Posted by SLS on September 1, 2014, at 18:55:44
In reply to thnx so much scott :) a few more ?'s... » SLS, posted by johnLA on September 1, 2014, at 15:30:04
With regard to lamotrigine and cognitive impairments:
It is also important to acknowledge the role that glutamate release inhibition might play in the production of cognitive impairments by lamotrigine - particularly learning and memory. It may be that the combination of sodium channel blockade and glutamate release inhibition acts synergistically to produce these side effects.
> 1. i am super med sensitive. i really like the idea of titrating up slowly on lamictal. thanks for telling me that the cognitive issues are usually dose related. i mean i was on 5mg of prozac and i felt wired/confused/anxious/headaches/etc. i am curious if there is 'low dose' response to lamictal?
I would not discount that possibility, but I doubt that it is very common.
It often occurs that someone will experience a transient improvement in depression at a dosage as low as 50 mg/day. For most people, I think this is a sort of startup effect that quickly disappears. A second transient improvement may then occur upon a dosage increase from 50 mg/day to 100 mg/day. This phenomenon often fools people into thinking that they will eventually recapture the lost antidepressant response if they continue treatment at the lower dosages. Many of them resist increasing the dosage to 200 mg/day. To complicate matters, some people experience a transient improvement upon dosage decreases. This only reinforces for some the notion that lower dosages are more effective than higher dosages.
> 2. you write that it is more robust when added with another antidepressant, ap, or anticonvulsant.
>
> any chance it could work alone?Yes. Most of the clinical trials for bipolar depression that reported a therapeutic effect for lamotrigine employed monotherapy. It makes a great deal of sense for you to try monotherapy first.
> or, play well with my 2mg of klonopin? klonopin and coffee are about the two best drugs i have tried in the last 4 years. seriously.
I wouldn't make any other changes at this point. As far as the combining of lamotrigine and clonazepine, I have not seen anything that would lead me to believe that you should be concerned with its safety.
You are great for my self-esteem!
:-)
I will keep your vocational suggestions in mind.
- 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:1069147
URL: http://www.dr-bob.org/babble/20140815/msgs/1070644.html