Posted by avid abulia on July 12, 2003, at 21:20:54
In reply to Lamictal Q's » HenryO, posted by Jack Smith on July 11, 2003, at 12:07:18
Hey all,
If anyone ever reads my posts (well, i guess someone probably does, but i am not terribly useful on here and i don't even come often cuz of that)... well, you would know that i have extensive experience with taking Lamictal.
I also (heh, probably similar to most or all of you here) read obsessively about the mechanism of action of meds...
Well, what has been found with Lamictal when used to treat cocaine addiction, is that if it is used in the usually *neurological* method of usage when getting a therapeutic level fast is quite important, which they also seem to do a lot at hospitals i've been in where they wanna get patients in and out fast fast fast food mental health, with a fairly rapid upward titration of 50mg every three days, it is little better than placebo for cocaine cravings. However, when titrated upwards more slowly, 12.5-25mg every 1-2 weeks, it takes longer to reach a therapeutic level but the effects on cocaine craving are pronounce, indicating that a slower titration has a greater effect at sensitizing dopamine receptors (there has been talk on some research papers i have read indicating that lamictal has an in vivo monoaminergic reuptake mechanism, however most medline papers indicate that it actually works by sensitizing monoamine receptors, not through reuptake inhibition)...
Well, so the point of that being, i don't know how fast you guys are going up on your lamictal doses, but most of the research indicates that the slower, the better.
I personally take 200mg of Lamictal twice per day, and i was initially started in the psych hospital with the fast-food approach, and was up to 200mg per day within two weeks. And it didn't have all that great of an antidepressant effect on me, at that point, but it was still a great prophylactic. Later on, upon receiving a diagnosis of epilepsy during hospitalization for an acute exacerbation of mood disorder, which prompted a doc to want to raise my dose, i told her about the studies for cocaine addiction showing much better effects with slow titration, and i convinced her to allow me to titrate up to her recommended dose of 400mg. by increments of 12.5 mg every two weeks. I had a lot of patience, by then, because i had been depressed for a long enough time out of my life that i was willing to wait things out if there was even a chance that doing it so slow would be better.
Well, long story short, i started to notice i wasn't depressed anymore along about 300mg., and by the time i got up to 400mg. i didn't feel anti-depressed, i felt... normal. Does anyone else know what i am talking about? To me, antidepressants don't seem to actually take away the pain of depression... they are like the morphine i occasionally had to use when i was getting migraines, i still knew i hurt, but i just didn't care so much anymore. Well, with Lamictal at 400mg., titrated in such a slow manner, it was like i actually *didn't hurt* any more.
Not to say i never had a relapse... that is the nature of the beast. But, Lamictal at that dose makes the relapses bearable, and it leads to complete inter-episodic recovery, whereas i nothing else before did that.
And i think the addition of Keppra to it, which happened to occur during a depressive relapse, has actually made me... i dunno... not just on the right medications, but actually better. I dunno if that makes since to any of you...
Este, son las cosas de vida, I'm a babbling psycho.
~AA
poster:avid abulia
thread:239906
URL: http://www.dr-bob.org/babble/20030708/msgs/241322.html