![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 37. This is the beginning of the thread.
Posted by jaby on January 14, 2002, at 14:13:17
After dealing with anxiety/depression/fibromyalgia for 5 years now, I was throw absolutely back to my normal healthy self for the first 3 days I used lamictal. I was cured! Since then I had tried to chase that experience uping the dose as directed, but never found it again-only side effects. I have used all of the SSRI's, effexor, remeron, trilpetal, trazadone, welbutrin (maybe a few more). I currently take 2600 mg. neurontin, 2.5 mg valium. Anyone have any ideas? All input is much appreciated!
Posted by JohnX2 on January 14, 2002, at 16:29:59
In reply to Lamictal worked great, pooped out, now what?, posted by jaby on January 14, 2002, at 14:13:17
I temporarily banned myself from this newsgroup,
but i'll give you a freebee recommendation.How about try a topamax + lamictal combo.
This is a new wave of experimentation and
is working well for me after 3 yrs of very
difficult to treat bipolar 2 (i just added
the topamax). Topamax by itself usually sucks
but I think there is potentially
substantial synergy with Lamictal
in how they jointly work on glutamate.
My experience on Topamax has been MUCH
BETTER than the vast majority of people who
have posted on this newsgroup. When I polled
to see who has tried it as an add on to Lamictal
there were no responders, so this is virgin
territory.(Topamax mediates glutamate in AMPA receptors
and Lamictal mediates gluamate in NMDA receptors,
the receptors are generally cascaded).Good Luck,
John> After dealing with anxiety/depression/fibromyalgia for 5 years now, I was throw absolutely back to my normal healthy self for the first 3 days I used lamictal. I was cured! Since then I had tried to chase that experience uping the dose as directed, but never found it again-only side effects. I have used all of the SSRI's, effexor, remeron, trilpetal, trazadone, welbutrin (maybe a few more). I currently take 2600 mg. neurontin, 2.5 mg valium. Anyone have any ideas? All input is much appreciated!
Posted by Krazy Kat on January 14, 2002, at 16:46:15
In reply to Re: Lamictal worked great, pooped out, now what? » jaby, posted by JohnX2 on January 14, 2002, at 16:29:59
"I temporarily banned myself from this newsgroup,
but i'll give you a freebee recommendation."John:
This bothers me. If you're going to continue on the board, please do. If not, I wish you wouldn't post such statements.
- KK
Posted by cindylou on January 14, 2002, at 18:23:29
In reply to Lamictal worked great, pooped out, now what?, posted by jaby on January 14, 2002, at 14:13:17
Jaby,
With the Lamictal, what dose did you start at? several people on this board (including me) seemed to feel much better at the very low doses of Lamcital, even though my pdoc says you need to get up to 100 mg to get a "therapeutic dose."A few people (including myself) believed that we felt the best early on in the treatment at a mere 12.5 or 25 mg. I am currently reducing my dosage -- went from 100 to 75 mg over the past few days and do seem to feel better.
Are you still on the Lamictal? Perhaps reducing the dose slowly until you feel better could help?
take care, cindy
> After dealing with anxiety/depression/fibromyalgia for 5 years now, I was throw absolutely back to my normal healthy self for the first 3 days I used lamictal. I was cured! Since then I had tried to chase that experience uping the dose as directed, but never found it again-only side effects. I have used all of the SSRI's, effexor, remeron, trilpetal, trazadone, welbutrin (maybe a few more). I currently take 2600 mg. neurontin, 2.5 mg valium. Anyone have any ideas? All input is much appreciated!
Posted by JohnX2 on January 14, 2002, at 21:04:58
In reply to Re: Lamictal worked great, pooped out, now what? » JohnX2, posted by Krazy Kat on January 14, 2002, at 16:46:15
maybe Dr. Bob should ban people who volunteer
to ban themselves, but then don't follow their
own rules. ;) I'm on a hypomanic
run right now tapering off this klonopin; I tried
to stay away from pbabble and other people to
not get into trouble, but inevitably I slip.regards,
john> "I temporarily banned myself from this newsgroup,
> but i'll give you a freebee recommendation."
>
> John:
>
> This bothers me. If you're going to continue on the board, please do. If not, I wish you wouldn't post such statements.
