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Dr. Bob is Robert Hsiung, MD,
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Posted by Ron Hill on March 13, 2003, at 2:35:43
In reply to Lamictal-I am depressed and it's getting worse, posted by Krissy P on March 12, 2003, at 19:20:23
Hi Kristen,
>I am really scared because I feel the depression slowly creeping it's ugly head again-after feeling so good.
Krissy, I'm going to say this as gently as I can and yet be stern enough so that you will hear me. Your pdoc has tried to convince you that you need to be on a moodstabilizer, I have told you that you need to be on a moodstabilizer, Maximus has told you that you need to be on a moodstabilizer, and others have said the same. A few days ago you were experiencing mania (or hypomania) and now you are feeling depressed. Can you see that you are cycling?
You've told me that your dx is BP II, and yet the only medication in your cocktail that even resembles a moodstabilizer is Lamictal. And your dose of Lamictal is nowhere near the therapeutic dose range. You have virtually no mood stabilization in your cocktail. And to add insult to injury you are taking an SNRI that can be very destabilizing to a BP II. Is it any wonder that you are cycling?
Call your pdoc and tell him/her that you have decided that he/she is right regarding your need for a first-line moodstabilizer. I personally do not think that Lamictal would provide enough mood stabilization to keep you from cycling even if it were fully ramped-up to the typical 300 mg/day range. Instead, I think you need to bring a first-line moodstabilizer on board. And since you did not respond well to Depakote, that leaves lithium. I know you are afraid that lithium will cause weight gain, but as I read your posts, it appears to me that you have never tried it.
As an aside, Lamictal must be ramped-up very slowly and carefully, if that is what you end up trying.
I care about you, Krissy. Please stop trying to self-medicate and call your pdoc.
-- Ron
Posted by Maximus on March 13, 2003, at 7:33:34
In reply to Re: Lamictal-I am depressed and it's getting worse » Krissy P, posted by Ron Hill on March 13, 2003, at 2:35:43
Posted by Krissy P on March 13, 2003, at 13:53:14
In reply to Re: Lamictal-I am depressed and it's getting worse » Krissy P, posted by Ron Hill on March 13, 2003, at 2:35:43
Thanks Ron, Yes, I hear you! I AM on a mood stabilizer-yes, Lamictal. What you don't seem to understand here is that 50mg works for me-even though, IYO, my dose of Lamictal is nowhere near the therapeutic dose range. I have posted before that I need VERY low doses. Example-A pdoc told me years back that 75mg of Effexor QD wasn't a therapeutic dose either BUT it worked for me. Please understand that before you suggest something, that some people, including me, do not need high doses of medication to function/feel "normal". Yes, I can see that I am cycling. Other things come into play here when I get depressed also-not just the meds. I found, after talking, and changing my attitude that I got passed the cycling last night, slept well, and took only 50 mg Lamictal. My body, at this moment, can only handle 50mg Lamictal-I will not put my health or others' at risk just because I am only taking a "non-therapeutic dose" of Lamictal-IYO. Why would you suggest Lithium when you know I am just now re-introducing 1 MS back into my system and, after several posts, am having a rough go????
As far as taking an SNRI that can be very destabilizing to a BP II-I have been on Effexor for a year before I went off, and it worked GREAT. What makes it any different now???? I know my body better than anyone, and I would appreciate it if you understood this. Your post, however gently you meant it to be, put a stitch in my side, and MAXIMUS' post didn't help things. Just because your opinions aren't taken there is no need to dis me with a "couldn't of said it better" post -MAX.
Thank God Jay already posted to me-that Lamictal must be ramped-up very slowly and carefully. I was told that, and I heard.
As far as Lithium-I called my pdoc today and she said no-while you're on Lamictal and are still getting used to it, I will not add Lithium, your body is and has doen okay on Starting back on Lamictal" So I did what you said here k! From your post, I feel you haven't listened to me very much concerning this matter.
At this point, I'm wondering if you DO care.
I appreciate you trying, but do you see my points here guys?? ( Ron nand MAXUMUS)????? There is A LOT left to be said..............
a quite disgruntled Kristen that WILL get over it-I had to respond==================================================================================================
Krissy, I'm going to say this as gently as I can and yet be stern enough so that you will hear me. Your pdoc has tried to convince you that you need to be on a moodstabilizer, I have told you that you need to be on a moodstabilizer, Maximus has told you that you need to be on a moodstabilizer, and others have said the same. A few days ago you were experiencing mania (or hypomania) and now you are feeling depressed. Can you see that you are cycling?
