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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by cache-monkey on December 20, 2004, at 0:21:28
Hey all,
I started Lamictal a couple of weeks ago. My dx is really unclear (anxious dysthymia/cyclothymia or possibly something in the BP spectrum). I started at the lowest possible dose (half a 25 mg tab), and felt like poop for a week: tired, more anxious, less drive, less able to concentrate.
But then, I started to feel better, especially for about five hours after taking a dose of Lamictal. And today, I took a full 25mg, divided, and a couple hours after the second half tab, I actually felt good. Really good. On the way home from some shopping, I was listening to Jefferson Starship's "We Built This City" and for the first time in over 18 months I felt just peaceful and happy (without being hypomanic).
And then I cried. For the first time since long ago when I was on an SSRI. Good tears. Tears from actually feeling a genuine emotion again (other than fear, emptiness, and occasional unwarranted exuberance), and realizing what I'd been missing.
Quite a response to such a low dose, and kind of quick. It's worn off a bit by now, probably because the Lamictal hasn't accumulated sufficiently at the higher dose, but I think this bodes well for my future with this drug.
BUT... me being the worry wart (haven't felt good consistently for long enought to crack that yet), what I'm worried about is poop out. My biggest fear is that I'll have felt "normal" emotions again, get used to it, and then the Lamictal will stop working and I'll go back to the bleakness.
I read somewhere that quick responses to SSRIs are often indicative of a relatively quick poop-out. Does anyone know if this is the case with Lamictal, too? (Or anything else about the poop-out possibility?)
Thanks,
cache-monkey
Posted by SLS on December 20, 2004, at 7:43:16
In reply to Quick response to Lamictal? / Poop-out worry, posted by cache-monkey on December 20, 2004, at 0:21:28
Unfortunately, your concerns are justified. However, you might find a more consistent effect at higher dosages. It is common for someone to feel very much better early in treatment at low dosages, only to require multiple dosage increases to maintain the response. For unipolar depression, Lamictal seems to be effective only when combined with an antidepressant. However, I don't think much work has been done to ascertain if any particular antidepressant is more effective than any other in such a combination.
Remain hopeful. You might be in the minority for whom Lamictal monotherapy works well. Be prepared to bring the dosage up, however. 200mg seems to be the "sweet-spot" for this drug when treating mood-disorders.
Good luck.
- Scott
Posted by banga on December 20, 2004, at 8:55:35
In reply to Re: Quick response to Lamictal? / Poop-out worry » cache-monkey, posted by SLS on December 20, 2004, at 7:43:16
I am in a similar boat. I responded to Lamictal within about 7 day of treatment (starting at 25 mg). Today I will be finally up o 100 mg. I also am a bit worried about poop-out, I guess I'll just have to see.
I have unipolar depression (with a variety of rule-outs, but that is the no-brainer diagnosis)....currently I am not taking another medication (I am still tpering off Cymbalta), I meet with my pdoc today to discuss our game plan more (she is my new doc, she has taken more time than anyone Ive ever met to look into my situation in such depth, both jumping to conclusio on diagnosis). On my short list are nortryptiline (a TCA), and Wellbutrin, though the latter in the past hasnt seemed to do much for me. No more SSRIs/SNRIs for me. And a stimulant.Do remember that this med does not poop out for everyone, and even if it wears off a little bit in time, other meds can be combined and sometimes the combination helps re-augment its benefits.
Wish you the best of luck!
Posted by cache-monkey on December 20, 2004, at 13:20:34
In reply to Re: Quick response to Lamictal? / Poop-out worry, posted by banga on December 20, 2004, at 8:55:35
Thank you, Scott and banga, for the input. I guess poop-out is always a possibility with psychotropics and I'll cross that bridge when I get to it. For now, I'll take comfort in the fact that Lamictal actually seems to be working (unlike Serzone, which did nothing or made me worse for like 5 months), and with an incredibly sub-clinical dose at that!
One more question for you guys (and anyone else reading): I think that when I started Lamictal I got this really weird muscle tension/lower back pain. I think it went away, but then it came back yesterday with the dose increase. I expect that it'll be tansitory. But I'm wondering if you've experienced this. Should I expect it with every dose increase?
