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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Bela on August 22, 2003, at 12:23:54
I hope I am following the correct procedure for starting a new thread. This subject may have been addressed before, in which case, I apologize, but I can't find it. My drug history: I am currently taking 200 mg. of Lamictal per day (100 morning and night) and have only exhibited radical mood shifts since I started taking SSRIs a few years ago. Before that, the only psych problem I had was insomnia.I am now on my 4th SSRI; all of them poop out after a few months of use--at least for me.The Lamictal was added this past January 2003 to stabilize daily mood swings and hopefully help maintain the efficacy of the SSRIs. It doesn't. I want to get off all of them but very, very slowly because I think the drugs are creating much of the problem.
Questions: does anyone have any thoughts or experiences on Lamictal dose reduction, withdrawal and relapse, its effect on SSRIs, etc? Does anyone else suspect that these drugs actually have exacerbated their problems? If you can shed ANY light on this rather frustrating matter, I would be greatly appreciative.
Bela
Posted by JahL on August 22, 2003, at 18:20:09
In reply to Lamictal: withdrawal, poop-out, effectiveness, posted by Bela on August 22, 2003, at 12:23:54
Hi Bela.
Can you tell me your diagnosis? I ask because SSRIs and indeed all antidepressants are notorious for inducing cycling (yr mood swings)in Bipolar patients. I can personally attest to this. Antidepressants should be avoided when possible with Bipolar, though this is not always practicle.
>The Lamictal was added this past January 2003 to stabilize daily mood swings and hopefully help maintain the efficacy of the SSRIs. It doesn't.
*If* the SSRIs are causing the cycling then it might be wise to cease these first so that you may judge whether the Lamictal alone dampens yr mood swings.
>I want to get off all of them but very, very slowly because I think the drugs are creating much of the problem.
Slow downwards (and upwards) titration is always advisable. Just one point; I have read a few times (anecdotal stuff) that individuals lowering their Lamictal dose sometimes need to then take a higher dose to recapture any previous benefits. I am now on 600mg daily (previously 200mg) precisely because of this phenomenon.
I should explain that when I first started Lamictal I experienced mild hypomania and Lamictal is still not first-line when it comes to mood stabilization, though it is considered particularly helpful where depression dominates.
I'm not trying to make an amateur diagnosis, just firing a few thoughts in yr direction.
Best,
Ta,
Jah.
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>
> Questions: does anyone have any thoughts or experiences on Lamictal dose reduction, withdrawal and relapse, its effect on SSRIs, etc? Does anyone else suspect that these drugs actually have exacerbated their problems? If you can shed ANY light on this rather frustrating matter, I would be greatly appreciative.
> Bela
>
>
Posted by HenryO on August 23, 2003, at 4:36:47
In reply to Re: Lamictal: withdrawal, poop-out, effectiveness » Bela, posted by JahL on August 22, 2003, at 18:20:09
I agree with the above post, if I read it correctly. I think long term SSRI use messes one up. I'd say slowly taper off the SSRI and see what the Lamictal alone is like. SSRI's were not good for me after about two years, but Lamictal by itself has been pretty good. Those SSRI's take a long time to leave your system. Be patient and when you start to feel awful boost the Lamictal a bit. I have gone through periods in which I felt my meds weren't working at all. Only to find out when I went off them that they had in fact been keeping me from experiencing something far worse.
Posted by Bela on August 25, 2003, at 10:12:51
In reply to Re: Lamictal: withdrawal, poop-out, effectiveness, posted by HenryO on August 23, 2003, at 4:36:47
>Many thanks to both Jah and Henry. Jah, you asked for my diagnoses. I am not sure whether you mean professional or personal, so I will give you both. I read considerable med literature because of my science/med background, and have done successful self-diagnoses before. Frequently, I find I have read more extensively than the docs, a common experience I am sure most of you have had. I am not trying to be critical; docs are overwhelmed with ever-changing literature.
A few years back, I was coerced into taking an SSRIs for insomnia. Prior to taking the SSRIs and mood stabilizers, I never had deep depression (suicidal thoughts), mania, or abnormal mood swings. Since taking the meds, I have experienced all of these except the mania. I was unsuccessfully placed on Lithium, then Lamictal to augment the failing SSRIs.
My personal life has never been anything but positive, with the exception of significant sexual dysfunctionality brought on by the meds. I am 60 and physically, at least, very healthy. Currently, I am titrating slowly off Remeron, but concurrently taking Lamictal (200 mg) and Lexipro (10 mg), both which likely mask the Remeron reduction. I feel great (positive, motivated, energy, NOT manic), but I have felt this way in the past, only to crash very abruptly. But, I emphasize, the crashes have been a post-med initiation phenomenon. There you have it. Again,thanks.
BelaI agree with the above post, if I read it correctly. I think long term SSRI use messes one up. I'd say slowly taper off the SSRI and see what the Lamictal alone is like. SSRI's were not good for me after about two years, but Lamictal by itself has been pretty good. Those SSRI's take a long time to leave your system. Be patient and when you start to feel awful boost the Lamictal a bit. I have gone through periods in which I felt my meds weren't working at all. Only to find out when I went off them that they had in fact been keeping me from experiencing something far worse.
This is the end of the thread.
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