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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Cindylou on November 20, 2001, at 13:07:20
I know it's recommended to take Lamictal twice a day. Does anyone know why this is so? Is there any harm (or any less benefit) if I take it all at night?
It seems that if I split the dose, and take some in the morning, i am much more volatile during the day. If I take it all at night, I must "sleep off" that volatility somehow!
Thanks for any information ...
cindy
Posted by JohnX2 on November 21, 2001, at 0:17:05
In reply to Lamictal - once a day okay?, posted by Cindylou on November 20, 2001, at 13:07:20
i believe if you are over 100 mg and at a steady
dose for a while a once a day dosing is ok. Usually you start
out 2-3x a day at the low doses because the body
can be so sensitive to adverse reactions. But once
you are past that then theoretically the elimination
time for the medication allows for once a day
dosing. I still split my into 2, but its easy
for me to do this when I brush my teeth in the
morning and night. If I have to dose a med 3x
a day, I find it too inconvienent.regards,
john> I know it's recommended to take Lamictal twice a day. Does anyone know why this is so? Is there any harm (or any less benefit) if I take it all at night?
>
> It seems that if I split the dose, and take some in the morning, i am much more volatile during the day. If I take it all at night, I must "sleep off" that volatility somehow!
>
> Thanks for any information ...
> cindy
Posted by SLS on November 21, 2001, at 7:22:28
In reply to Lamictal - once a day okay?, posted by Cindylou on November 20, 2001, at 13:07:20
> I know it's recommended to take Lamictal twice a day. Does anyone know why this is so? Is there any harm (or any less benefit) if I take it all at night?
>
> It seems that if I split the dose, and take some in the morning, i am much more volatile during the day. If I take it all at night, I must "sleep off" that volatility somehow!
>
> Thanks for any information ...
> cindy
Hi Cindy.Based upon my own experiences with Lamictal, I would recommend taking it twice a day. I have found that anything less allows for a bit of a let-down by the time 24 hours comes around. I take it three times a day.
- Scott
Posted by Cindylou on November 21, 2001, at 14:39:02
In reply to Lamictal - once a day okay?, posted by Cindylou on November 20, 2001, at 13:07:20
Hi,
Thanks both for your advice. I have another question for both of you ...Did you experience difficulty with Lamictal while titrating up? It seems as if the higher I get, the more irritable and agitated I get. I'm at the point now where the anxiety really gets out of control at times. (you should have seen me today waiting 2 hours with my toddler to get her photos taken ... nightmare!)
Klonapin doesn't seem to touch it, and if I try taking more Klonapin, it just knocks me out.
I'm also trying Serzone which helped at first, but now (five days into it) is making me feel very drugged feeling (a feeling I am all too familiar with from the myriad of other SSRIs and ADs I've tried).
After all that, my question for you guys is:
Is it worth keeping on with the Lamictal? I keep clinging to the hope that things will start to change when I hit 100 mg. That maybe I can stay at that level for a longer time and the anxiety effect will subside. (FYI - I just went up to 75 mg.)
Or should I just give up and move on to yet another trial?
Thanks in advance for your help and support.
cindy
Posted by SLS on November 22, 2001, at 8:31:31
In reply to Re: Lamictal - once a day okay? JohnX and SLS, posted by Cindylou on November 21, 2001, at 14:39:02
> Hi,
> Thanks both for your advice. I have another question for both of you ...
>
> Did you experience difficulty with Lamictal while titrating up? It seems as if the higher I get, the more irritable and agitated I get. I'm at the point now where the anxiety really gets out of control at times. (you should have seen me today waiting 2 hours with my toddler to get her photos taken ... nightmare!)
>
> Klonapin doesn't seem to touch it, and if I try taking more Klonapin, it just knocks me out.
>
> I'm also trying Serzone which helped at first, but now (five days into it) is making me feel very drugged feeling (a feeling I am all too familiar with from the myriad of other SSRIs and ADs I've tried).
>
> After all that, my question for you guys is:
>
> Is it worth keeping on with the Lamictal? I keep clinging to the hope that things will start to change when I hit 100 mg. That maybe I can stay at that level for a longer time and the anxiety effect will subside. (FYI - I just went up to 75 mg.)
>
> Or should I just give up and move on to yet another trial?
>
> Thanks in advance for your help and support.
> cindy
Cindy - If you began to experience irritability and anxiety before adding Serzone, then I guess you can assume that Lamictal is the culprit. I can't speak to whether these things would disappear with continued treatment. I didn't experience them myself and I don't recall coming across anyone who has. Of course, my recollections are always suspect.Some people can become somewhat manic on Lamictal, although it is infrequent. Mild mania can sometimes be expressed as irritability. However, Serzone has been known to produce irritability and anger also. If your symptoms appeared after adding Serzone, I would suspect it to be the culprit.
Perhaps the two drugs in combination produce irritability while neither does when taken alone. Since stopping and starting Serzone as an experiment would be much easier and quicker to do than with Lamictal, it would make sense to try that first. Of course, you would then have to make the difficult decision as to which one to commit to.
