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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 rjlockhart37 on September 3, 2020, at 9:39:37
i'm on 400mg, when i first started this, it dulled me out, now if i don't take 400mg in morning, its diffcult with depression. Max dose of fluoxetine was working but now have mood stablized and feel activated and normal, i have to take lamictal. I don't really like to so, because prozac has good morning antidepressant effect, and lamictal kinda blunts it out, but it also treats the depression, just not in the same way.
I really want to go off lamictaal or reduce dosage, i took 200mg the other day, with fluoxetine in morning, i could tell the fluoxetine effect, but got irrtible, or just felt imbalanced and took the full dose. Mood stablizer for depression, but sometimes mood stablizer blunts the full effect of antidepressant.
Maybe i'll take no lamictal in the morning, and take in evening. See what happens
Posted by porkpiehat on September 3, 2020, at 20:22:49
In reply to lamictal dosing, posted by rjlockhart37 on September 3, 2020, at 9:39:37
> i'm on 400mg, when i first started this, it dulled me out, now if i don't take 400mg in morning, its diffcult with depression. Max dose of fluoxetine was working but now have mood stablized and feel activated and normal, i have to take lamictal. I don't really like to so, because prozac has good morning antidepressant effect, and lamictal kinda blunts it out, but it also treats the depression, just not in the same way.
>
> I really want to go off lamictaal or reduce dosage, i took 200mg the other day, with fluoxetine in morning, i could tell the fluoxetine effect, but got irrtible, or just felt imbalanced and took the full dose. Mood stablizer for depression, but sometimes mood stablizer blunts the full effect of antidepressant.
>
> Maybe i'll take no lamictal in the morning, and take in evening. See what happens
Are you taking the generic or brand name Lamictal? For me, the generic has more of a stabilizing effect but doesn't help much with depression. The brand name stuff is activating for me but creates some hyppmanic/compulsive symptoms. Almost like they are separate drugs.
Posted by beckett2 on September 3, 2020, at 22:48:36
In reply to lamictal dosing, posted by rjlockhart37 on September 3, 2020, at 9:39:37
Keep taking the Lamictal. Because it is an antiepileptic, you should decrease more slowly.
If I'm mistaken, maybe someone can correct me on this.
Posted by rjlockhart37 on September 4, 2020, at 10:47:58
In reply to Re: lamictal dosing » rjlockhart37, posted by porkpiehat on September 3, 2020, at 20:22:49
Yes, the Lamictal brand is very expensive, i don't know which generic kind i have, but i do know it does provide antidepressant effect, but....when i get excited and really euphoric about something, it kinda blunts it. Like it keeps me down to earth, i used to be able to just take 1 200mg tablet in the morning, then take another tablet in late afternoon. But lately, i've been having to take 400mg in morning with Prozac, noticed much improvement in mood, and morning deepression. It's a bit activating, but....it keeps me down, i can't get really euphoric about something, it keeps the neurotransmitters at a ceiling level.
Posted by rjlockhart37 on September 4, 2020, at 10:51:54
In reply to Re: lamictal dosing » rjlockhart37, posted by beckett2 on September 3, 2020, at 22:48:36
yes, i started lamotragine in 2012, i still had antidepressant, almost hypomanic, good moods in the morning from prozac, but still had depression, so doctor added lamictal, at first i hated it. But then after time i started noticing, it has a ceiling effect, if your really euphoric and hypomanic, like really exicted, it has a cieling effect, but also same thing with depression, it keeps a ceiling effect from not letting go into depths of depression, so its like 2 way street, keeps me from getting really hypomanic, but also has a ceiling effect on depression. When i really feel depressed, i feel the lamotragine ... its kind hard to describe, but its like this feeling it won't let me get depressed to certain point, ceiling effect at baseline.
Posted by Lamdage22 on September 4, 2020, at 14:07:15
In reply to Re: lamictal dosing, posted by rjlockhart37 on September 4, 2020, at 10:51:54
Maybe that is not a bad thing. What goes up must come down.
