Psycho-Babble Medication Thread 984341

Shown: posts 1 to 10 of 10. This is the beginning of the thread.

 

Lithium and Lamictal Redundant in Unipolar MDD?

Posted by SLS on May 2, 2011, at 11:16:30

Hi.

I have read a handful of posts that describe lithium and Lamictal as being "redundant" when treating unipolar MDD. Can anyone present evidence that this is indeed true?


- Scott

 

Re: Lithium and Lamictal Redundant in Unipolar MDD? SLS

Posted by Phillipa on May 2, 2011, at 13:02:57

In reply to Lithium and Lamictal Redundant in Unipolar MDD?, posted by SLS on May 2, 2011, at 11:16:30

Personally til came to babble didn't know lithium was used for anything but bipolar. Lamictal was presented to me by my pdoc as a jumpstart so to speak of an SSRI or SNRI. I'd love to also know. Phillipa

 

Re: Lithium and Lamictal Redundant in Unipolar MDD?

Posted by Phillipa on May 2, 2011, at 13:15:22

In reply to Re: Lithium and Lamictal Redundant in Unipolar MDD? SLS, posted by Phillipa on May 2, 2011, at 13:02:57

Not scientific also not limited to just the two above meds but sounds like lithium is better for mania and lamictal better for depression so based on that I feel no not redundant. Don't know if this simple goodle search link will work but will try. Phillipa

http://www.mcmanweb.com/mood-stabilizers.html

 

Re: Lithium and Lamictal Redundant in Unipolar MDD?

Posted by desolationrower on May 2, 2011, at 14:11:30

In reply to Lithium and Lamictal Redundant in Unipolar MDD?, posted by SLS on May 2, 2011, at 11:16:30

I would guess the average study doesn't have enough statistical power to pick up the benefit of both vs just one, so even if you did find such evidence, i would tend to discount it

-d/r

 

Re: Lithium and Lamictal Redundant in Unipolar MDD?

Posted by linkadge on May 2, 2011, at 15:04:03

In reply to Re: Lithium and Lamictal Redundant in Unipolar MDD?, posted by desolationrower on May 2, 2011, at 14:11:30

Do you mean using *both* lithium and lamictal in MDD as an adjunctive?

Linkadge

 

Re: Lithium and Lamictal Redundant in Unipolar MDD? desolationrower

Posted by SLS on May 2, 2011, at 15:16:26

In reply to Re: Lithium and Lamictal Redundant in Unipolar MDD?, posted by desolationrower on May 2, 2011, at 14:11:30

> I would guess the average study doesn't have enough statistical power to pick up the benefit of both vs just one, so even if you did find such evidence, i would tend to discount it
>
> -d/r


Still, it would be nice if those people who provide the statement that lithium and Lamictal are redundant when treating MDD provide some rationale for making it - anything. The two drugs are nothing alike. Even if they did have common biological properties, I can't imagine that anyone could prove that such different molecules can never provide therapeutic results when used in tandem. To say that two drugs are redundant is to say that one should not bother to entertain the notion that combination treatment is worth trying.

Do you think Lamictal can help in unipolar depression? If so, then I feel quite strongly that there is enough proof of concept to study the issue further. There is no doubt that lithium can help as an augmenting agent.

Without providing a reason why lithium and Lamictal are redundant, I don't think one should discourage another from trying combination therapy if nothing else has helped.


- Scott

 

Re: Lithium and Lamictal Redundant in Unipolar MDD?

Posted by bleauberry on May 2, 2011, at 15:50:48

In reply to Lithium and Lamictal Redundant in Unipolar MDD?, posted by SLS on May 2, 2011, at 11:16:30

If they help, no matter what subjective "name" is given to someone's symptoms, then those meds are not redundant. If they do not help, no matter what the name, then they are redundant.

If we are waiting for scientific evidence, I think it is going to be a long wait. If there already exists scientific evidence, it can almost always be scrutinized when put under a microscope.

But I do know where you are coming from. It's all quite frustrating. In my own torturous journeys, the only true answer I could find were in my own personal trials. No amount of scientific evidence made any difference one way or the other. For example what science says should have been helpful, wasn't. And what science didn't even look at or mention, was.

Some people put a lot of faith in white coats. I am not one of those.

The best evidence on lamictal suggests it can "delay" a relapse.

I guess I am a fan of lithium, no matter what the diagnosis is, because it has biological benefits outside of the psychiatric treatment. It is a natural salt of the earth. It's only my opinion, but I think lithium is almost always dosed too high and results are expected too soon. If someone is in the emergency room, then obviously my stance on that is not appropriate. But for long term, I would favor it over lamictal for any kind of depression. The trick is in the size of the dose.

 

Re: Lithium and Lamictal Redundant in Unipolar MDD? linkadge

Posted by SLS on May 2, 2011, at 16:15:50

In reply to Re: Lithium and Lamictal Redundant in Unipolar MDD?, posted by linkadge on May 2, 2011, at 15:04:03

> Do you mean using *both* lithium and lamictal in MDD as an adjunctive?
>
> Linkadge


Yes.

I'm trying to have an open mind, but it seems counterproductive to deem two agents redundant without providing any evidence.

Lithium can always help provide support for recovery of brain tissue, even if no acute antidepressant effect is noticed. Apparently, Lamictal can be helpful in unipolar as well as bipolar depression. I just don't see how these two drugs can be deemed redundant when they do very different things.

- Scott

 

Re: Lithium and Lamictal Redundant in Unipolar MDD? bleauberry

Posted by SLS on May 2, 2011, at 16:29:56

In reply to Re: Lithium and Lamictal Redundant in Unipolar MDD?, posted by bleauberry on May 2, 2011, at 15:50:48

I disagree with you on only two points.

> If they help, no matter what subjective "name" is given to someone's symptoms, then those meds are not redundant. If they do not help, no matter what the name, then they are redundant.

Would we want to say that, globally, Wellbutrin and Effexor are redundant just because they didn't work for SLS?

> The best evidence on lamictal suggests it can "delay" a relapse.

Perhaps when used in a rapid cycling bipolar disorder. I am not sure, though. I am sure, however, that a great many people, including me, experience an acute antidepressant effect, often within the first week. This early response will often disappear, but return several weeks later.


- Scott

 

Re: Lithium and Lamictal Redundant in Unipolar MDD?

Posted by SLS on May 14, 2011, at 5:34:21

In reply to Lithium and Lamictal Redundant in Unipolar MDD?, posted by SLS on May 2, 2011, at 11:16:30

To revisit this issue, I found one paper that helps refute the idea that Lamictal and lithium are redundant.

"These results suggest that postsynaptic 5-HT1A receptors might be involved in the activity of lamotrigine. Furthermore, they demonstrate that lamotrigine more closely resembles valproate and carbamazepine than lithium, with the advantage of an anti-immobility effect in the mouse FST when administered on its own."

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1160563/


- Scott


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