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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by colin wallace on September 17, 2002, at 10:36:41
Three and a half weeks at a mere 12.5mg , and already a vast improvement in equanimity/stability and mood; very 'normalizing', quite activating, but without (so far) any sign of bringing on my usual AD bane (agitation, erratic and angry mood-swings or 'mixed-states').
25mg feels stupefying (like overshooting a zoloft dose), so being highly med-sensitive, will stay at 12.5 for a while.
Can be difficult to grab some zzz's as it keeps the mind ticking over late at night- but positive thoughts are a rarity, so let's enjoy them!
One drawback-feel groggy , weak and uncoordinated for a day after exercise, but I'm sure I'll adjust to that.
Verdict:better results by far than with any of the numerous AD's tried, or depakote (or a very brief, unpleasant stab at lithium.)
Waiting for the current 'euthymia' to fade, but hoping it won't....Col.
Posted by Peter S. on September 17, 2002, at 15:03:12
In reply to Lamictal Trial, posted by colin wallace on September 17, 2002, at 10:36:41
I'm glad to know it's working for you!
I also started out on a low dose and felt immediate results. Unfortunately the effect faded after about a week (not to be discouraging!) and I've increased the dosage ever since up to 600mg.
I'd be interested in hearing about your experience as you go along. Are you taking any other meds?
Peter
> Three and a half weeks at a mere 12.5mg , and already a vast improvement in equanimity/stability and mood; very 'normalizing', quite activating, but without (so far) any sign of bringing on my usual AD bane (agitation, erratic and angry mood-swings or 'mixed-states').
> 25mg feels stupefying (like overshooting a zoloft dose), so being highly med-sensitive, will stay at 12.5 for a while.
> Can be difficult to grab some zzz's as it keeps the mind ticking over late at night- but positive thoughts are a rarity, so let's enjoy them!
> One drawback-feel groggy , weak and uncoordinated for a day after exercise, but I'm sure I'll adjust to that.
> Verdict:better results by far than with any of the numerous AD's tried, or depakote (or a very brief, unpleasant stab at lithium.)
> Waiting for the current 'euthymia' to fade, but hoping it won't....
>
> Col.
>
Posted by jrbecker on September 18, 2002, at 11:07:44
In reply to Re: Lamictal Trial, posted by Peter S. on September 17, 2002, at 15:03:12
I'm also just starting out, currently at 25 mg once daily in the am. It's only been five days and I felt a pretty good mood life already. Most of the ataxia, double vision, somnolecence, and insomnia is fading, but of course so is the efficacy of the drug since I started it. Probably by the end of the week I'll bump up to 50 mg a day. Everybody talks about the dosage window and you just have to find it by being really patient. I think it's hard though, since the delicate balance of enjoying the efficacy vs the side effects is a fine line.
don't be discouraged though, since I think as we titrate up, we'll enjoy less probs with the side effects and the mood lift will be much more effective. I think the worst part is having to wait.
Posted by colin wallace on September 18, 2002, at 18:34:03
In reply to Re: Lamictal Trial, posted by Peter S. on September 17, 2002, at 15:03:12
Pete,
Other meds at the moment are down to virtually nothing- 10mg amitriptyline for insomnia, and 2mg diazepam for residual anxiety.
I am hypersensitive to meds though (usually responding to around 1/8 of a 'normal' dose range), and it's going to take me some time to hit the full 25mg at this rate! This seems to be
a double edged sword - plenty of room for titration at least, and I get all the benefits (not to mention side-effects) at relatively tiny doses.Col.
Posted by johnj on September 19, 2002, at 11:27:11
In reply to Lamictal Trial, posted by colin wallace on September 17, 2002, at 10:36:41
Hey Colin,
Nice to see you back. How exactly did the lithium trial go? What dosages did you try and did you try lithobid. I cannot tolerate lithium carbonate, but the lithobid is just fine. Let me know how you are doing. Excercise, etc. Glad to see you made it out of cyberjail. take care
johnj
Posted by colin wallace on September 19, 2002, at 13:32:03
In reply to Re: Lamictal Trial » colin wallace, posted by johnj on September 19, 2002, at 11:27:11
Hey there John,
Thought you'd been lost somewhere on that Thai/Burma rail project you were reconstructing in the jungles of your back garden...
To be honest, I'd had a pretty hellish time of it until recently (again!)
