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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 4 to 28 of 28. Go back in thread:
Posted by Racer on March 19, 2007, at 17:15:09
In reply to Lamotrigine is not good for me, posted by linkadge on March 19, 2007, at 16:31:16
So, uh, if I say that one week isn't really long enough to know what a medication is likely to do, will you tell me I'm wrong? Seriously, though, what dose are you taking, and are you titrating upwards on it? The thing with Lamictal is that it does kinda change a bit as you get into the therapeutic range. It still might not be for you, but honestly I didn't get a full feel for what it planned to do for me until about three months in.
Of course, what I found was that it gave me a few good days at each dose, but then cr*pped out. It wasn't for me. But a lot of people have much better results with it. You might be one of them, but you'd have to give it more than a week or two to find out.
Good luck
Posted by linkadge on March 19, 2007, at 18:47:02
In reply to Re: Lamotrigine is not good for me » linkadge, posted by Racer on March 19, 2007, at 17:15:09
I might give it a few days longer, but this is just not how I want to feel. It feels like I am taking too many steps backwards.
I am almost having visual hallucinations.
It feels like I have mixed ritalin and sedatives.
Linkadge
Posted by Joe Bloe on March 19, 2007, at 19:37:50
In reply to Re: Lamotrigine is not good for me, posted by linkadge on March 19, 2007, at 18:47:02
What is your dose? Maybe you have started too high?
Your explanation of how you're feeling from this drug is very similar to how I was feeling in week 1, (only I had great mood enhancement). I wanted off so bad from the side effects, but decided to stay on for the good mood. Week 5 now and doing much better, perhaps then in years, and this includes fluoxetine withdrawal that is reaching what I call, based on my past attempts, the "unbearable point" of past 4 weeks.
Looking forward to hearing your dose... Also, have you been drinking or smoking weed with it? I had 3 beers last THursday and I felt like it turned the Lamictal OFF for 2-3 days, at which point I was bombarded with SSRI withdrawal feelings of utter doom. They are gone now though.
Posted by linkadge on March 19, 2007, at 19:40:12
In reply to Re: Lamotrigine is not good for me, posted by Joe Bloe on March 19, 2007, at 19:37:50
I'm at 75mg. It just feels wrong. I don't know how else to describe it. Supposed to go up to 100mg soon. I think I am going to back off.
Linkadge
Posted by Joe Bloe on March 19, 2007, at 19:45:59
In reply to Re: Lamotrigine is not good for me, posted by linkadge on March 19, 2007, at 19:40:12
75 mgs at 7 days out? I'm not a psychiatrist, but from personal experience, that is a VERY quick titration. I think recommended starting dose (both anecdotally and from manufacturer), is 12.5 and/or 25 mgs. More than anything, this is vital to avoid getting "the rash." Slow titration is considered extremely important. My pdoc said 50 mgs at the end of month one is a good place to be.
I found 25 mgs to be a bit much for me for the first week and I backed down to 12.5 mgs.
Again, my hunch is that your dose is way (WAY) too high for week 1.
Posted by Phillipa on March 19, 2007, at 20:34:24
In reply to Re: Lamotrigine is not good for me, posted by Joe Bloe on March 19, 2007, at 19:45:59
Link starter packs here are 25mg for two weeks then 50mg for two weeks and then l00mg or some never go that high it works for them at a very low dose. I would back down. Love Phillipa
Posted by stargazer on March 19, 2007, at 20:43:49
In reply to Lamotrigine is not good for me, posted by linkadge on March 19, 2007, at 16:31:16
Lamictal made me fall on my face twice, First time needed two root canals in my front teeth, the only teeth in my mouth that never had any dental work up to that point.
Second time falling had complete workup for M.S. since other symptoms were also indicative of M.S.
Too bad I was too messed up to see it happening. My pdoc just kept saying go up a little higher, you're at a really low dose. I was up to 200 but had many symptoms on 100 mg.
What a mess!
Posted by notfred on March 19, 2007, at 20:45:41
In reply to Re: Lamotrigine is not good for me, posted by linkadge on March 19, 2007, at 19:40:12
Whoa ! Raise the dose no more than 25 mgs every 2 weeks to start, start at 25 mgs. If I went as fast as you are going I would get headaches. The worst I ever had. I get them just after I raise the dose, just for a day. If I started at the rate you did there is not enough lortab in the world to make it better.
