![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 15 to 39 of 82. Go back in thread:
Posted by Chloe on May 29, 2003, at 19:51:46
In reply to Re: ECT fixes TD » Chloe, posted by Ritch on May 28, 2003, at 22:11:19
> Chloe, it seems that you have gotten a bunch of important insight about your cycling from all of your recent ECT experience. For me it is just like a tribal seasonal songdance of sorts. That makes it predictable-which is helpful-but it makes you feel fatalistic about things and sometimes I discount good news too much. That's weird about your meds-lithium+doxepin+diazepam were the first three meds in different classes that I had been on simultaneously-but that was in the early '80's! Depression-wise the lithium worked better than Depakote, but it was a little mean on my thyroid and I only have 1/3 of a thyroid left. I've been quite wirey (predictably) the last few weeks and my pdoc wanted to add some lithium (but I can't handle it very well). We tried some Zonegran and it made me very irritable with insomnia (yuck), and then tried Keppra and that just made me listless and increased my anxiety/depression (slept better though). I haven't tried Lamictal yet.. I'm thinking about bringing it up in a very formal way at my next appt. though. I think if I follow the titration guidelines (despite being on Depakote), that I will be OK. But before I do that I want to add just a *tiny* bit of Buspar (2.5-5.0mg/day) to my current meds of
> Depakote 250mg
> Klonopin .5-.75mg
> Effexor approx. 4-6mg
> Fishoil 1-2G EPA
> I got a very good antianxiety response to Buspar previously-I'm just med sensitive and it made me dysphoric at higher doses (but it causes dysphoria in practically anybody in overdose). Thyroid stuff.... I would like to try that at some point because.... stimulants have been so successful in the past, and I think that adding something that could reduce the cycling and reduce depression/anergia would be a good route to follow.=====take care===MitchHey Mitch,
Can you give me refresher on Zonegran and Keppra? I don't recall their class or what they are used for.
And why the resurgence of Lamictal? There seems to be alot of people wanting to try it. What is your reason, if you don't mind me asking? Is Depakote not working so well? Too bad about the lithium, and your thyroid. I am sorry you lost some of your thyroid. I am glad what you have is working!
I am very happy with lithium as a mood stabilizer. It seems to agree with me. I just wish it helped with the cycling. Nothing touches that. And frankly I am so tired of putting my body through med trials. Way too hard on my little body. So this is it until I can find a better AP for prn use, or I get someone to take my thyroid issues...
Thanks
Chloe
Posted by Ritch on May 29, 2003, at 23:39:59
In reply to Re:Q for Mitch » Ritch, posted by Chloe on May 29, 2003, at 19:51:46
>
> > Chloe, it seems that you have gotten a bunch of important insight about your cycling from all of your recent ECT experience. For me it is just like a tribal seasonal songdance of sorts. That makes it predictable-which is helpful-but it makes you feel fatalistic about things and sometimes I discount good news too much. That's weird about your meds-lithium+doxepin+diazepam were the first three meds in different classes that I had been on simultaneously-but that was in the early '80's! Depression-wise the lithium worked better than Depakote, but it was a little mean on my thyroid and I only have 1/3 of a thyroid left. I've been quite wirey (predictably) the last few weeks and my pdoc wanted to add some lithium (but I can't handle it very well). We tried some Zonegran and it made me very irritable with insomnia (yuck), and then tried Keppra and that just made me listless and increased my anxiety/depression (slept better though). I haven't tried Lamictal yet.. I'm thinking about bringing it up in a very formal way at my next appt. though. I think if I follow the titration guidelines (despite being on Depakote), that I will be OK. But before I do that I want to add just a *tiny* bit of Buspar (2.5-5.0mg/day) to my current meds of
> > Depakote 250mg
> > Klonopin .5-.75mg
> > Effexor approx. 4-6mg
> > Fishoil 1-2G EPA
> > I got a very good antianxiety response to Buspar previously-I'm just med sensitive and it made me dysphoric at higher doses (but it causes dysphoria in practically anybody in overdose). Thyroid stuff.... I would like to try that at some point because.... stimulants have been so successful in the past, and I think that adding something that could reduce the cycling and reduce depression/anergia would be a good route to follow.=====take care===Mitch
>
> Hey Mitch,
> Can you give me refresher on Zonegran and Keppra? I don't recall their class or what they are used for.
> And why the resurgence of Lamictal? There seems to be alot of people wanting to try it. What is your reason, if you don't mind me asking? Is Depakote not working so well? Too bad about the lithium, and your thyroid. I am sorry you lost some of your thyroid. I am glad what you have is working!
> I am very happy with lithium as a mood stabilizer. It seems to agree with me. I just wish it helped with the cycling. Nothing touches that. And frankly I am so tired of putting my body through med trials. Way too hard on my little body. So this is it until I can find a better AP for prn use, or I get someone to take my thyroid issues...
