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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by twinch42085 on August 16, 2007, at 9:25:07
Can lamictal be used as a stand alone mood stabilizer or does it work better when it is augmented with another medication? Also, if it is used as an augmentor what are some of the medications that are the most popular to use?
Thanks : )
Posted by sam123 on August 16, 2007, at 12:20:40
In reply to lamictal, posted by twinch42085 on August 16, 2007, at 9:25:07
> Can lamictal be used as a stand alone mood stabilizer or does it work better when it is augmented with another medication?
Nope, lamictal is not used alone as an AD or mood stabilizer. It is an augmenter. It can be used alone as an AC, its original indication.
It is hard to suggest meds without knowing what condition you have.
Posted by twinch42085 on August 16, 2007, at 14:21:27
In reply to Re: lamictal, posted by sam123 on August 16, 2007, at 12:20:40
I have bipolar. I am on 25 mg of lamictal and 4 mg of Risperdal.
Thanks : )
Posted by sam123 on August 16, 2007, at 14:47:12
In reply to Re: lamictal » sam123, posted by twinch42085 on August 16, 2007, at 14:21:27
> I have bipolar. I am on 25 mg of lamictal and 4 mg of Risperdal.
>
> Thanks : )Is this combo working for you ? If not, what is not working ? (depressed, mixed state, hypomanic, etc).
Thing is, there is no such thing as a popular med,
one that works for me another hates. I liked effexor and do well on benzos yet they are often demonized here.So choosing meds based on how well another likes it will not predict your success. The same could be said for giving advice to others based on your experience with a med.
Posted by twinch42085 on August 16, 2007, at 15:39:47
In reply to Re: lamictal, posted by sam123 on August 16, 2007, at 14:47:12
The combo is working so far. It is still to soon to say if the combo will work because I started the lamictal about 2 weeks ago. Before I was on 800 mg of tegretol XR along with the risperdal, but I was staying depressed. Lamictal is suppose to have AD effects right? So I hope that it does it's job, but in the future it is likely that I will have to augment it with something? The risperdal works great for my mania. I have been on it for 6 months which is said to be way too long, but I have had no bad side effects from it.
Thanks : )
Posted by cloudydaze on August 16, 2007, at 19:27:29
In reply to Re: lamictal » sam123, posted by twinch42085 on August 16, 2007, at 15:39:47
I just started taking lamictal 25mg yesterday. My pdoc wants to see if I respond to it by itself. If not, he wants to add Abilify (one of the few I haven't tried).
I think he went for the lamictal first because I am more depressive than manic, and I haven't tolerated anti-psychotics well in the past.
But I'll probably end up taking abilify too.
How long does it take the lamictal to work? They told me at least a week.
Posted by twinch42085 on August 16, 2007, at 20:36:32
In reply to Re: lamictal, posted by cloudydaze on August 16, 2007, at 19:27:29
My pdoc told me that lamictal takes around 2-3 weeks to start working. Everyone is different though. I felt a difference the first day that I took it, but I knew that I needed to increase my dosage bc 25 mg is an low dose. It takes so long to work because the titration is slow. I am taking 4 mg of risperdal, but I am thinking about switching to abilify since it is a unique atypical. It doesn't completely block your dopamine, and I could use some dopamine. I too had more depression than mania. Hopefully the lamictal will do its job at helping me maintain.
twinch : )
Posted by sam123 on August 16, 2007, at 23:07:29
In reply to Re: lamictal » sam123, posted by twinch42085 on August 16, 2007, at 15:39:47
Lamictal is suppose to have AD effects right?
Yes, it does in me. It augments the Wellby but can't do the job by itself.
So I hope that it does it's job, but in the future it is likely that I will have to augment it with something?
Well you are on Risperdal, so the lamictal is working in an augmenting role. Sorry, but I cannot even predict the future med needs for myself !However, the target dose for lamictal is 200 mgs
for bipolar. For seizures 500 mgs is a common dose
and some take up to 700 mgs. There are some studies that indicate 400 mgs is no better than 200 mgs, for bipolar, while some report doses greater than 200 mgs help. You are on 25 mgs, so you have considerable room to play with the dose.
