![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Scatterbrained on June 17, 2014, at 16:33:43
Hi
So I'm on a combination of Lamictal 100, Lithium 150, Parnate 50 , Zyprexa 7.5 . I'm still depressed and my cognition is not where it needs to be. I had read that Lithium in micro doses can help cognition and potentiate an antidepressant but at bipolar doses can cause cognitive problems so going too far up on LI is just not an option for me. I need to work . On top of that I've been getting agitated from the Parnate, whether it is unmasking a bipolar disorder or not I'm not sure but that is the reason for the Zyprexa 7.5 . Would going up on the Lamictal be a good move as to prevent the agitation and hopefully a lower dose of the Zyprexa or would going up on the lithium be better? My concern is that I don't want to go on anything that does anything other than improve my cognition so Lamictal is dangerous in that respect although I have read that it can improve cognition in bipolar and I have found that to be the case as long as it's not too high. What are your thoughts?
Posted by Christ_empowered on June 17, 2014, at 17:36:58
In reply to Up on Lamictal or Lithium?, posted by Scatterbrained on June 17, 2014, at 16:33:43
I did well on lamictal 200 and now on lamictal 100 with trileptal, 1200. I also take 30 abilify.
I'd up the lamictal first and see what happens. Maybe you could then lower the zyprexa (?). I think cognitive issues with lamictal pop up when you get to 300-400, but I could be wrong...
...good luck!
Posted by ScAtterbrained on June 17, 2014, at 18:27:07
In reply to Re: Up on Lamictal or Lithium?, posted by Christ_empowered on June 17, 2014, at 17:36:58
Thanks
Posted by scatterbrained on June 17, 2014, at 18:58:04
In reply to Up on Lamictal or Lithium?, posted by Scatterbrained on June 17, 2014, at 16:33:43
does sls have any suggestion? greatly appreciated.
Posted by Phillipa on June 17, 2014, at 19:11:45
In reply to Re: Up on Lamictal or Lithium?, posted by scatterbrained on June 17, 2014, at 18:58:04
Post to him directly. If bipolar and a good dose shouldn't this lithium prevent bipolar if from a med? Phillipa
Posted by scatterbrained on June 17, 2014, at 19:20:47
In reply to Re: Up on Lamictal or Lithium?, posted by scatterbrained on June 17, 2014, at 18:58:04
have any suggestions?
Posted by Beckett on June 17, 2014, at 23:42:59
In reply to Up on Lamictal or Lithium?, posted by Scatterbrained on June 17, 2014, at 16:33:43
I am not sure there is a way to predicte how these meds will effect an individual. Lamictal effects my cognition. I take 200 mg. and hope (will) dial it back. I also take lithium 600 mg., but I tolerate Li well.
I'm not sure that lamictal has any effect on my anxiety at all. I wish it did. From what I've read, It should. Are you dealing with BPI? It occurs to me that agitation could be different than anxiety. Otherwise, is parnate o.k.? I'm curious how you deal with any insomnia.
Posted by ScAtterbrained on June 18, 2014, at 3:56:40
In reply to Re: Up on Lamictal or Lithium?, posted by Beckett on June 17, 2014, at 23:42:59
I don't have bipolar 1 but possibly nos, never been manic but antidepressants have made me agitated and confused and I can only tolerate them if I'm on Lamictal for some reason. Are you bipolar 1? Both doses seem quite low from what I understand.
As for insomnia , I had some trouble in the beginning but now it's not a problem
Posted by phidippus on June 22, 2014, at 14:43:33
In reply to Up on Lamictal or Lithium?, posted by Scatterbrained on June 17, 2014, at 16:33:43
Lamictal really starts being therapeutic at 200 mg. Lithium is really pointless at 150 mg and is probably conferring more side effects than anything else. The therapeutic range of lithium is determined by blood level and at minimum should be .6. I can't tell you what dose it will take to hit .6 but it certaainly is higher than 150 mg.
You're not sure you're bipolar?
Eric
Posted by herpills on June 23, 2014, at 16:35:22
In reply to Re: Up on Lamictal or Lithium? » Scatterbrained, posted by phidippus on June 22, 2014, at 14:43:33
Some people, including myself, get a therapeutic response with Lamictal at 100-150mg, but yeah 200mg is the "standard" dose. What is your opinion of doses in the 300-400mg range? herpills
Posted by phidippus on June 25, 2014, at 18:30:40
In reply to Re: Up on Lamictal or Lithium? » phidippus, posted by herpills on June 23, 2014, at 16:35:22
A lot of people experience a good reduction of symptoms at the 400 mg range.
Eric
Posted by Beckett on June 25, 2014, at 21:59:51
In reply to Up on Lamictal or Lithium?, posted by Scatterbrained on June 17, 2014, at 16:33:43
My Li level was .6, but I had tremors enough that they interfered with writing and keyboarding, so I dropped it. Maybe 300 mg. would help. That dose helped with 'thoughts of death'. My experience with lamictal is 200 mg. interferes with cognition (memory and word recall), but I do have benefits, so maybe your experience will be more positive than mine (no cognitive side effects)? Yes, I deal with bipolar, BPII. I think lamictal at 200 mg. helps with panic disorder as well.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.