> Thanks
> Chloe
>
>Zonegran and Keppra.... Well, they are the newest anticonvulsants that have been approved (for epilepsy). Of course, pdocs are trying them off-label for bipolar in some of their patients. I have heard little that is positive. I definitely got very irritable on the Zonegran-no doubt. Keppra was very tolerable (physically), and I noticed decreased pain, better sleep, less GI disturbance (which I definitely liked!), but it seemed to slowly make me more and more depressed. That's the trouble with many AED's-they can aggravate or cause psychosis and depression. However, Lamictal (another AED), has a track record for helping bipolar depression specifically. Folks with epilepsy like it because they feel more "normal" or "like themselves" (fewer behavioural side effects). Lamictal is in Phase III trials for an FDA indication for bipolar depression. IOW, it's got the empirical science going for it, it is just the potential rash issues that freak people out (including me). It seems like Lamictal by itself may not be a very good antimanic and probably does little for psychotic symptoms (like lithium can). So it often combined with lithium or Depakote. I am interested in Lamictal as a possible means of getting through my bipolar depressions without needing AD's or not needing to increase the dose of the AD I currently take for anxiety(Effexor) to the point where it aggravates cycling. You might look into Abilify. It has some troubles with insomnia, akathisia, and some irritability in some-so I don't know how it would set with you. The nice thing is that it seems to have little dystonia-and I think that is one thing you have a lot of trouble with AP's---Mitch
Posted by Chloe on May 30, 2003, at 22:00:59
In reply to Re:Q for Mitch » Chloe, posted by Ritch on May 29, 2003, at 23:39:59
> Zonegran and Keppra.... Well, they are the newest anticonvulsants that have been approved (for epilepsy). Of course, pdocs are trying them off-label for bipolar in some of their patients. I have heard little that is positive. I definitely got very irritable on the Zonegran-no doubt. Keppra was very tolerable (physically), and I noticed decreased pain, better sleep, less GI disturbance (which I definitely liked!), but it seemed to slowly make me more and more depressed. That's the trouble with many AED's-they can aggravate or cause psychosis and depression. However, Lamictal (another AED), has a track record for helping bipolar depression specifically. Folks with epilepsy like it because they feel more "normal" or "like themselves" (fewer behavioural side effects). Lamictal is in Phase III trials for an FDA indication for bipolar depression. IOW, it's got the empirical science going for it, it is just the potential rash issues that freak people out (including me). It seems like Lamictal by itself may not be a very good antimanic and probably does little for psychotic symptoms (like lithium can). So it often combined with lithium or Depakote. I am interested in Lamictal as a possible means of getting through my bipolar depressions without needing AD's or not needing to increase the dose of the AD I currently take for anxiety(Effexor) to the point where it aggravates cycling. You might look into Abilify. It has some troubles with insomnia, akathisia, and some irritability in some-so I don't know how it would set with you. The nice thing is that it seems to have little dystonia-and I think that is one thing you have a lot of trouble with AP's---Mitch
Hi Mitch,
What you talk about is fascinating...Most of the AED's I have tried make me feel irritable and blah at the same time. I think that "mixed" kinda state is what lead me to ECT. Thank god for Li in my case. It is interesting though that lamictal is being tried for BP depression. If I remember right, Lamictal had a lot of physical things I really hated, like feeling so achy and uncomfortable in my body. I think it gave me headaches too, and this was all before I reached therapuetic dose! That was hard for me, titrating up so slowly. But you don't want to get that rash. If you do try it, I really hope it's beneficial to you...
Thanks, my pdoc mention abilify to me. But when I did a smallest amount of research, I say the side effects you mentioned. Irritability is one of my biggest problems. I have an extremely short fuse. And so I don't want to try a med that might work like gasoline. I also fear insomnia. Some days are so hard and so long, the thought of not being able to sleep through part of it is terrifying. But so are these tongue and jaw problems. I wish I knew if it's ok to even take Seroquel if it exacerbates my movements. Is there any way to know if the movements will get worse? They don't seem to be worse than when I was on Thorazine/Mellaril. The movements kinda stopped at the level where I d/c'd those typical AP's. Oh, back when Clozaril first came out I was put on that. It worked so great, no tongue stuff, no chronic suicidal thoughts. But I got the dreaded agranularcytosis. Go figure.
Well, I guess I am just rambling. I hope you like Lamictal-if you go for it.
Take care
Chloe
Posted by Ritch on May 30, 2003, at 22:33:52
In reply to Re:Q for Mitch » Ritch, posted by Chloe on May 30, 2003, at 22:00:59
> Hi Mitch,
> What you talk about is fascinating...Most of the AED's I have tried make me feel irritable and blah at the same time. I think that "mixed" kinda state is what lead me to ECT. Thank god for Li in my case. It is interesting though that lamictal is being tried for BP depression. If I remember right, Lamictal had a lot of physical things I really hated, like feeling so achy and uncomfortable in my body. I think it gave me headaches too, and this was all before I reached therapuetic dose! That was hard for me, titrating up so slowly. But you don't want to get that rash. If you do try it, I really hope it's beneficial to you...
