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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by blueberry on May 27, 2006, at 6:30:30
Four days into lamictal I thought I was doing ok, just dealing with side effects. Also taking 2.5mg zyprexa.
Friday afternoon I felt an intense depression coming on and it got worse and worse. By dinner I was crying and in despair. Called my doctor. She said double the dose of lamictal, have something to eat, and watch TV with my daughter, stop the negative thinking. But I couldn't eat and I would have frieked out my daughter bigtime if I sat there sobbing in front of her.
It was cold and raining. I walked to the beach, took my shirt off, laid in the sand I figured I would die of exposure. If I could just get through the shivering part, I would enter that part where you actually feel warm and numb close to the end. Not sure how much time went by, but I was shivering with intense convulsions. Something told me to get up and go home. Could hardly walk. Six inch steps, very drunk-like, shaking uncontrollably, delirious. Went to bed. Woke this morning still crying.
Never in my life have I been this bad. Never have I actually tried to kill myself before. The only thing that changed was the addition of lamictal 25mg.
Posted by psychosage on May 27, 2006, at 7:36:53
In reply to Lamictal causing suicidal attempt, posted by blueberry on May 27, 2006, at 6:30:30
Do you feel irritable and agitated? Could it be a mixed mood brought on by Lamictal like an antidepressant manic switch? Trouble sleeping?
Posted by SLS on May 27, 2006, at 9:17:21
In reply to Lamictal causing suicidal attempt, posted by blueberry on May 27, 2006, at 6:30:30
Hi Blueberry.
Psyhosage might be on to something. Do you feel agitated?
Lamictal can trigger mania. Perhaps it is a mixed-state. It is difficult to say. With psychotropic drugs, one is often reduced to testing them empirically by induction rather than forecasting or explaining their effects by deduction. Paradoxical reactions are very common with these drugs. You know all of this. If this thing continues, it might make sense to discontinue the drug and then, possibly, reintroduce it to test for an association.
In the meantime, I think it makes sense to increase your dosage of Zyprexa. I am dubious that 2.5mg would be that effective at reducing suicidality.
Depression is a clever liar. Try not to listen to what it is saying to you. It is difficult to "not think negatively". Perhaps you can begin to recognize when it is the depression that is talking rather than your intellect. It is so hard. Depression really does warp one's thinking. Perhaps a CBT approach would be helpful.
If it were me, I would try to call the doctor and describe the emergency to him. Maybe he has seen this before. I wouldn't let it go too many days. You don't deserve to suffer unnecessarily.
I know depression can be painful. It is genuine psychic pain. I would consider raising the dosage of Zyprexa at this point in time.
- Scott
Posted by Larry Hoover on May 27, 2006, at 9:28:37
In reply to Lamictal causing suicidal attempt, posted by blueberry on May 27, 2006, at 6:30:30
I'm sorry you had this horrible experience.
Lar
Posted by blueberry on May 27, 2006, at 11:58:14
In reply to Re: Lamictal causing suicidal attempt » blueberry, posted by SLS on May 27, 2006, at 9:17:21
Scott,
No agitation or irritibility at all. Quite calm and relaxed actually. Just an overwhelming suicidal crying sobbing despair type depression. Definitely drug induced, no question about it. This was not a natural course of things I experience day to day. I was in pretty bad shape before beginning lamictal, but nothing in comparison to how I was 4 days later after starting it. Most of today has still been very bad as I patiently wait for lamictal to clear out. Then I'll be back to my baseline which is pretty bad and will go from there.
Zyprexa gives me jitters in the hands, especially upon waking, so I am fearful of increasing the dose above 2.5mg. But as paradoxical as everything has been with me, maybe a higher dose would actually help. The lamictal actually calmed the hand jitters, and right now I can feel the lamictal wearing off, anxiety coming back, and hand jitters returning. The tears seem to be less frequent.
