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lamical with ssri? » Cam W.

Posted by jazzdog on November 2, 2001, at 12:38:42

In reply to Re: will try to get lamictal » adamie, posted by Cam W. on November 1, 2001, at 18:23:58

> Judy - Personally, I have not seen much success using Lamictal™ (lamotrigine) as monotherapy in clinical situation (mind you, I have only seen a few Lamictal monotherapy regimens at the stores I have worked at). It is usually used as an adjunct to other mood stabilizers, like lithium and Epival™ (Depakote™ - divalproex).
> A few placebo-controlled trials (both company- and NIMH-funded) have been done using Lamictal as a monotherapy and in conjunction with another mood stabilizer, in both Bipolar I and Bipolar II patients. Although there were some potential methodologicaal errors in the ways the studies were conducted (eg. no rapid cyclers in a couple of studies; one study was all rapid cyclers; one study was open label; one study, only BPII responded; one study incl. tapering off of lithium which can lead to relapse; one study only used patients already stabilized on Lamictal; etc.) all the studies seemed to end up with about a 50% lamictal response rate and a 20% placebo response rate (weird, huh?).
> So, no matter what you do (use Lamictal with lithium, or by itself), you seem to have a 50-50 chance of having a response to it. I'd be interested to see a "Lamictal Monotherapy v. Lamictal-Depakote" study, but I haven't seen one, yet.
> Sorry to make your decision even more confusing. - Cam

Cam - do you know if any studies have been done with lamictal and ssris? I am about to start on lamictal along with 50 mg. zoloft (which I already take) in an attempt to treat my chronic derealization. The depersonalization unit at Maudsley Hospital in London claim they have had some success with this protocol. Are you familiar with this work? Thanks - a fellow Canadian




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