>
> - KK
Posted by Krazy Kat on January 15, 2002, at 9:40:44
In reply to Re: Lamictal worked great, pooped out, now what? » Krazy Kat, posted by JohnX2 on January 14, 2002, at 21:04:58
John:
You banned yourself because you had problems with the board - I'm just concerned that someone who is very much against pbabble, who then comes on and gives advice as a "freebie", is going to have another agenda at hand.
This is still the best board I've found - every board is going to have some things one doesn't like about it.
I'd much rather you re-evaluate your concerns and stay. But if you find yourself in a position where you feel the board is a bad place to be, then I wouldn't even visit the site.
- KK
Posted by jaby on January 15, 2002, at 13:21:58
In reply to Re: Lamictal worked great, pooped out, now what? » JohnX2, posted by Krazy Kat on January 15, 2002, at 9:40:44
Please don't use my thread to vent your frustrations with one another. I really just want to hear from people responding to my situation and don't want it to get lost as a result of someone's problems with eachother. Thanks!
> John:
>
> You banned yourself because you had problems with the board - I'm just concerned that someone who is very much against pbabble, who then comes on and gives advice as a "freebie", is going to have another agenda at hand.
>
> This is still the best board I've found - every board is going to have some things one doesn't like about it.
>
> I'd much rather you re-evaluate your concerns and stay. But if you find yourself in a position where you feel the board is a bad place to be, then I wouldn't even visit the site.
>
> - KK
Posted by jaby on January 15, 2002, at 13:23:13
In reply to Re: Lamictal worked great, pooped out, now what? » jaby, posted by JohnX2 on January 14, 2002, at 16:29:59
> What dosages are you using?
> I temporarily banned myself from this newsgroup,
> but i'll give you a freebee recommendation.
>
> How about try a topamax + lamictal combo.
> This is a new wave of experimentation and
> is working well for me after 3 yrs of very
> difficult to treat bipolar 2 (i just added
> the topamax). Topamax by itself usually sucks
> but I think there is potentially
> substantial synergy with Lamictal
> in how they jointly work on glutamate.
> My experience on Topamax has been MUCH
> BETTER than the vast majority of people who
> have posted on this newsgroup. When I polled
> to see who has tried it as an add on to Lamictal
> there were no responders, so this is virgin
> territory.
>
> (Topamax mediates glutamate in AMPA receptors
> and Lamictal mediates gluamate in NMDA receptors,
> the receptors are generally cascaded).
>
> Good Luck,
> John
>
>
>
> > After dealing with anxiety/depression/fibromyalgia for 5 years now, I was throw absolutely back to my normal healthy self for the first 3 days I used lamictal. I was cured! Since then I had tried to chase that experience uping the dose as directed, but never found it again-only side effects. I have used all of the SSRI's, effexor, remeron, trilpetal, trazadone, welbutrin (maybe a few more). I currently take 2600 mg. neurontin, 2.5 mg valium. Anyone have any ideas? All input is much appreciated!
Posted by Hattree on January 15, 2002, at 14:32:32
In reply to Re: Lamictal worked great, pooped out, now-John, posted by jaby on January 15, 2002, at 13:23:13
Same problem here, great results at first w/Lamictal at 25mg, basically the same respose at 100mg for awhile, then poopout. Going back down hasn't made a big differnce. What a drag--I was depression free for six months, a record. What about you? Cindy, any luck lowering your dose?
> > What dosages are you using?
>
>
>
>
> > I temporarily banned myself from this newsgroup,
> > but i'll give you a freebee recommendation.
> >
> > How about try a topamax + lamictal combo.
> > This is a new wave of experimentation and
> > is working well for me after 3 yrs of very
> > difficult to treat bipolar 2 (i just added
> > the topamax). Topamax by itself usually sucks
> > but I think there is potentially
> > substantial synergy with Lamictal
> > in how they jointly work on glutamate.
> > My experience on Topamax has been MUCH
> > BETTER than the vast majority of people who
> > have posted on this newsgroup. When I polled
> > to see who has tried it as an add on to Lamictal
> > there were no responders, so this is virgin
> > territory.
> >
> > (Topamax mediates glutamate in AMPA receptors
> > and Lamictal mediates gluamate in NMDA receptors,
> > the receptors are generally cascaded).
