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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by dondon on September 14, 2006, at 18:31:27
IS lamictal stimulating? and does lamictal increase dopamine indirectly?
Posted by Phillipa on September 14, 2006, at 19:53:00
In reply to lamictal and dopamine, posted by dondon on September 14, 2006, at 18:31:27
I only got to 50mg. Had an uncommon side effect excess salivating horrible. So quit. But at that dose I took it at bedtime and slept. Love Phillipa
Posted by Peter S. on September 14, 2006, at 23:46:55
In reply to lamictal and dopamine, posted by dondon on September 14, 2006, at 18:31:27
Lamictal has been great for me. It has worked better and longer than any anti-depressant. It gives me a great kick in the morning. I find it works best in combination with Neurontin. I also take Cymbalta. But it was the Lamictal that worked from the first day I took it. I'm nowhere near 100 percent, but I'm functioning much better than I used to (at least until the afternoon)
Posted by SLS on September 15, 2006, at 6:49:46
In reply to lamictal and dopamine, posted by dondon on September 14, 2006, at 18:31:27
> IS lamictal stimulating? and does lamictal increase dopamine indirectly?
This has been my suspicion for years. There may be a thing going on with Lamictal reducing glutamatergic neurotransmission from the thalamus to the nucleus accumbens.
- Scott
Posted by blueberry on September 15, 2006, at 17:48:26
In reply to lamictal and dopamine, posted by dondon on September 14, 2006, at 18:31:27
The first day I tried lamictal at just 12.5mg was incredible. Two hours after I took it I got a clear amphetamine rush with goosebumps and everything. I mean, I felt high and I felt absolutely great. It was without a doubt in my mind a dopamine feeling. It was clearly dopaminergic. I develope tolerance the good effects of dopamine super fast though, so the goodness did not last but a couple days, and then all I had left was some extreme nervousness and anxiety which also felt dopaminergic.
Posted by psychobot5000 on September 17, 2006, at 12:41:48
In reply to Re: lamictal and dopamine, posted by blueberry on September 15, 2006, at 17:48:26
> The first day I tried lamictal at just 12.5mg was incredible. Two hours after I took it I got a clear amphetamine rush with goosebumps and everything. I mean, I felt high and I felt absolutely great. It was without a doubt in my mind a dopamine feeling. It was clearly dopaminergic. I develope tolerance the good effects of dopamine super fast though, so the goodness did not last but a couple days, and then all I had left was some extreme nervousness and anxiety which also felt dopaminergic.
It seems hard to find good information on what lamotrigine's pharmacalogical effects actually are, but I had a similar experience--clearly improved mood, following the first dose, or any raised dose, followed by what seemed like down-regulation or compensation...all I know is that the positive effects disappeared, and I was left with a bit of cognitive slowing and sleepiness. Disappointing in the extreme.It seemed vaguely dopaminergic to me, but I have no evidence that that is actually the case. I have been trying to figure out what the antidepressant mechanism of action is for Lamictal, so as to find another med with similar workings, with little success.
Posted by SLS on September 17, 2006, at 13:25:38
In reply to Re: lamictal and dopamine, posted by psychobot5000 on September 17, 2006, at 12:41:48
Right now, the main actions that Lamictal is known for is to block sodium channels, some calcium channels, and to inhibit the release of glutamate.
There must be some reason for the presumed transient release of dopamine - probably in the nucleus accumens - that is probably secondary to one of these three properties or perhaps primary to one that has not been discovered yet. It might be due to an abrupt change in the degree of inhibition of release of glutamate in the thalamus, which would lead to increased DA release in the NucAcc (by decreasing kainate glutamatergic receptor activity there).
So...
You raise Lamictal, it goes to the thalamus, it enters glutamate neurons, it inhibits the release of glutamate into the synaptic cleft, the glutamate neuron across the cleft does not fire. That neuron, which travels on to the nucleus accumbens, is inhibitory upon DA neurons (acting in concert with GABA neurons), and normally prevents DA neurons from releasing DA. However, without this thalamic glutamate neuron firing, we have no inhibition, so this nucleus accumbens DA neuron is free to release its DA.
