Posted by SLS on February 18, 2012, at 7:16:37
In reply to Re: lamicital with AD starting up, posted by never2late on February 17, 2012, at 23:25:28
> I am not taking 300 because my doc only wants me to change one thing at a time in order to gauge my response. I mentioned to him that I was feeling better once starting the 150 for 14 days then felt depression creeping back in the next 14 days with uneven moods throughout the day.
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> He told me the next two things he would like me to try were lamictil, to help control the mood swings, and Intuniv ( you were right on the mark). I chose to start the lamictal first, as I have my sisters wedding coming up at the end of March and wanted to not be a sad sack on her special day. Intuniv might be down the road if the restlessness did not dissipate on its own. He said that the NE stimulation that might have positive effects on my brain might effect my body in negative ways. Thus the intuniv would counter that. This is my own words but I think thats what he was getting at.
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> The other reason he was satisfied with the 150 effexor was because I had been feeling restless during the day, wired but tired at some points. He said that due to the fact that I was taking Concerta and Ritalin that my NE stimulation was sufficient at this time and wanted to see if my body adjusted to the effexor in the next 4 weeks and what the impact of the lamictal would be as an adjunct.That sounds reasonable. As a caveat, it is still premature in the study of psychopharmacology to be able to conclude what dosage of a certain drug will ultimately be the most effective. In the first place, how does Effexor work? I don't know, but I do know that 300 mg has been observed to be the "sweet-spot" for this drug when treating more severe depressions.
Here is a theory of mine: Lamictal produces an antidepressant effect by increasing dopaminergic activity in the nucleus accumbens region of the brain. It would do this by inhibiting glutamatergic neurons from releasing glutamate in the thalamus. These glutamate neurons normally inhibit dopamine release in the nucleus accumbens. The net effect is that Lamictal produces its pro-dopaminergic effects via disinhibition. I could be wrong about this, of course. I have not yet come across a similar explanation in the medical literature. At any rate, if the Lamictal helps at all, you might consider adding Wellbutrin or Abilify to further increase dopamine activity.
Theories are fun, but not always clinically applicable.
Enjoy the wedding.
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1010499
URL: http://www.dr-bob.org/babble/20120212/msgs/1010620.html