> Thanks, my pdoc mention abilify to me. But when I did a smallest amount of research, I say the side effects you mentioned. Irritability is one of my biggest problems. I have an extremely short fuse. And so I don't want to try a med that might work like gasoline. I also fear insomnia. Some days are so hard and so long, the thought of not being able to sleep through part of it is terrifying. But so are these tongue and jaw problems. I wish I knew if it's ok to even take Seroquel if it exacerbates my movements. Is there any way to know if the movements will get worse? They don't seem to be worse than when I was on Thorazine/Mellaril. The movements kinda stopped at the level where I d/c'd those typical AP's. Oh, back when Clozaril first came out I was put on that. It worked so great, no tongue stuff, no chronic suicidal thoughts. But I got the dreaded agranularcytosis. Go figure.
> Well, I guess I am just rambling. I hope you like Lamictal-if you go for it.
> Take care
> ChloeChloe, It seems that lithium is definitely the right antimanic/antipsychotic med for you. I had some decent response in the past with Mellaril (10-30mg hs), but I have a cataract and one pigmented retina from just three years of use. So I really don't want any AP's at all of any kind. I've never been able to hack taking any one of them long term. Headache can be a big side effect for Lamictal users from what I've read here. I will get into that probably sooner or later.---Mitch
Posted by Chloe on May 31, 2003, at 10:36:11
In reply to Re:Q for Mitch » Chloe, posted by Ritch on May 30, 2003, at 22:33:52
> > Hi Mitch,
> > What you talk about is fascinating...Most of the AED's I have tried make me feel irritable and blah at the same time. I think that "mixed" kinda state is what lead me to ECT. Thank god for Li in my case. It is interesting though that lamictal is being tried for BP depression. If I remember right, Lamictal had a lot of physical things I really hated, like feeling so achy and uncomfortable in my body. I think it gave me headaches too, and this was all before I reached therapuetic dose! That was hard for me, titrating up so slowly. But you don't want to get that rash. If you do try it, I really hope it's beneficial to you...
> > Thanks, my pdoc mention abilify to me. But when I did a smallest amount of research, I say the side effects you mentioned. Irritability is one of my biggest problems. I have an extremely short fuse. And so I don't want to try a med that might work like gasoline. I also fear insomnia. Some days are so hard and so long, the thought of not being able to sleep through part of it is terrifying. But so are these tongue and jaw problems. I wish I knew if it's ok to even take Seroquel if it exacerbates my movements. Is there any way to know if the movements will get worse? They don't seem to be worse than when I was on Thorazine/Mellaril. The movements kinda stopped at the level where I d/c'd those typical AP's. Oh, back when Clozaril first came out I was put on that. It worked so great, no tongue stuff, no chronic suicidal thoughts. But I got the dreaded agranularcytosis. Go figure.
> > Well, I guess I am just rambling. I hope you like Lamictal-if you go for it.
> > Take care
> > Chloe
>
> Chloe, It seems that lithium is definitely the right antimanic/antipsychotic med for you. I had some decent response in the past with Mellaril (10-30mg hs), but I have a cataract and one pigmented retina from just three years of use. So I really don't want any AP's at all of any kind. I've never been able to hack taking any one of them long term. Headache can be a big side effect for Lamictal users from what I've read here. I will get into that probably sooner or later.---MitchWow, AP's really are the devil. I am sorry you developed eye problems. It's very scary that a med class that is so effective on symptoms, can be so potentially dangerous in terms of *permanant* side effects. I just wish so badly, that there was a med out there that would help with the intermitant rage, distorted thinking and suicidal ideation "attacks." There doesn't seem to any substitute for me so far. I'm just thankful I don't need AP's that often.
Good luck finding the right cocktail. I admire your stick-to-itness!
Take care,
Chloe
Posted by Ritch on June 1, 2003, at 9:54:38
In reply to Re: AP's.. » Ritch, posted by Chloe on May 31, 2003, at 10:36:11
> > Chloe, It seems that lithium is definitely the right antimanic/antipsychotic med for you. I had some decent response in the past with Mellaril (10-30mg hs), but I have a cataract and one pigmented retina from just three years of use. So I really don't want any AP's at all of any kind. I've never been able to hack taking any one of them long term. Headache can be a big side effect for Lamictal users from what I've read here. I will get into that probably sooner or later.---Mitch
>
> Wow, AP's really are the devil. I am sorry you developed eye problems. It's very scary that a med class that is so effective on symptoms, can be so potentially dangerous in terms of *permanant* side effects. I just wish so badly, that there was a med out there that would help with the intermitant rage, distorted thinking and suicidal ideation "attacks." There doesn't seem to any substitute for me so far. I'm just thankful I don't need AP's that often.
> Good luck finding the right cocktail. I admire your stick-to-itness!
