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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by Thrud on June 20, 2001, at 2:43:55
Hi all.
I am looking at Lamictal to treat my major depression + anxiety/panic.
How effective do you find it? What are the major side effects? Does it cause sexual dysfunction?
BTW, by what mechanisms does it improve mood/reduce anxiety?Thanks very much.
Thrud
Posted by SalArmy4me on June 20, 2001, at 8:17:49
In reply to Lamictal users, please help, posted by Thrud on June 20, 2001, at 2:43:55
Lamotrigine works on serotonin, alleviating anxiety and depression (unipolar or bipolar), according to these and other studies:
Southam E, Kirkby D, Higgins GA, Hagan RM. Lamotrigine inhibits monoamine uptake in vitro and modulates 5-hydroxytryptamine uptake in rats.
Eur J Pharmacol. 1998 Sep 25;358(1):19-24:
"The inhibition of the p-chloroamphetamine-induced 5-HT syndrome in rats suggests that lamotrigine also inhibits 5-HT uptake in vivo. These effects probably reflect an affinity for biogenic amine transporters..."Erfurth A, Amann B, Grunze H. Female genital disorder as adverse symptom of lamotrigine treatment. A serotoninergic effect?
Neuropsychobiology. 1998 Oct;38(3):200-1:
"The new anticonvulsant, lamotrigine, is becoming an important tool in the treatment of bipolar disorder, including bipolar depression. Its efficacy in bipolar depression might be linked to its inhibition of serotonin uptake..."Kumar TC, Khanna S.
Lamotrigine augmentation of serotonin re-uptake inhibitors in obsessive-compulsive disorder.
Aust N Z J Psychiatry. 2000 Jun;34(3):527-8.Shiah IS, Yatham LN, Lam RW, Zis AP. Effects of lamotrigine on the 5-HT1A receptor function in healthy human males.
J Affect Disord. 1998 May;49(2):157-62.
Posted by SalArmy4me on June 20, 2001, at 8:19:11
In reply to Lamictal users, please help, posted by Thrud on June 20, 2001, at 2:43:55
Lamictal (lamotrigine) is an anticonvulsant now being used to combat bipolar disorder and major depression. But the fear of a rash has caused many to avoid the drug, and they now suffer with a drug that has more side-effects.
The fears over Lamictal (lamotrigine) rashes are unfounded. The chance of having a mild to moderate rash are 3%--according to clinical trials. But clinical trials done years ago do not necessarily predict the incidence of side-effects now. Besides, most of these rashes were due to taking a combination of Valproate and Lamictal, and they resolve without hospital stays. I believe that the chance of a seizure from Wellbutrin is much higher, and the chance of a hypertensive crisis with phenelzine is a little higher.
The chance of having a severe rash leading to hospitalization is reported as 0.3%. With those odds, it is easier to get hit by
lightening than it is to have a Lamictal rash. Point in case: You never hear in the paper about someone severely harmed
by Lamictal.
I have taken Lamictal for one year with a moderate benefit and absolutely no side-effects. I believe that Lamictal will replace Lithium as the drug of choice in bipolar disorder in 10 years, due to its prominent antidepressant effect and benign side-effect profile.
Posted by Thrud on June 20, 2001, at 8:47:39
In reply to Re: Lamictal and unfounded fear of Rash » Thrud, posted by SalArmy4me on June 20, 2001, at 8:19:11
Hi Sal.
I won't let the rash issue stop me from trying it. If you suffer from anxiety, did you find it an effective anxiolytic? My depression follows my anxiety: if I can stop the anxiety my depression lifts.
If it blocks the re-uptake of seratonin it could also cause sexual dysfunction, right?Thrud
Posted by SalArmy4me on June 20, 2001, at 8:57:19
In reply to Re: Lamictal and unfounded fear of Rash, posted by Thrud on June 20, 2001, at 8:47:39
Here's what the genital dysfunction study said:
"The new anticonvulsant, lamotrigine, is becoming an important tool in the treatment of bipolar disorder, including bipolar depression. Its efficacy in bipolar depression might be linked to its inhibition of serotonin uptake. We present the case of a female schizoaffective patient successfully treated with 400 mg of lamotrigine developing considerable genital disorder, a side effect well known from the treatment with selective serotonin reuptake inhibitors (SSRIs). We suggest that female genital disorder induced by high doses of lamotrigine is a serotoninergic side effect."I don't believe it though. Perhaps most people aren't treated with as much lamotrigine (400 mg) so that this rarely becomes an issue.
I myself never noticed any sexual dysfunction with over 600 mg of lamotrigine, whereas I did with all the SSRI's and Effexor.
Posted by Autumn Despotis on June 20, 2001, at 10:07:18
In reply to Re: Lamictal and unfounded fear of Rash, posted by SalArmy4me on June 20, 2001, at 8:57:19
My pdoc says that there aren't really any sexual side effects with this drug. We'll see, I just started it yesterday. I'll keep you updated!
