Shown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by ben on July 17, 2001, at 13:24:28
I am on 30 mg Paxilfor more than a month and I have not a complete response to it. My mood is not stable enough and I experience fatigue. My doc wants to ad Lamictal for augmentation. He says that Lamictal is more stimulating than sedating an could help with my depessed mood (guess I am biploar II because I havent had a mania) It should be good for mood swings ?! Tried several AD (Celexa, Zoloft, Efexor, Surmontil, Remeron, Deanxit, Lithium and Zyprexa augmentation) with limited success; that means I had a response and pooped out quickly or I couldnt tolerate the meds (Lithium, Zoloft, Remeron and Zyprexa).
Any experinces ore suggestions with Lamictal
Posted by shelliR on July 17, 2001, at 17:43:35
In reply to Lamictal for ssri augmentation ? Please help !, posted by ben on July 17, 2001, at 13:24:28
> Any experinces ore suggestions with Lamictal
I had success adding lamictal to my MAOI. I don't know if it was energizing, but it was not sedating. Really I don't recall any side effects from it. I did gain 15 lbs, but that is very unusuaI; I highly recommend it as an augmentor.Shelli
Posted by JahL on July 17, 2001, at 21:45:48
In reply to Lamictal for ssri augmentation ? Please help !, posted by ben on July 17, 2001, at 13:24:28
My new pdoc is of the opinion that Lamictal is an excellent augmentor of SSRIs, and commonly prescribes this combination for BP II/III people (of which I am one).Olanzapine is added in more treatment-resistant cases...
He has just added Prozac (tried as monotherapy; pooped-out quickly) to my ongoing Lamictal treatment (150mg bid) (+Sulpiride+Klonopin).
Nothing as of yet but it's early days...
I can't say I have any side-effects to note from Lamictal, which dampens suicidal ideation & improves cognition a little 4 me.J.
> I am on 30 mg Paxilfor more than a month and I have not a complete response to it. My mood is not stable enough and I experience fatigue. My doc wants to ad Lamictal for augmentation. He says that Lamictal is more stimulating than sedating an could help with my depessed mood (guess I am biploar II because I havent had a mania) It should be good for mood swings ?! Tried several AD (Celexa, Zoloft, Efexor, Surmontil, Remeron, Deanxit, Lithium and Zyprexa augmentation) with limited success; that means I had a response and pooped out quickly or I couldnt tolerate the meds (Lithium, Zoloft, Remeron and Zyprexa).
>
> Any experinces ore suggestions with Lamictal
Posted by Janelle on July 17, 2001, at 23:16:45
In reply to Lamictal for ssri augmentation ? Please help !, posted by ben on July 17, 2001, at 13:24:28
My pdoc is of the opinion that Lamictal is an ACTIVATING med, but not to the point of inducing mania - in fact, she told me it is used as a MOOD STABILIZER (keeps you from going too far up or too far down), and just started me on it!
Nothing to report as of yet (no improvement in my condition, but no "bad" side effects either), but I'm only on a microdose and it's only been a few days ...
I'd say give Lamictal a try, given what you mentioned - check with your pdoc.
Good luck!
-Janelle
Posted by shelliR on July 17, 2001, at 23:24:34
In reply to Re: Lamictal for ssri augmentation ? » ben, posted by JahL on July 17, 2001, at 21:45:48
> My new pdoc is of the opinion that Lamictal is an excellent augmentor of SSRIs, and commonly prescribes this combination for BP II/III people (of which I am one).Olanzapine is added in more treatment-resistant cases...
>
> He has just added Prozac (tried as monotherapy; pooped-out quickly) to my ongoing Lamictal treatment (150mg bid) (+Sulpiride+Klonopin).
>
> Nothing as of yet but it's early days...
Hi Jah. It sounds like your new pdoc is a bit more adventurous than the usual over there. I hope so and hope you are doing somewhat better? Shelli
Posted by SalArmy4me on July 20, 2001, at 1:29:04
In reply to Lamictal for ssri augmentation ? Please help !, posted by ben on July 17, 2001, at 13:24:28
Here is part of the basis for clinicians' use of Lamictal augmentation in unipolar depressed patients:
MALTESE, THOMAS M. M.D.. Adjunctive Lamotrigine Treatment for Major Depression. American Journal of Psychiatry. 156(11):1833, November 1999:
"To the Editor: Lamotrigine, which at present has been indicated only for the treatment of epilepsy, has been reported to be possibly useful as an adjunctive treatment for bipolar disorder (1, 2). This letter presents two cases of its successful use as an adjunctive treatment for refractory major depression.
Ms. A was a 45-year-old woman who had been diagnosed with recurrent major depressive disorder; her therapeutic trials of bupropion, phenelzine, venlafaxine, imipramine, and nortriptyline had failed, and she had only been partially responsive to ECT. To her regimen of tranylcypromine, 70 mg/day, lithium carbonate, 1200 mg/day, and clonazepam (0.5 mg/day b.i.d. as needed, used sparingly for anxiety) treatment was added lamotrigine, 25 mg/day, and titrated to 75 mg/day within 3 weeks. Within 8 weeks, Ms. A reported a dramatic improvement in her mood and shortly thereafter returned to work. She continued to do well on this treatment regimen when assessed 6 months later.
Ms. B was a 43-year-old woman with recurrent major depressive disorder whose therapeutic trials of venlafaxine, fluoxetine, and paroxetine had failed. In addition, she could not tolerate a trial of nefazodone treatment. To her regimen of fluoxetine, 50 mg/day, and bupropion, 150 mg/day (sustained-release preparation), was added lamotrigine, 25 mg/day. Within 4 weeks, she, too, reported a dramatic improvement. "I can't remember the last time I felt this good," she commented. She continued to do well when assessed 2 months later.
In both cases, the addition of lamotrigine to the current psychotropic regimen resulted in a significant improvement in mood. The agent was well tolerated, with no additional side effects reported by either patient. In addition, neither had developed a rash of any kind. Whereas findings from a study with an N of two are resoundingly underwhelming, it appears that lamotrigine may be effective as an augmentation strategy in treating major depressive disorder, although future studies will be required to bear this out.
THOMAS M. MALTESE, M.D.
Syracuse, N.Y."
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