Posted by Ritch on June 12, 2003, at 13:52:28
In reply to Re: Lamictal: Ron Hill, Ritch 'Q' and 'A', posted by fluffy on June 12, 2003, at 10:58:14
> Sorry to interrupt this thread for people asking other questions. I tried to wade through all the questions and answers, but didn't have the patience.
>
> I've wanted to ask Ron Hill & Ritch some questions for awhile now, since I have read some informative posts from you two.
>
> Here's my situation:
>
> I'm a clear-cut case of Bipolar II. I have been titrating up on Lamictal for 11 weeks now, doing better than before, but my effect still "slips" if I don't titrate up within a couple of weeks. I still notice a fair amount of cycling--13 days "normal"--2 days hypomania--2-3 days of depression. There has been an overall reduction in my irritability, anger, anxiety & sleep problems, but only if I titrate up.
>
> My question is this: Is it realistic to expect full relief of symptoms & cycling on medication? Is this the *best* it's going to get? I wonder if I should jack with this monotherapy thing and take the risk of feeling worse.
>
> If I augement, would a pinch of Lithium do the trick? I know there are *many* meds to try. I just don't want to slip again.
>
> I tend to get REALLY hypomanic late in the summer, and then REALLY depressed in the fall and winter. At other times, I'm just cyclothymic. What would be your next step?Colin Wallace and others here are on Lamictal-I've never tried it yet. From what I understand from all the posts and other info I have read is that it is worthwhile to reach 200mg or so and hang in there a few weeks to realize the maximum benefit of the Lamictal. Your cycles are similar to mine. It is possible that your cycle length is too close to the titration frequency and the "slips" may be your natural "pattern" confusing things. See if you can either stay at your current dose of Lamictal "through" about 1.5x your cycle length and see if the "slip" fades AND/OR keep going up, but lengthen the time before your next scheduled increase to go beyond a full cycle length by some amount to try to separate the two effects somehow. If you start to get predominantly hypomanic in the late summer-I would wait for the symptoms to show first before reaching for the lithium. They might *not* show up or may be more attentuated than they have previously. If they do show up and are troublesome, lithium would be the thing to add if you don't want to hassle with the Lamictal blood levels jumping up by adding Depakote, although Depakote might work better than Li for you (given you are a rapid-cycler like me).
poster:Ritch
thread:99976
URL: http://www.dr-bob.org/babble/20030609/msgs/233438.html