>
> You've told me that your dx is BP II, and yet the only medication in your cocktail that even resembles a moodstabilizer is Lamictal. And your dose of Lamictal is nowhere near the therapeutic dose range. You have virtually no mood stabilization in your cocktail. And to add insult to injury you are taking an SNRI that can be very destabilizing to a BP II. Is it any wonder that you are cycling?
>
> Call your pdoc and tell him/her that you have decided that he/she is right regarding your need for a first-line moodstabilizer. I personally do not think that Lamictal would provide enough mood stabilization to keep you from cycling even if it were fully ramped-up to the typical 300 mg/day range. Instead, I think you need to bring a first-line moodstabilizer on board. And since you did not respond well to Depakote, that leaves lithium. I know you are afraid that lithium will cause weight gain, but as I read your posts, it appears to me that you have never tried it.
>
> As an aside, Lamictal must be ramped-up very slowly and carefully, if that is what you end up trying.
>
> I care about you, Krissy. Please stop trying to self-medicate and call your pdoc.
>
> -- Ron
>
>
Posted by Ron Hill on March 13, 2003, at 14:04:44
In reply to MAXIMUS AND RON.............................. » Ron Hill, posted by Krissy P on March 13, 2003, at 13:53:14
Posted by starlight on March 13, 2003, at 15:52:16
In reply to MAXIMUS AND RON.............................. » Ron Hill, posted by Krissy P on March 13, 2003, at 13:53:14
Krissy P,
I too am Bipolar II and really struggle with depression. I'm not sure that Lamictal by itself is enough to stabilize mood. I am on both Trileptal and Lamictal because the Trileptal wasn't enough to keep me away from the depression. He wasn't dissing you, and it appears that you had a classic defensive reaction to what I thought was some thoughtful advice. He probably suggested Lithium because it's a front line mood stabilizer - makes sense to me. He wasn't saying that you should take it - just that you should think about it and perhaps inquire which you did - so congrats.Any antidepressant is enough to cause mania over time in Bipolars. I took wellbutrin for over a year and thought it worked great, and by the end, I was definitely manic. I loved that aspect though and luckily I have a very good Pdoc who was patient with me and even though I was in denial, I eventually came around. I didn't see his post as attacking you. Only offering some advice that you can leave or take, or just think about for awhile. I totally agree on the self medicating though. I strongly believe in being patient and not using every little daily up and down as a reason to up or drop your dose - I think it's something to be reviewed over time - like every few weeks or so so you can establish a baseline and then decide how things are going. I too have a few side effects with the lamictal, but so what..., I know I'm going to have them, so I'm just patient with that too and give my body a chance to adjust. Starlight
> Thanks Ron, Yes, I hear you! I AM on a mood stabilizer-yes, Lamictal. What you don't seem to understand here is that 50mg works for me-even though, IYO, my dose of Lamictal is nowhere near the therapeutic dose range. I have posted before that I need VERY low doses. Example-A pdoc told me years back that 75mg of Effexor QD wasn't a therapeutic dose either BUT it worked for me. Please understand that before you suggest something, that some people, including me, do not need high doses of medication to function/feel "normal". Yes, I can see that I am cycling. Other things come into play here when I get depressed also-not just the meds. I found, after talking, and changing my attitude that I got passed the cycling last night, slept well, and took only 50 mg Lamictal. My body, at this moment, can only handle 50mg Lamictal-I will not put my health or others' at risk just because I am only taking a "non-therapeutic dose" of Lamictal-IYO. Why would you suggest Lithium when you know I am just now re-introducing 1 MS back into my system and, after several posts, am having a rough go????
> As far as taking an SNRI that can be very destabilizing to a BP II-I have been on Effexor for a year before I went off, and it worked GREAT. What makes it any different now???? I know my body better than anyone, and I would appreciate it if you understood this. Your post, however gently you meant it to be, put a stitch in my side, and MAXIMUS' post didn't help things. Just because your opinions aren't taken there is no need to dis me with a "couldn't of said it better" post -MAX.