> >
> > Good Luck,
> > John
> >
> >
> >
> > > After dealing with anxiety/depression/fibromyalgia for 5 years now, I was throw absolutely back to my normal healthy self for the first 3 days I used lamictal. I was cured! Since then I had tried to chase that experience uping the dose as directed, but never found it again-only side effects. I have used all of the SSRI's, effexor, remeron, trilpetal, trazadone, welbutrin (maybe a few more). I currently take 2600 mg. neurontin, 2.5 mg valium. Anyone have any ideas? All input is much appreciated!
Posted by Hattree on January 15, 2002, at 14:38:38
In reply to Re: Lamictal worked great, pooped out, now-John, posted by jaby on January 15, 2002, at 13:23:13
Most people here seems to be saying that titrating to the recommended dose does nothing, and the starting dose works well for at least awhile if you can tolerate it.
Just wondering if anyone's brain works like they say its supposed to.
Posted by cindylou on January 15, 2002, at 15:25:10
In reply to Re: Lamictal worked great, pooped out, posted by Hattree on January 15, 2002, at 14:32:32
Hi Hattree,
I'm so sorry to see Lamictal stopped working for you -- I remember you were doing well with Lamictal + Zoloft (Do I have that right?)Well, I've been down to 75 mg (from 100 mg) for a few days, and don't really feel much better. I did try upping the dose to 125 about a month ago and I felt horrible -- fatigue, depression, the works.
It seems this happens to me so often -- I just can't tolerate too much of anything in my system. We'll see -- maybe as I go lower on the Lamictal I'll feel better? Who knows ...
I hope you feel better soon, too.
cindy> Same problem here, great results at first w/Lamictal at 25mg, basically the same respose at 100mg for awhile, then poopout. Going back down hasn't made a big differnce. What a drag--I was depression free for six months, a record. What about you? Cindy, any luck lowering your dose?
>
> > > What dosages are you using?
> >
> >
> >
> >
> > > I temporarily banned myself from this newsgroup,
> > > but i'll give you a freebee recommendation.
> > >
> > > How about try a topamax + lamictal combo.
> > > This is a new wave of experimentation and
> > > is working well for me after 3 yrs of very
> > > difficult to treat bipolar 2 (i just added
> > > the topamax). Topamax by itself usually sucks
> > > but I think there is potentially
> > > substantial synergy with Lamictal
> > > in how they jointly work on glutamate.
> > > My experience on Topamax has been MUCH
> > > BETTER than the vast majority of people who
> > > have posted on this newsgroup. When I polled
> > > to see who has tried it as an add on to Lamictal
> > > there were no responders, so this is virgin
> > > territory.
> > >
> > > (Topamax mediates glutamate in AMPA receptors
> > > and Lamictal mediates gluamate in NMDA receptors,
> > > the receptors are generally cascaded).
> > >
> > > Good Luck,
> > > John
> > >
> > >
> > >
> > > > After dealing with anxiety/depression/fibromyalgia for 5 years now, I was throw absolutely back to my normal healthy self for the first 3 days I used lamictal. I was cured! Since then I had tried to chase that experience uping the dose as directed, but never found it again-only side effects. I have used all of the SSRI's, effexor, remeron, trilpetal, trazadone, welbutrin (maybe a few more). I currently take 2600 mg. neurontin, 2.5 mg valium. Anyone have any ideas? All input is much appreciated!
Posted by jazzdog on January 15, 2002, at 16:31:29
In reply to Re: Lamictal worked great, pooped out, now what? » Krazy Kat, posted by JohnX2 on January 14, 2002, at 21:04:58
Hi John -Glad you're back, and hope you stay. You're one of the people I've learned most from on this board. Now if only Cam will come back.
