![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by jaby on October 24, 2001, at 12:06:02
I just recently started Lamictal. This is only my third day. The first day I had a tremendously stimulating efect that lifted my depression tremendously. Yesterday I experienced an abrupt diminish of benefit around 4:00 PM. Today the benefit does not seem to be as great either. Those of you that have experience with this med: Have you experienced anything like this? I'm hoping it is just due to the slow titration schedule and that the benefits will eventually return. I plan to adhere to the dosing schedule completely, but will be really bumed if i never regain the way i felt the other day. Well, I had my life back for 1 1/2 days. Hoping for more. Let me now you thoughts/experiences.
Posted by JahL on October 24, 2001, at 13:37:48
In reply to Lamictal-poop out due to slow titration?, posted by jaby on October 24, 2001, at 12:06:02
> I just recently started Lamictal. This is only my third day. The first day I had a tremendously stimulating efect that lifted my depression tremendously. Yesterday I experienced an abrupt diminish of benefit around 4:00 PM. Today the benefit does not seem to be as great either. Those of you that have experience with this med: Have you experienced anything like this? I'm hoping it is just due to the slow titration schedule and that the benefits will eventually return. I plan to adhere to the dosing schedule completely, but will be really bumed if i never regain the way i felt the other day. Well, I had my life back for 1 1/2 days. Hoping for more. Let me now you thoughts/experiences.
Hi.
I had a similar-ish reaction. After about 3 weeks, whilst on only about 25mg, I added Klonopin to Lamictal & w/in a couple of hours I, like y'self, enjoyed a significant lift in mood (which lasted for the day). I was able to replicate this a few times. What's yr dx? I'm BPII & would class my experiences as mild hypomania.
Anyway, this seemed to be the precursor for a sustained, global improvement in all symptomology. This faded over about 6 weeks, tho' I still take Lamictal 4 its mild AD properties & because it helps me think *a little* more clearly. Raising the dose (now at 400mg) -slowly-failed to reinstate the improvement. I've now added 40mg of Prozac. British pdocs at the forefront of developments (which isn't actually saying that much) regard the 400/40mg combo highly. Indeed, it's the first recognised treatment for Depersonalition Disorder. We'll see...
J.
Posted by Roo on October 24, 2001, at 14:03:46
In reply to Re: Lamictal-poop out due to slow titration? » jaby, posted by JahL on October 24, 2001, at 13:37:48
Jaby,
I am just starting lamictal and have noticed something
similar. I feel really positive about an hour after
I take it, but as the afternoon wears on, I feel myself
becoming depressed again. I don't know what to think
of it. I have been considering that it's because
I'm at such a low dose (37.5mg) and not at a therapeutic
level yet.
Posted by jaby on October 24, 2001, at 14:12:20
In reply to Re: Lamictal-poop out due to slow titration? » jaby, posted by JahL on October 24, 2001, at 13:37:48
Thanks for you input. Is there any literature on the 400/40 combo you mentioned? Any luck with it thus far? My diagnosis is kind of in limbo. I started w. GAD w/ depression, but a BP diagnosis is being consider since I've really done better on AED's than anything else. I would say something like BPII becasue I never get any positives. Perhaps my mania is manifested as anxiety. Right now I take neurontin, just started the lamictal, and a tiny bit of valium.
Any more ideas you might have would be appreciated.
Thanks,
Jeff> > I just recently started Lamictal. This is only my third day. The first day I had a tremendously stimulating efect that lifted my depression tremendously. Yesterday I experienced an abrupt diminish of benefit around 4:00 PM. Today the benefit does not seem to be as great either. Those of you that have experience with this med: Have you experienced anything like this? I'm hoping it is just due to the slow titration schedule and that the benefits will eventually return. I plan to adhere to the dosing schedule completely, but will be really bumed if i never regain the way i felt the other day. Well, I had my life back for 1 1/2 days. Hoping for more. Let me now you thoughts/experiences.
>
> Hi.