Now you feel good - for awhile. The problem is, it doesn't last. Why doesn't it last? I don't know. Is it because you run out of DA because the enzymes can't keep up with demand? Hmm. Unlikely. Is it because... I'm not going to start this right now.
:-\
- Scott
Posted by blueberry on September 17, 2006, at 17:09:07
In reply to Re: lamictal and dopamine, posted by SLS on September 17, 2006, at 13:25:38
Excellent explanation Scott. Makes sense. Hey, you've had a break now and I'm curious, so please go ahead and finish what you weren't going to start...
:-)> Now you feel good - for awhile. The problem is, it doesn't last. Why doesn't it last? I don't know. Is it because you run out of DA because the enzymes can't keep up with demand? Hmm. Unlikely. Is it because... I'm not going to start this right now.
>
> :-\
>
>
> - Scott
Posted by psychobot5000 on September 17, 2006, at 22:03:44
In reply to Re: lamictal and dopamine, posted by SLS on September 17, 2006, at 13:25:38
A very interesting hypothesis--hmm...I wonder whether the (anti) glutaminergic antidepressant/mood stabilizers in development right now would function in a similar manner...or...I don't know.
Thankyou very much for sharing your knowledge (and theory) on this!
> Right now, the main actions that Lamictal is known for is to block sodium channels, some calcium channels, and to inhibit the release of glutamate.
>
...
>
> You raise Lamictal, it goes to the thalamus, it enters glutamate neurons, it inhibits the release of glutamate into the synaptic cleft, the glutamate neuron across the cleft does not fire. That neuron, which travels on to the nucleus accumbens, is inhibitory upon DA neurons (acting in concert with GABA neurons), and normally prevents DA neurons from releasing DA. However, without this thalamic glutamate neuron firing, we have no inhibition, so this nucleus accumbens DA neuron is free to release its DA.
>
> Now you feel good - for awhile. The problem is, it doesn't last. Why doesn't it last? I don't know. Is it because you run out of DA because the enzymes can't keep up with demand? Hmm. Unlikely. Is it because... I'm not going to start this right now.
>
> :-\
>
>
> - Scott
Posted by neuroman on September 19, 2006, at 18:33:38
In reply to Re: lamictal and dopamine, posted by Peter S. on September 14, 2006, at 23:46:55
Hi,
I'm not so sure that I agree with the premise that lamictal is dopaminergic. Glutamate stimulates dopamine release in certain brain regions. For instance, in the medial preoptic area (MPOA) glutamate stimulates dopamine release via increased nitric oxide production. Which may be why I felt an increase in libido for a few days after stopping it last year. Unfortunately, as we are all too aware, how most medications actually work once they are swallowed is still a mystery. Even to the people who produce them. With a medication that effects a number of different transmitters it's even more difficult to pinpoint what's going on.
Lamictal is an interesting medication and can be very helpful for some people. Unfortunately, when I tried it for a few months last year it made me feel horrible. It pretty much sucked what little energy I had left right out of me. However, when I added wellbutrin to the mix it pulled me back from the brink. By that point I had already decided that I wanted off of the lamictal. On the other hand, I have also taken neurontin in the past and am almost certain that it does have dopaminergic properties.
Paul
Posted by psychobot5000 on September 20, 2006, at 10:58:49
In reply to Re: lamictal and dopamine, posted by neuroman on September 19, 2006, at 18:33:38
Neurontin, eh?
I agree that we really don't know how any of these meds work--all we can do is make educated (or semi-educated) guesses.
Neurontin might be an interesting med to pursue--it clearly seems to help some people, but my understanding is that it has faired very poorly as an antidepressant/mood stabilizer in the controlled, double-blind studies. Some studies have it fairing -poorer- than placebo, which seems to mean that some people are actually made worse by it.