- Scott
Posted by jazzdog on November 22, 2001, at 10:43:54
In reply to Re: Lamictal - once a day okay? JohnX and SLS, posted by SLS on November 22, 2001, at 8:31:31
I'm in my third week on Lamictal. I started on 6.75 mg and am now at 25 mg. I'm starting to feel some effect, but not quite what I'd hoped. The Lamictal is making me sleepy, hungry for carbs, and more foggy than before - in fact, it's exacerbating the symptoms of my depression. Is this a common experience in the early stages? Does it change for the better at higher doses?
Thanks - Jane
Posted by Cindylou on November 22, 2001, at 13:16:03
In reply to Re: Lamictal - once a day okay? JohnX and SLS, posted by jazzdog on November 22, 2001, at 10:43:54
Hi Jane,
I hadn't heard of Lamictal making symptoms worse, but it did seem to make my depression worse at first (I started at 25 mg.) My pdoc said I couldn't blame anything on the Lamictal until I got up to 100 mg because it wouldn't have any kind of noticeable effect until then.Also, when I first started the Lamictal I also tried adding things like Provigil, Wellbutrin, and Zoloft (because I felt like you did -- tired, a little drugged on the Lamictal, so my pdoc suggested adding these things -- not all at once though!)
I usually experience "crashes" with stimulants, and Zoloft always makes me worse before I get better, so I attributed my worsening depression to the other drugs rather than the Lamictal.
Now that I'm up to 75 mg, the Lamictal isn't making me tired, but totally opposite -- extremely agitated and anxious.
It's a far cry from stabilizing my moods, that's for sure.
I added Serzone recently which has helped with the anxiety but makes me pretty fatigued; it seems if it's not one thing it's another.
Anyway, I hope this helps a bit, to know that you're not alone in feeling Lamictal may be making your symptoms worse. I am clinging to my pdoc's suggestion to keep taking the Lamictal until I get to 100 mg to see for sure what it may do for me.
Best of luck to you!
cindy
> I'm in my third week on Lamictal. I started on 6.75 mg and am now at 25 mg. I'm starting to feel some effect, but not quite what I'd hoped. The Lamictal is making me sleepy, hungry for carbs, and more foggy than before - in fact, it's exacerbating the symptoms of my depression. Is this a common experience in the early stages? Does it change for the better at higher doses?
>
> Thanks - Jane
Posted by Cindylou on November 22, 2001, at 13:20:15
In reply to Re: Lamictal - once a day okay? JohnX and SLS, posted by SLS on November 22, 2001, at 8:31:31
Hi Scott,
Yes, I did experience the anxiety and irritability BEFORE adding Serzone ... in fact, that's why I gave in and tried the Serzone in the first place. My pdoc suggested it, and I had a sample, but I was avoiding it at all costs since I usually have such bad side effects with ADs.But one day I was at my wit's end, and just swallowed 50 mg of the Serzone. It really helped the anxiety -- pretty much zapped it entirely. For a few days, I felt pretty good, but then the heavy drugged fatigue crept in. (My normal response to ADs.)
So, I know the Lamictal was causing the anxiety. I know the Serzone is causing the fatigue. I guess the question is, do I keep on keeping on? I've kind of answered it myself though ... at this point, since I'm almost to 100 mg, I will keep at it and see what happens.
Keeping my fingers crossed and hopes kind of up (but not too high) --
Thanks again,
cindy
> Cindy - If you began to experience irritability and anxiety before adding Serzone, then I guess you can assume that Lamictal is the culprit. I can't speak to whether these things would disappear with continued treatment. I didn't experience them myself and I don't recall coming across anyone who has. Of course, my recollections are always suspect.
>
> Some people can become somewhat manic on Lamictal, although it is infrequent. Mild mania can sometimes be expressed as irritability. However, Serzone has been known to produce irritability and anger also. If your symptoms appeared after adding Serzone, I would suspect it to be the culprit.
>
> Perhaps the two drugs in combination produce irritability while neither does when taken alone. Since stopping and starting Serzone as an experiment would be much easier and quicker to do than with Lamictal, it would make sense to try that first. Of course, you would then have to make the difficult decision as to which one to commit to.
>
>
> - Scott
Posted by jazzdog on November 22, 2001, at 15:26:05
In reply to Re: Lamictal - once a day okay? » jazzdog, posted by Cindylou on November 22, 2001, at 13:16:03
Thank you, Cindy. I'll keep a special eye on your posts, as someone who is several weeks ahead of me on the lamictal path. I'm also on Zoloft - 50 mg - but I'm reluctant to add anything else. I read a study that said adding zoloft to lamictal doubled lamictal blood levels, and I know this is also true of valproate and, I think, tegretol. Since so little research has been done with other drug combinations, I think playing it safe is a good idea. I wonder if there's any chance the Provigil or Wellbutrin sharply increased your levels, resulting in agitation and anxiety. Just a thought.
- Jane
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