From the monograph:
2 wks @25mgs/day
2 wks @50mgs/day
1 wk @100mgs/dayThats for those not taking another AED(s), if you are the schedule changes quite a bit. There are
dosing schedules here:
http://us.gsk.com/products/assets/us_lamictal.pdfSome start at 12.5; it is not uncommon to hit problems and need to drop the dose and move up more slowly. Most anyone would have side effects
at the rate you are going. Lamotrigine is for the patient, it takes 1-2 months to reach your target dose, ifLike I said, taking other anti-seizure meds effects how much you can take.
Posted by notfred on March 19, 2007, at 20:48:22
In reply to Re: Lamotrigine is not good for me, posted by notfred on March 19, 2007, at 20:45:41
Lamotrigine is for the patient, it takes 1-2 months to reach your target dose, if
>Opps.
Lamotrigine is for the patient, it takes 1-2 months to reach your target dose, if you are shooting for at least 100 mgs.
Posted by Quintal on March 19, 2007, at 21:15:32
In reply to Lamotrigine is not good for me, posted by linkadge on March 19, 2007, at 16:31:16
Yeah, to be fair I think you really do need to take it slowly and give it more time before rejecting it link. I started with 50mg and worked my way up to 200mg. Not high or low, just solid middle ground beneath my feet. It took nearly three months for me to notice that my mood was now stablilized and it was a weird feeling, but good. I couldn't tolerate it without a benzo though. Klonopin + Lamictal was a good synergistic combo.
Here is my RemedyFind rating of Lamictal that I think might give you an idea of how things take shape slowly.
__________________________________________________
Xanadu (192) Rating Updated!
Durham, United Kingdom
8/18/2005 8:57:36 PM
Effectiveness: 8
No Side Effects: 8
Ease of Use: 9
Long Term Use: 9
Cost Effectiveness: N/A
Lamotrigine-Potential for Anxiety & Mood Disorders
I have been given a provisional diagnosis of bipolar II disorder, I also suffer from Social Anxiety Disorder. I have been prescribed lamotrigine to stabilise my mood and hopefully reduce anxiety.I started lamotrigine at 50 mg and the notorious rash appeared within four days of starting it. I asked my psychiatric nurse for advice and we both agreed that it would be best to continue with the treatment as I was feeling well and had no other symptoms.
The rash was not irritating, though it spread to over my abdomen and down to my right knee -- that particular rash looked like prickly heat and was raised and pink. I also had a different type of rash along my right elbow and up to my wrist which was flat and looked like dark flecks of blood beneath the skin.
The rash lasted for approximately two and a half weeks, and disappeared two days after increasing the dose to 100 mg daily. I do take the antihistamine levocetirizine (Xyzal) for hayfever anyway, but I decided to take chlorpheniramine (Piriton) in addition to that in an attempt to reduce the rash. I'm not sure if it really had any effect, since the rash appeared to fade of its own accord.
I understand why the manufacturers and most doctors advise patients to discontinue lamotrigine at the first sign of any rash, however, I think that this may be mainly down to the fact that doctors fear that they will be sued if they do not give this advice. In reality I think that most people who get the rash develop the non-serious form and have nothing to fear. The real danger signs are when you have the rash and start to feel flu-like symptoms.
Up until now I have yet to feel any effect from lamotrigine. Actually, only today have I felt a subtle change -- I can't quite describe it and in fact it might not be related to lamotrigine at all, but I'm hopeful that this drug will be useful either as a monotherapy, or at the very least I'm hoping it will form the backbone of my medication regimen.
Apart from the rash, which was transient and non-irritating, I have had no other side effects from lamotrigine. It is among the most tolerable medications that I have ever taken.
I will continue to update this review as the dose increases or if any developments occur.
UPDATE 1:
My dose has just been increased to 200mg daily, with no aparent beneficial or adverse effects. Lamotrigine does not seem to be having any effect at all now. I'd like to increase the dose up to the maximum, however it is unlikely that my psychiatrist would consent to this (he is ultra cautious), and I am losing hope and patience with this medicine; and psychiatry in general.
UPDATE 2:
After four months of taking lamotrigine I feel that I can now say it is the most effctive anti-depressant that I have ever taken (and believe me I have taken a very broad selection). I haven't had a major depressive incident since I started taking it, which is very unusual for me. I'm quite impressed and pleased with the result. I was getting quite skeptical at one point.