> Thank God Jay already posted to me-that Lamictal must be ramped-up very slowly and carefully. I was told that, and I heard.
> As far as Lithium-I called my pdoc today and she said no-while you're on Lamictal and are still getting used to it, I will not add Lithium, your body is and has doen okay on Starting back on Lamictal" So I did what you said here k! From your post, I feel you haven't listened to me very much concerning this matter.
> At this point, I'm wondering if you DO care.
> I appreciate you trying, but do you see my points here guys?? ( Ron nand MAXUMUS)????? There is A LOT left to be said..............
> a quite disgruntled Kristen that WILL get over it-I had to respond
>
> ==================================================================================================
>
>
> Krissy, I'm going to say this as gently as I can and yet be stern enough so that you will hear me. Your pdoc has tried to convince you that you need to be on a moodstabilizer, I have told you that you need to be on a moodstabilizer, Maximus has told you that you need to be on a moodstabilizer, and others have said the same. A few days ago you were experiencing mania (or hypomania) and now you are feeling depressed. Can you see that you are cycling?
> >
> > You've told me that your dx is BP II, and yet the only medication in your cocktail that even resembles a moodstabilizer is Lamictal. And your dose of Lamictal is nowhere near the therapeutic dose range. You have virtually no mood stabilization in your cocktail. And to add insult to injury you are taking an SNRI that can be very destabilizing to a BP II. Is it any wonder that you are cycling?
> >
> > Call your pdoc and tell him/her that you have decided that he/she is right regarding your need for a first-line moodstabilizer. I personally do not think that Lamictal would provide enough mood stabilization to keep you from cycling even if it were fully ramped-up to the typical 300 mg/day range. Instead, I think you need to bring a first-line moodstabilizer on board. And since you did not respond well to Depakote, that leaves lithium. I know you are afraid that lithium will cause weight gain, but as I read your posts, it appears to me that you have never tried it.
> >
> > As an aside, Lamictal must be ramped-up very slowly and carefully, if that is what you end up trying.
> >
> > I care about you, Krissy. Please stop trying to self-medicate and call your pdoc.
> >
> > -- Ron
> >
> >
>
>
Posted by Maximus on March 13, 2003, at 16:14:57
In reply to MAXIMUS AND RON.............................. » Ron Hill, posted by Krissy P on March 13, 2003, at 13:53:14
Posted by Lawrence S. on March 14, 2003, at 1:58:17
In reply to Lamictal-I am depressed and it's getting worse, posted by Krissy P on March 12, 2003, at 19:20:23
Krissy, I'm sorry to hear that you are not feeling well. You are not alone. I had a similar experience when I tried lamictal. I got up to 50mg slowly after about a month. They say lamictal has an antideppresant effect. I did not experience that, however I did have a outstanding calm feeling when taking it. The calm later turned into a lack of feeling of pleasure, or anhedonia. Then my mood would swing from blah to real bad. After about a month and a half I had to stop. I don't know if this helps you or makes you feel worse. I stopped the L. and am back to being my same old dysthymic, anxious self. Hope your feeling better soon.
Lawrence S.
Posted by Krissy P on March 14, 2003, at 2:14:50
In reply to Re: Lamictal-I am depressed and it's getting worse, posted by Lawrence S. on March 14, 2003, at 1:58:17
Thanks Lawrence S, I hope you are feeling better soon too! Lamictal does give me a calm feeling-for now, but I'm BPII and tend to cycle-bad.
May I ask what meds you are on? Do you have a diagnosis?
Hang in there:-)
Thanks again, Kristen
==================================================================================================Krissy, I'm sorry to hear that you are not feeling well. You are not alone. I had a similar experience when I tried lamictal. I got up to 50mg slowly after about a month. They say lamictal has an antideppresant effect. I did not experience that, however I did have a outstanding calm feeling when taking it. The calm later turned into a lack of feeling of pleasure, or anhedonia. Then my mood would swing from blah to real bad. After about a month and a half I had to stop. I don't know if this helps you or makes you feel worse. I stopped the L. and am back to being my same old dysthymic, anxious self. Hope your feeling better soon.
Lawrence S.
