Posted by colin wallace on March 10, 2003, at 11:14:32
In reply to Re: Lamictal and Lithium = best match-Max » JackD, posted by Maximus on March 9, 2003, at 20:18:53
> What i've read, heard and even discussed with my pdoc is the following strategy. Reduce your Lamictal down to 300 mg and add a tiny dose of TCA (not SSRI), like Desipramine at 25 mg. That will do the job for sure without any side effect. You might talk of that with your pdoc.
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> Bye!
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> Max.Max,
I like the concept of the lithium/lamictal combo.,but would be hesitant to say the least, about adding a low dose tricyclic where depression continues to slip through the net.
I take 300mg of Lamictal, and will shortly be discussing adding an additional med. with a bipolar specialist psych.I may well go for lithium too.
Funnily enough,at one point I was keen on adding a low dose of Lofepramine(metabolized to Desipramine if I remember rightly)but as you probably know,all current opinion seems unequivocally set against TCA's as the worst culprits for precipitating mania in bipolars.
My own experience has been that SSRI's are far more likely to do so(seems your psych. agrees with this?)but I just wondered why she suggested the TCA in particular over an SSRI?
I'm guessing here that perhaps keeping the TCA dosage marginal will negate any destabilizing effect, but I can't see why this shouldn't apply to an SSRI, or indeed any other AD.
I'd love to know the reasoning here, because if I thought it was safe, I'd opt for a low dose(noradrenergic)TCA over an SSRI anyday.Glad you've been kept well for 3 years too-that's good to hear.
Col.
ps.Just ditched a tiny dose of Prozac aswell myself,as I don't really trust it in the long term.
poster:colin wallace
thread:207324
URL: http://www.dr-bob.org/babble/20030310/msgs/207725.html