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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 46. This is the beginning of the thread.
Posted by BetweenDreams81 on January 17, 2011, at 15:57:34
Since I am just starting Lamictal (free starter pack) I have been researching a bit more about it. One of the confusing things has been that prices for lamotrigine are all over the board. I then started reading other forums/discussions which accounted for many experiences with the generic forms of Lamictal...some nightmareish situations which really give me pause.
Now I am on the fence about the generic form.
What experiences do you have? What brand do you take if the generic is working for you? or would you stick to the real brand?...I am uninsured so it does make a huge difference for me financially...but if the generic were to throw me off back to where I have been for the past year, then that isn't any good either.
I found prices from $7.50 for generic (Dr.Reddy's) to $216.00 for the Lamictal brand (200mg, 30 tabs)
What to do...
Posted by emme on January 17, 2011, at 17:00:54
In reply to Generic Lamictal (lamotrigine) experiences?, posted by BetweenDreams81 on January 17, 2011, at 15:57:34
I've done okay with Teva brand generic. I got worse on Dr. Reddy's, and then improved once I switched back to Teva. YMMV of course. That's the only drug I've ever noticed a difference between brands/generics, and was surprised since I wasn't expecting it.
You might wish to use the brand name for a while to find out how the drug works for you. Then if you try a generic and have problems, you will at least know that the brand name works.
emme
Posted by emme on January 17, 2011, at 17:03:53
In reply to Generic Lamictal (lamotrigine) experiences?, posted by BetweenDreams81 on January 17, 2011, at 15:57:34
BTW, if you haven't already, you might check to see if you qualify for patient assistance from the manufacturer of Lamictal (GSK?). If you're uninsured, getting that assistance would make your life easier!
Posted by Phillipa on January 17, 2011, at 21:10:09
In reply to Patient assistance programs, posted by emme on January 17, 2011, at 17:03:53
Emme I once looked into it and found at that time you could not own real estate forget other particulars. Phillipa ps I feel brand first also great idea
Posted by emme on January 17, 2011, at 21:20:28
In reply to Re: Patient assistance programs » emme, posted by Phillipa on January 17, 2011, at 21:10:09
> Emme I once looked into it and found at that time you could not own real estate forget other particulars. Phillipa ps I feel brand first also great idea
Must be variable. I received medication directly from the manufacturer for a while, and no questions were asked about whether I owned real estate.
Posted by Phillipa on January 17, 2011, at 21:49:45
In reply to Re: Patient assistance programs, posted by emme on January 17, 2011, at 21:20:28
Really? This was cymbalta long time ago what was the proceedure? Thanks Phillipa
Posted by BetweenDreams81 on January 17, 2011, at 23:50:33
In reply to Generic Lamictal (lamotrigine) experiences?, posted by BetweenDreams81 on January 17, 2011, at 15:57:34
http://www.togetherrxaccess.com/Tx/jsp/home.jsp
This is a link to the Together Rx Access Card. you can get 25%-40% off brand name prescriptions if you qualify. I just applied for it. It is very simple. Also, I have a query into their customer service about their Bridges to Access program. Here's hoping it can be made affordable...this is not a cheap drug!
Found some websites with responses that Teva generic is decent. and www.healthwarehouse.com has very inexpensive generic Rx's...they use Dr. Reddy generics which supposedly aren't very good, but it's only $15 extra to choose the specific generic brand you want out of several different suppliers (making my total $35/90 day supply of 200 mg Teva lamotrigine). So...we'll see...I've been internet surfing like mad all day trying to find the best solution and my next action plan.
Posted by morgan miller on January 18, 2011, at 0:55:22
In reply to Generic Lamictal (lamotrigine) experiences?, posted by BetweenDreams81 on January 17, 2011, at 15:57:34
Why Lamictal? I don't want to discourage you from trying something might be helpful, but I have to say, I was not a fan of Lamictal. I actually wonder if it had some long term detrimental effects, effects that I am healing from still.
What else have you tried? Sorry, I think you have revealed this before.
Is Lamictal a last resort after trying everything else?
Morgan
Posted by SLS on January 18, 2011, at 5:33:03
In reply to Generic Lamictal (lamotrigine) experiences?, posted by BetweenDreams81 on January 17, 2011, at 15:57:34
For me, generic lamotrigine is not as effective as GSK Lamictal. Teva was better than Mylan, but not good enough for me.
Others may fare better than me.
- Scott
Posted by mellow on January 18, 2011, at 6:41:35
In reply to Re: Generic Lamictal (lamotrigine) experiences?, posted by SLS on January 18, 2011, at 5:33:03
I'm one of those rare cases where Lamictal was a wonder drug. Of course I was started on it in combo with Trileptal. Once I started anti convulsants and got a bipolar diagnosis life got a lot better. It was like we finally knew what was wrong.