Posted by rjlockhart37 on September 5, 2020, at 12:15:46
In reply to Re: lamictal dosing, posted by Lamdage22 on September 4, 2020, at 14:07:15
yeah, mental overthinking about something, or getting over euphoric, that always comes down. It keeps, i can be in a good mood, but not euphoria, but notice when i get depressed, the lamotragine has this feeling that its forcing nuerotransmitters to go down. It's like this anti-depressant effect, force not going into depression
Fluoetine is good antidepressant, but can cause hypmania
Posted by SLS on September 10, 2020, at 12:06:50
In reply to Re: lamictal dosing » rjlockhart37, posted by beckett2 on September 3, 2020, at 22:48:36
Hi.
I would express the same caution that Beckett2 has regarding the abrupt discontinuation of lamotrigine. In general, coming off of drugs that inhibit seizures might actually produce them if you do it too fast. It is sort of a rebound effect created by the sudden stoppage, and the brain not being prepared to make up for the sudden recoil (rebound). It can be compared to what happens if you stop taking a benzodiazepine too fast. The resulting withdrawal effects creates more anxiety than you had when you first started taking it.
Lamotrigine dosages are pretty consistent, from what I've read and what I've seen reported here.
< 200 mg/day is usually ineffective. Of course, we have a few exceptions to this rule here.
= 200 mg/day is sort of a sweet-spot. I think more people respond to this dosage than any other.
> 200 mg/day is sometimes needed to get the most out of it.
Any mild-moderate cognitive or memory impairments can disappear entirely over time. This is more likely to be a matter of months rather than weeks.
The original name-brand product, Lamictal, (GSK) works best for me. I have tried Teva and Mylan versions of lamotrigine. The old, original Teva generic product came closest to Lamictal in my experience. Mylan gave me little therapeutic benefit, but with all of the side effects. Also, I had to go from 300 mg/day to 500 mg/day to obtain relief at all.
I don't know what other brands of generic lamotrigine are available. However, Teva has since acquired another generic manufacturer that had already been making lamotrigine. They were making a single dosage form in an extended-release preparation - Lamotrigine XR 150 mg. Since the acquisition, Teva added all other dosage forms to their product line. Which recipe and manufacturering plant is being used? I don't know.
Very important: If you are taking a non-XR versions of the name-brand or generic, I think a twice a day dosing schedule works best. I take 300 mg/day as 150 mg b.i.d.
- Scott
Posted by porkpiehat on September 10, 2020, at 13:06:38
In reply to Re: lamictal dosing, posted by SLS on September 10, 2020, at 12:06:50
I am definitely an exception. Lamictal has a host of side effects including significant cognitive problems, sleep disturbances, muscle contractions in my neck, larynx, and esophagus. Daily headaches and light sensitiviy. Obsessiveness and hypomanic symptoms also.
I can't take more than 125mgs/day without the symptoms becoming too bad. Combine with Celexa and the SE's are way exacerbated.
I'm aware at this dose that I'm not getting the full benefit of the drug. Also I can't really reduce without falling apart. I would have to take a few months off if I were to try.
I concur with the Lamictal vs non-Teva generics assessment Scott made. For me they are almost like different drugs. Fewer side effects with the generics but with more of a flattening effect...when I get obsessive they are dark obsessions; The "blue ones" boost my mood and motivation much more but the side effects are kinda bananas.
Posted by SLS on September 10, 2020, at 20:50:36
In reply to Re: lamictal dosing » SLS, posted by porkpiehat on September 10, 2020, at 13:06:38
> I am definitely an exception. Lamictal has a host of side effects including significant cognitive problems, sleep disturbances, muscle contractions in my neck, larynx, and esophagus. Daily headaches and light sensitiviy. Obsessiveness and hypomanic symptoms also.
>
> I can't take more than 125mgs/day without the symptoms becoming too bad. Combine with Celexa and the SE's are way exacerbated.
>
> I'm aware at this dose that I'm not getting the full benefit of the drug. Also I can't really reduce without falling apart. I would have to take a few months off if I were to try.