Posted by Ron Hill on March 14, 2003, at 12:39:21
In reply to Re: MAXIMUS AND RON.............................., posted by starlight on March 13, 2003, at 15:52:16
Posted by Lawrence S. on March 15, 2003, at 1:06:32
In reply to Re: Lamictal-I am depressed and it's getting worse » Lawrence S., posted by Krissy P on March 14, 2003, at 2:14:50
Krissy, Thanks for asking. My diagnosis changes with every Pdoc I see. I think my most prominent symptoms are deppresion, GAD, SP, with some mood swings. I'm currently on Klonopin 1.5mg, DHEA 150mg, fish oil and St. Johns wort and ritalin. I had been on nardil in the past for about 5 years with excellent results. I had to quit nardil when I had hernia surgery 3 years ago and have been trying to find a replacement for it with dissapoiting results. Lawrence
Posted by SpreadDaALoha on March 16, 2003, at 21:23:20
In reply to Re: Lamictal-I am depressed and it's getting worse, posted by Lawrence S. on March 15, 2003, at 1:06:32
I take 300mg Lamictal (with 4 mg Folic Acid) and 1500mg of Keppra [The Keppra at night and the Lamictal twice per day]. I have had no rash issues.
My "diagnosis" is Bipolar II (primary challenges are irritability (with infrequent irrational outbursts), racing thoughts, depression, and social anxiety). [By the way, I often wonder if I have ADD+irritable depression+social anxiety instead of Bipolar II, but I am not an expert]
On these meds (Keppra and Lamictal) my irritability and racing thoughts seem to have decreased, and my mood seems to be a bit better. However, I feel slightly lethargic and unmotivated, but this is better than extreme irritablity. I have only been on these meds since maybe November or so.
[I had a short stint on 50mg Topamax, but I quit because it made me WAY tired and sad which is funny because I hear it helps some depressed people (good things were substantial decrease in irritability and some weight loss). Also used to take 400mg Neurontin 3x per day (I didn't like the short half life) which helped with social anxiety and made me less irritable...but my doc took me off it and I sort of miss the way it helped my social anxiety--he says he doesnt like what it does to gaba molecule or something similar to what alcohol does]
So any comments on my experiences would be cool. The Keppra/Lamictal seems to be sustaining me (lower irritablity/racing thoughts), but I wish I was less depressed. My doctor mentioned the next step being an addition of Selegilene (antidepressant med originally for Parkinsons disease I think). He said he would be cautious about Selegilene increasing my irritability, but he still thinks its the next step depending on his assessment at my next appointment.
Oh I also see a friendly psychologist once a week now (prescribed by my PDoc, which makes me nervous, but I suppose it can't hurt).
:) ???????????????
Posted by wcfrench on March 17, 2003, at 22:30:42
In reply to LAMICTAL/KEPPRA ( Topamax/Neurontin/Selegilene ), posted by SpreadDaALoha on March 16, 2003, at 21:23:20
I started Lamictal about 3 1/2 weeks ago and at first it seemed to be working well. I was able to live in the moment and not get so hung up about everything and overly emotionally obsess on my own ruminating thoughts. I have slowly increased dosage from 50mg/day to 125/day (I have a pretty high tolerance) with no problems but the effect has seem to left me. Do you think it's that I need a higher dose to be effective? I am dx as Bipolar II, and recently (last few days) I have been having mixed states (I think)... basically going between peace and severe anxiety, especially with girls in my life (potential relationships). I hate this. I'll be outgoing and confident one hour, and the next, I'll want to run like a baby because I feel like I am not liked. For God's sake will it stop?
I was on Depakote before Lamictal and it worked well after about a month (500mg 2x/day, from beginning to end) but I had a huge appetite and was still a little apathetic so I decided to try Lamictal for its antidepressing reputation. I have definitely noticed that it's better in this respect (At least initially) but I don't know where it's going now. I'm also on 100mg Zoloft and 100mg Wellbutrin, having come down a couple months ago from 150 Zoloft and 200 Wellbutrin. I use .5mg Klonopin in social situations.
I wasn't drinking much but then I had a week or so when I drank for a few nights, maybe 3-4 beers one night, at the most 5 or 6 one night, and on a couple of other nights like 2 beers. Over a week's time, do you think that would screw up my titration schedule? I have heard this, but I asked my pdoc and he said something along the lines of "alcohol doesn't affect as much the absorption of the medicine in the liver as it does have a depressing effect..".. But wouldn't you notice a depressing effect right away and not throughout the next week? I've heard people say that it [alcohol] can lag or slow your medicine intake and it will feel as if you aren't taking any. What do you all think? Too many possibilities!!! Increase dosage? I need stability. Thanks friends.