> Take care,
> ChloeChloe, they really help a lot of people though. I remember when I was taking Mellaril my pdoc was always asking me stuff like: "Do you think you could take a little *more*?" ;) Usually 10mg at bedtime was all I ever took, and mainly just for anxiety and sleep. Getting up the next day was really pleasant-much less foggy-headed than with the newer ones I've tried. For me, lithium just didn't get onto the cycling like Depakote does. It just takes a lot of work NOT to be on them!--Mitch
Posted by maryhelen on June 1, 2003, at 14:36:06
In reply to Re: AP's.. » Chloe, posted by Ritch on June 1, 2003, at 9:54:38
I feel so discouraged by what I read in other posts about Lamitcal. It seems that most people are getting a great response and then it poops out.
I am on 90 mg of Parnate and had to augment because it started to lose it's effect. I augmented it with Lithium but when I went to 1200 mg. the side effects began. Even going back down I was left with tremors, twitching, hair loss, but worst of all my mind was dull and I wasn't getting things. I have just returned to work and I could not tolerate these side effects.
Unfortunaley, the Lithium did have an anti-depressant effect. The doctor put me on Lamitcal and I now am at 100 mg. after a month. I have never felt better. I have treatment resistant depression and have tried more meds than I can name, including 2 separate rounds of ECT. Now I am scared that the Lamitcal will poop out and I cannot go back into that depression and keep my job.Anyone had good, long lasting results with Lamitcal.
Thanks,
maryhelen
Posted by Ritch on June 1, 2003, at 16:59:09
In reply to Re: AP's.., posted by maryhelen on June 1, 2003, at 14:36:06
> I feel so discouraged by what I read in other posts about Lamitcal. It seems that most people are getting a great response and then it poops out.
>
> I am on 90 mg of Parnate and had to augment because it started to lose it's effect. I augmented it with Lithium but when I went to 1200 mg. the side effects began. Even going back down I was left with tremors, twitching, hair loss, but worst of all my mind was dull and I wasn't getting things. I have just returned to work and I could not tolerate these side effects.
> Unfortunaley, the Lithium did have an anti-depressant effect. The doctor put me on Lamitcal and I now am at 100 mg. after a month. I have never felt better. I have treatment resistant depression and have tried more meds than I can name, including 2 separate rounds of ECT. Now I am scared that the Lamitcal will poop out and I cannot go back into that depression and keep my job.
>
> Anyone had good, long lasting results with Lamitcal.
>
> Thanks,
>
> maryhelen
Maryhelen, I've been closely reading posts about Lamictal as well, because I would like to go for a trial myself at some point in the future. However, I wouldn't get prematurely discouraged about the "poop-out" phenomenon. I can't remember a post from a unipolar depressive on Lamictal that found a quick success then a poopout. Everything I'm reading relates to bipolar's experience with the stuff. I'm beginning to wonder whether some of the poop-out phenomenon you are hearing about may be the "mood stabilizing" or antimanic effects of Lamictal becoming more prominent with time being on the drug. If my "highs" were *totally* gone-I would feel deprived in some ways. I also wonder if there is a tricky dose range that people may be going past as well. Or to complicate matters-an optimum relatively narrow dose range that "moves around". I hope things continue to work for you-remember it still IS a success!
Posted by maryhelen on June 1, 2003, at 19:16:02
In reply to Re: Lamictal success stories?? » maryhelen, posted by Ritch on June 1, 2003, at 16:59:09
Thank you so much for responding to my post Ritch. There was so much information and I was wondering and selfishing hoping that this wasn't so much referring to my treatment resistant depression. You have given me an instant boost and hope. I will just go with the good feeling I have and pray for the best.
The knowledge and support you share is incredible and I thank you so much.
maryhelen
Posted by colin wallace on June 3, 2003, at 9:07:59
In reply to Re: Lamictal success stories for Ritch, posted by maryhelen on June 1, 2003, at 19:16:02
Maryhelen,
I've been taking Lamictal now for almost a year, and yes, it can be a tricky med. to get to grips with.Titrating can be difficult at first,with many experiencing a degree of irritability which can be managed by making smaller increments.
Then, strangely there comes a point(round about 50mg) where dose increases become easy, and any irritability can be managed by 25mg increases!
200mg seems to yield good results(some here have reached 500mg or so-I hit 400mg myself),although the 'poop-out' phenomenon(which I ran into aswell)can simply mean that you'll need an additional antidepressant thrown in.
I now take 250mg Lamictal, and 10mg Prozac has reinforced the Lam. effect-I'm still doing very well indeed.
(I've been diagnosed BP11 and was previously treatment resistant, and unable to tolerate even tiny doses of most antidepressants.)
Hope this helps a little.It's a great med overall.Best,
Col.
Posted by Ritch on June 3, 2003, at 9:19:51
In reply to Re: Lamictal success stories for Ritch » maryhelen, posted by colin wallace on June 3, 2003, at 9:07:59
> Maryhelen,
>
>
> I've been taking Lamictal now for almost a year, and yes, it can be a tricky med. to get to grips with.Titrating can be difficult at first,with many experiencing a degree of irritability which can be managed by making smaller increments.
> Then, strangely there comes a point(round about 50mg) where dose increases become easy, and any irritability can be managed by 25mg increases!
