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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 2 to 26 of 26. Go back in thread:
Posted by dbc on May 19, 2008, at 23:03:22
In reply to Lamictal making me manic??, posted by qbsbrown on May 19, 2008, at 21:28:47
Yep, during titration its not uncommon to have hypomania. It happens every single time i bump a dose for a few days and i generally have insomnia and feel rather uhhm for lack of a better word "stupid".It goes away when you stay at a steady dose which i rarely have (almost at 400mg woooo).
Posted by Phillipa on May 19, 2008, at 23:46:44
In reply to Re: Lamictal making me manic??, posted by dbc on May 19, 2008, at 23:03:22
I must be made of cement as I took 50mg and felt nothing but the spitting. Why don't meds seem to affect me . Are you both bipolar? Love Phillipa ps it was given to me to boost an ad.
Posted by dbc on May 20, 2008, at 11:12:35
In reply to Re: Lamictal making me manic??, posted by Phillipa on May 19, 2008, at 23:46:44
No im not bipolar but the effective dosage is somewhere between 50mg - 300mg and it seems to be variable in each person. I felt something the first 100mg or so but it really didnt start working untill 250+ and now im almost at 400.
Posted by qbsbrown on May 20, 2008, at 11:18:24
In reply to Re: Lamictal making me manic??, posted by dbc on May 20, 2008, at 11:12:35
Antidepressant alone and i get thrown in to mixed moods with severe irratability.
I was wondering if lamictal even at 50mgs could gaurd against that, so i can take celexa for OCD and sleep.
Brian
Posted by SLS on May 20, 2008, at 11:54:09
In reply to Can even 50mgs gaurd against 'mixed episodes', posted by qbsbrown on May 20, 2008, at 11:18:24
DBC is exactly right about Lamictal, especially if it is your first time taking it. You might feel improved or hypomanic as a reaction to dosage increases. I do not think you can use a lower dosage of Lamictal based upon the presence of other drugs. 200mg is the mean effective dose per day. It is unlikely that you will feel steadily better until you reach that dosage. You can stop at each dosage incease to see if it "sticks" at a dosage lower than 200mg, but I must emphasize that it is important to recapture the antidepressant effect as soon as possible so that you do not miss the opportunity of having your brain be responsive to treatment.
- Scott
Posted by qbsbrown on May 20, 2008, at 11:58:12
In reply to Re: Can even 50mgs gaurd against 'mixed episodes' » qbsbrown, posted by SLS on May 20, 2008, at 11:54:09
Scott, is that saying that it's advisible not to add an antidepressant until you reach the 200mg dosage? The lamictal causes my horrible physical anxiety, with nervous adrenaline running through my groins all day. I think celexa would allieviate this, but i don't want to run the risk of going in to a mixed episode.
Brian
Posted by dbc on May 20, 2008, at 13:26:39
In reply to Scott:, posted by qbsbrown on May 20, 2008, at 11:58:12
I use simple valium for the more intense and activating periods of titration. I had some weird psychotic features (paranoia, visual disturbances, etc) somewhere between 100mg - 200mg and my doctor was like AH HAH IT IS BIPOLAR AFTER ALL and started scripting me seroquel which did nothing except make me sleep.
She starts talking about geodon and all sorts of nonsense to stop the hypomania/psychotic features and i flat out told her to give me a higher dose of valium before going to extreme measures. Of course all the negative symptoms go away and she's left annoyed that whatever was going on didnt fit her DX and the most obvious choice worked. It wasnt a large dose for any benzo 10mg - 20mg daily , which is around 1/2mg of xanax.
Posted by qbsbrown on May 20, 2008, at 13:29:11
In reply to Re: Scott:, posted by dbc on May 20, 2008, at 13:26:39
Yeah, once I got up to 100mgs, I started popping the Ativan like crazy.
I wonder if Lithium would help smooth this hypomania over.
Brian
Posted by Maximus on May 20, 2008, at 13:55:16
In reply to Lamictal making me manic??, posted by qbsbrown on May 19, 2008, at 21:28:47
Hi Brian,
I just received your pm.
So you're bipolar, mainly depressed and anxious and your medication is Lamictal alone. And you asked me if Lithium could help with the agitation issue? Ok...
