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Dr. Bob is Robert Hsiung, MD,
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Posted by gardenergirl on April 2, 2008, at 14:52:06
In reply to Re: Lamictal » tallandhandsomeswife, posted by Quintal on April 2, 2008, at 13:43:02
I had noticeable irritability at 125 mg. I upped it to 150 mg and it eventually went away. But whenever I went back down to 125 mg, it came back. Lower and higher than that dose was fine, but for some reason that dose was not at all. Weird. I eventually went off of it and tried lithium to boost my AD.
You might see what happens if you go up in dose. Good luck.
gg
Posted by Phillipa on April 2, 2008, at 15:12:37
In reply to Re: Lamictal » Quintal, posted by gardenergirl on April 2, 2008, at 14:52:06
Unfortuanately never got above 50mg and had no side effects at all. Then I had a wierd side effect of excess spitting and it was constant. After I'd gone off it it occureed to me that I also go very angry while on the med. Phillipa
Posted by emme on April 2, 2008, at 17:59:36
In reply to Lamictal, posted by tallandhandsomeswife on April 2, 2008, at 10:08:36
If you're already on 100 mg at only 3 weeks, I wonder if that is too fast a titration for you. Just a thought.
emme
Posted by gardenergirl on April 2, 2008, at 18:18:02
In reply to Re: Lamictal » tallandhandsomeswife, posted by emme on April 2, 2008, at 17:59:36
Posted by dbc on April 2, 2008, at 18:49:09
In reply to Good catch! I agree. (nm) » emme, posted by gardenergirl on April 2, 2008, at 18:18:02
100mg should be week 4, someone screwed up. Lamictal in my experience is pretty energizing especially at the lower doses up untill you start hitting the serious mood stabilization levels 150 - 200mg. Im on 200mg currently and if you can tolerate it lamictal is really powerful especially if you allow it a month or two to work its magic.
Posted by chiron on April 2, 2008, at 19:19:42
In reply to Lamictal, posted by tallandhandsomeswife on April 2, 2008, at 10:08:36
I have made a copy of Lamictal posts to give me hope. Many of them say that they experienced agitation/irritability that did go away.
It might be a good idea to titrate a little slower. I am going up 12.5 a week.
Posted by Phillipa on April 2, 2008, at 19:24:53
In reply to Re: Lamictal, posted by chiron on April 2, 2008, at 19:19:42
Chiron that is smart to me as now you reminded me that at the time the pdoc said I could also do that as it's the way they do kids. She's for going slow on any med anyway. Reason is to avoid side effects and that way people will take meds. Phillipa
Posted by obsidian on April 2, 2008, at 19:47:52
In reply to Lamictal, posted by tallandhandsomeswife on April 2, 2008, at 10:08:36
oh yeah, made me super-irritable
went away eventually, but GEEZ!
Posted by tallandhandsomeswife on April 2, 2008, at 21:48:15
In reply to Re: Lamictal » tallandhandsomeswife, posted by Quintal on April 2, 2008, at 13:43:02
Thank you for that information. At least I know that I'm not imagining it! Yes, I have definitely felt like taking a few people out in traffic and just like losing it in general! I have never experienced the temper that I seem to have shortly after taking Lamictal. I called my pdoc last night about it and later just got a message from him advising me to try taking it at night so I'm asleep during my angry time, but to continue on it and he'd see me on the 16th. Very casual like it's no big deal. Either he doesn't care or just sees it as no big deal (or both) but trust me, it is. My husband has about had it with me and just can't understand that this comes from nowhere, is unplanned, and that it is very hard to control. I'm not terribly well acquainted with Klonopin. I know that it is a benzo, often used to treat anxiety, that's about it. I was on Adderall for several months while my doctor was trying to choose between ADHD and a bipolar disorder, and did see good effects from it (between crashes from it wearing off) but I was having lots of oral problems (burning mouth, dryness and more) and came off of it along with Cymbalta at the same time and have really taken a nose dive since. I'm not sure where to go but on the 16th when I see the pdoc maybe I'll ask him about Klonopin. Thanks so much and any more info. on your experience with Lamictal or Klonopin would be appreciated! Good evening!