- Jane
Posted by jazzdog on January 15, 2002, at 16:39:17
In reply to Re: Lamictal worked great, pooped out » Hattree, posted by cindylou on January 15, 2002, at 15:25:10
Sorry to hear Lamictal isn't working for both of you - you were my Lamictal models! I found a brief, two-day effect at 12.5 mg, then that effect dissipated. However, although I don't feel any dramatic effect at 100 mg, I do find that I am much more easygoing than I used to be. Things that would get me very riled up just don't seem to get to me. I've heard that the brief initial effect is very common, then if fades until you hit 150 to 300 mg and reach a therapeutic dose. I've also heard that this therapeutic dose can take a month to six weeks to kick in. So I'm a long way from giving up on this drug yet - at least six months, since I'm aiming at 250 mg. I'll keep you both posted, and I'll follow both your progress with interest.- Jane
Posted by Krazy Kat on January 15, 2002, at 17:05:01
In reply to Please don't ruin my thread, posted by jaby on January 15, 2002, at 13:21:58
jaby:
I understand - it is frustrating when threads change direction, but they inevitably do.
if anything further comes up for me not re: LAmictal, I'll start another thread.
BTW, I'm having a terrible time starting up Lamictal right now.
Depakote worked best for me, but I did gain weight on it.
- KK
Posted by jaby on January 15, 2002, at 18:58:28
In reply to Re: Please don't ruin my thread » jaby, posted by Krazy Kat on January 15, 2002, at 17:05:01
KK,
Thanks for your kind words. I had trouble with L after the first few days. Things got easier after a week or two and the I experienced side effects after 150mg+
> jaby:
>
> I understand - it is frustrating when threads change direction, but they inevitably do.
>
> if anything further comes up for me not re: LAmictal, I'll start another thread.
>
> BTW, I'm having a terrible time starting up Lamictal right now.
>
> Depakote worked best for me, but I did gain weight on it.
>
> - KK
Posted by Krazy Kat on January 15, 2002, at 21:25:35
In reply to Re: Please don't ruin my thread, posted by jaby on January 15, 2002, at 18:58:28
jaby:
I'm stopping L. per my pdoc's advice. It's all so frustrating, isn't it?
- KK
Posted by Dinah on January 15, 2002, at 22:37:00
In reply to Re: Please don't ruin my thread, posted by Krazy Kat on January 15, 2002, at 21:25:35
> jaby:
>
> I'm stopping L. per my pdoc's advice. It's all so frustrating, isn't it?
>
> - KKI'm sorry it didn't work out for you, Kat. Could any part of this be Depakote withdrawal? What is your pdoc thinking of trying next?
I hope you feel better soon.
Dinah
Posted by JohnX2 on January 16, 2002, at 1:00:30
In reply to Re: Lamictal worked great, pooped out, now what? » JohnX2, posted by Krazy Kat on January 15, 2002, at 9:40:44
I felt the board was an excellent place
to be around, specifically to ask Cam a question
about Zyprexa, but he is banned , and I don't
agree with the rational for it , and I feel it
was a bad trade-off to ban him in favor of the
policy.Thanks for your concern,
John> John:
>
> You banned yourself because you had problems with the board - I'm just concerned that someone who is very much against pbabble, who then comes on and gives advice as a "freebie", is going to have another agenda at hand.
>
> This is still the best board I've found - every board is going to have some things one doesn't like about it.
>
> I'd much rather you re-evaluate your concerns and stay. But if you find yourself in a position where you feel the board is a bad place to be, then I wouldn't even visit the site.
>
> - KK
Posted by JohnX2 on January 16, 2002, at 1:02:25
In reply to Please don't ruin my thread, posted by jaby on January 15, 2002, at 13:21:58
Point well taken.
Many apologies.Good luck with your medicines.
-john
> Please don't use my thread to vent your frustrations with one another. I really just want to hear from people responding to my situation and don't want it to get lost as a result of someone's problems with eachother. Thanks!
>
>
> > John:
> >
> > You banned yourself because you had problems with the board - I'm just concerned that someone who is very much against pbabble, who then comes on and gives advice as a "freebie", is going to have another agenda at hand.
> >
> > This is still the best board I've found - every board is going to have some things one doesn't like about it.
> >
> > I'd much rather you re-evaluate your concerns and stay. But if you find yourself in a position where you feel the board is a bad place to be, then I wouldn't even visit the site.
> >
> > - KK
Posted by Krazy Kat on January 16, 2002, at 8:35:19
In reply to Re: Stopping Lamictal » Krazy Kat, posted by Dinah on January 15, 2002, at 22:37:00
Dinah:
Thanks!