Posted by Phillipa on May 27, 2006, at 14:56:05
In reply to Re: Lamictal causing suicidal attempt » SLS, posted by blueberry on May 27, 2006, at 11:58:14
Blueberry it must be paradoxical cause I read the literture on lamictal last night and the side effects are geared toward anxiety hence am dose. I don't know if I even want to try it. Love Phillipa
Posted by denise1966 on May 27, 2006, at 15:31:36
In reply to Lamictal causing suicidal attempt, posted by blueberry on May 27, 2006, at 6:30:30
Hi Blueberry,
Just want to say I can sort of relate to the way you are feeling on Lamictal. I started with it pretty much inconsistently at a high dose and sort of felt better, clearer headed the next day.
Anyway, I've now started it on a more realistic dose and yesterday I felt not anxious but really sluggish, it felt almsot the way Nardil made me feel. I was sobbing on the phone to my boyfriend (well ex now :-)) and today have been mentally composing a suicide note to my doctor.So I understand how you feel, I definately agree with Scott, to increase the Zyprexa, 10mg of Zyprexa always makes me feel more rational (although I often don't follow my own advice). Here's hoping the Lamictal helps us both.
Wasn't it you who was considering ECT because that's what I've been thinking of pushing for. I'm absolutely sick of faffing around with medication that either doesn't work or makes me feel worse.
Denise
Posted by SLS on May 27, 2006, at 15:42:53
In reply to Re: Lamictal causing suicidal attempt » SLS, posted by blueberry on May 27, 2006, at 11:58:14
Hey you guys!
Please stick around. I guarantee that things will get better.
- Scott
Posted by heaven help me on May 27, 2006, at 15:51:00
In reply to Re: Lamictal causing suicidal attempt, posted by denise1966 on May 27, 2006, at 15:31:36
Have you changed the dose of Zyprexa AT ALL within, say, the last month? When I was on it (for 2 years) and tried to wean off by lowering the dose about 2-3 weeks LATER I went into a major suicidal state. I saw no reason to live (& in reality I have tons) and I just wanted to die. My husband had to hold my face and tell me it was the medicine and to wait longer! I ended up back on the Zyprexa until this year when I took a full year to wean off by very, very slowly reducing it until I was literrally taking a speck a day. In the mean time I went on to Lamictal (200mg/day) and Recently onto Geodon (still checking that one out). So, I do wonder if increasing the Zyprexa is a good idea? I AM NO EXPERT ON THIS! Just sharing my experience.
So sorry to hear how you feel. I have BEEN THERE. Continue to hold on, be strong, mind over mind. It WILL get better.
Blessings
mary
PS: I have to say it really was/is the Lord that keeps me alive but I don't want to offend anyone and get kicked off the board...but it's true
:)
Posted by Phillipa on May 27, 2006, at 16:02:48
In reply to Re: Lamictal causing suicidal attempt » blueberry, posted by psychosage on May 27, 2006, at 7:36:53
How can a mood stabalizer create a manic response. Aren't they supposed to stop them? And Blueberry you said you quit the prozac and it is not working anymore so I was thingking with the long half life of prozac could it now be all out of your sytem and that's creating the suicidal thoughts. Love Phillipa ps I know you said you started it again
Posted by blueberry on May 27, 2006, at 19:43:11
In reply to Re: Lamictal causing suicidal attempt, posted by denise1966 on May 27, 2006, at 15:31:36
Nice to hear from you denise. I dropped lamictal in a heartbeat and am already feeling improved. My doc thinks my episode was just part of my disease, and I said emphatically no way. But if she is insistent on me rechallenging, I might do it at 12.5mg every other day. The stuff seems to hang on for almost two days, even though the halflife is shorter than that. For me less has always been more. Standard doses of things are not good for me. I saw a comment from someone else who swears they do just fine with 6mg lamictal (you read that right...6mg).
> Hi Blueberry,
>
> Just want to say I can sort of relate to the way you are feeling on Lamictal. I started with it pretty much inconsistently at a high dose and sort of felt better, clearer headed the next day.
> Anyway, I've now started it on a more realistic dose and yesterday I felt not anxious but really sluggish, it felt almsot the way Nardil made me feel. I was sobbing on the phone to my boyfriend (well ex now :-)) and today have been mentally composing a suicide note to my doctor.