Posted by Thrud on June 20, 2001, at 18:17:35
In reply to Re: Lamictal and unfounded fear of Rash, posted by Autumn Despotis on June 20, 2001, at 10:07:18
> My pdoc says that there aren't really any sexual side effects with this drug. We'll see, I just started it yesterday. I'll keep you updated!
Thanks! Are you susceptible to SD? Unfortunately every single AD I've tried has given me SD.
Thrud
Posted by Autumn Despotis on June 20, 2001, at 20:34:11
In reply to Re: Lamictal and unfounded fear of Rash, posted by Thrud on June 20, 2001, at 18:17:35
> > My pdoc says that there aren't really any sexual side effects with this drug. We'll see, I just started it yesterday. I'll keep you updated!
>
> Thanks! Are you susceptible to SD? Unfortunately every single AD I've tried has given me SD.
>
> ThrudSeveral AD's have made me completely lose all interest in just about everything, so I guess I'm susceptible. It certainly doesn't make things easy if you're in a marriage, like me. I wish you the best of luck, and hope you find the right meds. It seems like a long road to find the right meds, will it ever end???
Autumn
Posted by Thrud on June 20, 2001, at 21:25:39
In reply to Re: Lamictal and unfounded fear of Rash, posted by Autumn Despotis on June 20, 2001, at 20:34:11
> Several AD's have made me completely lose all interest in just about everything, so I guess I'm susceptible. It certainly doesn't make things easy if you're in a marriage, like me.
Yes, that would probably be worse than my case: being single and in my "prime", my lack of sexual activity simply strikes people as "strange". At least I don't have a partner to satisfy.
> I wish you the best of luck, and hope you find the right meds. It seems like a long road to find the right meds, will it ever end???
Best of luck to you too. It certainly is a long road, the worst part being there may be no "right" med for a lot of us......
Thrud
Posted by Autumn Despotis on June 20, 2001, at 23:45:15
In reply to Re: Lamictal and unfounded fear of Rash, posted by Thrud on June 20, 2001, at 21:25:39
That's optimistic! LOL You're probably right, though!
Autumn
Posted by briana on June 22, 2001, at 11:50:15
In reply to Re: Lamictal and unfounded fear of Rash, posted by Autumn Despotis on June 20, 2001, at 23:45:15
I just started Lamictal yesterday and I felt fine (I am taking it every other day initially). However, today I feel dizzy, nauseated, and extremely tired. Are these side effects of Lamictal? The only side effect I know of is the dreaded and infamous rash. I don't know about any others.
Would I be feeling side effects so soon?
Is it a bad idea to exercise when feeling dizzy, even if you know that the dizziness comes from the drug?
I am on quite a bit of medication for TLE and BPD. I take 1200 lithium, 2400 Neurontin, 10 Celexa and now the Lamicatal.
Thanks for your advice. This site has been such a lifesaver to me.
Brie
That's optimistic! LOL You're probably right, though!
>
> Autumn
Posted by Cam W. on June 22, 2001, at 12:17:44
In reply to Re: Lamictal-- side effects already? Cam? Others?, posted by briana on June 22, 2001, at 11:50:15
Brie - Those (dizziness, nausea, and mailaise) are probably the most common start-up side effects of Lamictal™ (lamotrigine). They are another reason that the dose of Lamictal has to be raised gradually. Increasing the dose slowly will minimize this (yes, it could be worse). The side effects usually emerge right away, while it may take up to a month to see any therapeutic effect from the Lamictal. Many people do see some relief within a week of starting Lamictal, though.
I have found that Lamictal seems to be a good adjunctive (add-on) drug for lithium, in many people with bipolar disorder, especially if depression is a problem.
Hope that this is of some help. - Cam
Posted by Autumn Despotis on June 22, 2001, at 14:29:04
In reply to Re: Lamictal-- side effects already? » briana, posted by Cam W. on June 22, 2001, at 12:17:44
> Brie - Those (dizziness, nausea, and mailaise) are probably the most common start-up side effects of Lamictal™ (lamotrigine). They are another reason that the dose of Lamictal has to be raised gradually. Increasing the dose slowly will minimize this (yes, it could be worse). The side effects usually emerge right away, while it may take up to a month to see any therapeutic effect from the Lamictal. Many people do see some relief within a week of starting Lamictal, though.
>
> I have found that Lamictal seems to be a good adjunctive (add-on) drug for lithium, in many people with bipolar disorder, especially if depression is a problem.
>
> Hope that this is of some help. - CamMan, I am having side effects already, too, I'm only on 50 mg. a day so far. Stomach problems seem to be irritating, but not bad enough to consider discontinuing it. I'm hoping this is the drug to help me. Gee, I feel like I've said that before, ha ha!
I have mixed/dysphoric bipolar disorder, and have had probs with some combos of drugs. Now I'm just on Lamictal, and fish oil, for God's sake! Omega 3 Fatty Acids, yuck, 3-9 grams a day. Is anyone else on this crap? I hate swallowing the extra large capsules from hell. . .
