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Re: Lamictal What the hell is going on wcfrench

Posted by Ritch on March 17, 2003, at 23:25:20

In reply to Lamictal What the hell is going on, posted by wcfrench on March 17, 2003, at 22:30:42

> I started Lamictal about 3 1/2 weeks ago and at first it seemed to be working well. I was able to live in the moment and not get so hung up about everything and overly emotionally obsess on my own ruminating thoughts. I have slowly increased dosage from 50mg/day to 125/day (I have a pretty high tolerance) with no problems but the effect has seem to left me. Do you think it's that I need a higher dose to be effective? I am dx as Bipolar II, and recently (last few days) I have been having mixed states (I think)... basically going between peace and severe anxiety, especially with girls in my life (potential relationships). I hate this. I'll be outgoing and confident one hour, and the next, I'll want to run like a baby because I feel like I am not liked. For God's sake will it stop?
> I was on Depakote before Lamictal and it worked well after about a month (500mg 2x/day, from beginning to end) but I had a huge appetite and was still a little apathetic so I decided to try Lamictal for its antidepressing reputation. I have definitely noticed that it's better in this respect (At least initially) but I don't know where it's going now. I'm also on 100mg Zoloft and 100mg Wellbutrin, having come down a couple months ago from 150 Zoloft and 200 Wellbutrin. I use .5mg Klonopin in social situations.
> I wasn't drinking much but then I had a week or so when I drank for a few nights, maybe 3-4 beers one night, at the most 5 or 6 one night, and on a couple of other nights like 2 beers. Over a week's time, do you think that would screw up my titration schedule? I have heard this, but I asked my pdoc and he said something along the lines of "alcohol doesn't affect as much the absorption of the medicine in the liver as it does have a depressing effect..".. But wouldn't you notice a depressing effect right away and not throughout the next week? I've heard people say that it [alcohol] can lag or slow your medicine intake and it will feel as if you aren't taking any. What do you all think? Too many possibilities!!! Increase dosage? I need stability. Thanks friends.
> Sincerely,
> Charlie

Hi Charlie, I haven't tried Lamictal yet, but I figured I would respond anyhow because I am wondering if you are having a Depakote withdrawal reaction of sorts. Depakote DOES induce a metabolic slowing syndrome (which is responsible for the weight gain it can cause), and reversing that by discontinuing it might ramp up your energy level a little higher than you might be able to handle all at once. 1G is fairly high for BP-II. From what the others here that have tried Lamictal say it seems that you need to be in the 200-400mg range for bipolar. Given that you are on such higher doses of other meds-you probably aren't med sensitive and that might be the target you need to be aiming for. Hope others jump in with some thoughts---Mitch




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