- KK
Posted by Hattree on January 16, 2002, at 9:09:14
In reply to Lamictal - Hattree, CindyLou, posted by jazzdog on January 15, 2002, at 16:39:17
I haven't given up on Lamictal yet--it may be premature to say that it has pooped out, but in the beginning I was positively cheerful and that has not lasted. Gradually my old dysthymic self has been resurfacing.
I decided to stick with 100 for awhile. I realized that holidays and weather had derailed my exercize routine, and that I should get back to that before messing with my meds.
Also, Jane's anecdote that the initial burst of good feeling is common and then you need to go much higher discourages me from dropping back down.
Keep me posted, guys--hope it works for you.
>
> Sorry to hear Lamictal isn't working for both of you - you were my Lamictal models! I found a brief, two-day effect at 12.5 mg, then that effect dissipated. However, although I don't feel any dramatic effect at 100 mg, I do find that I am much more easygoing than I used to be. Things that would get me very riled up just don't seem to get to me. I've heard that the brief initial effect is very common, then if fades until you hit 150 to 300 mg and reach a therapeutic dose. I've also heard that this therapeutic dose can take a month to six weeks to kick in. So I'm a long way from giving up on this drug yet - at least six months, since I'm aiming at 250 mg. I'll keep you both posted, and I'll follow both your progress with interest.
>
> - Jane
Posted by cindylou on January 16, 2002, at 13:20:20
In reply to Re: Lamictal - Jane, CindyLou, posted by Hattree on January 16, 2002, at 9:09:14
I met with my pdoc today thinking that we would decide to get off of the Lamictal (I started decreasing the dose before I met with her, and do seem to feel a bit better on 75 mg than I did at 100).
Anyway, she really insisted that I look and come across to her much better than I have in previous visits. She said that before I was more "distraught," but I seem much more at ease now. I trust her opinion greatly -- she's seen me for over a year now and has always been open to my suggestions. So I am definitely open to her opinion and suggestions as well.
She also seems to think that a lot of my depression and fatigue as of late may be due more to emotional/cognitive reasons than chemical, which could very well be true.
We decided to stay on the 75 mg of Lamictal (plus the 75 mg of Serzone which seems to take the edge off agitation, even at that low of a dose). We are also going to try to add a low dose of Prozac for 2 weeks on, 2 weeks off each month to see if it will keep me from crashing on it, and also to see if it will help during PMS.
So, that's the scoop. Looks like the three of us (Hattree, Jane and me) aren't giving up the Lamictal ship yet!
Keep me posted and I'll do the same,
cindy
> I haven't given up on Lamictal yet--it may be premature to say that it has pooped out, but in the beginning I was positively cheerful and that has not lasted. Gradually my old dysthymic self has been resurfacing.
>
> I decided to stick with 100 for awhile. I realized that holidays and weather had derailed my exercize routine, and that I should get back to that before messing with my meds.
>
> Also, Jane's anecdote that the initial burst of good feeling is common and then you need to go much higher discourages me from dropping back down.
>
> Keep me posted, guys--hope it works for you.
>
>
>
> >
> > Sorry to hear Lamictal isn't working for both of you - you were my Lamictal models! I found a brief, two-day effect at 12.5 mg, then that effect dissipated. However, although I don't feel any dramatic effect at 100 mg, I do find that I am much more easygoing than I used to be. Things that would get me very riled up just don't seem to get to me. I've heard that the brief initial effect is very common, then if fades until you hit 150 to 300 mg and reach a therapeutic dose. I've also heard that this therapeutic dose can take a month to six weeks to kick in. So I'm a long way from giving up on this drug yet - at least six months, since I'm aiming at 250 mg. I'll keep you both posted, and I'll follow both your progress with interest.
> >
> > - Jane
Posted by JahL on January 16, 2002, at 16:02:28
In reply to Re: Lamictal worked great, pooped out, posted by Hattree on January 15, 2002, at 14:32:32
> Same problem here, great results at first w/Lamictal at 25mg, basically the same respose at 100mg for awhile, then poopout. Going back down hasn't made a big differnce. What a drag--I was depression free for six months, a record.
Snap. This pattern seems very common. I've been on 400mg for about 6 months (at the behest of ignorant, by-the-book pdocs) and I can't say there's any improvement over say, 100mg. I had the euthymic/hypomanic reaction at about 25mg and it faded over about 6 weeks.