> 200mg seems to yield good results(some here have reached 500mg or so-I hit 400mg myself),although the 'poop-out' phenomenon(which I ran into aswell)can simply mean that you'll need an additional antidepressant thrown in.
> I now take 250mg Lamictal, and 10mg Prozac has reinforced the Lam. effect-I'm still doing very well indeed.
> (I've been diagnosed BP11 and was previously treatment resistant, and unable to tolerate even tiny doses of most antidepressants.)
> Hope this helps a little.It's a great med overall.
>
> Best,
>
> Col.Colin, I'm glad that you're doing well! I noticed that you *decreased* the dosage of the Lamictal from 400mg down to 250mg. Was it because you found that 250mg was plenty enough and that more didn't seem to make much difference? Just wondering... I've read some of your other posts about irritability.. did the Prozac wind up helping with the irritability or did it resolve on its own by being on the Lamictal? thanks in advance for any resonses, thinking about trying this sometime soon... maybe start getting ramped up on it in time for wintertime!
Posted by colin wallace on June 3, 2003, at 15:04:25
In reply to Re: Lamictal success stories for Ritch » colin wallace, posted by Ritch on June 3, 2003, at 9:19:51
From this page you can confirm your post, revise your post, or register if you haven't already.
--------------------------------------------------------------------------------Confirm your post:
Re: Lamictal success stories for Ritch
Board: Psycho-Babble
Email: will notify of follow-ups
Language: English
>
>
> Colin, I'm glad that you're doing well! I noticed that you *decreased* the dosage of the Lamictal from 400mg down to 250mg. Was it because you found that 250mg was plenty enough and that more didn't seem to make much difference? Just wondering... I've read some of your other posts about irritability.. did the Prozac wind up helping with the irritability or did it resolve on its own by being on the Lamictal? thanks in advance for any resonses, thinking about trying this sometime soon... maybe start getting ramped up on it in time for wintertime! ##
Emperor Mitch!My experience with Lamictal was that, initially, I was determined to go it alone with monotherapy,and I suppose that makes my responses to the med. 'untainted'at least.
200mg seemed to be the magic threshold for me, and it gave superb results- depression all but vanished,no traces of anxiety or irritability, functioning improved(I couldn't even put a tent up pre-lamictal, I recall;it was beyond me).
Yes, the effect waned after a while(sudden breakthrough irritability/swings/depression), but was quickly recaptured by whacking up another 50mg.I remember planning in advance for a 300mg cut-off point, whereby if the effect faded,I'd throw in reinforcements of some type-wasn't at all sure what to try.
With me, when the effect faded, my world just cracked into pieces, and any rainy/overcast weather would hammer me, and keep me groaning in bed.
Anyway, I hung in there until 400mg, and realised that the pattern was set, and that when 400mg faded too, the effect I was left with was *just the same* as at 200mg.Inadequate by itself.
I'd long suspected that my anger/irritability issues were due at least in part to low seratonin levels(ssri's had helped, but also made me giddy, high 'socially inappropriate'and/or angry).Not ideal, but neither was anything else.
One day, during filthy grey weather, I just took a whole 20mg Prozac(desperation) whilst waiting for a psych. appointment to ask for some lith. and a TCA, as per my contingency plan.
To my amazement, I got a mild but noticable uplift in mood,and none of the unwanted effects.I did this for a few weeks, just to get me through short-term, but by then I'd noticed I was having fewer anger swings.
As it happened, my psych. went sick,and my appointment was postponed for 3 months, so I thought what the hell, let's give it a shot in the meantime.
That was 9 weeks ago, taking 250mg Lamictal,and 20mg Prozac on alternate days.In short, I began to feel much better overall, the weather bothered me less, and I began to feel much more sociable and definitely, far less angry, bitter mood swings.
It felt like a healthy med. synergy;the Prozac bolstered the Lamictal, the Lamictal 'tempered' the Prozac, and the Lamictal effect seemed recaptured.
I still have some distance to go, and other contingency plans to tinker around with if necessary(I've cautiously added some NADH to head off any possible ssri anerga), but so far, so good.
I hope you do give it a shot, because if I remember rightly, you're taking a low dose AD already??Whatever happens, I'm sure it will bring you up another level at least, and help smoothe out those swings.
As for next winter, I'm looking forward to that like I'd look forward to stapling my %%%%% to the ceiling on Christmas day.
Let us know how ya get on mate.Col.
--------------------------------------------------------------------------------Emperor Mitch!
My experience with Lamictal was that, initially, I was determined to go it alone with monotherapy,and I suppose that makes my responses to the med. 'untainted'at least.
200mg seemed to be the magic threshold for me, and it gave superb results- depression all but vanished,no traces of anxiety or irritability, functioning improved(I couldn't even put a tent up pre-lamictal, I recall;it was beyond me).
Yes, the effect waned after a while(sudden breakthrough irritability/swings/depression), but was quickly recaptured by whacking up another 50mg.I remember planning in advance for a 300mg cut-off point, whereby if the effect faded,I'd throw in reinforcements of some type-wasn't at all sure what to try.
