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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 tedrew on July 27, 2008, at 9:34:46
I started on Lamictal in early June for ongoing depression/anxiety. I am up to 100mgs a day.Does this med even work for depression/anxiety. I went through the bad stress of a separation in early July but I would have expected Lamictal to have had some therapeutic effect by now. They say that the target dose for depression is maybe 200 mgs, but I am already starting to get some cognitive blunting and many people supposedly do well at 100mgs so whats up. I have taken Wellbutrin 400mgs SR a day for many months and em up to 4 mgs of Xanax a day at least to get through this more current separation debacle. Does Lamictal give you a significant therapeutic effect at all. Like to hear some good experiences.
Posted by Quintal on July 27, 2008, at 10:03:04
In reply to Does Lamictal have therapeutic value, posted by tedrew on July 27, 2008, at 9:34:46
Lamictal works for me. I use it for Bipolar I and it seems to have a mild antidepressant effect. I take 100mg now, but years ago I took 200mg, and that maybe had a stronger antidepressant effect. Like you, I found the cognitive impairment at doses above 100mg a bit much so that's why I've kept it at 100mg this time. One of the unexpected gains this time was how it helped with neuropathic/ fibromyalgia pain. It still works great for that, maybe even better than it does for my mood.
Q
Posted by Phillipa on July 27, 2008, at 12:12:38
In reply to Re: Does Lamictal have therapeutic value, posted by Quintal on July 27, 2008, at 10:03:04
Q it works for pain thanks for that education I had no idea. I was on a low dose and forget if it helped my back pain. Thanks for the knowledge. Phillipa. The 50mg seemed to make me angry as I threw a plastic bottle against a brick store front. Different reactions.
Posted by dbc on July 27, 2008, at 13:04:00
In reply to Re: Does Lamictal have therapeutic value » Quintal, posted by Phillipa on July 27, 2008, at 12:12:38
The dosing for lamictal is variable for everyone and 100mg isnt very much at all considering some people take 400mg on here. I take 300.
Posted by tedrew on July 27, 2008, at 13:09:55
In reply to Re: Does Lamictal have therapeutic value, posted by dbc on July 27, 2008, at 13:04:00
> The dosing for lamictal is variable for everyone and 100mg isnt very much at all considering some people take 400mg on here. I take 300.
> I am sorry that doesn't answer my question. For your depression has 300mgs helped. Also my Psych told me that they dont like to go above 200mgs for even some of their bipolars because they really start to complain of memory and cognitive impairment
Posted by dbc on July 27, 2008, at 15:55:45
In reply to Re: Does Lamictal have therapeutic value, posted by tedrew on July 27, 2008, at 13:09:55
Im probably not really bi polar, just an atypical depressive with serious anxiety/panic. It certainly has anti-depressant effects for some people. It buffers you from the world and relives some of the features which is more or less what all anti-depressants do.
Does it cause cognitive impairment, yes. That goes with the territory of when you start taking anything that messes with glutamate blockading. To be honest when i was titrating up the dose i felt like a zombie and could barely remember my name. But the effect went away when i hit a steady dose.
The only long term cognitive effects i've noticed is vocabulary seeking, i have the problem of recalling words " oh the words just on the tip of my tongue i cant remember it ugh".Perhaps your doctor was talking about you in terms of side effects and what your tolerance threshold is for them when referring to 200mg because thats pretty baseless. Any doctor thats been in the game for a long time will repeat "everyone is different and i have no way to predict what the outcome will be but i can tell you what possible ones there could be" like a mantra. There are people on 600mg or more for seizures.
Im not sure how experianced you are with ADs outside of SSRIs/SNRIs/etc but as far as the class of drugs go lamictal has very few side effects which is why its used so much.
Posted by tedrew on July 27, 2008, at 17:40:10
In reply to Re: Does Lamictal have therapeutic value, posted by dbc on July 27, 2008, at 15:55:45
Thanks for your feedback. It truly was helpful. There are alot of similarities in your thoughts with how I feel about the other meds and even lamictal right now. I will just remain patient. The forgetting of words or trying to come up with the right word is a big problem but I will play it one day at a time. Thanks again.