Posted by elanor roosevelt on April 3, 2008, at 1:14:16
In reply to Re: Lamictal » Quintal, posted by tallandhandsomeswife on April 2, 2008, at 21:48:15
might you bring down your dose a bit until the 16th?
i'm on week 2 of 25mg
meds have really helped me with my kid and my temper
i screamed a lot more before the medspdocs can be real jerks about telling you to hang in when your side effects are NG
good luck
and when you get angry around the kids go over the edge in the other direction and sing loud silly songs
be kind to yourself and when your husband has had it with you take long baths by candle light while your he watches the kids
Posted by Quintal on April 3, 2008, at 13:01:59
In reply to Re: Lamictal » Quintal, posted by tallandhandsomeswife on April 2, 2008, at 21:48:15
The others may have a point about the titration rate - I think it took nearly two months for me to titrate up to 200mg, which was the dose I took for two years. I was taking it for about two or three months before I noticed the full effect - my mood slowly got calmer, like the ripples on a pond slowly settling after a stone has been thrown in. After that, it just sort of kept me happy and stable from that point on. No long-term side effects that I recall, but in the beginning I had severe word-finding and spelling difficulties almost to the point of dyslexia - I could barely read for the first few weeks.
I had been taking Klonopin for years prior to Lamictal, and I think it must have been masking some of the Lamictal side effects like irritability and insomnia, as these only appeared when I quit Klonopin. Maybe a small dose of something like Valium might help with the irritability in the short term, at least until you reach the right dose. Klonopin may have mood stabilizing properties in itself, but some people find it makes them feel depressed.
Q
Posted by tallandhandsomeswife on April 3, 2008, at 16:05:33
In reply to Re: Lamictal, posted by elanor roosevelt on April 3, 2008, at 1:14:16
Thanks! Yeah, I'm definitely going to have to develop some sort of plan before I head straight into a nervous breakdown. I feel like I'm trying so hard but getting nowhere. I've tried to go to the gym and focus on other people and not myself, but I'm just at my rope's end. No one seems to understand and at this moment I feel like just giving up and throwing in the towel. The headache (literal headache) is really making my nerves stand on end and I feel like everyone is out to get me, like I wish people would just back away unless they have something positive to say. I am also feeling like I am such a bother to everyone that I know. I'm really feeling like a waste of humanity. Oh well. Hopefully I'll snap out of this as I am quite an emotional wreck. I admit that I'm not totally clear on my thinking, no doubt. I really would like to get off of the Lamictal and just go with a tranquilizer! Thanks for you advice, really, regarding how to handle the kids. I love them so much and more than anything do not want to have a negative impact on them. I grew up with a parent that never considered the impact of anything that he did on his children, and I never want to be that person. Thanks for taking the time out to encourage me, because it was your choice, and is truly appreciated. Have a great evening :)
Posted by Bea K on April 5, 2008, at 23:06:17
In reply to Lamictal, posted by tallandhandsomeswife on April 2, 2008, at 10:08:36
I was perusing these boards and saw your post, and I couldnt help but make an account and answer it. So, be warned, I'm rediculously verbose, and not the best speller, but here we go:
I was really surprised to see that you're on 100mg of Lamictal at only three weeks of taking it. The current suggested titration advocated by the manufacturer in the Lamictal starter pack is 2 weeks at 25mg, 2 weeks at 50mg, and 1 week at 100mg. Some psychiatrists even start at 12.5 for two weeks before moving to 25mg.