I've been on a generic by Zydus pharmaceutical for a few years now. Works pretty good for me. Honestly I might have had some trouble with the switch if I was reading babble at the time. I had no idea the generic had the reputation of causing people to swing or destabilize. I wouldn't let it rock you. Some of the stuff we read on here can put ideas in our head. I know people who have gone off SSRI's cold turkey and not felt a thing. I'm in the process of trying to get to monotherapy at 150mg. which is actually lower than the therapeutic dose of 200mg. This is with my supplements/diet/exercise of course. I have been stable for a year or so with the exception of a few rough months while tapering my SSRI.
All and all if I can get over my psychological addiction to atypicals, lamotrigine might be my magic bullet in the end. I responded to it very quickly in 2006, but watch out for that rash. That can be serious for some people. I was lucky. Good luck!
mellow
Posted by SLS on January 18, 2011, at 7:16:21
In reply to Re: Generic Lamictal (lamotrigine) experiences?, posted by mellow on January 18, 2011, at 6:41:35
> I'm one of those rare cases where Lamictal was a wonder drug. Of course I was started on it in combo with Trileptal. Once I started anti convulsants and got a bipolar diagnosis life got a lot better. It was like we finally knew what was wrong.
Did you experience mania or hypomania? I have chronic depression without switches into mania. What role in your therapy do you think Trileptal plays? Does it act as an antidepressant for you?
Thanks.
- Scott
Posted by morgan miller on January 18, 2011, at 14:04:03
In reply to Re: Generic Lamictal (lamotrigine) experiences?, posted by mellow on January 18, 2011, at 6:41:35
Mellow, do you experience any cognitive deficits on lamotrigine, in spite of it's effectiveness?
Posted by BetweenDreams81 on January 18, 2011, at 15:19:29
In reply to Re: Generic Lamictal (lamotrigine) experiences?, posted by morgan miller on January 18, 2011, at 0:55:22
Hey Morgan,
Thanks for posting...No, this was my first actual appointment and evaluation with a psychiatrist, first time on Rx meds for this. He is a fan of Lamictal I'm guessing, said he has seen much fewer side effects...though lithium was mentioned as well since I did have some positive effect with the Lithium orotate.
Xanax has definiterly helped the anxiety/negative self talk a lot, but I am a bit leary of being on it for any real length of time...but needed something as I have been staying basically in my room for the past 2 months or more. I am now venturing out much more even in just the past 6 days.
What were your experiences with Lamictal? What makes you surprised it was the first plan of action? (not a defensive question, just truly curious as I have not been down this road yet.)
Thanks again
Posted by BetweenDreams81 on January 18, 2011, at 15:27:45
In reply to Re: Generic Lamictal (lamotrigine) experiences?, posted by SLS on January 18, 2011, at 5:33:03
Thanks Scott, if I can get the GSK drug for a relatively decent price $60/mo or so, I will stick with the brand for a little while to give this a true shot before switching to a generic...unless of course I don't respond to it or have adverse reactions. I'm on day 6 of the titration (orange) packet...nothing noted as of yet, but then again it's only at 25mg.~Kate
Posted by BetweenDreams81 on January 18, 2011, at 15:47:31
In reply to Re: Generic Lamictal (lamotrigine) experiences?, posted by mellow on January 18, 2011, at 6:41:35
I'm glad it works so well for you...I am hoping that I do not have too much of a battle figuring out the right mix. Even just the xanax is helping out right now...BUT I also have to keep some thoughts/impulses in check...like I was just thinking today about what stallion to breed my mare to! (aaaggghhh!) My big issue on the hypomanic(?) side has been the significant impulsive purchases which put me into MAJOR financial ruin. Last 4 years running I have purchased or leased an accumulation of 8 horses...that is not such a great thing when I cannot afford the upkeep, or fall back into a depression that leaves me hibernating and not able to leave the house to find work (self employed).
Thank goodness I am down to 3 horses in my care...even this is quite expensive.
The depression side of things can be utterly debilitating. I think this is why he decided to go the route of Lamictal (??) since acording to him it seems to work better with those who are more on the depressive side of the scale.
I have noticed that it seems to go in cycles with the seasons...is this typical at all??? or am I just nuts?? Impulsive decisions are often around May-August...start feeling low and depressive around Oct. with the lowest point usually around Feb...I'm feeling that cycle this past season/year for sure.
Posted by BetweenDreams81 on January 18, 2011, at 15:56:59
In reply to Re: Generic Lamictal (lamotrigine) experiences? » BetweenDreams81, posted by emme on January 17, 2011, at 17:00:54
Thanks emme for the link!...I added the other link for the Rx discount card...which seems really uncomplicated and you can print it out to use right away.