Sincerely,
Charlie
Posted by Ritch on March 17, 2003, at 23:25:20
In reply to Lamictal What the hell is going on, posted by wcfrench on March 17, 2003, at 22:30:42
> I started Lamictal about 3 1/2 weeks ago and at first it seemed to be working well. I was able to live in the moment and not get so hung up about everything and overly emotionally obsess on my own ruminating thoughts. I have slowly increased dosage from 50mg/day to 125/day (I have a pretty high tolerance) with no problems but the effect has seem to left me. Do you think it's that I need a higher dose to be effective? I am dx as Bipolar II, and recently (last few days) I have been having mixed states (I think)... basically going between peace and severe anxiety, especially with girls in my life (potential relationships). I hate this. I'll be outgoing and confident one hour, and the next, I'll want to run like a baby because I feel like I am not liked. For God's sake will it stop?
>
> I was on Depakote before Lamictal and it worked well after about a month (500mg 2x/day, from beginning to end) but I had a huge appetite and was still a little apathetic so I decided to try Lamictal for its antidepressing reputation. I have definitely noticed that it's better in this respect (At least initially) but I don't know where it's going now. I'm also on 100mg Zoloft and 100mg Wellbutrin, having come down a couple months ago from 150 Zoloft and 200 Wellbutrin. I use .5mg Klonopin in social situations.
>
> I wasn't drinking much but then I had a week or so when I drank for a few nights, maybe 3-4 beers one night, at the most 5 or 6 one night, and on a couple of other nights like 2 beers. Over a week's time, do you think that would screw up my titration schedule? I have heard this, but I asked my pdoc and he said something along the lines of "alcohol doesn't affect as much the absorption of the medicine in the liver as it does have a depressing effect..".. But wouldn't you notice a depressing effect right away and not throughout the next week? I've heard people say that it [alcohol] can lag or slow your medicine intake and it will feel as if you aren't taking any. What do you all think? Too many possibilities!!! Increase dosage? I need stability. Thanks friends.
>
> Sincerely,
> CharlieHi Charlie, I haven't tried Lamictal yet, but I figured I would respond anyhow because I am wondering if you are having a Depakote withdrawal reaction of sorts. Depakote DOES induce a metabolic slowing syndrome (which is responsible for the weight gain it can cause), and reversing that by discontinuing it might ramp up your energy level a little higher than you might be able to handle all at once. 1G is fairly high for BP-II. From what the others here that have tried Lamictal say it seems that you need to be in the 200-400mg range for bipolar. Given that you are on such higher doses of other meds-you probably aren't med sensitive and that might be the target you need to be aiming for. Hope others jump in with some thoughts---Mitch
Posted by Krissy P on March 17, 2003, at 23:27:09
In reply to Lamictal What the hell is going on, posted by wcfrench on March 17, 2003, at 22:30:42
Hi, I am experiencing this exact same thing:
I started Lamictal about 2 1/2 weeks ago and at first it seemed to be working well too. I was able to live in the moment and not get so hung up about everything and overly emotionally obsess on my own ruminating thoughts, basically going between peace and severe anxiety also with this one guy (a potential relationship).
I agree with your doc when he says "alcohol doesn't affect as much the absorption of the medicine in the liver as it does have a depressing effect.." but I'm not a doc.
>>>>>>But wouldn't you notice a depressing effect right away and not throughout the next week? NOT NECESSARILY.
I know that when I've drank more in the past while on meds, I have felt as if I wasn't taking any, but that was probably the alcohol effects.
Be honest with your doc about the drinking and I hope you wouldn't necassarily increase the dose because you want to drink more. Hang in there and best of luck.
Keep me posted k?!
:-)Kristen
--------------------------------------------------------------------------------------------------
I have slowly increased dosage from 50mg/day to 125/day (I have a pretty high tolerance) with no problems but the effect has seem to left me. Do you think it's that I need a higher dose to be effective? I am dx as Bipolar II, and recently (last few days) I have been having mixed states (I think)... basically going between peace and severe anxiety, especially with girls in my life (potential relationships). I hate this. I'll be outgoing and confident one hour, and the next, I'll want to run like a baby because I feel like I am not liked. For God's sake will it stop?