As I understand it, the main side effect that people want to avoid is the extreamly serious Steven Johnson's rash. There are other side effects as well, including irritability, headaches, nausea, etc, that could be potentially avoided by titrating up your dose slowly.Lamictal can also cause an adverse reaction in patients that are on other medication that interfears with the way it works. You may want to make a list of all the medications you are on, including any vitamins and over the counter meds, and take it to your pharmacist to see if any of them could be causing the problem. Additionally, and your doctor may have told you this already, NEVER take Lamictal with a diet pill. That could be another possible reason for your reaction, as could any alchol usage in conjunction with Lamictal.
You didn't mention if you had been previously taking another mood stablizer or antidepressant, but if you were and you stopped it at the time you started Lamictal, your symptoms could be signs of withdrawl from another medication that you may have recently quit. There is also the possibility that another drug that you have been taking recently has not yet cleared your system (the half life of many psycotropic drugs is longer than you would think) and that drug may be interfearing with your Lamictal, or just now inducing withdrawal-like symptoms. If you decide to take the list to your pharmacist, I would include any drugs that you recently quit using.
I believe that if none of the above seem to apply to you, you are either:
1. having an adverse effect to the drug itself
OR
2. possibly entering into a hypomanic or manic mood swing, which could be either connected or unconnected with the Lamictal.Lamictal has been sometimes known to induce mania and rapid cycling in some patients, especially when titrated up too quickly. I, personally, was in a group therapy program with another patient who started Lamictal, got to her three week dosage of 50mg, and found that it caused her to become extreamely manic, impulsive, and agressive. It is by no means a common reaction, and I've met many, many people who never experianced that side effect, but it has happened.
I started taking Lamictal in November of 2007, and am currently on a dosage of 150mg which I take at night before sleep, for my diagnosis of Bipolar 2. I love my Lamictal. It cuts down on my over-all irritability, and allows me an ease with people and smoothness to my realtionships that I thought I had lost a long time ago when I started to experiance the onset of my Bipolar 2 (which had been mistakenly diagnosed as depression for 9 whole years.) It cuts down on the intensity of my mood swings, and while I do notice that I still have them, they are not nearly as intense. I used to be depressed all the time. I did not get the "happy mania," but instead got the dysphoric hypomanic mood swings. With the Lamictal, I am no longer constantly stuck in the "down" part of my moodchart, but instead find myself able to experiance happiness much more often than I have since the onset of my mood disorder. I believe that I am closer to a normal spectrum of emotions with the Lamictal.
As I understand it, mood disorders, and Bipolar disorders in specific, are often very, very difficult to diagnose and treat. Drugs do not at all work in the same way for mood disorders as they do for depression (mild, general, or situational). It may take you more than a few trys before you find what works for you. It's important to work closely with your psychiatrist to find what is right for you. I would reccomend tracking your moods in a journal so that you will be able to better see any trends that your drugs may be causing, and sharing that with your psychiatrist.
Which brings me to my next point. Bipolar (any type of) is not an easy diagnosis to make. It is often misdiagnosed, usually by psychiatrists mistaking it for depression (like in my case) but could also be diagnosed instead of another mood disorder, personality disorder, depression, or medical problem. Has your doctor rulled out thyroid problems? Have you have your blood checked for vitamin defficiencies? You may want to find another psychiatrist and ask for a second opinion.
I think that it would be a great idea to learn more about the disorder on your own as well, so that you can get more of a feeling for whether your symptoms really match or not. There are lots of good books and internet sites out there that can help you understand your disorder. Your psychatrist should be able to help you understand your condition, and help you find information on Bipolarism as well. If he/she is unable to, or impatient with it, then it's probably time to start looking for another one.
I believe that your mental health is the most important thing in your life. Unhealthy people simply cannot function as well as healthy people. They do not make as good of employees, friends, parents. I think that people need to focus on themselves before they can fully focus on others. Any and all time that you can afford to spend on seeking the best treatment available to you will be more than worth it in the end.