The only residual side-effects are impaired memory and concentration. However, I feel that the beneficial effects of lamotrigine outweigh its disadvantages.
UPDATE 3:
One year on and lamotrigine is still having a benificial effect on my depressive tendencies, but little impact on 'highs' or impulsive spending. We tried raising the dose to 300mg, but I felt spaced-out and extremely irritable, agitated and had severe insomnia. I felt like killing someone and had persistent sucicidal thoughts.
All of these side-effects disappeared when we reduced the dose back to 200mg daily.
Dosage Strength: 200 mg. tablet
Frequency: 0.5 dose 2 x a day
Total Length: 1 year
Brand: Lamictal
17 members found this review helpful.
__________________________________________________Q
Posted by flmm on March 19, 2007, at 21:46:46
In reply to Re: Lamotrigine is not good for me » linkadge, posted by Quintal on March 19, 2007, at 21:15:32
So don't take it!
Posted by linkadge on March 20, 2007, at 9:17:29
In reply to Re: Lamotrigine is not good for me, posted by flmm on March 19, 2007, at 21:46:46
I don't think I will. I honestly don't want to take something for 2 months to realize it is not going to work out.
Perhaps this is the wrong approach.
Its just the way it makes me feel. Crazy, irritable, then apathetic 5 minautes later. Its almost as if it makes my mood more unstable.
It doesn't give me a content feeling, it just gives me that feeing where my brain reveleas to me everything I want but can't have.
The way it makes me feel is just too unpredictable.Its just not for me. I'd prefer lithium or depakote over it any day.
The visual stuff is just too wierd.
Sorry, I'm pathetic I know.Linkadge
Posted by linkadge on March 20, 2007, at 9:20:12
In reply to Re: Lamotrigine is not good for me, posted by flmm on March 19, 2007, at 21:46:46
I don't think people understand what I am looking for. I just want to relax in a positive way. Anticonvulstants and antipsychotis will help you relax, in the sense that they make you feel low, but there are oter ways to relax.
I'm talking better chill pills. I'm talking drugs that actually make you feel better.
Pipe dreams I suppose.
Linkadge
Posted by Racer on March 20, 2007, at 11:38:48
In reply to Re: Lamotrigine is not good for me, posted by linkadge on March 20, 2007, at 9:20:12
>
> I'm talking better chill pills. I'm talking drugs that actually make you feel better.
>
> Pipe dreams I suppose.
>
>
>
> LinkadgeThey are pipe dreams if you don't give meds an honest try. I have to agree that you haven't given Lamictal a fair try, between starting so high -- what was your doctor thinking? -- and only giving it a week.
That said, you know I understand about not sticking with it. I've gone through periods where it was a miracle if I made it past day three. Looking back, I'm thankful I had someone to encourage me through that period, so that I could get to the benefits of some of these drugs. And I made it through several month on Lamictal, and even gave it a full three weeks at 200mg before I decided it wasn't worth it. Sure, it's frustrating when that happens -- but it's also sometimes necessary in order to find what really does work. I know you know all this.
Good luck, Link. I hope you find something that helps.
Posted by Bob on March 20, 2007, at 12:41:41
In reply to Re: Lamotrigine is not good for me, posted by linkadge on March 20, 2007, at 9:17:29
> Its just the way it makes me feel. Crazy, irritable, then apathetic 5 minautes later. Its almost as if it makes my mood more unstable.
>
> It doesn't give me a content feeling, it just gives me that feeing where my brain reveleas to me everything I want but can't have.
>
>
> The way it makes me feel is just too unpredictable.
>
> Its just not for me. I'd prefer lithium or depakote over it any day.
>
> The visual stuff is just too wierd.
>
>
> Sorry, I'm pathetic I know.
>
> Linkadge
>
>
I've had many treatments like that. Especially the part about how the treatment/drug reveals all the things you want but can't have. That is well said.The fact that you're apologizing clearly highlights the extreme problem with mental illness. With how many other diseases would we feel compelled to apologize when a treatment goes dreadfully wrong?
Posted by notfred on March 20, 2007, at 12:55:13
In reply to Re: Lamotrigine is not good for me » linkadge, posted by Bob on March 20, 2007, at 12:41:41
" With how many other diseases would we feel compelled to apologize when a treatment goes dreadfully wrong? "
Here it is not the treatment but a dosing schedule
**way** out of wack with the excepted, safe levels.
Posted by linkadge on March 20, 2007, at 13:08:15
In reply to Re: Lamotrigine is not good for me » linkadge, posted by Racer on March 20, 2007, at 11:38:48
Well, it has been a litle more than a week. More like 11 days. I understand what you are saying, thought ususually my intution has been fairly good. Ie the meds that I thought would suck long term usually do.