It's taken me ages to even half recover from the 'mixed episode' zoloft (and huge stress) pushed me into.My depression slammed in really badly, and a mere 200mg of slow-release lithium saw me waking up in the mornings with suicidal thoughts.Things had slipped way too far , too quickly for my liking, so I reached for the emergency-pack of Lamictal I'd bought over the net some time back (my disinterested, yawning UK psych. wouldn't allow it, and didn't want to see me for six month's- I'd have probably done myself in by then!)
Basically, I have to split a 25mg pill in half, and it's a med. unlike any other I've tried.
AD's feel quite coarse by comparison, and I feel so much better in a very short space of time- 3 1/2 weeks, and it ain't fading at all.
Went out for a meal and a drink last night, and cycled 20 miles or so off road today, both of which would have been way beyond me a month ago.
(booze with lamictal gave me legs like a new-born calf though-gonna avoid that for a while).
Have also been referred to a neuro., as my unusual med sensitivity and adverse reactions to all meds (except my secret Lamictal)have perplexed my GP.She is also perplexed at my dramatic improval of late..
When I see the neuro, guess It'll be time to come clean about the lamactil too...!!
All the best,Col.
Posted by colin wallace on September 19, 2002, at 13:45:19
In reply to Re: Lamictal Trial, posted by jrbecker on September 18, 2002, at 11:07:44
Hi there,
Glad you've had some initial success too; strangely, the beneficial effects for me at 12.5mg don't yet seem to be fading at all, although the experiences of the majority tend to suggest that it will.
When I take a stab at 25 mg , it feels way too overwhelming at the minute-I slur my words and find it almost impossible to walk with anything like coordination!My therapeutic widow has always been miniscule though, and i can forsee 25mg serving me well for some to come- will try for split doses (12.5 am/pm) when I can tolerate it.So far, so good.
Oh yeah, no rash either.Always a bonus....Col.
Posted by catmint on September 20, 2002, at 1:59:35
In reply to Re: Lamictal Trial » johnj, posted by colin wallace on September 19, 2002, at 13:32:03
Hey Colin,
You sound great. Please keep us posted on how you are doing in the next few weeks. Promise, no yawns here!
I am interested in your progress on Lamictal, because I have similar sypmtoms as you (agitated "mixed states", and hypersensitivity to all meds)
I have tried Nuerontin (caused anxiety and had no effect on mood), Zoloft (felt like I took a hit of bad LDS), Serzone (zzzz), Zyprexa( zombie), Wellbutrin( extreme irritability), Prozac( SD and insomnia) and Depakote (stomach distress and anhedonia). Am considering Lamictal so keep me posted. Take care,
Amy
Posted by jrbecker on September 20, 2002, at 15:54:52
In reply to Re: Lamictal Trial » jrbecker, posted by colin wallace on September 19, 2002, at 13:45:19
Been about a week now since I started and tomorrow I'm going to go up to 50 mg once daily in the morning. All of my side effects have finally diminished, but so has the efficacy as well. Think it just takes some time to really push up the dosage, especially for anyone that is really sensitive to meds.
For myself, I know this is because I have a dx of atypical depression, that is associated with hypoactivity of the HPA axis, and thus, poor functioning of the stress hormones -- which makes one really reponsive to low doses of any med.
At this rate I shouldn't be complaining though, since unlike a lot of other people, I'm feeling a benefit right away from the dosing.
Posted by Ron Hill on September 21, 2002, at 0:35:09
In reply to Re: Lamictal Trial » johnj, posted by colin wallace on September 19, 2002, at 13:32:03
> Went out for a meal and a drink last night, and cycled 20 miles or so off road today, both of which would have been way beyond me a month ago.
> (booze with lamictal gave me legs like a new-born calf though-gonna avoid that for a while).
-----------------------Hi Colin,
Here is a question for you. And in answering it, I want you to be as honest with yourself as possible.
Have you ever observed a correlation between drinking alcohol and the onset of mild (or moderate) depression the following day or two subsequent to the consumption?
As we have talked before, you and I have very similar reactions to medications and our dx's are perhaps the same, or at least similar (Bipolar II). For me, I loved the "3 Beer Effect" which included a quicker wit, an enhanced feeling of well being, a greater self confidence, and a heightened clarity of thought, to mention a few. However, when I began to chart my moods, it became clear that alcohol consumption induces a mild to moderate depression in me the following few days. As much as I loved having a few beers with friends or family, I no longer do so because I know it will induce some depression. It's just like clockwork. Just an FYI, for what it’s worth.