With me, when the effect faded, my world just cracked into pieces, and any rainy/overcast weather would hammer me, and keep me groaning in bed.
Anyway, I hung in there until 400mg, and realised that the pattern was set, and that when 400mg faded too, the effect I was left with was *just the same* as at 200mg.Inadequate by itself.
I'd long suspected that my anger/irritability issues were due at least in part to low seratonin levels(ssri's had helped, but also made me giddy, high 'socially inappropriate'and/or angry).Not ideal, but neither was anything else.
One day, during filthy grey weather, I just took a whole 20mg Prozac(desperation) whilst waiting for a psych. appointment to ask for some lith. and a TCA, as per my contingency plan.
To my amazement, I got a mild but noticable uplift in mood,and none of the unwanted effects.I did this for a few weeks, just to get me through short-term, but by then I'd noticed I was having fewer anger swings.
As it happened, my psych. went sick,and my appointment was postponed for 3 months, so I thought what the hell, let's give it a shot in the meantime.
That was 9 weeks ago, taking 250mg Lamictal,and 20mg Prozac on alternate days.In short, I began to feel much better overall, the weather bothgered me less, and I began to feel much more sociable and definitely, far less angry, bitter mood swings.
It felt like a healthy med. synergy;the Prozac bolstered the Lamictal, the Lamictal 'tempered' the Prozac, and the Lamictal effect seemed recaptured.
I still have some distance to go, and other contingency plans to tinker around with if necessary(I've cautiously added some NADH to head off any possible ssri anerga), but so far, so good.
I hope you do give it a shot, because if I remember rightly, you're taking a low dose AD already??Whatever happens, I'm sure it will bring you up another level at least, and help smoothe out those swings.
As for next winter, I'm looking forward to that like I'd look forward to stapling my %%%%% to the ceiling on Christmas day.
Let us know how ya get on mate.Col.
-------------------------------------------------------------------------
Posted by katia on June 3, 2003, at 15:45:56
In reply to Re: Lamictal success stories for Ritch » maryhelen, posted by colin wallace on June 3, 2003, at 9:07:59
Hi Colin,
I noticed that you have a dx of bpII. When were you diagnosed? I'm going in for an appt. with a good pdoc in two weeks and have yet to receive a proper dx after a year of four different ADs. The more I research and hear about BPII, the more I think there's more going on with me than just unipolar depression. I have an inkling that's what my dx will be, that or some mixed state of depression/bipolar II. How long did it take you to be accurately dxed? and what was your med history like up to Lamictal? and what have your "symptoms" been? thanks.
Katia
Posted by starlight on June 3, 2003, at 15:48:36
In reply to Re: Lamictal success stories for Ritch » Ritch, posted by colin wallace on June 3, 2003, at 15:04:25
I've gone up 25mgs to a total of 100 mgs per day and am going up another 50 on Thursday. I've never had a 50mg increase so I'm interested to see the difference. I like the drug but have also noticed that it seems to lose effectiveness. I recall from Dr. Bowden's lecture that there was an effectiveness threshold, does anyone remember what that was?
So I'll be hitting 150 Thurs. I'm still on the trileptal, but would give anything to just be able to take one drug that had no side effects.
starlight
Posted by Peter S. on June 3, 2003, at 16:17:39
In reply to Re: AP's.., posted by maryhelen on June 1, 2003, at 14:36:06
Hi all,
Lamictal is still an enigma to me. It was great for a couple of months and then started to poop out. Now I take 50mg in the morning and it gives me a boost but then poops out in the afternoon. I was up to 600mg but it seems like 50mg works just as well as any higher dose. I've tried Prozac as augmentation which seemed to work for a while but then pooped out too. I'm thinking of trying another SSRI like Lexapro.
It's great to hear other people's experiences!
Posted by Ritch on June 3, 2003, at 22:47:22
In reply to Re: Lamictal success stories for Ritch » Ritch, posted by colin wallace on June 3, 2003, at 15:04:25
Colin, thanks for responding! I don't want to try to start Lamictal until after my summertime depression is over with (in late August/early September). That gives me time to titrate during a fairly stable period. No mixed stuff ever happens to me in the fall/winter-I just turn into a hibernating, tired, hungry, atypical unipolar depressive. Depakote does diddly for my depression, it only works on mania and hostility. The little bit of Effexor I take works fairly well for grouchiness anyhow. Who knows maybe I can get off Depakote and Klonopin and just take Lamical+low Effexor? Wow, two meds. It's been awhile. Take care dude!
Posted by Ritch on June 3, 2003, at 22:51:52
In reply to Lamictal Experiences, posted by Peter S. on June 3, 2003, at 16:17:39
> Hi all,
>
> Lamictal is still an enigma to me. It was great for a couple of months and then started to poop out. Now I take 50mg in the morning and it gives me a boost but then poops out in the afternoon. I was up to 600mg but it seems like 50mg works just as well as any higher dose. I've tried Prozac as augmentation which seemed to work for a while but then pooped out too. I'm thinking of trying another SSRI like Lexapro.
