Posted by colin wallace on February 18, 2003, at 5:53:07
In reply to Re: Lamictal + Prozac » colin wallace, posted by Ron Hill on February 17, 2003, at 12:47:40
Greetings Ronald old chum!
Let's start with the depression;around six months ago, if you recall,I'd relapsed badly and slid into a dangerous mixed-state.This was due to a combination of ugly factors,the ugliest of which was a parent having been diagnosed with brain cancer, unrelenting rain,chronic body-pain(fibromyalgia type-stuff),numerous med. failures,no job and precious little social contact for three years- and an 'unopposed' SSRI to ensure that I finally blew my lid!!!
I had no access to a psych., and looking back, was in pure unadulterated mania-I very nearly did away with myself if I'm honest.After crashing my car at breakneck speed, I found a hospital and begged to be placed on a mood stabilizer... but valproate and lithium made things worse.
Then came my nifty little box of Lamictal in the post, and the rest you know.
Today,I feel better than I have in years;my mind is sharp and clear, I have ABSOLUTELY no depression to speak of,no swings or dysphoria(I no longer fall into my personal mantrap of fixating on a subject and spinning off into anger) clear plans for the future, a semblance of a social life- and I start a new job next week.I'm actually looking forward to it(inasmuch as anyone looks forward to work!)In short, I feel normal.
Lamictal is responsible for my revival, and I thank God I followed my own instincts and placed myself on it.
So, currently I'm taking 200mg Lamictal,2mg diazepam,100mg Neurontin at night(neuropathic pain/stiffness), along with just 10mg Amitryptaline for sleep.
The Prozac 'sprinkle' probably amounts to maybe 2mg/4mg max. , meaning I can get over a weeks mileage from a 20mg capsule.As I mentioned before,it feels entirely different with the Lamictal in place-nice little uplift, but not the silly 'high'or irritability it previously caused.
This may seem like trying to fix something that ain't broken, but there's reason behind my madness?!Although I have no depression symptoms, my problems begin and end with the weather.After around three weeks of continuous rain and gloom, I begin to slide.It's more a slip towards hypomania than pure depression.Feels like cogs in my head loosing their synchronicity and coming unmeshed.My head hurts,I begin to seriously contemplate jumping on a plane(with hardly any money!)and just flying the hell away to anywhere on earth where there's sunshine.I get frustrated and angry, and spit out sentences like "this stinking ****** country is unfit for human habitation!!You get my drift.Not pleasant.
Now I agonized about how to tackle this for some time, and I seem to be defenceless against it.
SSRI's(the dreaded enemy)have proven efficacy against SAD(or a downward bipolar seasonal swing)but we all know the risks.I read an up to the minute article yesterday challenging the hypothesis of the long-term destabalizing effects of using(low dose)AD's with BP(with a mood stabilizer of course)- in this study at least, those on concurrent AD's actually fared slightly better.But I think this debate won't be solved for years.
In my case,I need to 'marshall my troops' to the North rampart and prepare to fend of(next years)bad weather.I believe that, unfortunately, I will need to risk a low dose AD for as long as I'm stuck in the UK.I seem to have little choice.TCA's sem to be the worst culprits for precipitating mania, and(low-dose) Prozac actually compares quite well all in all(Zoloft one of the worst, as we both know!!)
Feeling normal right now is a good starting point to gauge my reactions-any irritability or aberrant thoughts, and Prozac gets the boot.
A retrial of lithium in combo with Lamictal is then an option, and then failing that,I'd have no qualms in trying an MAOI.But I don't think it'll come to that.There's also Topomax, but that doesn't really grab me either.
I like the idea of this ENADA stuff, although I haven't done too much research yet.I may well give it a whirl, and if it feels good, who knows?
By the way, our old friend SAM-E doesn't mix with Lamictal AT ALL- sends me clawing up the wall straightaway!
My med regime is doing it's job perfectly right now, but like you, I'm always looking ahead in case of pitfalls.Fingers crossed.
What are your personal 'med. contingency' plans?
I know you bottomed out with Lamictal once on silly doses, but have you ever thought of a re-trial(like Amy)?At least we both have options still.
Anyway, glad you're feeling well over there, and keep me posted with your progress.Keep bouncing any thoughts, advice and ideas too!!Always welcome.
Col.
poster:colin wallace
thread:138803
URL: http://www.dr-bob.org/babble/20030214/msgs/201423.html