It’s very good to hear from you again, Colin. Glad to see you're having good initial results with Lamictal. Hope it continues.
-- Ron
Posted by Peter S. on September 21, 2002, at 16:12:13
In reply to Re: Lamictal Trial, posted by jrbecker on September 20, 2002, at 15:54:52
It sounds like your experience of Lamictal is very similar to mine. It worked almost immediately and then the effect gradually wore off. I'm up to 600mg plus 600mg Neurontin and it's working but not completely consistently. I'm also taking 10mg of Prozac which seems to provide a boost. I may try to play around with the Prozac and see what happens.
I would love to hear your experiences and how it goes for you. My depression also seems to be of the atypical variety with some bipolar III? features.
Pete
> Been about a week now since I started and tomorrow I'm going to go up to 50 mg once daily in the morning. All of my side effects have finally diminished, but so has the efficacy as well. Think it just takes some time to really push up the dosage, especially for anyone that is really sensitive to meds.
>
> For myself, I know this is because I have a dx of atypical depression, that is associated with hypoactivity of the HPA axis, and thus, poor functioning of the stress hormones -- which makes one really reponsive to low doses of any med.
>
> At this rate I shouldn't be complaining though, since unlike a lot of other people, I'm feeling a benefit right away from the dosing.
Posted by BobS. on September 22, 2002, at 19:59:59
In reply to Re: Lamictal Trial » colin wallace, posted by Ron Hill on September 21, 2002, at 0:35:09
Ron,
I have noticed a similar phenomenon with alcohol, but have not been dx bipolar of any kind, nor am I taking lamictal. I would really appreciate your complete diagnosis and current medication(s). Also, how was your diagnosis arrived at. My diagnosis is panic with some mild OCD. My medication is Xanax after years of fiddling with SSRIs with all their adverse effects. A pdoc back in the past told me that I "may" be a "mild" bipolar and wanted to try valproate. I refused.
Regards,
BobS.> > Went out for a meal and a drink last night, and cycled 20 miles or so off road today, both of which would have been way beyond me a month ago.
> > (booze with lamictal gave me legs like a new-born calf though-gonna avoid that for a while).
> -----------------------
>
> Hi Colin,
>
> Here is a question for you. And in answering it, I want you to be as honest with yourself as possible.
>
> Have you ever observed a correlation between drinking alcohol and the onset of mild (or moderate) depression the following day or two subsequent to the consumption?
>
> As we have talked before, you and I have very similar reactions to medications and our dx's are perhaps the same, or at least similar (Bipolar II). For me, I loved the "3 Beer Effect" which included a quicker wit, an enhanced feeling of well being, a greater self confidence, and a heightened clarity of thought, to mention a few. However, when I began to chart my moods, it became clear that alcohol consumption induces a mild to moderate depression in me the following few days. As much as I loved having a few beers with friends or family, I no longer do so because I know it will induce some depression. It's just like clockwork. Just an FYI, for what it’s worth.
>
> It’s very good to hear from you again, Colin. Glad to see you're having good initial results with Lamictal. Hope it continues.
>
> -- Ron
>
Posted by colin wallace on September 23, 2002, at 5:00:50
In reply to Re: Lamictal Trial » colin wallace, posted by Ron Hill on September 21, 2002, at 0:35:09
Well if it ain't me ol' pal and fellow hustler Ron Hill..!
Good to hear from you Ron- hope you've settled comfortably in your new cabin after all the prior upheaval, and that you're otherwise fit and well.Any momentous life plans in the pipeline?>>>Have you ever observed a correlation between drinking alcohol and the onset of mild (or moderate) depression the following day or two subsequent to the consumption?
This is a tricky one to answer Ron, because it really depends on which meds I'm taking at the time!For example, having a few beers whilst taking an SSRI was actually very enlivening and quite good fun (at the time), whereas meds like Remeron or any tricyclic would see me quickly deteriorate into a stammering wreck- our mutual friend sam-e would turn me into a quick-witted, grinning verbal sharpshooter after a drink too.
The only constant is the fact that I've always suffered the most merciless hangovers imaginable, and hence don't tend to drink very often (or a great deal) anyway.Obviously a monster hangover worsens depression in any case, but I think with me it's actually due to the hangover itself as opposed to a directly attributable mood crash.
