Posted by Dwight on January 7, 2001, at 22:37:34
In reply to Re: Does Lamictal cause memory problems?, posted by SLS on January 6, 2001, at 19:37:26
Thanks for all the information, SLS. I may try the Lamictal at some point, but I'm a writer and in grad. school right now so my memory is vital. I'm wary of anything that might affect my memory. I'm thinking of going back to Nardil, even though I know I'll get fat again.
> Hi again.
>
> I forgot to mention that for mood-disorders, Lamictal monotherapy has been found to be significantly more effective than Neurontin. Together, they make a good combination in treatment-resistant cases according to NIMH studies.
>
> ---------------------------------------------
>
> From
> Journal of Clinical Psychopharmacology
> December 2000 (Volume 20, Number 6)
>
>
> A Placebo-Controlled Study of Lamotrigine and Gabapentin Monotherapy in Refractory Mood Disorders
>
> Frye MA, Ketter TA, Kimbrell TA, et al
>
> J Clin Psychopharmacol. 2000;20:607-614
>
> The standard pharmacologic agents used in the treatment of bipolar disorder (ie, lithium, divalproex sodium, and carbamazapine) are all limited in terms of effectiveness and side effects. Refractory affective illness is therefore a particularly difficult issue for clinicians and patients. The authors attempted to examine the efficacy of 2 third-generation anticonvulsants, lamotrigine and gabapentin, in the treatment of refractory bipolar illness. They examined 31 patients with refractory bipolar illness and placed them in a double-blind randomized series of 6-week crossover trials of lamotrigine, gabapentin, and placebo. The patients responded most robustly to the lamotrigine, with a response rate of 52%, vs rates of 26% for gabapentin and 23% for placebo. The mean dosages were 274 mg/d for lamotrigine and 3987mg/d for gabapentin. The medications were generally well tolerated, with 1 patient developing a rash that necessitated discontinuation of lamotrigine. The authors concluded that lamotrigine held promise as monotherapeutic agent for the treatment of refractory bipolar illness, whereas gabapentin seemed to hold more promise as an adjunctive agent.
>
>
> ---------------------------------------------
>
>
> > Hi Dwight,
> >
> > I would have responded to your post earlier had I not forgotten to do so.
> >
> > :-)
> >
> > > I have found Neurontin quite helpful for my social anxiety, but I only take it rarely now because it causes memory problems. Does lamictal also cause memory problems? Does it work in a way similar to Neurontin?
> >
> > Lamictal can disrupt memory quite a bit at high dosages. At 450mg, while driving, I would all of a sudden not recognize roads that I have driven down all of my life. Perhaps worse, at the same time, I would forget where I was going.
> >
> > At 300mg, I have virtually no memory problems. What little there may have been when I first raised the dosage from 200mg (the average effective dosage for depression) to 300mg dissipated within one or two months. With this information in mind, I would advocate your giving Lamictal a try. Generally, it produces the least amount of cognitive changes among the anticonvulsants and unlike the others, possesses true antidepressant properties.
> >
> > I don't know whether or not depression is an issue with you, but social anxiety is often associated with atypical depression or bipolar depression. I do not know anything about the use of Lamictal exclusively for social anxiety without depression.
> >
> >
> > For depression:
> >
> > NIMH has found that Lamictal + Neurontin is often very effective when either alone is inadequate.
> >
> > My non-credentialed suggestion:
> >
> > I would suggest to you that you begin taking Neurontin continuously at the lowest dosage that does not affect your memory too much (600mg-900mg?). Then, begin to titrate Lamictal in the way suggested for monotherapy:
> >
> > 25mg - > 2 weeks
> > 50mg - > 2 weeks
> > 100mg - > 1-2 weeks
> > 100+ - > as per doctor's suggestions
> >
> > Effective dosages for bipolar depression:
> >
> > Range: 50mg-300mg
> > Average: 200mg
> >
> >
> > Let me know what you decide. Don't be too concerned about the memory difficulties.
> >
> > Good luck.
> >
> >
> > - Scott
poster:Dwight
thread:50927
URL: http://www.dr-bob.org/babble/20001231/msgs/51114.html