>
> I was on Depakote before Lamictal and it worked well after about a month (500mg 2x/day, from beginning to end) but I had a huge appetite and was still a little apathetic so I decided to try Lamictal for its antidepressing reputation. I have definitely noticed that it's better in this respect (At least initially) but I don't know where it's going now. I'm also on 100mg Zoloft and 100mg Wellbutrin, having come down a couple months ago from 150 Zoloft and 200 Wellbutrin. I use .5mg Klonopin in social situations.
>
> I wasn't drinking much but then I had a week or so when I drank for a few nights, maybe 3-4 beers one night, at the most 5 or 6 one night, and on a couple of other nights like 2 beers. Over a week's time, do you think that would screw up my titration schedule? I have heard this, but I asked my pdoc and he said something along the lines of "alcohol doesn't affect as much the absorption of the medicine in the liver as it does have a depressing effect..".. But wouldn't you notice a depressing effect right away and not throughout the next week? I've heard people say that it [alcohol] can lag or slow your medicine intake and it will feel as if you aren't taking any. What do you all think? Too many possibilities!!! Increase dosage? I need stability. Thanks friends.
>
> Sincerely,
> Charlie
Posted by BarbaraCat on March 18, 2003, at 15:33:44
In reply to Lamictal-I am depressed and it's getting worse, posted by Krissy P on March 12, 2003, at 19:20:23
Krissy,
I have to agree with Ron and Maximus here. You are not, I repeat not, on a mood stabilizer. Lamictal is tossed into that category because of it's anti-epileptic profile but it doesn't work well enough if you need something different. I know this well because I've been in a very similar place to you. I'm fine at 50mg lamictal and if I start increasing I get depressed. I'm on a tricyclic after being on all the SSRI's and SNRI's in the book. The only thing that makes everything else tie together and work is lithium. Without lithium, NOTHING works. Lithium alone does not work but it is a necessary part of my brew.I HATE taking it because it's caused my hypothyroid condition to worsen and I'm concerned about kidney problems. But I'm only taking 600mg which seems to be the magic number for me. If you have the kind of bipolar syndrome that responds best to lithium, believe me, nothing else is going to work as well. You'll continue to futz around with this med and that. They'll work for a while and then you'll get in that weird mixed hypomanic depressed place again. I can only say to give lithium a try. For what is does, nothing else does it better. After many off/on attempts I am now a greatful believer that sometimes those old fashioned meds work the best - at least for me. As far as the weight, I now feel so much better (since starting nortriptyline) that I'm inspired to exercise like mad and am getting in better shape than ever.
Posted by Krissy P on March 18, 2003, at 18:34:13
In reply to Lamictil is NOT a mood stabilizer » Krissy P, posted by BarbaraCat on March 18, 2003, at 15:33:44
Wow-ok! I hear you here. I was just told it was a mood stabilizer. But I also have heard the same thing you say here,
Thanks for the clarification.
> Krissy,
> I have to agree with Ron and Maximus here. You are not, I repeat not, on a mood stabilizer. Lamictal is tossed into that category because of it's anti-epileptic profile but it doesn't work well enough if you need something different. I know this well because I've been in a very similar place to you. I'm fine at 50mg lamictal and if I start increasing I get depressed. I'm on a tricyclic after being on all the SSRI's and SNRI's in the book. The only thing that makes everything else tie together and work is lithium. Without lithium, NOTHING works. Lithium alone does not work but it is a necessary part of my brew.
>
> I HATE taking it because it's caused my hypothyroid condition to worsen and I'm concerned about kidney problems. But I'm only taking 600mg which seems to be the magic number for me. If you have the kind of bipolar syndrome that responds best to lithium, believe me, nothing else is going to work as well. You'll continue to futz around with this med and that. They'll work for a while and then you'll get in that weird mixed hypomanic depressed place again. I can only say to give lithium a try. For what is does, nothing else does it better. After many off/on attempts I am now a greatful believer that sometimes those old fashioned meds work the best - at least for me. As far as the weight, I now feel so much better (since starting nortriptyline) that I'm inspired to exercise like mad and am getting in better shape than ever.