>
> It's great to hear other people's experiences!
>
>Peter, thanks for relaying that info! I wonder also that Lamictal may have a fairly flat dose-response curve for bipolar. No need spending more money or your liver processing more medication than it has to. I wouldn't be surprised if I went up in 5mg increments every two weeks that 25mg would be sufficient.
Posted by maryhelen on June 4, 2003, at 7:23:16
In reply to Re: Lamictal Experiences » Peter S., posted by Ritch on June 3, 2003, at 22:51:52
I posted on June 1st and felt great. Yesterday, I could feel my mood slipping.
A situation with speaking with my boss is imperative to me, not because I am getting fired, but she had slandered me when I was away. I have to feel in top mental condition to be able to do this effectively,and I was.
I am on Parnate 90 mg and 100 mg. Lamitcal. I tried reaching my pdoc to see if I should tirate another 25 mg, but can't wait, so I am today. I do understand that it may take him a bit to get back to me with hospitals closing in Toronto.
Do you think this is okay? Do I take the extra dose in the morning, as I have done?
Any help would be appreciated.
maryhelen
Posted by Ritch on June 4, 2003, at 9:35:22
In reply to Re: Lamictal Experiences, posted by maryhelen on June 4, 2003, at 7:23:16
> I posted on June 1st and felt great. Yesterday, I could feel my mood slipping.
>
> A situation with speaking with my boss is imperative to me, not because I am getting fired, but she had slandered me when I was away. I have to feel in top mental condition to be able to do this effectively,and I was.
>
> I am on Parnate 90 mg and 100 mg. Lamitcal. I tried reaching my pdoc to see if I should tirate another 25 mg, but can't wait, so I am today. I do understand that it may take him a bit to get back to me with hospitals closing in Toronto.
>
> Do you think this is okay? Do I take the extra dose in the morning, as I have done?
>
> Any help would be appreciated.
>
> maryhelenMaryhelen, the only titration schedule I've seen is at: http://www.psycheducation.org/depression/meds/lamotrigine.htm
They are using 1/2 of 25mg pills per week to titrate up to 100mg. Beyond that I don't know what is acceptable. Maybe you can talk to a nurse at your doctor's office or a colleague. You don't want to get the rash.
Posted by colin wallace on June 4, 2003, at 12:42:42
In reply to Re: Lamictal Experiences, posted by maryhelen on June 4, 2003, at 7:23:16
> I posted on June 1st and felt great. Yesterday, I could feel my mood slipping.
>
> A situation with speaking with my boss is imperative to me, not because I am getting fired, but she had slandered me when I was away. I have to feel in top mental condition to be able to do this effectively,and I was.
>
> I am on Parnate 90 mg and 100 mg. Lamitcal. I tried reaching my pdoc to see if I should tirate another 25 mg, but can't wait, so I am today. I do understand that it may take him a bit to get back to me with hospitals closing in Toronto.
>
> Do you think this is okay? Do I take the extra dose in the morning, as I have done?
>
> Any help would be appreciated.
>
> maryhelenMaryhelen,
Once you're safely past say,the 75mg mark with no adverese experiences, 25mg increments should be fine, and work fairly quickly.
If you're med sensitive, or experience unmanageable irritability, go with a 12.5mg increase instead(I used a pill splitter when I first started Lamictal and took tiny doses).Best,
Col.
Ps. I safely jumped up in 50mg increments once I'd past 100mg, and I'm med sensitive too.
Also, you could try taking the extra 25mg in the evening(say 5 pm) if it doesn't interfere with your sleep.Some find this helps sustain the effect.
Posted by starlight on June 4, 2003, at 14:11:05
In reply to Re: Lamictal success stories for Ritch » colin wallace, posted by Ritch on June 3, 2003, at 22:47:22
Ritch,
I wouldn't wait to start the lamictal - I was really, really down on just the trileptal and I definitely got a good boost from the lamictal, and I also got a nice anti anxiety feeling, or a less agitated feeling.Of other note, I go up 50mgs tomorrow. So that should be interesting. I'll be at 150. I'm surprised to see such high doses at times and am hoping that this will do it for me.
starlight
Posted by Peter S. on June 4, 2003, at 15:22:14
In reply to Re: Lamictal Experiences » Peter S., posted by Ritch on June 3, 2003, at 22:51:52
Hi Ritch,
I generally titrate up in 50mg increments and have had no problem with skin rash. Of course that's just me and it's worth being very careful because of the risk. I wish you the best of luck with it! Keep us updated, and if I find some way to augment the Lamictal effectively I'll definitely post about it.
Peter
> > Hi all,
> >
> > Lamictal is still an enigma to me. It was great for a couple of months and then started to poop out. Now I take 50mg in the morning and it gives me a boost but then poops out in the afternoon. I was up to 600mg but it seems like 50mg works just as well as any higher dose. I've tried Prozac as augmentation which seemed to work for a while but then pooped out too. I'm thinking of trying another SSRI like Lexapro.
