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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by Tabitha on May 6, 2016, at 14:17:41
My pdoc upped my dose of Lamictal from 150 to 200mg. My mood has taken an upturn. Could be placebo effect, since it's only been a week on the new dose. I really wasn't expecting an improvement though. I'm still on 300mg lithium plus an SNRI.
Went to a metal band show last night. It was fun and I enjoyed the energy of the music and the people head-banging and moshing. The band has been around a while so the crowd included a lot of middle-aged fans. Either the show raised my mood, or my improved mood allowed me to enjoy it.
Posted by PeterMartin on May 6, 2016, at 14:28:36
In reply to Better with more Lamictal, posted by Tabitha on May 6, 2016, at 14:17:41
Thanks for posting. I just increased from 150 to 200 on Lamictal as well and your post makes me optimistic it'll help.
Hope you have continued success!!
Posted by Phillipa on May 7, 2016, at 12:06:51
In reply to Re: Better with more Lamictal, posted by PeterMartin on May 6, 2016, at 14:28:36
Scott has posted that at least his optimal dose of lamictal is 200mg. So that sounds right to me. Phillipa
Posted by Tabitha on May 7, 2016, at 13:24:05
In reply to Re: Better with more Lamictal, posted by Phillipa on May 7, 2016, at 12:06:51
Thanks Peter & Phillipa. I'm still in a brighter mood, so am starting to think this is a real effect.
Posted by J Kelly on May 7, 2016, at 15:45:52
In reply to Re: Better with more Lamictal, posted by Tabitha on May 7, 2016, at 13:24:05
> I'm still in a brighter mood, so am starting to think this is a real effect.
Hey this is great news! Hope it continues :)
Jade
Posted by rjlockhart37 on May 8, 2016, at 1:01:27
In reply to Better with more Lamictal, posted by Tabitha on May 6, 2016, at 14:17:41
lamictal i've taken when im in a mood slump, it doenst really put me in good mood but it takes me out of a depression slump, back to normal.....at 200mg, ill notice i'm not depressed anymore and able to do things in a ok mood
i think it stabilizes neuron flow, maybe polarizing the flow of neurotransmitters.....
Posted by Lamdage22 on May 8, 2016, at 5:06:16
In reply to Re: Better with more Lamictal, posted by rjlockhart37 on May 8, 2016, at 1:01:27
good for you
i didnt feel anything on it
Posted by Horse on May 9, 2016, at 19:25:59
In reply to Better with more Lamictal, posted by Tabitha on May 6, 2016, at 14:17:41
Interesting. My doc upped my lamictal from 200mg to 250mg because I still experience lows (my mood cycles frequently).
Sometimes I wonder about lamictal, I mean how it works or I suppose why, too. Although I am better off than than most times in my life, I'm pessimistic by habit because I have been ill with cyclothymia since my pre teen years, and as I am sure it has been for many of you, I have taken many medications.
Tabitha, I'm glad your mood is good :)
Posted by Tabitha on May 10, 2016, at 15:34:28
In reply to Re: Better with more Lamictal » Tabitha, posted by Horse on May 9, 2016, at 19:25:59
> Interesting. My doc upped my lamictal from 200mg to 250mg because I still experience lows (my mood cycles frequently).
>
> Sometimes I wonder about lamictal, I mean how it works or I suppose why, too.I remember when Neurontin was the big new thing. It had few side effects, but unfortunately people eventually learned it didn't really help mood much, either. Maybe Lamictal will go the same way. I think they're both off-label usage right?
> Although I am better off than than most times in my life, I'm pessimistic by habit because I have been ill with cyclothymia since my pre teen years, and as I am sure it has been for many of you, I have taken many medications.I hear you. It's a med merry-go-round.
>
> Tabitha, I'm glad your mood is good :)
>
>I think it might have been a false dawn. I had a meltdown on Sunday and still feeling very anxious & heavy.
Posted by Horse on May 10, 2016, at 16:33:46
In reply to Re: Better with more Lamictal » Horse, posted by Tabitha on May 10, 2016, at 15:34:28
> > Interesting. My doc upped my lamictal from 200mg to 250mg because I still experience lows (my mood cycles frequently).
> >
> > Sometimes I wonder about lamictal, I mean how it works or I suppose why, too.
>
> I remember when Neurontin was the big new thing. It had few side effects, but unfortunately people eventually learned it didn't really help mood much, either. Maybe Lamictal will go the same way. I think they're both off-label usage right?
>
>
> > Although I am better off than than most times in my life, I'm pessimistic by habit because I have been ill with cyclothymia since my pre teen years, and as I am sure it has been for many of you, I have taken many medications.
>
> I hear you. It's a med merry-go-round.
>
> >
> > Tabitha, I'm glad your mood is good :)
> >
> >
>
> I think it might have been a false dawn. I had a meltdown on Sunday and still feeling very anxious & heavy.