>
> I had a similar-ish reaction. After about 3 weeks, whilst on only about 25mg, I added Klonopin to Lamictal & w/in a couple of hours I, like y'self, enjoyed a significant lift in mood (which lasted for the day). I was able to replicate this a few times. What's yr dx? I'm BPII & would class my experiences as mild hypomania.
>
> Anyway, this seemed to be the precursor for a sustained, global improvement in all symptomology. This faded over about 6 weeks, tho' I still take Lamictal 4 its mild AD properties & because it helps me think *a little* more clearly. Raising the dose (now at 400mg) -slowly-failed to reinstate the improvement. I've now added 40mg of Prozac. British pdocs at the forefront of developments (which isn't actually saying that much) regard the 400/40mg combo highly. Indeed, it's the first recognised treatment for Depersonalition Disorder. We'll see...
>
> J.
Posted by JahL on October 24, 2001, at 14:50:00
In reply to Re: Lamictal-poop out due to slow titration?, posted by jaby on October 24, 2001, at 14:12:20
> Thanks for you input. Is there any literature on the 400/40 combo you mentioned?
I doubt it. It just seems to have evolved from clinical practice. I'm a med veteran (40-odd & counting) so I've seen a few different pdocs and recently this combo has been recommended to me a number of times. Apparently Lamictal might have mild serotonin reuptake properties & so could theoretically augment SSRIs.
>Any luck with it thus far?
Too early to tell tho' there's certainly no SSRI-worsening & I'm more motivated than I have been 4 a while (which, again isn't saying much).
> My diagnosis is kind of in limbo. I started w. GAD w/ depression, but a BP diagnosis is being consider since I've really done better on AED's than anything else. I would say something like BPII becasue I never get any positives. Perhaps my mania is manifested as anxiety.
Sounds like my condition, right down to the lack of mood reactivity & (limited) response to AEDs.
>Right now I take neurontin, just started the lamictal, and a tiny bit of valium.
For me, Klonopin seems to augment the Lamictal.
> Any more ideas you might have would be appreciated.
Just to be patient with the Lamictal titration. I had the rash once (cleared up quickly tho') & my skin would itch (probably the precursor to the rash) after abrupt dose changes.
J.
Posted by jaby on October 25, 2001, at 13:55:52
In reply to Re: Lamictal-poop out due to slow titration? » jaby, posted by JahL on October 24, 2001, at 14:50:00
Jahl,
I just noticed my face is maybe rashing a bit and had a congested feeling in my chest shortly after having started. I have a problem with cartilage in my sternum that likely accounts for much of that feeling though. What was you rash like (color, shape, location, etc.). My skin is really dry because it is getting cold here, so it's so hard for me to tell anything. Having read a little about the rash now I've got myself freaked. Did you visit the ER for your rash and how did you or your dr. decide to continue? Did you reduce the dosage at all? Any info is appreciated.
Thanks,
J> > Thanks for you input. Is there any literature on the 400/40 combo you mentioned?
>
> I doubt it. It just seems to have evolved from clinical practice. I'm a med veteran (40-odd & counting) so I've seen a few different pdocs and recently this combo has been recommended to me a number of times. Apparently Lamictal might have mild serotonin reuptake properties & so could theoretically augment SSRIs.
>
> >Any luck with it thus far?
>
> Too early to tell tho' there's certainly no SSRI-worsening & I'm more motivated than I have been 4 a while (which, again isn't saying much).
>
> > My diagnosis is kind of in limbo. I started w. GAD w/ depression, but a BP diagnosis is being consider since I've really done better on AED's than anything else. I would say something like BPII becasue I never get any positives. Perhaps my mania is manifested as anxiety.
>
> Sounds like my condition, right down to the lack of mood reactivity & (limited) response to AEDs.
>
> >Right now I take neurontin, just started the lamictal, and a tiny bit of valium.
>
> For me, Klonopin seems to augment the Lamictal.
>
> > Any more ideas you might have would be appreciated.
>
> Just to be patient with the Lamictal titration. I had the rash once (cleared up quickly tho') & my skin would itch (probably the precursor to the rash) after abrupt dose changes.
>
> J.