Well, Lamictal is not a firt line mood stabilizer for the anxious ones, though. Depakote would be a better choice, but you can't take it. Adding Lithium might help a bit, but anxiety would still be a problem, imo.
You may ask to your psychiatrist the following combos, if you didn't try them yet.
1- A small dose of Lamictal + Lithium + SSRI/SNRI
2- Seroquel + Lamictal
N.B. If you don't need a big antidepressant punch, you might consider Seroquel alone, or a simple combo of Lithium + SSRI/SNRI.
Good luck!
Posted by SLS on May 20, 2008, at 14:19:00
In reply to Scott:, posted by qbsbrown on May 20, 2008, at 11:58:12
> Scott, is that saying that it's advisible not to add an antidepressant until you reach the 200mg dosage? The lamictal causes my horrible physical anxiety, with nervous adrenaline running through my groins all day. I think celexa would allieviate this, but i don't want to run the risk of going in to a mixed episode.
>
> BrianIt may be that Lamictal is not a good drug for you. Reverse field and start the antidepressant of your choice first - perhaps one that you experienced a partial improvement to - and add Lamictal afterwards to see how you react to it. If you still react to the Lamictal badly, then, as was suggested, you might want to go for Depakote if there is any hint of mania, including a mixed episode.
What was your diagnosis before your reaction to Lamictal? What have you tried so far? How did you react?
- Scott
Posted by SLS on May 20, 2008, at 14:26:38
In reply to Can even 50mgs gaurd against 'mixed episodes', posted by qbsbrown on May 20, 2008, at 11:18:24
> Antidepressant alone and i get thrown in to mixed moods with severe irratability.
>
> I was wondering if lamictal even at 50mgs could gaurd against that, so i can take celexa for OCD and sleep.
>
> BrianI wish I had read this post more closely.
Lamictal is a rather poor anti-manic drug. For what you are looking for, Depakote or one of the atypical antipsychotics might be better choices.
Interestingly, Lamictal can help with rapid-cycling, especially when used in combination with lithium.
I would say that you have no need of Lamictal. You might as well not play with this drug if you have a manic reaction to it, which is not unheard of.
- Scott
Posted by chiron on May 22, 2008, at 18:35:57
In reply to Re: Lamictal making me manic??, posted by dbc on May 20, 2008, at 11:12:35
I need some hope. I am just starting 225mg of Lamictal, approaching 250. I think it has helped a little, maybe at least with evening out my mood. I've always been depressed, 20+ years, and I'm sick of it. (also on Celexa, Xanax, & Wellbutrin)
What did you notice at the 250 level & how long after you reached that dose? What have you noticed as you have increased the dosage?
Thanks.
Posted by liza05342 on May 28, 2008, at 0:29:18
In reply to Lamictal making me manic??, posted by qbsbrown on May 19, 2008, at 21:28:47
It sounds like it could be. I couldn't take it cause I felt like bugs were crawling all over me and the itching was bad. It has done wonders for my daughters mood swings though and she never had a bad experience on it.
Posted by blueboy on May 28, 2008, at 7:59:29
In reply to DBC:, posted by chiron on May 22, 2008, at 18:35:57
This entire thread is confusing me.
I have a good pdoc, who uses Lamactil fairly frequently. He says that the normal dosage for his Bipolar II patients is 50 mg per day and considers that to be the typical therapeutic dosage for mood stabilization.
Posted by qbsbrown on May 28, 2008, at 16:27:05
In reply to Re: Lamictal making me manic?? » qbsbrown, posted by Maximus on May 20, 2008, at 13:55:16
I am able to get this medicine, but not seroquel. I wonder if it would allow me to raise lamictal dose to get the antidepressant effects w/o the hypomania and anxiety it seems to induce.
Brian
Posted by Jeroen on May 31, 2008, at 7:44:56
In reply to Re: Lamictal making me manic??, posted by liza05342 on May 28, 2008, at 0:29:18
well, thats psychosis and paranoid side effect
i got psychosis from this medicine lamictal
be very carefull and consider quiting now because its dangerous
try Seroquel, it worked once for me but it stopped working
Posted by blueboy on May 31, 2008, at 9:51:39
In reply to Re: Can even 50mgs gaurd against 'mixed episodes' » qbsbrown, posted by SLS on May 20, 2008, at 11:54:09
> I do not think you can use a lower dosage of Lamictal based upon the presence of other drugs.