So far, lamictal at 12.5mg is ample for me, and as I said, it doesn't seem to mix well with beer-but that's a small price to pay by my reckoning.Stay well,
Col.
Posted by amber_spirit on September 23, 2002, at 13:28:20
In reply to Re: Lamictal Trial » jrbecker, posted by colin wallace on September 19, 2002, at 13:45:19
I'm interested to hear about the slurring words effect.
I've been fighting this and thought it was a result of
one of my other meds (depakote or seroquel) but maybe
it is the lamictal. Also, I seem to be very sensitive
to the lamictal. I've be cutting the 25mg into fourths
and taking 3/4 each morning bc 25mg seems to much and
12.5 didn't seem to keep my mood up where it should be.
I've been at this dose for over a month and it seems
to be working well for me. So, not everyone gets a
quick tolerance.AS
Posted by colin wallace on September 24, 2002, at 4:04:07
In reply to Re: Lamictal Trial, posted by catmint on September 20, 2002, at 1:59:35
Hi Amy,
I've reached a month on Lamictal, and
interestingly, it's positive effects at a very low dose seem to be holding steady.My mood is level throughout the day, and (come to think of it) I actually don't feel depressed, and rarely feel irritable.I do feel kind of 'delicate' though (keep waiting for it all to come tumbling down again- need to re-learn optimism!)
Speaking as one for whom all else has failed, I'd recommend you give it a whirl if you're still considering it.Col.
Posted by colin wallace on September 24, 2002, at 4:13:22
In reply to Re: Lamictal Trial, posted by amber_spirit on September 23, 2002, at 13:28:20
Hi there,
I've been doing exactly the same as you- dividing a 25mg pill into 1/4's and taking 3/4's...for me too, 25mg slightly overshoots and effects my speech and coordination.
Delicate business ain't it?!You and I seem to be in the minority who don't develop a quick tolerance (although depakote will elevate/prolong your lamictal blood levels, as you know).
Posted by McPac on September 25, 2002, at 13:05:34
In reply to Re: Lamictal Trial » amber_spirit, posted by colin wallace on September 24, 2002, at 4:13:22
I already know that Lamictal has strong anti-depressant properties.
My question is: Does Lamictal increase serotonin levels (like an ssri would?)
I know it's an anti-convulsant, but I need to know if it increases serotonin levels?
Thanks so much to anybody who responds!
Posted by catmint on September 26, 2002, at 1:11:30
In reply to Need a Lamictal Question Answered, posted by McPac on September 25, 2002, at 13:05:34
Hi McPac,
I asked my doctor the same question and she thinks it works on gaba not serotonin. Hope that helps.
Amy
Posted by catmint on September 26, 2002, at 1:25:38
In reply to Re: Lamictal Trial » catmint, posted by colin wallace on September 24, 2002, at 4:04:07
>>> I do feel kind of 'delicate' though (keep waiting for it all to come tumbling down again- need to re-learn optimism!)Hi Colin,
Thanks for responding. When you say that you are "waiting for it to all come tumbling down," do you mean that you haven't had any triggers in the past month and you are afraid what will happen when you do?
Amy
Posted by colin wallace on September 26, 2002, at 4:01:05
In reply to Re: Lamictal Trial » colin wallace, posted by catmint on September 26, 2002, at 1:25:38
Hi there Amy,
I suppose what I meant is that, having been severely depressed for a number of years (punctuated with short 'bursts' of relative improvement) I'm very afraid of having a relapse, and need to put a good healthy year or so between me and the depression before I'll fully believe it !!
I'm even contemplating returning to work (new job) after almost three years....scary.Col.
Posted by catmint on September 27, 2002, at 0:51:21
In reply to Re: Lamictal Trial » catmint, posted by colin wallace on September 26, 2002, at 4:01:05
Col,
I will be crossing my fingers for you that you don't relapse into a depression. Please can you keep me posted on how you are feeling?
I am seeing my pdoc in about a week, supposedly with my decision to take Lamictal or contunue to stay off meds totally. I am growing weary of the short bursts of energy and the long depresssions, yet I still try my own holistic methods with varying success.
Col, I hope Lamictal will provide for you the stability to return to work. keep riding your bike to deal with the stress! Please keep me posted.
Posted by McPac on September 27, 2002, at 9:48:17
In reply to Re: Need a Lamictal Question Answered, posted by catmint on September 26, 2002, at 1:11:30
Thanks Amy! (nm)
This is the end of the thread.
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