>
>I'm sorry to hear that. I had a trigger yesterday that I'm working off. There isn't really a cure for me, just rolling with all the sh*t, and therapy. Awareness is good, but sometimes I witness a mood hamstringing me. I suppose what I do afterwards is what"s artful.
Thumbs up to you, and a high five for good measure. Hang in there.
Posted by Tabitha on May 10, 2016, at 18:58:26
In reply to Re: Better with more Lamictal » Tabitha, posted by Horse on May 10, 2016, at 16:33:46
> There isn't really a cure for me, just rolling with all the sh*t, and therapy.
Wow, that sounds really profound to me and useful as an attitude. I hope I can develop your level of acceptance some day.
> Awareness is good, but sometimes I witness a mood hamstringing me. I suppose what I do afterwards is what"s artful.Yes, I really hate seeing myself functioning poorly and feeling miserable, but I have to give myself credit for chugging along for this long.
>
> Thumbs up to you, and a high five for good measure. Hang in there.Thank you!
Posted by porkpiehat on May 18, 2016, at 12:58:38
In reply to Better with more Lamictal, posted by Tabitha on May 6, 2016, at 14:17:41
I am currently struggling with this too. I feel like after being on Lamictal for 10 years it is contributing to a lack of drive, a heavy sadness, and a hypervigilance that makes me (in my mind) lash out at everyone around me by finding their faults while ruminating over arguments to protect myself from imaginary attacks.
I was thinking "you are depressed so increase from 150mgs to 200 mgs, but these symptoms almost always kicks in 2 hours after my morning dose of lamictal.
What was your experience at 150mgs? Did you find it did more harm than good at a lower dose? Where are you now at 200 mgs?
Posted by Tabitha on May 18, 2016, at 13:32:01
In reply to Re: Better with more Lamictal » Tabitha, posted by porkpiehat on May 18, 2016, at 12:58:38
> I am currently struggling with this too. I feel like after being on Lamictal for 10 years it is contributing to a lack of drive, a heavy sadness, and a hypervigilance that makes me (in my mind) lash out at everyone around me by finding their faults while ruminating over arguments to protect myself from imaginary attacks.
>
> I was thinking "you are depressed so increase from 150mgs to 200 mgs, but these symptoms almost always kicks in 2 hours after my morning dose of lamictal.Have you tried taking it at bedtime instead of morning?
>
> What was your experience at 150mgs? Did you find it did more harm than good at a lower dose? Where are you now at 200 mgs?At 150mg, it helped greatly for about a year, then I relapsed with depression. That's a very common outcome for me. I did not notice any negative side effects though.
At 200mg, I've had ups and downs the past month. Initially it seemed to be lifting my mood. Then I had a pretty severe depression for a few days. Now I'm feeling good, almost to the point of hypomania. I changed from nighttime dose to morning after suspecting it was causing insomnia. So I'll likely continue with it. I am starting to think I just need to change meds or dosage at least once a year to avoid the inevitable poop out.
Posted by porkpiehat on May 25, 2016, at 7:57:54
In reply to Re: Better with more Lamictal » porkpiehat, posted by Tabitha on May 18, 2016, at 13:32:01
I cannot take it at night. It doesn't give me a speedy feeling but I certainly feel very untired and if I do sleep I'm "conscious" throughout the night, if that makes sense.
I've also experienced a hypomanic feeling on it at times, but I don't feel that it's a true mania because it kicks in hours after dosing and fades.
I think if it were true hypomania it wouldn't come and go with dosing schedule.
The fact that it can act so differently over time and at different doses goes overlooked I think and muddies the diagnostic waters.
Despite the problems I've had with it, I know that I descend into awful despair after a week or so of dropping off my dose, but that was with Celexa, which exaggerated the ups and the downs.
What does your therapist say about all this? Is there a psychological component?
Posted by Tabitha on May 25, 2016, at 15:13:14
In reply to Re: Better with more Lamictal » Tabitha, posted by porkpiehat on May 25, 2016, at 7:57:54
> I cannot take it at night. It doesn't give me a speedy feeling but I certainly feel very untired and if I do sleep I'm "conscious" throughout the night, if that makes sense.
>
> I've also experienced a hypomanic feeling on it at times, but I don't feel that it's a true mania because it kicks in hours after dosing and fades.Wow, since I posted last I've been having problems with the 200mg. During the daytime I was feeling just awful-- not depressed exactly but a combo of sadness, anger, and sort of a disgusted feeling. Like nothing I've experienced before. I thought it might be either (1) the change to morning dosing, (2) the increase to 200mg. I tried night time dosing and barely slept at all, but it turned out I'd forgotten my sleep meds :-(
Anyway I am wondering if like you suspect, there are bad reactions tied to the dose timing. It makes no sense to me since it's supposed to stabilize mood.
I'm also on an SNRI, but am tapering off it. Perhaps that is making the situation worse.
Re therapy, I don't do it anymore. I went for over 20 years and can't say it helped. Meds and life situation make a much bigger difference for me than talk therapy ever did.