Actually, I think I read something about certain drugs interacting with Lamictal so that a significantly larger or smaller dose of Lamictal was needed. IIRC, it has something to do with the thyroid.
Try Google, maybe "Lamictal thyroid" or something.
Posted by qbsbrown on May 31, 2008, at 14:49:32
In reply to Re: Lamictal making me manic??, posted by Jeroen on May 31, 2008, at 7:44:56
I think you're right about having a paranoid and mild psychosis reaction to lamictal. Strange though, I never had it in the past. Perhaps it could be the mixing with the Dexedrine that I take.
I tried quitting cold turkey from 50mgs, but fell in to a bad depression/mixed mood episode. Perhaps I have to go to 25 for a while, although I want off.
Posted by garylee on June 1, 2008, at 16:02:41
In reply to Re: Lamictal making me manic??, posted by qbsbrown on May 31, 2008, at 14:49:32
Hi
I wouldn't have thought that Lamictal would cause psychosis... But, in my experience, when I first started taking it 8 years ago it did promote a mild hypomanic reaction, which was quite pleasant actually :O)
For this reason I would titrate the dose slowly, maybe 25mg a week, or less. If it makes BP II/NOS hypomanic like myself then it could possibily, I suppose cause mania in Schizophrenic's?
Just take the titration slowly (to avoid the rash too), I'm sure the hypomania will clear. It is a very good med and has helped me and others no end...
Gary
Posted by Amigan on October 8, 2008, at 2:46:04
In reply to Lamictal making me manic??, posted by qbsbrown on May 19, 2008, at 21:28:47
> As I got to 75mgs, taken in the morning, I'm having serious racing thoughts that are uncontrolable. Then around 6pm it all calms down and I feel fine. Should I take my dose at night, so that it's calm by morning, split the dose, or drop back down to 50?
>
> Too bad I'm taking this for racing thoughts and it's doing the opposite.I have recently started taking Lamictal for exactly the same purpose. It's too early to say anything but now i fear that i chose the wrong mood-stabilizer!..
Posted by cloudydaze on October 11, 2008, at 0:49:04
In reply to Re: Scott:, posted by dbc on May 20, 2008, at 13:26:39
I take 150mg of lamictal, and I think sometimes it does make me manic. But last time it did, my doc increased my antipsychotic (abilify) to offset it. It has worked so far with this method...
Posted by Jeroen on October 11, 2008, at 1:28:07
In reply to Lamictal, posted by cloudydaze on October 11, 2008, at 0:49:04
thats bad, cuz if it gave you manic psychosis that doesnt go away, and you quit abilify for any reasons, you will still have it
Posted by cloudydaze on October 20, 2008, at 23:09:39
In reply to Re: Lamictal, posted by Jeroen on October 11, 2008, at 1:28:07
I don't normally have psychosis with mania, however the antipsychotic helps with my manic symptoms of insomnia, racing thoughts, jitters/anxiety attacks, and paranoia. I don't plan on going off either medication, because they work so well together.
Mania will come whether i take the lamictal or not. Its just that sometimes I have worse episodes and it requires a medication adjustment.
Posted by Jeroen on October 21, 2008, at 2:11:04
In reply to Re: Lamictal, posted by cloudydaze on October 20, 2008, at 23:09:39
just a warning here of what happened to me in summer of 2007
Posted by yxibow on October 25, 2008, at 12:24:59
In reply to Re: Lamictal, posted by Jeroen on October 21, 2008, at 2:11:04
> just a warning here of what happened to me in summer of 2007
Jeroen, we've heard about the Lamictal induced psychosis which still fathoms anything I've heard about a non-dopaminergic drug taken for that short of a time, but then anything can happen like the Zyprexa that has given me a dystonic reaction in my arms and legs one year running after I took it for a month.
Point being, there are rare effects but they're rare and, they really really shouldn't happen, for a lack of a better word, but not everyone gets them.
That's why they're rare. ;( And that's also why there are other explanations, sometimes.
You may also be medication sensitive in some ways too, just as I am also.
-- tidings
This is the end of the thread.
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