Posted by wcfrench on March 19, 2003, at 14:49:39
In reply to Lamictal-Thanks for the clarification » BarbaraCat, posted by Krissy P on March 18, 2003, at 18:34:13
I have taken 150mg Zoloft, 1000 Depakote, 60mg Remeron, 160 Geodon, 600-700 Seroquel... not all at the same time of course. I found the most beneficial dosages to be around those dosages if not slightly lower. It seemed though, that all the increases helped. Should I ask my doc if I should increase past 100mg/2x ? Thanks for your help!
-Charlie
Posted by BarbaraCat on March 19, 2003, at 15:14:17
In reply to Re: Lamictal-What's high dosage??, posted by wcfrench on March 19, 2003, at 14:49:39
I don't know since I can't seem to go past 75mg on lamictal. It causes anxiety and that is my bane. This is unusual since I was at one time on 300mg zoloft, another time on 90mg of Remeron. Each increase helped for a while but then the antidepressant effect wore off and I was left with the body twitches. For me, the breakthrough came when I realized I was Bipolar 2 and no amount of SSRIs was going to work without adding lithium.
Why do you want to increase, are you not getting good antidepressant results from lamictal? I've heard of people going up to 400mg and above, but perhaps you need to add another class of med if you're not quite getting there.
> I have taken 150mg Zoloft, 1000 Depakote, 60mg Remeron, 160 Geodon, 600-700 Seroquel... not all at the same time of course. I found the most beneficial dosages to be around those dosages if not slightly lower. It seemed though, that all the increases helped. Should I ask my doc if I should increase past 100mg/2x ? Thanks for your help!
>
> -Charlie
Posted by SpreadDaALoha on March 19, 2003, at 16:09:35
In reply to Re: Lamictal-What's high dosage??, posted by BarbaraCat on March 19, 2003, at 15:14:17
I'm bipolar II. I take 300mg Lamictal and 1500mg Keppra. My irritability and racing thoughts have basically subsided, and these meds have had a mild/significant antidepressant effect (but not enough for me). My doc was deciding between Remeron and Selegilene--he decided Selegilene. I am starting with 2.5mg every other day, which is a very small dose...I'm to see him in two weeks.
He didn't opt to increase my Lamictal or Keppra (although he thought about increasing my Keppra). I'm hoping the Lamictal/Keppra/Selegilene combination will work for me. I wonder what dosage of Selegilene I will need...
Posted by SpreadDaALoha on March 19, 2003, at 16:14:12
In reply to Re: Lamictal-What's high dosage??, posted by SpreadDaALoha on March 19, 2003, at 16:09:35
Lamictal may not be a mood stabilizer for all, but it is for some. For some it has antidepressant properties. Although it hasn't been shown to work as an anti-manic by itself, studies have shown some mood stabilizing properties (not just antidepressant).
So lamictal aids in mood stabilization for some. I have rarely heard of it causing depression at higher doses. Just wanted to add my two cents...
Posted by BarbaraCat on March 19, 2003, at 16:47:21
In reply to Re: Lamictal-What's high dosage??, posted by SpreadDaALoha on March 19, 2003, at 16:09:35
What is Keppra? Are you in the US? Haven't heard of it here. Selegilene is mainly a dopamine enhancer, very little if any serotonin/NE affect and not generally used for antidepressant qualities. Deciding between it and Remeron is like apples and oranges so I wonder what his thoughts are. Very interesting combination. Have you ever been on lithium? It's been a life saver for me, even with the annoying side effects.
I was on Remeron up to 90mg and it started out great and then pooped in a big way. Nortriptyline has turned out to be the best AD I've been on which shocked the heck out of me, having been on all the newer esoteric stuff.
> I'm bipolar II. I take 300mg Lamictal and 1500mg Keppra. My irritability and racing thoughts have basically subsided, and these meds have had a mild/significant antidepressant effect (but not enough for me). My doc was deciding between Remeron and Selegilene--he decided Selegilene. I am starting with 2.5mg every other day, which is a very small dose...I'm to see him in two weeks.
>
> He didn't opt to increase my Lamictal or Keppra (although he thought about increasing my Keppra). I'm hoping the Lamictal/Keppra/Selegilene combination will work for me. I wonder what dosage of Selegilene I will need...
