generally depressing for me.
Posted by sigolene on April 2, 2006, at 0:12:46
In reply to Lamictal causing depression?, posted by Whit_in_Texas on March 30, 2006, at 7:32:01
I experienced a good effect on Lamictal 25mg for 3 months, then depression again. But my pdoc said I have to increase Lamictal up to 200mg (what I did slowly) and he said that it can take until 6 months to 1 year sometimes to be effective ! We'll see.
Posted by SLS on April 2, 2006, at 7:11:12
In reply to Re: Lamictal causing depression?, posted by sigolene on April 2, 2006, at 0:12:46
> I experienced a good effect on Lamictal 25mg for 3 months, then depression again. But my pdoc said I have to increase Lamictal up to 200mg (what I did slowly) and he said that it can take until 6 months to 1 year sometimes to be effective ! We'll see.
That doesn't sound right to me if one is treating unipolar depression or bipolar depression in the absence of rapid cycling. It can, however, take 6 months or more if one is attempting to treat rapid-cycling.
If you are not rapid-cycling, I would suggest that you continue to work with other treatments with or without Lamictal. You might want to add Wellbutrin at this point.
- Scott
Posted by sigolene on April 2, 2006, at 7:30:16
In reply to Re: Lamictal causing depression? » sigolene, posted by SLS on April 2, 2006, at 7:11:12
Thank you for your advice. I'm bipolar II rapid cycling, and I'm already since 3 weeks on wellbutrin 300mg. But now I feel so TIRED that I could sleep everywhere, even if I add ritalin.
Do you know if this effect with wellbutrin can go away after more than 3 weeks ?
Posted by SLS on April 2, 2006, at 7:58:48
In reply to Re: Lamictal causing depression? Scott » SLS, posted by sigolene on April 2, 2006, at 7:30:16
> Thank you for your advice. I'm bipolar II rapid cycling, and I'm already since 3 weeks on wellbutrin 300mg. But now I feel so TIRED that I could sleep everywhere, even if I add ritalin.
> Do you know if this effect with wellbutrin can go away after more than 3 weeks ?
I have been taking Wellbutrin for 3 weeks too. I have noticed some tiredness, and I do sleep alot. I don't know how long it will last, but I think it is worth continuing. Caffeine helps.I hope you get well soon.
- Scott
Posted by Racer on April 2, 2006, at 14:37:31
In reply to Lamictal causing depression?, posted by Whit_in_Texas on March 30, 2006, at 7:32:01
> This is my third time to try lamictal because my pdoc thinks it will help, but every time I get to a certain point, I feel more depressed and fatigued. I am taking most of it at night now, but I thought it was supposed to be activating?
>
> I am up to 125mg now.I'm feeling a bit dim this morning, so forgive me. Did you say that you never got up to therapeutic doses on your other trials? If that's the case, then it's worth titrating up to 200mg and staying there for a couple of weeks -- just to see what you see. Might be that it's the right answer for you. And it does show good faith cooperation with your doctor, always a good thing.
But your experience sounds a lot like mine. I tried Lamictal twice, the first time for several weeks and it ended with a huge meltdown on my part -- no sleep for several days, uncontrollable twitching, etc. That was combined with so many other drugs, though, and they'd pretty much all been shuffled around too recently to know if that was the Lamictal, and it wasn't even high enough dose to make me think that was really the problem. So we'll ignore that, 'k? The second, though, I got to 200mg and stayed there for several weeks. What happened was that I had a few days of improvement at 150mg, and at 200mg, but otherwise it increased my depression pretty severely. Just not the right drug for me, at all. The doctor wanted to raise it, just because I did have those few days of relief at each dosage increase, but since I was MORE depressed each time, after it passed, I wasn't willing. I had just gotten to where if this was it, it wasn't good enough and I'd just as soon give up. And that feeling passed within a week or so of getting off it.
So, in my opinion, it's worth giving it a try. It's worth raising it to therapeutic dosages, although I probably wouldn't bother going above 200mg. It's worth giving it a couple of weeks to see if it's going to be your friend.
But it's also not a magic cure for every case of depression, no matter how popular it is getting. It may not help you. All you've lost is time, which is unfortunate, because your time is valuable, and it's hellish to feel this bad, but at least you're likely to have some rebound improvement when you stop it, if it doesn't work.
Good lcuk.
Posted by Whit_in_Texas on April 2, 2006, at 16:55:33
In reply to Re: Lamictal causing depression? Scott » sigolene, posted by SLS on April 2, 2006, at 7:58:48
Hello everyone, I am the real Whit. The person writing in my stead previously is my wife. I have no problem with her doing so and I gave her full permission to do so (as I was completely non-functional). Besides, she has a Ph.D. in Psychology, and has had me as a 12 year "in-patient"!
