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Re: lamictal not working?

Posted by SLS on July 16, 2006, at 12:30:20

In reply to lamictal not working?, posted by ciaolavida on July 16, 2006, at 11:52:15

> I've been taking lamictal for 6 weeks and the dose is up to 200 mg. My problem is that the cycling is still just as bad as before, and the severity is nearly as bad, too. (6 or more cycles a day, really REALLY low lows and pretty high highs). Does this mean that lamictal just won't work for me? I'm so confused because it seems to work so well for everyone, and I'm just so sick of it.

True ultradian rapid cyclicity is extremely rare. It is often mistaken for the mood lability seen in borderline personality and related disorders. This does not mean that mood stabilizers do not have a place in their treatment. They do. However, there are specific psychosocial treatments that are designed to aid in the recovery from these illnesses, so accurate diagnosis is important.

I have never seen any medical literature suggesting that Lamictal was successful at treating ultradian bipolar disorder, perhaps because there are so few cases to treat. It is true, however, that Lamictal has been suggested for rapid-cyclicity in general. What other drugs have you tried?

The problem with treating rapid-cyclicity is that it often takes many months before the drug begins to penetrate the cycle. I am unaware of any way to predict which treatments will work in advance. It often makes sense to use two or more mood stabilizers at the same time, if for no other reason but to save time and avoid performing multiple drug trials.

Perhaps you don't cycle, but are really suffering from a mixed-state bipolar presentation. Mood lability / mood-swings / cycling are often the words used by sufferers to describe what they experience. This is easier to treat, and might include antidepressants along with mood stabilizers.

- Scott




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