Interestingly the first true hypomanic episode was precipitated by the addition of 0.25mg/Klonopin, which seemed to 'kickstart' the Lamictal benefits.
I continue to take up to 1mg of Klonopin (against pdoc's advice) daily with my Lamictal and I can state with certainty that, for myself at least, a special synergy exists btwn the 2 meds. Neither works by themselves but together they do help fairly significantly (chronically suicidal vs acutely so). Curiously, my brother, who has a milder form of my BPII, only seems to benefit from Zyprexa+Klonopin. Neither works alone. Of course both are purported to have mood-stabilizing qualities.
*Have any of you considered augmenting Lamictal before giving up on it (if you're at that stage)? The consensus amongst pdocs I have spoken to is that Lamictal is very amenable to augmentation, VPA notwithstanding. I have just had Celexa and L-Tryptophan (available only on special licence) added to augment Lamictal's supposed S-reuptake inhibition characteristics.
Best,
J.
Posted by Hattree on January 16, 2002, at 17:41:35
In reply to Re: Lamictal augmentation?, posted by JahL on January 16, 2002, at 16:02:28
I augment with Zoloft and Amphetamines (I don't get the jitters from Lamictal at all), plus sleep aids. Tried dropping the Zo but no luck.
> > Same problem here, great results at first w/Lamictal at 25mg, basically the same respose at 100mg for awhile, then poopout. Going back down hasn't made a big differnce. What a drag--I was depression free for six months, a record.
>
> Snap. This pattern seems very common. I've been on 400mg for about 6 months (at the behest of ignorant, by-the-book pdocs) and I can't say there's any improvement over say, 100mg. I had the euthymic/hypomanic reaction at about 25mg and it faded over about 6 weeks.
>
> Interestingly the first true hypomanic episode was precipitated by the addition of 0.25mg/Klonopin, which seemed to 'kickstart' the Lamictal benefits.
>
> I continue to take up to 1mg of Klonopin (against pdoc's advice) daily with my Lamictal and I can state with certainty that, for myself at least, a special synergy exists btwn the 2 meds. Neither works by themselves but together they do help fairly significantly (chronically suicidal vs acutely so). Curiously, my brother, who has a milder form of my BPII, only seems to benefit from Zyprexa+Klonopin. Neither works alone. Of course both are purported to have mood-stabilizing qualities.
>
> *Have any of you considered augmenting Lamictal before giving up on it (if you're at that stage)? The consensus amongst pdocs I have spoken to is that Lamictal is very amenable to augmentation, VPA notwithstanding. I have just had Celexa and L-Tryptophan (available only on special licence) added to augment Lamictal's supposed S-reuptake inhibition characteristics.
>
> Best,
> J.
Posted by Blue Cheer 1 on January 16, 2002, at 19:52:30
In reply to Lamictal worked great, pooped out, now what?, posted by jaby on January 14, 2002, at 14:13:17
> After dealing with anxiety/depression/fibromyalgia for 5 years now, I was throw absolutely back to my normal healthy self for the first 3 days I used lamictal. I was cured! Since then I had tried to chase that experience uping the dose as directed, but never found it again-only side effects. I have used all of the SSRI's, effexor, remeron, trilpetal, trazadone, welbutrin (maybe a few more). I currently take 2600 mg. neurontin, 2.5 mg valium. Anyone have any ideas? All input is much appreciated!
If you're going to discontinue Lamictal, it's prudent to do so in a stepwise fashion (e.g., in increments of 50 mg. every 2 weeks). Otherwise, you might find that it actually did have mood stabilizing and/or antidepressant effects after all. I discontinued Lamictal once (from 250 mg/day) over a 2 week period -- only to find that I was far more depressed off it. Then, you have to go through the slow escalation once again to regain the efficacy you thought was lost. Same goes for Trileptal d/c from a 900 mg/day dose - in two weeks. The depression (and increased anxiety) was unbearable, but with Trileptal I was able to go right back up to 900 mg/day in a week. So, by going down slowly you can better determine (and at what point) whether or not it had been working.
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Dr. Bob is Robert Hsiung, MD,
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