I found lamictal seemed to start having mild AD effects at 25 mgs this built up slowly to 300 mgs, my maintenance dose. (I have atypical depression and epilepsy. The lamictal is for seizures, the AD effects are an added bonus)It seems there are many options today for treating bipolar and assoc. mania, depression, and mixed states.
Posted by Peter S. on August 17, 2007, at 0:35:46
In reply to Re: lamictal, posted by sam123 on August 16, 2007, at 23:07:29
Lamictal really works as an anti-depressant for me but the effect gradually goes away during the day. The antidepressant effect kicks in after a couple of hours. I can go off it for a week and then take it and get an immediate effect. Very weird. I take it with Neurontin- which seems to help but I'm not sure how.
> Lamictal is suppose to have AD effects right?
>
> Yes, it does in me. It augments the Wellby but can't do the job by itself.
>
>
> So I hope that it does it's job, but in the future it is likely that I will have to augment it with something?
>
>
> Well you are on Risperdal, so the lamictal is working in an augmenting role. Sorry, but I cannot even predict the future med needs for myself !
>
> However, the target dose for lamictal is 200 mgs
> for bipolar. For seizures 500 mgs is a common dose
> and some take up to 700 mgs. There are some studies that indicate 400 mgs is no better than 200 mgs, for bipolar, while some report doses greater than 200 mgs help. You are on 25 mgs, so you have considerable room to play with the dose.
> I found lamictal seemed to start having mild AD effects at 25 mgs this built up slowly to 300 mgs, my maintenance dose. (I have atypical depression and epilepsy. The lamictal is for seizures, the AD effects are an added bonus)
>
> It seems there are many options today for treating bipolar and assoc. mania, depression, and mixed states.
>
Posted by LlurpsieNoodle on August 17, 2007, at 7:50:11
In reply to Re: lamictal » cloudydaze, posted by twinch42085 on August 16, 2007, at 20:36:32
hi twinch,
I take lamictal and it worked well as an antidepressant/mood stabilizer. Took about 2-3 weeks to kick in. my pdoc increased the rate of the titration because my symptoms were pretty severe. It really did work.unfortunately, my life kind of changed abruptly and I was getting mood swings and more and more depression/depressive reactions (whatever that is- my mind would process some event and react with a very abrupt and dark depression. scary).
so, I changed my meds completely about 3 weeks ago, and it's REALLY working. in fact 2 days ago my therapist told me that he couldn't see anything wrong with me at all (clean bill of health- yay!)
I kept the lamictal (300mng) and added abilify- great for the mood swings, but you're already on risperdal, so that's probably doing similar things. and an antidepressant. I'm LOVING the antidepressant. zoloft- 50 mg. I felt better within a few days. I also have been battling some nasty acid in my stomach, but aside from that, a complete success.
some klonopin for when the anxiety and agitation kick in. I'm supposed to take it 2x a day as preventative, but I'm taking it 1x a day or prn, now that I've been able to adopt less pessimistic attitudes and get some coping mechanisms going.
I'm sorry to hear that you're depressed. yes, the lamictal is a good antidepressant. Sounds like you're doing the right things. hang in there.
I'm guessing that an anti-depressant may not be indicated with bipolar disorder. Of course none of my docs wants to tell me that I have bipolar, but all of my medications indicate "yes" and I have known for some time that I'm being treated like bipolar II, even if I don't meet dx criteria... oh well.
-Ll
Posted by fuzz54 on August 17, 2007, at 13:10:39
In reply to Re: lamictal » twinch42085, posted by LlurpsieNoodle on August 17, 2007, at 7:50:11
I took Lamictal as a mood stabilizer in conjuction with Paxil. I was rare in that I responded immediately to 25 mg of Lamictal. It stabilized me too much at first in fact, because I had almost no emotion but was stable. Then I slowly adjusted to the drug over a few weeks and started increasing the dosage all the way up to 200 mg. It worked to stabilize my mood, but after a few months on it I decided I needed more emotional range and slowly tapered off the drug.
