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Bowden: Lamictal add-on?

Posted by colin wallace on March 4, 2003, at 14:21:50

In reply to Bowden: lithium worsens cycling-reasons?, posted by Ritch on March 4, 2003, at 13:20:47

Hi doc.,

I am a BP11 who has worsened and cycled into dysphoric hypomania on numerous AD trials over three years of major depression (of varying severity)and have basically lost a grasp on my 'stabilty' as a result.I am under a lot of personal stress though.
I had made an amazing recovery on Lamictal within three months, and once stable, realized that I had always been disposed to these dysphoric bouts, but had previously been able to control them.
My progress quickly deteriorated once my doc. decreed that I should halt my Lam. at 100mg for a month, despite my insistence that I should be capitalizing on my progress and titrating weekly.
I have crashed into a depression again and recently suffered another hypomanic episode.
I've brought myself up to 300mg(weekly 50mg increments)and am slowly coming around again.I lost a lot of ground,and my progress has been damaged.
I take around 200mg Neurontin which seems to help a too, but I have been contemplating asking for a Lamictal add-on, possibly Trileptal, for added stability and an additional AD effect.
Lithium and valproate (individually)depressed me.
My question(at last!)is,what are your thoughts on Trileptal as a(tentative) Lamictal add-on, or a possible retrial of Lith/Depakote in small doses.
Breakthrough depression/dysphoria are my main concerns in equal measure.Any thoughts(hypothetically of course)would be greatly appreciated.

Thanks for your time- your lecture was most helpful too.

Col.


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