Perhaps worth a shot, though, especially if it might in some way be dopaminergic.
Posted by neuroman on September 20, 2006, at 20:31:09
In reply to Re: lamictal and dopamine, posted by psychobot5000 on September 20, 2006, at 10:58:49
Along with anhedonia, depression and amotivation, I have a chronic pain issue that I'm trying to deal with. That's why I tried neurontin. It did help a little in the pain department, but what I really found interesting is that it made me horny. I've tried it on a few different occasions and it's had this effect each time. Finally, a medication with a good side effect! The problem I have with it is that I seem to develop a tolerance to it rather quickly. I really haven't had the nerve to keep pushing the dose up to a point beyond which tolerance might not develop.
In any event, I know that they are going to find that neurontin has some type of dopaminergic or dopamimetic property. It could be the fact that it opens potassium channels, which if I'm not mistaken, is something that dopamine also does. I'll have to keep reading up on it.
Paul
Posted by JBand on November 29, 2007, at 8:46:44
In reply to Re: lamictal and dopamine, posted by psychobot5000 on September 20, 2006, at 10:58:49
I know this is the dopamine lamotrigine board but since neurontin has been mentioned a lot.......
I became violent, suicidal and otherwise practically evil in thought, word and action 1 hour after taking neurontine for the first time. It was awful. How I got out of it without killing myself and/or destroying everthing in sight was a miracle. I scared my wife and kids so badly that they had to go to a motel for the night. I did and said all kinds of terrible things. I'm very passive by nature and wouldn't say or do anthing to injure another fellow being. It took me months to get over the repercussions. What happened? Been treatment resistant for chronic, acute, clinical depression for years until I tried lamotrigine. It worked for 3 years and is becoming more and more intermitant in its effect. ECT and all other SSRI's, tricyclics, maoi's sopped working. Just rambling right now. Never really posted anthing on a message forum before. I know I'm predominately dopamine deficient.Thanks
Posted by nechron99 on May 23, 2008, at 12:54:33
In reply to lamictal and dopamine, posted by dondon on September 14, 2006, at 18:31:27
Curious - Just found this board... Have been 'diagnosed' as being moderately Bipolar II, though without extreme mood swing - mostly slow cycling with low motivation and interest, hypomania triggered by external 'positive' events, definately 'atypical depression'.
Been on the Lamictal, ramped up to 200mg daily, caused cognative disturbances as well as the triggering of 'dark dreams' (depressive subjects), also noticed these 'dark dreams' with tried on Seroquel too... Lower dosage of Lamictal seems to eliminate the dark dreams and cognative issues ('lethargic thinking')
This to me indicates that there definately IS a dopaminergic action to Lamictal. Seroquel is a dopamine antagonist, and one of the 'symptoms' of low dopamine IS dark dreams. Interestingly, on the other hand, when I was prescribed Cymbalta, my dreams were intensely vivid...
I have heard that for BP-II, Lamictal and either Mirapex or Deprenyl (selegeline) is effective - presumably because the Lamictal modulates the mood swings (via dopamine control) and that the Mirapex or Deprenyl acts to increase the dopamine levels in the synapses. (Both are Dopamine agonists.)
Ideally from what I've read thus far, the trick with BP-II is to contain the mood swings as well as relieve the dopamine-related depression... Sheesh...!
Anyone here with BP-II that can comment or has found a good regimine???
Posted by SLS on May 23, 2008, at 13:17:50
In reply to Re: lamictal and dopamine, posted by nechron99 on May 23, 2008, at 12:54:33
Hi.
My personal theory with Lamictal is that it acts to disinhibit dopamine release in the nucleus accumbens by inhibiting the release of glutamate in the thalamus.
You are suggesting that you experience a biphasic response to Lamictal. Do you feel that the depression itself is made worse by Lamictal at higher dosages, or is it that the cognitive side effects produced at the higher dosages reduce further your function and memory beyond that produced by the depression?
I don't know how to relate this to Seroquel
- Scott
This is the end of the thread.
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