Posted by SLS on September 24, 2006, at 8:24:20
In reply to Lamictal » SLS, posted by tensor on September 23, 2006, at 11:28:07
> > I respond best to 100mg of nortriptyline. I think my blood level is 123 ng/ml. It is in combination with Lamictal. Unfortunatly, it only produces about a 15% improvement, but it gets me out of bed.
> Based on my situation, would you recommend me adding lamictal to remeron and nortrip? Should i make any changes in my current dosage first? If you happen to have some good links about lamictal and recurring unipolar depression, please let me know, need to arm myself with some good articles before my appointment with my pdoc.
Here a few listings of abstracts on Medline involving unipolar depression.
My doctor has found Wellbutrin + Lamictal to be particularly effective. I really don't know what to recommend to you regarding your present treatment. You may have reached a dead-end of sorts. However, I would not abandon it without adding Lamictal first. You might try to add the Lamictal now and leave it in place as you try other things if it becomes necessary.I think you should first establish a therapeutic dosage of nortriptyline based upon blood levels. You will need to remain at any one dosage for 10 days before testing. You can begin the Lamictal as you do this. Use the starter pack that they offer for bipolar patients. If unavailable, you can get the 25mg tablets to start with and use the following titration schedule if you are not taking Depakote. If you are taking Depakote, divide the dosages in half.
25mg x 2 weeks
50mg x 2 weeks
100mg x 1 week
* 150mg x 1 week
200mg - target dosage* I stuck the 150mg in there. I am rather conservative. You can skip it if you want. It does not appear in the manufacturer's recommendations:
http://www.rxlist.com/cgi/generic/lamotrigine_ids.htm
What is the Remeron doing for you at 15mg?
- Scott
poster:SLS
thread:688067
URL: http://www.dr-bob.org/babble/20060919/msgs/688625.html