>
> So I understand how you feel, I definately agree with Scott, to increase the Zyprexa, 10mg of Zyprexa always makes me feel more rational (although I often don't follow my own advice). Here's hoping the Lamictal helps us both.
>
> Wasn't it you who was considering ECT because that's what I've been thinking of pushing for. I'm absolutely sick of faffing around with medication that either doesn't work or makes me feel worse.
>
>
> Denise
Posted by blueberry on May 27, 2006, at 19:47:49
In reply to Re: Lamictal causing suicidal attempt, posted by heaven help me on May 27, 2006, at 15:51:00
Though I ponder the idea every day of increasing zyprexa from 2.5mg to something higher, I do resist that. I too have had horrible withdrawals from zypexa which included near death experiences of depression, anorexia, insomnia, paranoia, and an intensely heightened sense of sound that scared me. Those were the reasons I went back on it after 10 weeks off. I really do not want to be stuck at a higher dose.
The size of my zyprexa dose had not changed recently. I did however change 2.5mg in the evening to 1.25 in the evening and 1.25 at noon to get a smoother ride out of it about a week ago. I wonder.
Posted by blueberry on May 27, 2006, at 19:53:23
In reply to Re: Lamictal causing suicidal attempt, posted by Phillipa on May 27, 2006, at 16:02:48
Hi Phillipa,
There's definitely no mania stuff going on here.
The prozac has worn off, but it was only 2.5mg for 4 days, so it wasn't much to begin with. I had recently changed my zyprexa dose from 2.5mg in the evening to 1.25 in the evening and 1.25 at lunch.
I was actually liking lamictal at first. Maybe I'm one of those people that respond well to ultra low doses of it, maybe just every other day, and that by following standard dosing guidelines I went too far.
We all know how mileage varies. Someone commented that they do just fine on 6mg lamictal and no more than that. I think so often docs and we are in a hurry to reach what they call "therapeutic doses" and in doing so forget that each person is unique.
Posted by Phillipa on May 27, 2006, at 20:48:36
In reply to Re: Lamictal causing suicidal attempt » heaven help me, posted by blueberry on May 27, 2006, at 19:47:49
Blueberry what's your diagnosis? Are the meds correct for it? I know a lot of people do well on low doses of meds. Have you considered ECT too? Love Phillipa
Posted by heaven help me on May 27, 2006, at 23:19:37
In reply to Re: Lamictal causing suicidal attempt » heaven help me, posted by blueberry on May 27, 2006, at 19:47:49
blueberry, go ask your Dr. if splitting the dose can change the way you respond to Zyprexa. I have been known to sit on the table in my Dr.s office and tell him "I am not leaving here until I feel like I have a good understanding and a good plan". The things you are saying sound like my w/d from Zyprexa did. I am no Dr. though. Go talk to yours and politely demand help.
blessings
mary
PS: I am NOT suggesting going off Zyprexa, do what the Dr. says!
Posted by Meri-Tuuli on May 28, 2006, at 9:17:22
In reply to Re: Lamictal causing suicidal attempt, posted by SLS on May 27, 2006, at 15:42:53
Hiya Blueberry,
I'm sorry I can't offer any advice but please do stick around as Scott says!!
If I were a magic fairy I would wish away all pyschiatric illness for everybody.
Sometimes we have to get worse before we can get better.
Kind regards
Meri
x
Posted by ed_uk on May 28, 2006, at 12:56:51
In reply to Re: Lamictal causing suicidal attempt » Phillipa, posted by blueberry on May 27, 2006, at 19:53:23
Dear Blueberry
I'm so sorry for what you went through. I hope things continue to improve now you've stopped Lamictal.
Ed
Posted by SLS on May 30, 2006, at 10:47:36
In reply to Lamictal causing suicidal attempt, posted by blueberry on May 27, 2006, at 6:30:30
Hi Blueberry.
Have you ever tried Provigil (modafinil)?
Perhaps you need more glutamate and not less. Lamictal inhibits the release of glutamate whereas Provigil increases it.
This is, of course, a rather simplistic way of thinking about these drugs, but you never know.
- Scott
This is the end of the thread.
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