I have made huge changes in my life since my disorder was correctly diagnosed, and I began treatment. Currently, for me this means a select coctail of drugs, as well as a group and individual therapy commitment. I am continuing to work on my disorder and the problems that have been invited into my life because of it, and I am a stronger, happier person today because of this.
I wish you the best of luck in your own journey to deal with your disorder. It can be very, very difficult, but don't worry; you're going to get there!
Posted by Phillipa on April 6, 2008, at 20:24:17
In reply to Re: Lamictal, posted by Bea K on April 5, 2008, at 23:06:17
Bea what an excellent and well thought out post I as well was given a starter pack that started with 25mg for two weeks, etc, at 50 mg experience excess spitting which is listed as uncommon side effect. But constantly every minute or so even had to open car door to spit and found that I even threw a plastic bottle in anger at a store. I am diagnosed anxiety/depression. Tried twice to take med. So does this mean not bipolar? Phillipa
Posted by tallandhandsomeswife on April 6, 2008, at 21:09:53
In reply to Re: Lamictal, posted by Bea K on April 5, 2008, at 23:06:17
Posted by henryo on April 7, 2008, at 3:50:29
In reply to Lamictal, posted by tallandhandsomeswife on April 2, 2008, at 10:08:36
It is interesting how many of these responses to this post were from women. I wonder if it has somewhat different effects on the sexes. I have posted many times about my experiences with the Lamicatal. No anger, but it could also have nothing at all to do with gender.
Posted by Quintal on April 7, 2008, at 9:26:32
In reply to Re: Lamictal, posted by henryo on April 7, 2008, at 3:50:29
I am male and had severe anger problems on Lamictal. I have also been diagnosed with borderline personality disorder, and irrational anger is a big part of that, but it definately got much worse on Lamictal.
Q
Posted by Tallandhandsomeswife on April 8, 2008, at 9:11:29
In reply to Re: Lamictal » tallandhandsomeswife, posted by Quintal on April 3, 2008, at 13:01:59
> The others may have a point about the titration rate - I think it took nearly two months for me to titrate up to 200mg, which was the dose I took for two years. I was taking it for about two or three months before I noticed the full effect - my mood slowly got calmer, like the ripples on a pond slowly settling after a stone has been thrown in. After that, it just sort of kept me happy and stable from that point on. No long-term side effects that I recall, but in the beginning I had severe word-finding and spelling difficulties almost to the point of dyslexia - I could barely read for the first few weeks.
Thank you for that information. When I see my doc on the 16th I'm definitely going to ask him about adding something like Klonopin to the Lamictal while working on getting to the ideal dose. I'm so glad to hear about the pond--ripple out effect. That makes me feel much more positive about sticking it out with the Lamictal. It's so funny (not literally) that you mentioned your speech side effect. I had something similar. I could mentally find the word that I wanted to say but just couldn't seem to say it. Does that make sense? It was as if the words in my brain weren't making it to the part that makes you actually verbalize them.
Any headaches with Lamictal? Thanks again so much
>
> I had been taking Klonopin for years prior to Lamictal, and I think it must have been masking some of the Lamictal side effects like irritability and insomnia, as these only appeared when I quit Klonopin. Maybe a small dose of something like Valium might help with the irritability in the short term, at least until you reach the right dose. Klonopin may have mood stabilizing properties in itself, but some people find it makes them feel depressed.
>
> Q
Posted by henryo on April 9, 2008, at 1:14:26
In reply to Re: Lamictal, posted by Tallandhandsomeswife on April 8, 2008, at 9:11:29
OK, I stand corrected. -anger not a gender thing.
Yes, if you don't split your doses up to twice daily you can get a headache. Especially when your new to it.
But once again I think Lamictal is great. No rash and far far less pain than any other med before.
Posted by elanor roosevelt on April 13, 2008, at 16:43:54
In reply to Re: Lamictal, posted by henryo on April 9, 2008, at 1:14:26
how long til it kicks in?