Posted by JahL on October 25, 2001, at 15:35:25
In reply to Re: Lamictal-poop out due to slow titration?-to Ja, posted by jaby on October 25, 2001, at 13:55:52
> Jahl,
> I just noticed my face is maybe rashing a bit and had a congested feeling in my chest shortly after having started. I have a problem with cartilage in my sternum that likely accounts for much of that feeling though. What was you rash like (color, shape, location, etc.).The reason I developed the rash was because I (stupidly) missed a dose, allowing Lamictal serum levels to drop. The next dose therefore precipitated a steep increase in these levels, which immediately led to the rash. I think it is sharp increases in dose that are responsible for the rash, as opposed to the actual Lamictal dosage. [Moral of the story? Take yr meds at regular intervals]
The rash covered my chest/stomach and looked very much like sunburn; angry & red. The colouring was v. consistent. There was no change of texture to the skin.
The itching, mostly on my arms, usually occurred with each dose increase and would fade after a few days. Again, it was a sensation reminiscent of itching caused by sun damage.
>My skin is really dry because it is getting cold here, so it's so hard for me to tell anything. Having read a little about the rash now I've got myself freaked. Did you visit the ER for your rash and how did you or your dr. decide to continue?
Fortunately the rash had began to fade by the following morning & so I took no action. Besides my pdoc knows less than me so there was no point in consulting him.
Tho' the chances of developing the potentially fatal Stevens-Johnson rash are very small, this depends upon taking prompt action, usually stopping the drug. I would guess that most people here would advise you make immediate contact with yr pdoc for guidance & maybe visit the ER if you are particularly worried (or any rash appears to be worsening).
>Did you reduce the dosage at all?
No. I stayed on the same dose for a week w/o incident before moving up a notch. No problems since.
It might be worth canvassing the opinions & experiences of others here. I have no way of knowing if my rash was typical. I don't think you should panic; just keep an eye on things & act quickly if it becomes evident that you have the rash. FWIW many people have developed the rash & managed to continue by dropping the dose & then proceeding at a slower pace.
Good luck,
J.
Posted by llorona on October 26, 2001, at 20:27:49
In reply to Re: Lamictal-poop out due to slow titration?-to Ja, posted by jaby on October 25, 2001, at 13:55:52
I could not be more discouraged with all of these meds! It's been paxil,sezone, zoloft, effexxor, remeron, wellbutrin, neurontin, klonopin and now lamictal. (Right now, remeron, wellbutrin, neurontin and klonopin for emergencies or when I want to sleep my life away).
I felt no rush of happiness after I took my first 25 mgs. of lamictal. Perhaps this is because I had a neurontin "appointment" scheduled soon after. I am really in a quandry because I can't handle the thought of anything making me too jumpy, but feeling so blah that I think I may never really smile again is a major drag.
My whole life has turned upside down with this looooong episode of depression. Now everything is about paying for meds and trying to decide on a bearable career with health insurance. I was once a performer ( and a good one) but now the comedy mask no longer fits, and my dreams of performing ever again are all but shattered. I was once beautiful and interesting, but now my sadness and flat affect make me wonder if I will ever be lucky enough to worry about sexual side effects from meds.
Sorry to have gone on and on. I guess I just wonder if there will really be a morning. Has lamictal made a palpable difference for anyone? I am really ready to throw in the proverbial towel.
Thanks
Posted by Hattree on October 31, 2001, at 9:02:20
In reply to Re: Lamictal-poop out due to slow titration?-to Ja, posted by llorona on October 26, 2001, at 20:27:49
Lamictal (w/ Zoloft) has made a bigger difference for me than anything, and I've been on a dozen meds.
> I could not be more discouraged with all of these meds! It's been paxil,sezone, zoloft, effexxor, remeron, wellbutrin, neurontin, klonopin and now lamictal. (Right now, remeron, wellbutrin, neurontin and klonopin for emergencies or when I want to sleep my life away).
>
> I felt no rush of happiness after I took my first 25 mgs. of lamictal. Perhaps this is because I had a neurontin "appointment" scheduled soon after. I am really in a quandry because I can't handle the thought of anything making me too jumpy, but feeling so blah that I think I may never really smile again is a major drag.