There are no rules, I realize, but I am just not ready to take this med for longer than this. Even a few more weeks of feeling like this could jepordize a lot.
Linkadge
Posted by linkadge on March 20, 2007, at 13:12:33
In reply to Re: Lamotrigine is not good for me, posted by notfred on March 20, 2007, at 12:55:13
I started at 50mg a day for 7 days then was supposed to go upto 100mg on day 7, increasing by 50mg each week.
Linkadge
Posted by linkadge on March 20, 2007, at 13:14:19
In reply to Re: Lamotrigine is not good for me, posted by notfred on March 20, 2007, at 12:55:13
Its just like with effexor. People kept telling me to give it more time. That was the biggest waste ever. I felt like garbage for 6 months when if I had my way I would have stopped it within a week.
I'm not going to let that happen agian.
Linkadge
Posted by notfred on March 20, 2007, at 14:52:07
In reply to Re: Lamotrigine is not good for me, posted by linkadge on March 20, 2007, at 13:12:33
> I started at 50mg a day for 7 days then was supposed to go upto 100mg on day 7, increasing by 50mg each week.
>
>
> LinkadgeThat is too fast, per the manufacture.
You know, I already posted this & a link to the monograph, and other posters have said much the same so I give up on you, link.
Posted by linkadge on March 20, 2007, at 16:01:54
In reply to Re: Lamotrigine is not good for me, posted by notfred on March 20, 2007, at 14:52:07
>so I give up on you, link
Hey, no worries. The melanin binding scared me enought as it is. Don't need to go blind.
Linkadge
Posted by Joe Bloe on March 20, 2007, at 16:11:01
In reply to Re: Lamotrigine is not good for me, posted by linkadge on March 20, 2007, at 9:17:29
> I don't think I will. I honestly don't want to take something for 2 months to realize it is not going to work out.
By day 7 on 12.5mgs, I knew it was going to work out. Two months may be an overstatement.
> Perhaps this is the wrong approach.
>
> Its just the way it makes me feel. Crazy, irritable, then apathetic 5 minautes later. Its almost as if it makes my mood more unstable.Again, I can't even imagine starting at 50 mgs. 25 was too much for me for week 1. I can imagine that at 50mgs, it is making you more unstable.
> It doesn't give me a content feeling, it just gives me that feeing where my brain reveleas to me everything I want but can't have.
>
>
> The way it makes me feel is just too unpredictable.Again, I think the unpredictability is from the high dose.
That being said, like most of these meds, a lot of people do not respond in a positive way. However, I do not think that this case can be placed into that category because of the unorthodox dosing scheme.
Posted by Joe Bloe on March 20, 2007, at 16:13:41
In reply to Re: Lamotrigine is not good for me, posted by Joe Bloe on March 20, 2007, at 16:11:01
I wonder what might happen if you lowered your dose to 25 and stabilized there for at least two weeks.My only concern would be that you might have some withdrawal effects from starting so high, which could hurt your chances of any short term positive effects.
Posted by Phillipa on March 20, 2007, at 19:54:20
In reply to Re: Lamotrigine is not good for me, posted by linkadge on March 20, 2007, at 13:14:19
I agree with you Link. Love Phillipa
Posted by theo on March 25, 2007, at 20:02:32
In reply to Re: Lamotrigine is not good for me, posted by linkadge on March 20, 2007, at 9:17:29
> I don't think I will. I honestly don't want to take something for 2 months to realize it is not going to work out.
>
> Perhaps this is the wrong approach.
>
> Its just the way it makes me feel. Crazy, irritable, then apathetic 5 minautes later. Its almost as if it makes my mood more unstable.
>
> It doesn't give me a content feeling, it just gives me that feeing where my brain reveleas to me everything I want but can't have.
>
>
> The way it makes me feel is just too unpredictable.
>
> Its just not for me. I'd prefer lithium or depakote over it any day.
>
> The visual stuff is just too wierd.
>
>
> Sorry, I'm pathetic I know.
>
> LinkadgeThat's about the best description of how I feel on Lamictal put into words. I sometimes refered to it as my mood de-stabilizer.
This is the end of the thread.
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