Posted by SLS on May 28, 2009, at 5:28:33
In reply to Re: Generic Lamictal - lamotrigine » SLS, posted by yxibow on May 28, 2009, at 2:34:28
> > I was dispensed a generic version of Lamictal for the first time this past month. My doctor thinks it is possible that this change is what has allowed for my recent deterioration. I had my pharmacy special order another brand of generic. I don't want to mention any names just yet. I have some old Lamictal laying around that I will take for the next week to see if it makes a difference. My doctor showed me the pill bottles that people brought in to him that had been filled with a generic. All of these people had relapsed on this one particular brand.
> I just can't see this, but I suppose if the Lamictal is working especially well and there is low tolerance for any mg change, then maybe something could happen.It is ironic that a friend of mine was recently changed from the brand name Lamictal to the same generic that I was dispensed. She had been doing very well on it. She was then changed to a third preparation of lamotrigine with disasterous effects. She all but relapsed completely into depression. She couldn't wait to be switched back to the first generic she was on. She is recovering very nicely.
> Oh, there's no reason to be secretive, its in the Orange Book. I think there's a handful of generic companies for lamotrigine.
Yes, but the CVS wholesaler would only supply the pharmacy with one brand of generic lamotrigine. I had to have them call as a special order for another manufacture's preparation. So, I know of at least three generic versions of lamotrigine.
> There is also, as you know, a placebo factor.
Actually, I sort of fell for the lie that depression tells. I attributed my feeling worse to a situational issue that I don't usually react to so negatively. I did not expect to feel worse. I really didn't expect anything at all. Because I experienced an increase in vegetative symptoms, I have become quite sure that it was a worsening of my bipolar depression. The situation didn't help, though.
> Also psychological reasons may place a "decline", and although admittedly the rule is the last medication change, there are other things involved in conditions.The only variable I can think of is my exposure to memantine (Namenda). I suppose it could have destabilized me so as to leave me more depressed as late as one week after discontinuing the drug.
> Causality is not always causation, though there can be suspicions.
I agree.
> > I now have to reevaluate my recent negative experiences while taking Namenda (memantine). I tried it while taking the generic lamotrigine. It might make sense to restart it, especially if I feel better after switching brands of lamotrigine.
> I know your medication combination is probably as complicated as mine -- but I have seen no difference with generic Lamictal (Teva). Of course, whether it is doing anything important at one point or another is another story.If it is not helping at all, then it would not really matter whether or not the Teva brand were inferior to the GSK brand. You would feel no worse for switching to placebo.
> Fewer medications are always better than more, but that's just a side comment.
Mine is that one should enter treatment with the goal of taking as few medications at the lowest effective dosages as is possible.
At the moment, I have tested all of the four drugs I am taking by attempting to reduce the dosage and/or discontinuing it. After I relapsed, I titrated the dosages again in order to establish the minimum dosage that produces maximal effect. It turned out that each drug contributes to the improvement I glean from the treatment regime.
Currently:
Parnate 80mg
nortriptyline 150mg
lamotrigine 200mg
Abilify 20mgCompared to some people here, this is relatively few drugs to treat a depression so severe and recalcitrant.
> Namenda was horrible for me at 20mg,Gosh. That doesn't so sound good.
In what ways did Namenda affect you?
Thanks, Jay.
- Scott
poster:SLS
thread:897970
URL: http://www.dr-bob.org/babble/20090524/msgs/898068.html