>
> My whole life has turned upside down with this looooong episode of depression. Now everything is about paying for meds and trying to decide on a bearable career with health insurance. I was once a performer ( and a good one) but now the comedy mask no longer fits, and my dreams of performing ever again are all but shattered. I was once beautiful and interesting, but now my sadness and flat affect make me wonder if I will ever be lucky enough to worry about sexual side effects from meds.
> Sorry to have gone on and on. I guess I just wonder if there will really be a morning. Has lamictal made a palpable difference for anyone? I am really ready to throw in the proverbial towel.
> Thanks
Posted by Cindylou on November 2, 2001, at 19:43:02
In reply to Re: Lamictal-poop out due to slow titration?-to Ja » llorona, posted by Hattree on October 31, 2001, at 9:02:20
Has anyone tried Lamictal plus Serzone?
I have just started Lamictal a few weeks ago, and just increased to 50 mg. I am tired and irritable, and I don't know if it's the Lamictal, or just me and my depression.
My pdoc says the Serzone can help the anxiety/agitation, but that it also causes fatigue. Will I be doomed to have increased fatigue with the Serzone + Lamictal combo? I am med sensitive, and seem to get fatigued by almost all the drugs out there (all the SSRIs, antipsychotics, even stimulants after a few days will poop out and leave me exhausted.)
I keep thinking that MAYBE just maybe I may have a chance with the Serzone working with the Lamictal ...
Would appreciate any feedback out there --
-cindy
Posted by Hattree on November 3, 2001, at 8:12:20
In reply to Re: Lamictal + Serzone anyone?, posted by Cindylou on November 2, 2001, at 19:43:02
I actually don't find Serzone sedating, and I take it along with Zoloft and Lamictal (just recently added it because when I took it in the past it kept my weight under control, and seems to be helping again--never did make me especially tired). I was already doing well on Lamictal, I'm not seeing any particular difference with the Serzone, but I'm not taking very much.
> Has anyone tried Lamictal plus Serzone?
>
> I have just started Lamictal a few weeks ago, and just increased to 50 mg. I am tired and irritable, and I don't know if it's the Lamictal, or just me and my depression.
>
> My pdoc says the Serzone can help the anxiety/agitation, but that it also causes fatigue. Will I be doomed to have increased fatigue with the Serzone + Lamictal combo? I am med sensitive, and seem to get fatigued by almost all the drugs out there (all the SSRIs, antipsychotics, even stimulants after a few days will poop out and leave me exhausted.)
>
> I keep thinking that MAYBE just maybe I may have a chance with the Serzone working with the Lamictal ...
>
> Would appreciate any feedback out there --
>
> -cindy
Posted by VMBW on November 3, 2001, at 19:10:22
In reply to Re: Lamictal-poop out due to slow titration?-to Ja, posted by llorona on October 26, 2001, at 20:27:49
> Don't give up. I've been on every med you mentioned and Lamictal has literally been a life-saver. However, I am on 400mgs daily. I did not have any response with 50 or even 100. You might might want to up the dosage before throwing in the towel on Lamictal buy every day there seems to be more and more successes with Lamictal.
I could not be more discouraged with all of these meds! It's been paxil,sezone, zoloft, effexxor, remeron, wellbutrin, neurontin, klonopin and now lamictal. (Right now, remeron, wellbutrin, neurontin and klonopin for emergencies or when I want to sleep my life away).
>
> I felt no rush of happiness after I took my first 25 mgs. of lamictal. Perhaps this is because I had a neurontin "appointment" scheduled soon after. I am really in a quandry because I can't handle the thought of anything making me too jumpy, but feeling so blah that I think I may never really smile again is a major drag.
>
> My whole life has turned upside down with this looooong episode of depression. Now everything is about paying for meds and trying to decide on a bearable career with health insurance. I was once a performer ( and a good one) but now the comedy mask no longer fits, and my dreams of performing ever again are all but shattered. I was once beautiful and interesting, but now my sadness and flat affect make me wonder if I will ever be lucky enough to worry about sexual side effects from meds.
