Posted by Ron Hill on February 13, 2003, at 12:09:37
In reply to Re: Lamictal Update » Ron Hill, posted by colin wallace on February 13, 2003, at 4:31:07
Colin,
Last summer I thought you had found the solution to your brain chemistry issues with Lamictal. I was hoping that at least one of us was "fixed". What kinds of symptoms are causing you to feel the need to add an SSRI or TCA?
What is your dx according to your current pdoc? It is a pdoc you are seeing, correct? What is your dx according to Colin? Is it possible that there is a bipolar II component in your dx? I ask this because I am of the firm belief that BP II patients should not take SSRI's nor TCA's without a moodstabilizer fully in place and even with a moodstabilizer I personally don't think SSRI's or TCA's have efficacy over the long run in BP II patients. Please check out Dr. James Phelps' web site and find the links that discuss his stance on this issue. Also, check out the links he provides on the subject. I think he is right-on with regard to this issue. Bottom line: Dr. Phelps is of the opinion that MAOI's are typically the best class of ADs for BP II patients. He also has a BP II questionnaire on his site. If you want, you can fill out the questionnaire and score the results. Here is the link to his web site:
http://www.psycheducation.com/
I don't know if you are BP II, but as I've told you before, I've always suspected that you have some BP II component in your dx. My opinion is based primarily on your reaction to SSRI's (without moodstabilizer) and that at times you have cycled into a dysphoric mood state. I could be all wet on this Colin. Take it for what it is; a friend offering his layman opinion in hopes of being able to help.
-- Ron
------------------------------------------> > Hi Colin,
> >
> > Happy to hear about the new job. Best Wishes!
> >
> > Correct me if I'm wrong, but I remember my friend Colin shouting from the roof tops that he would never touch another SSRI. What's up with adding Prozac to your Lamictal?
>
> Hey there Ron ol' buddy,
>
> You are right;when in the throes of Zoloft madness, I did swear I'd never, ever go near an SSRI again!And Lamictal has been(unavoidable cliche)well, nothing short of miraculous.
> Trouble is I've hit 200mg, and although I could probably getaway with doubling this, my best guess is that it will need augmenting at some point-it does have a tendancy to fade for a lot of people.
> I'm having a rough time, as always,this winter, and want to build up some solid resilience before next year.The Prozac thing came about one day when the weather had been really foul(gales etc) for weeks, and even Lamictal couldn't fend off the crash(although it greatly reduced it).I had a few brand Prozac in a drawer,and no Lamictal left, and I recklessly threw one down my neck.I always liked the 'feel' of Prozac, but it would, of course, destabilize me badly-nothing like Zoloft though.Anyway,with Lamictal firmly in place, I seemed to get all the *good* feeling from Prozac, without the instant agitation, erratic swings etc.
> And as someone else mentioned, Lamictal gives you much more latitude to experiment with AD's due to the underlying stability it provides.
> I was planning on adding the TCA Lofepramine anyway, but I'll carefully test out the Lamictal/Prozac combo. first.Any sign of anger/instability, and in the bin it goes!
> I have, by the way, reduced the dose to a sprinkle, as this seems sensible.
> I can (and may well yet) easily switch to a low dose TCA at any time.
> Glad you're getting results from this new NADH venture- if we hadn't bankrupted ourselves with Sam-e, I might have considered joining you!!
>
> Keep us posted Ron,
> and stay well.
>
> Col.
poster:Ron Hill
thread:138803
URL: http://www.dr-bob.org/babble/20030208/msgs/200101.html