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Re: Lamictal, update Squiggles

Posted by Maximus on August 2, 2002, at 23:03:52

In reply to Re: Lamictal, update Maximus, posted by Squiggles on August 2, 2002, at 21:42:58

> Interesting - i wonder what the advantage
> of this augmentation is over the old
> just lithium dose with Rivotril and/or some
> other benzo.

Well, actually i can not speak for myself yet. "Fingers crossed". However, my pdoc went at so much conferences and contributed at many studies (in that direction), than i tend to believe her.

Grosso modo, here's why:

1- Lithium is "probably" the best anti-manic/hypomanic agent. Lithium is a very well known med. But the Lithium is also "so and so" (generally) for the depression. And Li does almost nothing for the "rapid cyclers". So many many bipolars need an antidepressant for their depression. Not a big deal.

2- Lamictal is without a doubt the best agent (anticonvulsant) for the bipolar depression. More and more studies tend to prove it. The side effect profile is indeed very low. Lamictal is also marvelous for the rapid cycling condition. But its anti-manic properties are weaker than Lithium.

3- There is absolutely no interaction between Lithium and Lamictal. In combo, we need a lower dose of each other. Moreover, in combo the need for a benzo is almost nil.

Their mechanism of action is extremely complicated. But the most important is their action on glutamate receptors via also their own mechanism.

But as you know, in psychiatry, there is no panacea and of course no "one fit for all".

Hope that helps!




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