Thanks for the advice to stick with brand for a few months...that sounds like a good idea. To get a clear read on if it is really going to work I probably should at least stick to the brand. If I had adverse reactions with the generic without trying the brand first I may give up on a good thing...so hopefully it works out just fine.
Posted by morgan miller on January 18, 2011, at 16:38:21
In reply to Re: Generic Lamictal (lamotrigine) experiences? » morgan miller, posted by BetweenDreams81 on January 18, 2011, at 15:19:29
Hey BD,
The worst side effect I experienced with lamictal was my brain feeling as if it just simply was not functioning at a high level. I remember after about 6 weeks on lamictal and being at 150 mg, it took me 2 hours to clean my friend's very small 1 bedroom apartment kitchen. I just could not get my motor going. At somewhere between 75 and 125 mg, I experienced a feeling of not wanting to talk and having some difficulty doing so as well. In my experience of taking antidepressants and mood stabilizers, no medication seemed to negatively affect my neurological function as much as Lamictal, with the exception of maybe Zyprexa.
Lamictal has been shown to possibly negatively impact Long Term Potentiation, which I believe has something to do with synaptic communication/plasticity that impacts memory formation. This might explain many complaints of cognitive impairment with Lamictal.
I don't think Lamictal has the ability to impair neurological function in the long run and I do think it is something you will recover from if you do experience such impairment, but as with any of these drugs, there is always some risk that someone may experience long term issues.
What makes you surprised it was the first plan of action?
I guess I am not really surprised as much as I do not agree with it. I think there are other medications out there that are less likely to be as invasive. I have a hard time believing that lamotrigine's potential for therapeutic benefit is the best fit for you. I would personally prefer to try a low dose of a few SSRIs as I do not think the potential for harm is as great. Also, lamotrigine is an anti-epileptic, it was developed specifically for this use, not for depression, anxiety, or mood issues.
I am all for the medication that is most likely to make someone feel good in a way that makes it easier for them to behave in a more productive fashion, with the least potential for harm and side effects. I took Zoloft for years and would still be on it had I not stopped. But if most psychiatrists knew I was bipolar(I did not at the time) they likely would have wanted me to try to get off Zoloft and transition to a new class of drugs. Why not stick with a drug that helps me feel good and normal much of the time and has been shown over and over again to not have a negative impact on someone's cognitive ability/neurological function for a large part of the population of people that try it. All you have to do is search the internet. You will not find the kinds of complaints about drugs like Zoloft that you find with drugs like Lamictal. I understand many doctors are worried about making someone feel manic with SSRIs so they try a drug like lamotrigine instead. I also understand that lamotrigine has helped many people. I am all for keeping lamotrigine in the toolbox of psychiatrists as a potential therapy for their patients. I just think that lamotrigine is still going through this honeymoon/drug du jur phase and this is influencing doctors to prescribe it more than it should be for patients that would be better off on other medications in the long run.
Lamotrigine is a heavy heavy duty medication, one that I believe is much more so than medications like SSRIs. IMHO, more caution should be used when prescribing it.All that said, I do not want to discourage you from trying something that might end up being a very good treatment for you. I'm sorry if I have discouraged you or instilled any fear in you.
Morgan
Posted by BetweenDreams81 on January 18, 2011, at 16:56:21
In reply to Re: Generic Lamictal (lamotrigine) experiences? » BetweenDreams81, posted by morgan miller on January 18, 2011, at 16:38:21
Thanks for the info Morgan....it is something to keep in mind. I do think he was afraid to put me on SSRI's because I have been swinging abit and maybe because my reaction to Adderall is so extreme, it definitely throws me into mania/hypomania. It could be because my mom is on an SSRI and even though she is still taking it, I know it is not all that effective cause I'm living with her and see her everyday. Could be that he is taking into consideration my sister's history of reacting to different drugs as well. Who knows why this was his first lineup...I will ask him next time I talk with him though, just to at least find out his usual progression of trial/error.
We'll see how it goes, but if I do notice the signs you are talking about, at least I know about them and can 'hopefully' be mindful enough to notice and talk with him about it. I am glad to know of this, but I think I am also good at keeping an open mind...and I am soooo driven to get my life back on track that I am trying my best to maintain a good mind set that is as optimistic as possible while still being well-grounded in reality.
Thank you for sharing your experience!
Posted by BetweenDreams81 on January 18, 2011, at 17:22:56
In reply to Re: Generic Lamictal (lamotrigine) experiences? » BetweenDreams81, posted by morgan miller on January 18, 2011, at 16:38:21
...I don't want to jinx myself, but I think I qualify for the GSK Bridges to Access program...cross fingers. That would be a huge weight off of my shoulders financially speaking!
Posted by morgan miller on January 18, 2011, at 17:36:45
In reply to Cross Fingers!..., posted by BetweenDreams81 on January 18, 2011, at 17:22:56
That would be great! I hope you do qualify for this!