Posted by blueboy on July 28, 2008, at 11:21:27
In reply to Does Lamictal have therapeutic value, posted by tedrew on July 27, 2008, at 9:34:46
> I started on Lamictal in early June for ongoing depression/anxiety. I am up to 100mgs a day.Does this med even work for depression/anxiety.
AFAIK, Lamictal is only approved (as a psychoactive) for prevention of depressive episodes in bipolar patients. It may have some effect on prevention of mania. I have never heard of it preventing anxiety as such.
There are off-label reports of Lamictal being effective in drug-resistant unipolar depression, but I think the general practice is to exhaust other possibilities first. The beauty of Lamictal is that it can stabilize mood in bipolar conditions with a low degree of side effects. It is particularly effective in preventing or easing the depressive phase of a bipolar cycle.
However, I haven't seen any research that would show Lamictal effectively treating a depressive episode. Certainly the official story is that it only useful for preventing depression, i.e. if taken before the episode starts. It prevents, but does not cure. It's more like a vaccine.
One possibility is that success with "treatment resistant" unipolar depression is because such depression is actually a bipolar cycle with minimal hypomania. Very often, bipolar II patients will complain only of depression because hypomania feels "normal" or even great. (Whereas Bipolar I patients will typically go "nuts" and engage in really bizarre behavior.)
> I went through the bad stress of a separation in early July but I would have expected Lamictal to have had some therapeutic effect by now. They say that the target dose for depression is maybe 200 mgs, but I am already starting to get some cognitive blunting and many people supposedly do well at 100mgs so whats up.
Again, the official line on Lamictal is that it is ineffective, or its effectiveness is not proven, to bring a patient out of a depressive episode. I am not a doctor, and if I were a doctor I wouldn't diagnose you over the internet, so please take anything I say with a healthy dose of skepticism. But to me, you don't sound like someone that would be expected to respond to Lamictal.
Posted by dbc on July 28, 2008, at 11:35:51
In reply to Re: Does Lamictal have therapeutic value, posted by blueboy on July 28, 2008, at 11:21:27
As a long term panic patient i can say lamictal most definetly is effective for extreme anxiety. But doesnt seem to dent day to day stuff, im not quite sure how to explain it.
Posted by tedrew on July 28, 2008, at 12:54:12
In reply to Re: Does Lamictal have therapeutic value, posted by dbc on July 28, 2008, at 11:35:51
I think you are right. In the past I have tried quite a few meds, but with mostly tolerability issues. My doc has been a little vague about me possibly being bipolar 2. I am losing confidence fast in the med. the literature is also vague on depression outcomes with Lamictal. Showing only a 40% response that was of any significance in unipolar depressed patients in one study. A big percentage saw no appreciable improvement.
Posted by yxibow on July 29, 2008, at 2:13:44
In reply to Does Lamictal have therapeutic value, posted by tedrew on July 27, 2008, at 9:34:46
> I started on Lamictal in early June for ongoing depression/anxiety. I am up to 100mgs a day.Does this med even work for depression/anxiety. I went through the bad stress of a separation in early July but I would have expected Lamictal to have had some therapeutic effect by now. They say that the target dose for depression is maybe 200 mgs, but I am already starting to get some cognitive blunting and many people supposedly do well at 100mgs so whats up. I have taken Wellbutrin 400mgs SR a day for many months and em up to 4 mgs of Xanax a day at least to get through this more current separation debacle. Does Lamictal give you a significant therapeutic effect at all. Like to hear some good experiences.
Yes -- my doctor does believe it is an antidepressant. I currently take 200mg. I just got it renewed -- its patent is off, its now just lamotrigine. At some point I may go up on it.
-- tidingsJay
Posted by blueboy on July 29, 2008, at 9:38:32
In reply to Re: Does Lamictal have therapeutic value » tedrew, posted by yxibow on July 29, 2008, at 2:13:44
> Yes -- my doctor does believe it is an antidepressant. I currently take 200mg. I just got it renewed -- its patent is off, its now just lamotrigine. At some point I may go up on it.
>Whoa! Good news. Are you able to get prescriptions filled for generic lamotrigine, and are you in the US?