Anyway, I have some of my own questions that I would love to get your feedback on. First, let me tell you that I have a severe case of treatment resistant depression which blasted its way into my life about 15 years ago. Since then my diagnosis has bounced all over the place – MDE, BP I, BPII, ADHD. I’ve been through just about the full gamut of treatments, including SSRIs, atypicals, MAOIs and Tri-cyclics – I even got so desperate I asked to have ECT done (had 3 treatments – lost a lot of memory – I don’t recommend it).
A few years ago – 5 at least – I was visiting back home in Austin. My brother had been taking Ritalin and Adderall practically his whole life and had a bunch of med bottles in the middle of the kitchen table. This was back before the backlash against those drugs and Adderall was working so well for my brother. The bottle was almost full and, being the curious cat that I am, I took one (10mg I think). I have my own bachelors in Psych. and had a lot of courses in psychopharmacology, etc. so I knew it wouldn’t do me too much harm.
Anyone out there that has taken amphetamine in any form, illicit or prescribed (Adderall consists of a mix of Amphetamine salts), can relate back to their first use. Bliss and euphoria all over the place. It kicked in as we were driving home, subtly but steadily. I was thinking, “This must be what it is like to be normal” and could not believe that a tiny little pill could have such an amazing effect. Now I wish that I had never experienced it.
Cutting to the chase: I convinced my pdoc to let me try Adderall. First 10mg, then 20mg, and after switching pdocs a couple of times I was taking EIGHTY mg of Adderall, on top of the plethora of other meds, just to feel normal. I was also put on Klonopin (up to 4mg/day) to I could sleep at night. It gut really ugly after that but I will spare you.
So now here I am: suffering from a dual addiction to Adderall and Klonopin on top of my original depression. I have something of a plan to taper off of the Klonopin, but I need some serious help with the Adderall.
Going off Adderall is pure hell – Anhedonia becomes your master. Unless you have felt it yourself it is impossible to completely comprehend. It means literally “the inability to experience pleasure.” I could try to describe it, but everything falls so short. Let me put it this way: if given the choice between being in full health with anhedonia or becoming a quadriplegic but never experiencing anhedonia, I would take the latter.
DOES ANYBODY KNOW ANYTHING HELPFUL ABOUT ADDERALL WITHDRAWAL???
I just finished three days off of it. I took every sleep aid I had available as sleep is the only escape. I wanted to quit for good but after 3 days I am ready to tear myself apart. I do not want to exist anymore. I wish I had never been born into this hellish world. What were once suicidal ideations are starting to cross the line. And yes, I have been “hospitalized” – several times. Those places are worse than being in jail. Please help me if you know anything helpful at all.
Best regards,Whit
Posted by Racer on April 2, 2006, at 20:09:05
In reply to The real Whit_in_Texas... (quite long...sorry!), posted by Whit_in_Texas on April 2, 2006, at 16:55:33
That sounds terrible.
When you stopped the Adderall, did you taper down? That would probably ease it a bit.
And have you talked to your doctor about how to stop it? Seems to me there would be some drugs that might help with the withdrawal. I'd wonder if maybe Wellbutrin would help? Or even a bit of amantadine? Maybe some Abilify? Those are just thoughts, and they come from someone whose ignorance about psychopharmacology is pretty extensive. Still, there may be something out there that could help get you past this.
Good luck.
Posted by Reggie BoStar on April 8, 2006, at 8:16:02
In reply to Lamictal causing depression?, posted by Whit_in_Texas on March 30, 2006, at 7:32:01
I am currently on a "starter kit" of Lamictal at only 25mg/day. I also take Wellbutrin 150 mg twice a day. Not only is my depression increasing quickly - my appetite is gone and when I do eat I get diarrhea.
But this is typical. Prescribing psychiatrists really don't know which of the many medications alone or in combination will help a given patient. "That recipe didn't work? Well, then let's try this one...."
The pharm industry loves it. What better way to make money than by pumping out a bunch of useless drugs and advertising them as effective?
"If one medication doesn't work, try another. Don't give up, you'll find the one that's right for you!" That's the come-on message. In reality, if you're lucky you'll get an expensive placebo whose side-effects you can tolerate.
So, Wellbutrin and Lamictal have been added to my list of useless money pits.
Posted by curtm on April 17, 2006, at 13:31:30
In reply to Re: Lamictal causing depression? » Whit_in_Texas, posted by Reggie BoStar on April 8, 2006, at 8:16:02
Lamictal works great for me. You may notice the difference later when you are forget to take it sometime. I take 200 mg twice daily. Works better for me to split it because it wears off a little in the late afternoon. Good luck
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