Posted by henryo on April 15, 2008, at 6:15:10
In reply to Re: Lamictal, posted by henryo on April 9, 2008, at 1:14:26
Well, it took about two months to build up to a dose I imagined I could feel. Then another month to approach a therapeutic dose. They actually have a test to determine the blood levels. I can't say what that is about. I only got tested once, three years into it. I mean, I know if I'm in pain or not and I know if I am sleeping badly. Maybe the test has some other usefulness.
Moving on- Going at a rate of 25mg every week, I worked up to a dose of 400mg. The fatal rash concept got my attention, so I took it slow. I found it painfully slow. I had to get off all the other meds and then pray Lamictal would work. The results were good though and five years later still are. I think many people go for the 400mg to 450mg range. For me, if I take even a tiny bit more than 400mg, I can watch myself sleep. That's weird and it sucks.
I have to say as good as Lamictal was there were times when I still got depressed, though not nearly half as bad or as long as I would have without it. That I know. My crashes were/are/seem to be, seasonal. Lamictal is certainly the best thing to date. For me no weight gain, everything else works right, no problems. It is vastly better than nothing and it doesn't screw me up in some exotic way, that I know of.
Just a note, as I have posted before, I added Deplin this January and it has been very positive. Had to cut way back on the Lamictal cause it kicked up the sleep thing. Now I take 300mg Lamictal, 5mg Deplin. The addition of Deplin in my case has been powerful.
I sought out the Deplin because as I said, as good as Lamictal has been I had my moments/weeks that were less good. I got tired of that and stumbled on to a small miracle. That I know is off topic. But our responses to these meds are so idiosyncratic that who can guess what or how much will do what to whom.
Posted by Phillipa on April 15, 2008, at 19:37:58
In reply to Re: Lamictal, posted by henryo on April 15, 2008, at 6:15:10
Henyro interesting a mood stabalizer with Deplin so a med labelled ad isn't necessarily all it will work with. Thanks for that info. Phillipa
Posted by chiron on April 18, 2008, at 0:58:41
In reply to Re: Lamictal, posted by henryo on April 15, 2008, at 6:15:10
Was 400 your target range from the beginning, or did you take breaks from increasing your dosage to see how you felt?
I just reached 200 & my dr. wants to stop there (I don't know for how long). I think it helps, and I have had other drugs make me worse, so I feel like it is almost my last hope (for my lifetime miserable depression). I also take 30 Celexa, 2mg Xanax, & 150 Wellbutrin.
fyi - I have been on Lamictal for almost a year (my body needs to go slow + I've added the other meds)
I know it can take a while to kick in, but I cannot continue at this level of mood (down, low motivation, lonely even though I have friends and can put on a happy face, agitation, etc, etc)
Posted by henryo on April 18, 2008, at 6:23:14
In reply to Re: Lamictal » henryo, posted by chiron on April 18, 2008, at 0:58:41
Yes I think it was recommended/prescribed that 450 might be what was required. But mostly I had a target response in mind, that of achieving the greatest relief from this peculiar mental anguish that I possibly could. I was told that a therapeutic dose is often 350-450mg, though though not always. It varies on both ends of the extreme. My sister takes 150mg plus another med. I have heard of people who take in excess 500mg.
I felt better as I increased the dose so I continued increasing the dose in the hope of stamping out depression as thoroughly as I might. I would like to have increased it more. However I found the aforementioned trigger point of sleep disruption. So I stopped at 400. Taking more Lamictal does help me feel better. I just get that very unpleasant side effect. I can be asleep yet be conscious that I am asleep. It was not restful. Any amount of Lamictal over 400mg does that - for me.
Posted by Jeroen on April 23, 2008, at 8:53:35
In reply to Lamictal, posted by tallandhandsomeswife on April 2, 2008, at 10:08:36
i have psychosis, hallucination of that 8 months ago
still have the psychosis, need to go on high dosage neuroleptic wich i dont like but yes ill try clozapine first and see how it goes
This is the end of the thread.
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