Thanks again,
cache-monkey
Posted by SLS on December 20, 2004, at 13:33:44
In reply to Lamictal back pain?, posted by cache-monkey on December 20, 2004, at 13:20:34
Hi C-M.
> One more question for you guys (and anyone else reading): I think that when I started Lamictal I got this really weird muscle tension/lower back pain. I think it went away, but then it came back yesterday with the dose increase. I expect that it'll be tansitory. But I'm wondering if you've experienced this. Should I expect it with every dose increase?I have never heard of that reaction before, although ataxia is a possible side effect. I guess anything is possible with these drugs. It will be interesting to see if you experience it with every dosage increase. Please report your experiences, as I'm sure it will be important for other people to know.
Good luck.
- Scott
Posted by theo on December 20, 2004, at 18:13:32
In reply to Lamictal back pain?, posted by cache-monkey on December 20, 2004, at 13:20:34
I've experienced muscle pains, lower back and even pain in my hip.
I did a search and actually found cases of people on Lamictal with hip joint pain!
My pains never went away, I just got used to them. Lamictal is a great med. Word of advice, if you feel good at a dose while titrating even though your doc has given you a higher target dose, STAY AT THAT DOSE. I felt great at a dose and my doctor said "keep going up." I kept going up only to feel worse at higher doses and now having to go back down. Doctors sometimes act like they know the "magic dose", but listen to your body, dosing is tricky with this med.
Posted by banga on December 20, 2004, at 18:31:02
In reply to Re: Lamictal back pain? » cache-monkey, posted by theo on December 20, 2004, at 18:13:32
I could swear that I read somewhere that Lamictal can cause back pain (don't ask me where--I have serious memory issues lately!!). I do have a lower back problem, it has been worse, but I can't say why. I also have spent so much more time in bed, it could just as well be plain stiffness and lack of exersise.
Posted by ghost on December 21, 2004, at 20:47:12
In reply to Quick response to Lamictal? / Poop-out worry, posted by cache-monkey on December 20, 2004, at 0:21:28
i had a good response to lamictal right away. so good that i stayed on 25mg for longer than average. 50mg also worked well for longer than average.
i never pooped out, but i did get teh rash. unrelated, i think.
glad lamictal's working for you :)
Posted by BariTenor on December 24, 2004, at 20:43:32
In reply to Quick response to Lamictal? / Poop-out worry, posted by cache-monkey on December 20, 2004, at 0:21:28
I'm on my third day of Lamictal to augment Cymbalta for depression. Like you, I've been started at 12.5 mg, and like you, I've been really sleepy all day. But I'm not sure whether the sleepiness at this point is the Lamictal, the Cymbalta, or the depression itself.
I'm hoping the Lamictal picks me up quickly as it did you.
Baritenor
Posted by cache-monkey on December 30, 2004, at 15:18:21
In reply to Re: Lamictal back pain?, posted by SLS on December 20, 2004, at 13:33:44
Hey Scott and all,
Just thought I'd update with my Lamictal back pain issues. I've upped my dose from 12.5 to 25 to 50 mg, where I currently am.
I've often had sore and tight muscles the past few years, but not quite like this. The back pain seems to be less of an issue now. But I do notice a generalized muscle/tendon tightness that comes and goes. Especially in the neck, back and groin.
I'm pretty sure it's related to the Lamictal, since it is unlike what I've previously experienced. It's not debilitating, but somewhat annoying. (The groin tension is possibly linked to a small loss of erectile function, though, which is less than cool.) I'm sticking with the Lamictal for now to see what shakes down.
Best,
cache-monkey> Hi C-M.
>
> > One more question for you guys (and anyone else reading): I think that when I started Lamictal I got this really weird muscle tension/lower back pain. I think it went away, but then it came back yesterday with the dose increase. I expect that it'll be tansitory. But I'm wondering if you've experienced this. Should I expect it with every dose increase?
>
> I have never heard of that reaction before, although ataxia is a possible side effect. I guess anything is possible with these drugs. It will be interesting to see if you experience it with every dosage increase. Please report your experiences, as I'm sure it will be important for other people to know.
>
> Good luck.
>
>
> - Scott
This is the end of the thread.
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