Posted by rina on August 17, 2007, at 18:14:49
In reply to Re: lamictal, posted by cloudydaze on August 16, 2007, at 19:27:29
Lamictal can stand alone as a mood stabilizer but my pdoc said the best mood stabilizer combo if a patient does well with the combo is Depakote/Lamictal.
Posted by twinch42085 on August 17, 2007, at 21:26:27
In reply to Re: lamictal, posted by rina on August 17, 2007, at 18:14:49
doesn't depakote cause more side effects then usual while taking depakote?
Posted by rina on August 17, 2007, at 23:56:02
In reply to Re: lamictal » rina, posted by twinch42085 on August 17, 2007, at 21:26:27
Different people have different experiences and side effects with it. For instance, I couldn't go higher than 500mg. Anything higher left me in a funk but lamictal and dep is a tried and true combination. Best to see what your pdoc thinks though.
Posted by Bonnie_CA on August 18, 2007, at 0:19:12
In reply to Re: lamictal » rina, posted by twinch42085 on August 17, 2007, at 21:26:27
My pdoc wants to take me off of Lexapro eventually and just take Lamictal and use a benzo to combat the agitated state Lamictal gets me in. I was taking xanax but I decided to try taking klonopin, and that seems to be working better (I'm still on Lexapro). I can give you a better answer when my doc actually does take me off the Lexapro.
-Bonnie
Posted by twinch42085 on August 18, 2007, at 10:19:19
In reply to Re: lamictal, posted by Bonnie_CA on August 18, 2007, at 0:19:12
So lamictal can make you agitated or have anxiety?
thanks : )
Posted by twinch42085 on August 18, 2007, at 15:16:33
In reply to Re: lamictal, posted by Bonnie_CA on August 18, 2007, at 0:19:12
So lamictal can make you agitated and cause anxiety?
: )
Posted by sam123 on August 18, 2007, at 15:47:17
In reply to Re: lamictal » Bonnie_CA, posted by twinch42085 on August 18, 2007, at 15:16:33
BP folks report lamictal can kick them into hypomanic state; most common during titration
up or down and dose changes in general. Like missing a dose.I found this on the crazymeds site:
"Don't be surprised if you get anxious or have other hypomanic effects if taking it for bipolar disorder."
Posted by rina on August 18, 2007, at 15:55:43
In reply to Re: lamictal » Bonnie_CA, posted by twinch42085 on August 18, 2007, at 15:16:33
Everyone responds differently. The first time I was on lamictal, it worked for about a year, then stopped working. I stopped it for a year. Now I'm back on it and it seems to be doing fine.
Posted by rina on August 18, 2007, at 15:58:46
In reply to Re: lamictal, posted by sam123 on August 18, 2007, at 15:47:17
That's why I say everyone is different. My titration was 3days at a time starting at 25mg up to 200mg and I'm bipolar. So the best advice is to follow your doctors lead and listen to your body most importantly.
Posted by Bonnie_CA on August 19, 2007, at 7:02:55
In reply to Re: lamictal, posted by twinch42085 on August 18, 2007, at 10:19:19
Yes.
Posted by twinch42085 on August 19, 2007, at 17:39:21
In reply to Re: lamictal » twinch42085, posted by Bonnie_CA on August 19, 2007, at 7:02:55
Do you think that I should suggest to my pdoc about adding on a benzo? If so, which benzo do you think works the best having bipolar?
Thanks : )
Posted by twinch42085 on August 19, 2007, at 18:22:22
In reply to Re: lamictal » Bonnie_CA, posted by twinch42085 on August 19, 2007, at 17:39:21
The type of benzo that will work probably depends on the type of person you are right?
I start 50 mg tomorrow. I am actually excited about it : )
Posted by twinch42085 on August 19, 2007, at 19:12:52
In reply to Re: lamictal » twinch42085, posted by Bonnie_CA on August 19, 2007, at 7:02:55
sorry if i confused anyone on the last post I made. I start 50 mg of lamictal tomorrow.
: )
This is the end of the thread.
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