> >
> > It's great to hear other people's experiences!
> >
> >
>
> Peter, thanks for relaying that info! I wonder also that Lamictal may have a fairly flat dose-response curve for bipolar. No need spending more money or your liver processing more medication than it has to. I wouldn't be surprised if I went up in 5mg increments every two weeks that 25mg would be sufficient.
>
>
Posted by Ritch on June 4, 2003, at 23:53:43
In reply to Re: Lamictal success stories for Ritch, posted by starlight on June 4, 2003, at 14:11:05
> Ritch,
> I wouldn't wait to start the lamictal - I was really, really down on just the trileptal and I definitely got a good boost from the lamictal, and I also got a nice anti anxiety feeling, or a less agitated feeling.
>
> Of other note, I go up 50mgs tomorrow. So that should be interesting. I'll be at 150. I'm surprised to see such high doses at times and am hoping that this will do it for me.
> starlight
>Well, I'm a little hesitant about it because I have had skin reactions to meds in the past and I am taking Depakote (which complicates things) and reasonably stable now. You said you had an antianxiety effect from the Lamictal? Can you elaborate on that a little? The Depakote I take helps a little with my panic disorder, I just wonder if Lamical would have any *antipanic* properties. thanks for responding.
Posted by Ritch on June 4, 2003, at 23:59:20
In reply to Re: Lamictal Experiences » Ritch, posted by Peter S. on June 4, 2003, at 15:22:14
My next appointment comes up fairly soon, and it will be my last appointment before I dive into my summertime depressive episode. I didn't want to try Lamictal for this episode because I would titrate the slowest possible way and I would be in the thick of everything at too low a dose to see if it helps much. Also, I tend to get some mixed symptoms during the summer and don't want that to mess with the trial. I want plain-jane vanilla unipolar atypical depressive symptoms for it to tackle (in the wintertime episode), and I want a stable period to ramp up very slowly before that (September+October). thanks!
> Hi Ritch,
>
> I generally titrate up in 50mg increments and have had no problem with skin rash. Of course that's just me and it's worth being very careful because of the risk. I wish you the best of luck with it! Keep us updated, and if I find some way to augment the Lamictal effectively I'll definitely post about it.
>
> Peter
>
>
> > > Hi all,
> > >
> > > Lamictal is still an enigma to me. It was great for a couple of months and then started to poop out. Now I take 50mg in the morning and it gives me a boost but then poops out in the afternoon. I was up to 600mg but it seems like 50mg works just as well as any higher dose. I've tried Prozac as augmentation which seemed to work for a while but then pooped out too. I'm thinking of trying another SSRI like Lexapro.
> > >
> > > It's great to hear other people's experiences!
> > >
> > >
> >
> > Peter, thanks for relaying that info! I wonder also that Lamictal may have a fairly flat dose-response curve for bipolar. No need spending more money or your liver processing more medication than it has to. I wouldn't be surprised if I went up in 5mg increments every two weeks that 25mg would be sufficient.
> >
> >
>
>
Posted by colin wallace on June 5, 2003, at 5:13:09
In reply to Re: Lamictal success stories for Ritch » colin wallace, posted by katia on June 3, 2003, at 15:45:56
> Hi Colin,
> I noticed that you have a dx of bpII. When were you diagnosed? I'm going in for an appt. with a good pdoc in two weeks and have yet to receive a proper dx after a year of four different ADs. The more I research and hear about BPII, the more I think there's more going on with me than just unipolar depression. I have an inkling that's what my dx will be, that or some mixed state of depression/bipolar II. How long did it take you to be accurately dxed? and what was your med history like up to Lamictal? and what have your "symptoms" been? thanks.
> Katia
Hi Katia,Actually, from the word go (a little over three years ago) I knew that my depression wasn't run of the mill.When I took my first AD (fluoxetine)I experienced wild mood swings, euphoria,awful anger,panic, etc. etc.Unfortunately, my responses to every other AD I tried (without a mood stabilizer) were equally unpleasant-effexor was the worst, Remeron the least offensive, although my moods were still off the wall.
I had excellent results with Sam-e for a while, but again, no mood-stabilizer, eventual mixed state response.
It would take too long to detail every treatment option I've tried, suffice it to say that basically, the only things I've yet to try are the MAOI's and AP's.
The information I'd gleened from this board, and from other posters with similar responses led me believe I was somewhere on the BP side of things, although my GP was unconvinced-until that is, I went into full blown hypomania on Zoloft.
My initial diagnosis was 'double depression', but my psych. at the time conceded that I 'might' be BP 11.I think he agreed this, just to keep me happy!!
Actually, I've given up attaching too much importance on my diagnosis-I don't care to pin labels on myself, I'm only concerned about what works.
My new psych. however, does believe me to be BP11, and once I'd experienced stability on Lamictal, and began to react 'normally' to antidepressants, this was confirmed.
Best,
Col.
Go forward in 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.