>
>
Posted by Krissy P on March 19, 2003, at 18:44:56
In reply to Re: Lamictal-What's high dosage?? » SpreadDaALoha, posted by BarbaraCat on March 19, 2003, at 16:47:21
Hi BarbaraCat, would you be willing to share the side effects you have experienced from Lithium? And what your dosage is? Any information would be appreciated.
I am going to talk to my pdoc about starting Lithium, but it seems my depression is worse than my mania.
Hope to hear back, and thanks:-)
Kristen
--------------------------------------------------------------------------------------------------
Have you ever been on lithium? It's been a life saver for me, even with the annoying side effects.
>
> I was on Remeron up to 90mg and it started out great and then pooped in a big way. Nortriptyline has turned out to be the best AD I've been on which shocked the heck out of me, having been on all the newer esoteric stuff.
>
> > I'm bipolar II. I take 300mg Lamictal and 1500mg Keppra. My irritability and racing thoughts have basically subsided, and these meds have had a mild/significant antidepressant effect (but not enough for me). My doc was deciding between Remeron and Selegilene--he decided Selegilene. I am starting with 2.5mg every other day, which is a very small dose...I'm to see him in two weeks.
> >
> > He didn't opt to increase my Lamictal or Keppra (although he thought about increasing my Keppra). I'm hoping the Lamictal/Keppra/Selegilene combination will work for me. I wonder what dosage of Selegilene I will need...
> >
> >
>
>
Posted by SpreadDaALoha on March 19, 2003, at 18:45:10
In reply to Re: Lamictal-What's high dosage?? » SpreadDaALoha, posted by BarbaraCat on March 19, 2003, at 16:47:21
I am in Honolulu. Keppra is a newer anti-epileptic. There are NO studies that show it effective as far as I know. Some Pdocs are using it for bipolar as mood stabilizer and mood enhancer (maybe other things like sleep-not sure). So like Neurontin, soon they will figure out if it does any good or not. My Pdoc is pretty assured that it works. I think it is a good mood stabilizer...Keppra and Lamictal work for me...time will tell.
Hmmmm...I wonder if that tricyclic you mentioned would work for me. My Pdoc seems very smart and I think he really studies all the latest information. He knows I had problems with Wellbutrin (dopamine issues I suppose) and I liked Zoloft but after I started Wellbutrin I quit both (maybe Zoloft didn't poop out and the Wellbutrin is what messed me up--I got very aggressive). He knows Selegilene's effect on dopamine and other things (and knows how Wellbutrin affected me) so he must know what he is doing. I think he thinks it is a healthier drug than SSRI's or Tricylcics (in terms of what it does to brain...he said a study showed it made rats live longer...I think he knows I will appreciate that it is a "smart drug" whatever that means (he knows I have trouble concentrating and thinking clearly in addition to my depression).
Heheheheh. I hate having to take drugs. Oh well. I also hate to go to psychologist, but I am doing it anyway (he is nice--it is just hard for me to open up)...
Aloha ya'll! (I'm a southerner transplanted to Hawaii)
Posted by SpreadDaALoha on March 19, 2003, at 18:51:47
In reply to Re: Lamictal-What's high dosage??, posted by SpreadDaALoha on March 19, 2003, at 18:46:35
I have to add something funny...
I am in graduate school (how I am doing it I do not know). I went to the nutritionist because it is cheap at school and I was curious. I told her my diet and she said "well I would have bipolar disorder too if I ate like you do!" She was only kidding, but it made me think a lot about my diet better...
Posted by Krissy P on March 19, 2003, at 18:54:29
In reply to Re: Lamictal-What's high dosage??, posted by SpreadDaALoha on March 19, 2003, at 18:51:47
Hey-
what?????!!!! what role does diet play in BP? May I ask what your diet is? I want to compare mine lol I know we need to eat a lot and I know the Omega-3 Fatty acids in salmon, etc. are key to mood, but what did she mean by that? lol that is funny! Hope to hear back from ya!
Aloha:-)
Kristen
--------------------------------------------------------------------------------------------------> I have to add something funny...
> I am in graduate school (how I am doing it I do not know). I went to the nutritionist because it is cheap at school and I was curious. I told her my diet and she said "well I would have bipolar disorder too if I ate like you do!" She was only kidding, but it made me think a lot about my diet better...
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