Posted by porkpiehat on May 25, 2016, at 15:37:40
In reply to Re: more Lamictal » porkpiehat, posted by Tabitha on May 25, 2016, at 15:13:14
You are my soul sister!
I have done therapy off and on for 20 years and while I have gotten some nuggets about dealing with other people and insight about my own pathology I feel more frustration over therapy.
We spend a lot of time digging things apart and I'm like "no sh*t, I tear myself apart every time I have a spare moment in my head, but what can we do about it?" and it always goes to deep breathing or "that's where our work lies" without any follow up. Then I walked around suicidal because I feel there is no hope at all.
Anywhoo...I find lamictal behaves differently with different drugs. Alone it slows me down, but with Celexa it seems to amp me up.
I have friends that report they have had mixed episodes on lamictal and ended up in the hospital. I will definitely jump from dysphoric to rageful and then snap back to normal sometimes. After years on meds I can't really discern normal mood changes from med reactions. People with trauma can be extra sensitive to changes and seem like they are cycling.
sorry if you already said this, but what is your dx?
Posted by Tabitha on May 26, 2016, at 17:27:41
In reply to Re: more Lamictal » Tabitha, posted by porkpiehat on May 25, 2016, at 15:37:40
> and it always goes to deep breathing or "that's where our work lies" without any follow up.
Ahahaha, that's great, it's therapist-speak for "I have no idea how to solve this problem but I'm getting paid by the hour so let's keep talking about it and pretend that talking about it is actually important work"
> I have friends that report they have had mixed episodes on lamictal and ended up in the hospital. I will definitely jump from dysphoric to rageful and then snap back to normal sometimes.
Yeah it's weird, they use it off-label as a mood stabilizer, but some people on it for seizures report that it makes them moody. It doesn't give you a good sense that the effects are very well-understood.
> After years on meds I can't really discern normal mood changes from med reactions.
Right? It's so hard to know what if anything is triggering mood changes.
>
> sorry if you already said this, but what is your dx?Bipolar 2. Mostly severe depression. I get hypomania from SSRI. Not sure if I ever really had hypomania before starting meds. How about you?
Posted by porkpiehat on June 2, 2016, at 15:18:12
In reply to Re: more Lamictal » porkpiehat, posted by Tabitha on May 26, 2016, at 17:27:41
Dx depends on who you talk to. Looks like BPII precipitated by trauma and SSRI.
I leave therapy every day now feeling awful and broken and that we are speaking different languages. I'm going to give it one more week.
I took a small break from the Wellbutrin as it is making me a little scattered and irritable. It's funny I can say celexa did they same thing at least as low doses.
Just taking the Lamictal I can do activities and concentrate but I concentrate on my damages. A natural lightheartedness and spontaneousness disappears and interractions become tough and labored.
the mood brightens with the WB and celexa but the stillness is gone and I feel like I'm constantly "losing my place." I'm a little quicker to irritability.
Not sure where to go next. Life is on hold hoping that therapy would progress but I'm really starting to believe is 90 percent neurochemical although the triggers and history are sometimes situational.
Posted by porkpiehat on June 3, 2016, at 13:35:48
In reply to Re: more Lamictal » Tabitha, posted by porkpiehat on June 2, 2016, at 15:18:12
Tabitha after a day of crappy despair (and therapy) I held off on my morning dose of Lamictal and the sad/damaged/defensive mind never popped up!
Knowing that I couldn't just stop cold turkey I took 50mgs instead of 100mg after lunch. Within 2 hours the defensive/wary brain came back, but instead of deeply sad I'm all hyper and knee-shaking and a little confused. WTF?!?! I either go way up or way down
Are you still at 200mgs or did you change?
Posted by Tabitha on June 3, 2016, at 14:07:11
In reply to Re: more Lamictal))tabitha » porkpiehat, posted by porkpiehat on June 3, 2016, at 13:35:48
> Are you still at 200mgs or did you change?Yes I'm still taking 200mg. Currently tapering off the SNRI I have been taking, since theoretically the lamictal+lithium should be enough. It's probably too soon to say, but I feel calmer than usual since that change. I'm not noticing any bad effects from the lamictal increase. Possibly not sleeping as well as before, but that may be due to caffeine. It's tough to limit my daily coffee.
Sorry to hear you're having some bad reactions to the lamictal. I try not to judge meds until it's been a couple weeks at least. There are too many other factors.
On the therapy, it sounds disappointing that you're not connecting with your T. I'm pretty cynical about therapy in hindsight, but I know it felt like a valuable support at times, particularly the first few years. I hope you can work things out or find someone or something else to help.
Posted by porkpiehat on June 3, 2016, at 15:58:26
In reply to Re: more Lamictal))tabitha » porkpiehat, posted by Tabitha on June 3, 2016, at 14:07:11
I'll be very interested in what your response is once you've weaned off the SNRI. I may have said this before but for me Lamictal works much differently with AD's (I've been on it for 10 years).
I'm glad you're feeling calmer :)
This is the end of the thread.
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