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Re: Lamictal + Prozac

Posted by Houston on November 7, 2003, at 22:19:05

In reply to Re: Lamictal + Prozac Ron Hill, posted by colin wallace on February 18, 2003, at 5:53:07

> Hi there.

I have been on lamictal for about seven weeks now. It was great the first four weeks until we upped the dose to 150 which sent me spiraling into deep depression. I could not stop crying and I had fleeting thoughts of suicide which I would have never carried out...but it scared me that I thought of them. So they reduced my dosage to 100 and added 20 of prozac. I haven't been better in at least 10 years and I'm only 31!

> Greetings Ronald old chum!
> Let's start with the depression;around six months ago, if you recall,I'd relapsed badly and slid into a dangerous mixed-state.This was due to a combination of ugly factors,the ugliest of which was a parent having been diagnosed with brain cancer, unrelenting rain,chronic body-pain(fibromyalgia type-stuff),numerous med. failures,no job and precious little social contact for three years- and an 'unopposed' SSRI to ensure that I finally blew my lid!!!
> I had no access to a psych., and looking back, was in pure unadulterated mania-I very nearly did away with myself if I'm honest.After crashing my car at breakneck speed, I found a hospital and begged to be placed on a mood stabilizer... but valproate and lithium made things worse.
> Then came my nifty little box of Lamictal in the post, and the rest you know.
> Today,I feel better than I have in years;my mind is sharp and clear, I have ABSOLUTELY no depression to speak of,no swings or dysphoria(I no longer fall into my personal mantrap of fixating on a subject and spinning off into anger) clear plans for the future, a semblance of a social life- and I start a new job next week.I'm actually looking forward to it(inasmuch as anyone looks forward to work!)In short, I feel normal.
> Lamictal is responsible for my revival, and I thank God I followed my own instincts and placed myself on it.
> So, currently I'm taking 200mg Lamictal,2mg diazepam,100mg Neurontin at night(neuropathic pain/stiffness), along with just 10mg Amitryptaline for sleep.
> The Prozac 'sprinkle' probably amounts to maybe 2mg/4mg max. , meaning I can get over a weeks mileage from a 20mg capsule.As I mentioned before,it feels entirely different with the Lamictal in place-nice little uplift, but not the silly 'high'or irritability it previously caused.
> This may seem like trying to fix something that ain't broken, but there's reason behind my madness?!Although I have no depression symptoms, my problems begin and end with the weather.After around three weeks of continuous rain and gloom, I begin to slide.It's more a slip towards hypomania than pure depression.Feels like cogs in my head loosing their synchronicity and coming unmeshed.My head hurts,I begin to seriously contemplate jumping on a plane(with hardly any money!)and just flying the hell away to anywhere on earth where there's sunshine.I get frustrated and angry, and spit out sentences like "this stinking ****** country is unfit for human habitation!!You get my drift.Not pleasant.
> Now I agonized about how to tackle this for some time, and I seem to be defenceless against it.
> SSRI's(the dreaded enemy)have proven efficacy against SAD(or a downward bipolar seasonal swing)but we all know the risks.I read an up to the minute article yesterday challenging the hypothesis of the long-term destabalizing effects of using(low dose)AD's with BP(with a mood stabilizer of course)- in this study at least, those on concurrent AD's actually fared slightly better.But I think this debate won't be solved for years.
> In my case,I need to 'marshall my troops' to the North rampart and prepare to fend of(next years)bad weather.I believe that, unfortunately, I will need to risk a low dose AD for as long as I'm stuck in the UK.I seem to have little choice.TCA's sem to be the worst culprits for precipitating mania, and(low-dose) Prozac actually compares quite well all in all(Zoloft one of the worst, as we both know!!)
> Feeling normal right now is a good starting point to gauge my reactions-any irritability or aberrant thoughts, and Prozac gets the boot.
> A retrial of lithium in combo with Lamictal is then an option, and then failing that,I'd have no qualms in trying an MAOI.But I don't think it'll come to that.There's also Topomax, but that doesn't really grab me either.
> I like the idea of this ENADA stuff, although I haven't done too much research yet.I may well give it a whirl, and if it feels good, who knows?
> By the way, our old friend SAM-E doesn't mix with Lamictal AT ALL- sends me clawing up the wall straightaway!
> My med regime is doing it's job perfectly right now, but like you, I'm always looking ahead in case of pitfalls.Fingers crossed.
> What are your personal 'med. contingency' plans?
> I know you bottomed out with Lamictal once on silly doses, but have you ever thought of a re-trial(like Amy)?At least we both have options still.
> Anyway, glad you're feeling well over there, and keep me posted with your progress.Keep bouncing any thoughts, advice and ideas too!!Always welcome.
> Col.




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