Yeah, whining is an apparent side effect, too. Sorry, everyone! It does make me terribly tired, also, though I don't mind that so far!
Posted by Miriamne on June 23, 2001, at 18:47:49
In reply to Re: Lamictal-- side effects already? , posted by Autumn Despotis on June 22, 2001, at 14:29:04
I seem to have stumbled on a very useful thread here... all of you are providing very useful feedback about Lamictal. I am about to begin taking it for my bipolar (II) depression. I have tried what seems like a universe of SSRIs, some in combination with Wellbutrin. I'm struggling to find something that lifts the depression, does not cause sexual dysfunction and that does not completely "flatten" my feelings (I'm an artist and my work has completely stopped for the last several years).
I'll keep checking to see how everyone here is doing... and let y'all know how it works out for me. This site is such a wonderful resource and such a good source of support from people who really understand what it's like.
Thanks,
Miriamne
Posted by Miriamne on September 4, 2001, at 19:16:09
In reply to Re: Lamictal-- side effects already? , posted by Autumn Despotis on June 22, 2001, at 14:29:04
At the end of August, I was just beginning to take Lamictal, having tried many SSRIs and a few added drugs like Wellbutrin, etc. I was in one of the worst depressions I can remember (diagnosed Bipolar II). I posted some questions here and received a lot of good advice, helpful stories of others' experiences, and moral support.
I just want to thank everyone who responded to my posting, and let you all know I am feeling much better on Lamictal. I was a little worried over the possible side effects (especially the infamous rash), but my pdoc increased the dose very gradully and I've been fine. It was hard waiting the 3 -4 weeks to feel better, esp. not knowing if this would be "the" drug for me, but now I'm glad I stuck it out.
There are no sexual side effects -- a big problem previously on the SSRIs -- and I feel so much more stable. The best thing is, I can still FEEL things, without having the feelings get out of control either way, i.e, I don't become agitated and I don't get depressed; I just experience emotions but don't get incapacitated by them. This is a great gift, since even the best SSRIs made me feel a little artificial.
The only things I would even guess are side effects are tiredness, some muscle weakness which I notice when I exercise, and a tendency to cry more when I do feel something deeply, happy or sad. But I've always turned on the waterworks pretty easily, so I don't know if I can blame that on the meds!
Thanks, many thanks to all who helped me via this bulletin board... I will keep checking in, in case I need more info, or in case I can be of help to someone else.
Sincerely,
Miriamne
Posted by Hattree on September 5, 2001, at 9:48:43
In reply to Lamictal - Update and Thanks, posted by Miriamne on September 4, 2001, at 19:16:09
Glad to hear you're doing well. How much Lamictal are you taking?
> At the end of August, I was just beginning to take Lamictal, having tried many SSRIs and a few added drugs like Wellbutrin, etc. I was in one of the worst depressions I can remember (diagnosed Bipolar II). I posted some questions here and received a lot of good advice, helpful stories of others' experiences, and moral support.
>
> I just want to thank everyone who responded to my posting, and let you all know I am feeling much better on Lamictal. I was a little worried over the possible side effects (especially the infamous rash), but my pdoc increased the dose very gradully and I've been fine. It was hard waiting the 3 -4 weeks to feel better, esp. not knowing if this would be "the" drug for me, but now I'm glad I stuck it out.
>
> There are no sexual side effects -- a big problem previously on the SSRIs -- and I feel so much more stable. The best thing is, I can still FEEL things, without having the feelings get out of control either way, i.e, I don't become agitated and I don't get depressed; I just experience emotions but don't get incapacitated by them. This is a great gift, since even the best SSRIs made me feel a little artificial.
>
> The only things I would even guess are side effects are tiredness, some muscle weakness which I notice when I exercise, and a tendency to cry more when I do feel something deeply, happy or sad. But I've always turned on the waterworks pretty easily, so I don't know if I can blame that on the meds!
>
> Thanks, many thanks to all who helped me via this bulletin board... I will keep checking in, in case I need more info, or in case I can be of help to someone else.
> Sincerely,
> Miriamne
Posted by Miriamne on September 5, 2001, at 9:55:44
In reply to Re: Lamictal - Update and Thanks, posted by Hattree on September 5, 2001, at 9:48:43
> Glad to hear you're doing well. How much Lamictal are you taking?
I'm now taking 200mg/day, split between morning and evening. I'm thinking of consulting the dr about my sleep problems, though. It's nice to be energized a little-- but not when one is trying to rest!
Miriamne
Posted by Mondeo on April 10, 2002, at 15:54:02
In reply to Re: Lamictal-- side effects already? » briana, posted by Cam W. on June 22, 2001, at 12:17:44
what would be the max.permitted dosage of Lamictal which one can permit himself taking to check its efficiency,before switching to another,IF even under such a max.dosage it won't be as good as expected?
This is the end of the thread.
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