>
> I concur with the Lamictal vs non-Teva generics assessment Scott made. For me they are almost like different drugs. Fewer side effects with the generics but with more of a flattening effect...when I get obsessive they are dark obsessions; The "blue ones" boost my mood and motivation much more but the side effects are kinda bananas.
I'm sorry lamotrigine isn't working out for you. It's an instance when it is not a good thing to be exceptional.Can you think of any reason why it makes sense to continue taking lamotrigine? Have you been on it for more than two months at the highest dosage you can tolerate? If you were feeling great (but not too great) on lamotrigine, it would be a difficult decision to make whether or not it's worth the side effects. With what you describe as side effects, I would almost certainly discontinue lamotrigine immediately - although gradually - unless your doctor can honestly tell you that he has seen this before.
- Scott
Posted by rjlockhart37 on September 10, 2020, at 22:02:25
In reply to Re: lamictal dosing, posted by SLS on September 10, 2020, at 12:06:50
Scott, I take 400mg in the morning, it does have an antidepressant effect. It used to dull me out, but things changed. If only take Prozac alone, without lamotrragine i get kinda unstable, little irrtible. Then when i take it things calm down, and go back to stable
I've taken up to 600mg, it was too much. I stayed with 400, for a long time 200 was a good amount, then i started noticing more antidepressant-mood stablization at 400
this is just a quick question, i take 2 200mg tablets in the morning, and wondering if it lasts all day
Posted by rjlockhart37 on September 11, 2020, at 10:31:56
In reply to Re: lamictal dosing » SLS, posted by rjlockhart37 on September 10, 2020, at 22:02:25
the half life of lamotargine is 29 hours, so cutting that in half would be 14 hours. That's what i've researched and found out, plus lamictal stay in your system even without lamictal xr
Posted by SLS on September 11, 2020, at 11:14:57
In reply to Re: lamictal dosing » SLS, posted by rjlockhart37 on September 10, 2020, at 22:02:25
> Scott, I take 400mg in the morning, it does have an antidepressant effect. It used to dull me out, but things changed. If only take Prozac alone, without lamotrragine i get kinda unstable, little irrtible. Then when i take it things calm down, and go back to stable
>
> I've taken up to 600mg, it was too much. I stayed with 400, for a long time 200 was a good amount, then i started noticing more antidepressant-mood stablization at 400
>
> this is just a quick question, i take 2 200mg tablets in the morning, and wondering if it lasts all dayI'm glad you had the idea to push the dosage to 400 mg/day if you are getting relief from it. It is not common for people to need that much, though.
https://www.rxlist.com/lamictal-drug.htm#dosage
- Scott
Posted by rjlockhart37 on September 11, 2020, at 15:29:41
In reply to Re: lamictal dosing » rjlockhart37, posted by SLS on September 11, 2020, at 11:14:57
take 2 40mg prozac capsules, 2 lamotragine tablets, nuvigil in the morning, then i take smaller doses of diazepam later on. I really don't like diazepam but i take 5mg in the morning, 2.5 after noon, 5mg at night
i've adapted, because if i dont take lamictal at that dose i get irrtible, it works with the prozac with antidepressant effect, with this mood stabilization, when i took prozac alone i was euphoric but also up and down, my doc put me on lamictal 200mg daily, we moved to 300mg, it was too dulling, but then after a while adjusted, i took 400mg after drinking alcohol and was depressed and it pulled me out of it. That's why i told my doctor how it helps depression, it mood slumps, prozac alone, im not depressed, but since she put me on lamictal it helped with mood stablization
usally i take 400mg in the morning, with prozac.
Posted by rjlockhart37 on September 11, 2020, at 15:33:02
In reply to Re: lamictal dosing, posted by rjlockhart37 on September 11, 2020, at 15:29:41
really don't like diazepam, it's anxiety relief, but your less motivated to do things, irresponsible. I noticed out of all the benzos i've taken, valium has valium slumps
This is the end of the thread.
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