Posted by bleauberry on January 18, 2011, at 17:43:51
In reply to Generic Lamictal (lamotrigine) experiences?, posted by BetweenDreams81 on January 17, 2011, at 15:57:34
One of the examples of generic lamictal that stands out in my mind is that of SLS, which he commented on in this thread. Over the years there have been multiple examples.
One doctor I know will not even prescribe generics at all. He has seen enough troubles, failures, bizarre side effects, and relapses with them that he does not consider them reliable in the effort to move progress forward. Most doctors I think do not have their eyes fully open to see the clues and trends that are right in front of them every day. They assume what everyone else assumes, that is, generics are equivalent to brand. They aren't. Different is different, in SLS's own words, and I agree.
You know the old saying, "you get what you pay for." I personally believe with maybe 70% of meds on the market, that is true. $4 fluoxetine is NOT the same as $100 prozac. Even the claim that the active ingredient is identical is misleading.
My doctor did actually have one generic pain killer he preferred over brand because he got better results with it. He didn't have any bias one way or the other, he just watched for consistent trends. He was much more of a medical detective with his patients than most doctors are. Generics didn't provide consistent trends except in the disappointment department, most of the time. Not enough observed consistent performance to be first line anyway.
The topic spans many drugs. It isn't just lamictal. I've noticed the difference myself several times. Twice I didn't even know I had been switched, so it was truly a blind experience. Even for a common headache, I find brand Advil to be much better than the generic. The generic works, but not with the same oomph.
I think a wise strategy is to begin any treatment with the expensive brand. Assuming it does well, which it may or may not, then try switching to generic and see what happens. It might stay well, or it might fall apart. If it stays well, then you can save a ton of money. If it doesn't, go back to brand. For someone to start a treatment on say, example, generic lamictal, and then fail that trial, well, they never really tried lamictal, so they can't say lamictal didn't work for them!
To me, the following meds in generic form were absolutely horrible experiences: Lamictal, modafinil, prozac, xanax. I did fine on brand prozac, brand xanax, and brand modafinil. Lamictal just wasn't for me no matter, but at least the brand version was tolerable. Generic not.
Odd, but just as my doctor found one generic to be more reliable than brand, I too found that generic Ritalin is much better for me than brand. The real stuff just feels aweful to me.
Posted by BetweenDreams81 on January 18, 2011, at 18:02:50
In reply to Re: Generic Lamictal (lamotrigine) experiences?, posted by bleauberry on January 18, 2011, at 17:43:51
Thank you bleauberry for sharing your experience...I feel the same way about staying with the brand Lamictal after reading so many stories...at least to know whether it is the right thing or not...and hopefully I really do qualify for the GSK Bridges to Access program which would provide me with their brand name meds.
Now about Xanax (should mention, it is generic)
How long does one normally feel its effects? I am currently taking 0.25 mg 2x/day. I definitely notice it when it kicks in...I get uber drowsy for about 30 min, and then I'm fine...for 3-4 hours in a stressful situation or if I am particularly low or negative...longer, about 6-8 hours if I'm not stressed out to begin with. When I feel it "stop" working I automatically have a feeling like there is a hampster wheel of negative thoughts/feelings and anxiety running through my head. Sometimes, I can feel my heart rate increase...again, 30 min after I take the xanax, it's gone again.
Now I can see why this can become habit forming. I have never had an "addictive" personality so I don't 'think' I'm feeling addicted to it?? Is this an indication that I am still adjusting to it? Does this sound like it needs to be increased or XR formula? Or??? Just noticing and wondering...I want to be careful and responsible with this drug. I have e-mailed pdoc about it.
Posted by Phillipa on January 18, 2011, at 18:46:49
In reply to Now about Xanax (alprazolam) » bleauberry, posted by BetweenDreams81 on January 18, 2011, at 18:02:50
Been on it for many years and haven't increased dose. Some need regular xanax if they take the long acting. Personally it didn't work for me. Some say it doesn't release consistently. Greenstone is the only xanax I'd take. Made by manufacturer of real name brand xanax. Phillipa
Posted by BetweenDreams81 on January 18, 2011, at 19:25:03
In reply to Re: Now about Xanax (alprazolam) » BetweenDreams81, posted by Phillipa on January 18, 2011, at 18:46:49
Thanks Phillipa, What dosage do you take? (if it isn't too personal)
Posted by Phillipa on January 18, 2011, at 20:05:23
In reply to Re: Now about Xanax (alprazolam) » Phillipa, posted by BetweenDreams81 on January 18, 2011, at 19:25:03
Before any other meds and just a benzo .25 mg three times a day. Or 4 hard to remember. And now just under lmg bedtime only. Phillipa ps benzos for 40 years yes it's true
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