My last prescription was for lamotrigine, generic if available, and CVS gave me Lamictal.
Posted by Quintal on July 29, 2008, at 11:42:33
In reply to Re: Does Lamictal have therapeutic value, posted by blueboy on July 29, 2008, at 9:38:32
Incidentally lamotrigine has been available as generic in UK for a long time. The first script I got was filled with Lamictal, but the last two scripts have been filled with generic.
Q
Posted by yxibow on July 29, 2008, at 14:41:15
In reply to Re: Does Lamictal have therapeutic value, posted by blueboy on July 29, 2008, at 9:38:32
> > Yes -- my doctor does believe it is an antidepressant. I currently take 200mg. I just got it renewed -- its patent is off, its now just lamotrigine. At some point I may go up on it.
> >
>
> Whoa! Good news. Are you able to get prescriptions filled for generic lamotrigine, and are you in the US?
>
> My last prescription was for lamotrigine, generic if available, and CVS gave me Lamictal.Yes, It just went generic this month and I am in the US. So I'm a little leary because it is an AED and I have so much on board, I think I will split the difference between what i have left of the "original" and the generic and then go full on the generic.
-- tidingsJay
Posted by mickapoo on August 2, 2008, at 7:22:59
In reply to Does Lamictal have therapeutic value, posted by tedrew on July 27, 2008, at 9:34:46
> I started on Lamictal in early June for ongoing depression/anxiety. I am up to 100mgs a day.Does this med even work for depression/anxiety. I went through the bad stress of a separation in early July but I would have expected Lamictal to have had some therapeutic effect by now. They say that the target dose for depression is maybe 200 mgs, but I am already starting to get some cognitive blunting and many people supposedly do well at 100mgs so whats up. I have taken Wellbutrin 400mgs SR a day for many months and em up to 4 mgs of Xanax a day at least to get through this more current separation debacle. Does Lamictal give you a significant therapeutic effect at all. Like to hear some good experiences.
I have been on Lamictal 300mg per day for many months. I suffer from depression & anxiety, social phobia, and severe mood swings. The dr thought Lamictal may help towards my mood swings, thinking maybe it was a mild case of bipolar. But the Lamictal did nothing for my mood swings.
Posted by UGottaHaveHope on August 3, 2008, at 13:33:51
In reply to Re: Does Lamictal have therapeutic value, posted by mickapoo on August 2, 2008, at 7:22:59
Did Lamictal do anything for your anxiety and depression? Hope you are well, Michael
Posted by mickapoo on August 3, 2008, at 16:34:28
In reply to Re: Does Lamictal have therapeutic value » mickapoo, posted by UGottaHaveHope on August 3, 2008, at 13:33:51
> Did Lamictal do anything for your anxiety and depression? Hope you are well, Michael
It's hard to say, as I was on a combination of medications, and I believe I was on Wellbutrin first, augmented with Buspar, and then when I told my physician I was still having erratic mood swings, she added Lamictal. I took 300mg/day.
It was that combination that did in fact lift my depression enough that I was wanting to actual get out of bed or off the couch. However, it only helped a small amount, and in general, I was still depressed.
Whether or not Lamictal by itself would have helped, I do not know. It was not her first choice for depression as I guess it's not known for it's anti-depressive properties but more for treatment of bi-polar disorder. Because of my mood swings, she thought maybe there was a touch of that present.
As far as general anxiety, those meds did nothing for it. I would take Klonopin as needed. I can't stress enough that it only helped "anxiety"- so if I was stressed out about work or something it would help. However, regarding my social phobia, it did nothing to help whatsoever.
Posted by tedrew on August 6, 2008, at 14:38:43
In reply to Re: Does Lamictal have therapeutic value » UGottaHaveHope, posted by mickapoo on August 3, 2008, at 16:34:28
I am now at 150mgs of lamictal after going through depression that got severe. I don't seem to be getting much improvement of the depression or anxiety at all at this dosage. And when things work. they tend to start working at lower than the target doses at least for me. The doc wants me to get up to 200mgs per day, but I have to get back to work and I don't think it is the answer.
This is the end of the thread.
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