> Sorry to have gone on and on. I guess I just wonder if there will really be a morning. Has lamictal made a palpable difference for anyone? I am really ready to throw in the proverbial towel.
> Thanks
Posted by Cindylou on November 5, 2001, at 21:01:07
In reply to Re: Lamictal + Serzone anyone?, posted by Hattree on November 3, 2001, at 8:12:20
Thanks, Hattree..
It's good to hear some positive feedback on Serzone -- I was browsing through the archives and found mostly negative reports.If you don't mind me asking, are you bipolar? I just found out that I most likely am bipolar (with mostly depression) so that explains why most antidepressants don't work for me like they do for others. I'm wondering if Serzone will just be another AD that I react negatively to.
Another question -- does the Zoloft make you sedated? I was on it for quite a long time several years ago, and I was exhausted the entire course of treatment. It helped my mood, but I can't afford to be a zombie now that I have a toddler to take care of.
Thanks again for your reply,
cindy> I actually don't find Serzone sedating, and I take it along with Zoloft and Lamictal (just recently added it because when I took it in the past it kept my weight under control, and seems to be helping again--never did make me especially tired). I was already doing well on Lamictal, I'm not seeing any particular difference with the Serzone, but I'm not taking very much.
>
> > Has anyone tried Lamictal plus Serzone?
> >
> > I have just started Lamictal a few weeks ago, and just increased to 50 mg. I am tired and irritable, and I don't know if it's the Lamictal, or just me and my depression.
> >
> > My pdoc says the Serzone can help the anxiety/agitation, but that it also causes fatigue. Will I be doomed to have increased fatigue with the Serzone + Lamictal combo? I am med sensitive, and seem to get fatigued by almost all the drugs out there (all the SSRIs, antipsychotics, even stimulants after a few days will poop out and leave me exhausted.)
> >
> > I keep thinking that MAYBE just maybe I may have a chance with the Serzone working with the Lamictal ...
> >
> > Would appreciate any feedback out there --
> >
> > -cindy
Posted by Hattree on November 6, 2001, at 17:31:05
In reply to Re: Lamictal + Serzone anyone? » Hattree, posted by Cindylou on November 5, 2001, at 21:01:07
Nope, not bipolar. Dysthymia and ADD sans a shred of hyperactivity. I'm lethargic by definition, but not especially more so on Zoloft or Serzone. Without stimulants, my kids kick my butt. Actually, they still kick my butt, but not as hard.
> Thanks, Hattree..
> It's good to hear some positive feedback on Serzone -- I was browsing through the archives and found mostly negative reports.
>
> If you don't mind me asking, are you bipolar? I just found out that I most likely am bipolar (with mostly depression) so that explains why most antidepressants don't work for me like they do for others. I'm wondering if Serzone will just be another AD that I react negatively to.
>
> Another question -- does the Zoloft make you sedated? I was on it for quite a long time several years ago, and I was exhausted the entire course of treatment. It helped my mood, but I can't afford to be a zombie now that I have a toddler to take care of.
>
> Thanks again for your reply,
> cindy
>
> > I actually don't find Serzone sedating, and I take it along with Zoloft and Lamictal (just recently added it because when I took it in the past it kept my weight under control, and seems to be helping again--never did make me especially tired). I was already doing well on Lamictal, I'm not seeing any particular difference with the Serzone, but I'm not taking very much.
> >
> > > Has anyone tried Lamictal plus Serzone?
> > >
> > > I have just started Lamictal a few weeks ago, and just increased to 50 mg. I am tired and irritable, and I don't know if it's the Lamictal, or just me and my depression.
> > >
> > > My pdoc says the Serzone can help the anxiety/agitation, but that it also causes fatigue. Will I be doomed to have increased fatigue with the Serzone + Lamictal combo? I am med sensitive, and seem to get fatigued by almost all the drugs out there (all the SSRIs, antipsychotics, even stimulants after a few days will poop out and leave me exhausted.)
> > >
> > > I keep thinking that MAYBE just maybe I may have a chance with the Serzone working with the Lamictal ...
> > >
> > > Would appreciate any feedback out there --
> > >
> > > -cindy
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.