Posted by n_wolfie on February 23, 2009, at 20:00:23
In reply to Re: Lamictal optimal dosage » mickapoo, posted by SLS on February 22, 2009, at 21:18:24
Scott, I'm more confused than ever. My mood has dipped from the Lamictal reduction, and my word retrieval writing skills are much worse. When I was on the 500 of Lamictal, my mood was actually pretty good, and I could write, my word retrieval was great (I thought it wasn't, but when I actually wrote I discovered it was), and now my mood has dipped, and I'm having trouble writing, and my memory is still bad. All around I feel worse. Do I just need to wait it out? I just added 2 more posts on this, but they're pretty disjointed, my writing is suffering from the Lamictal reduction.
> > Not trying to doubt you,
>
> You should. I often doubt myself.
>
> > just wondering about your comment that:
> >
> > >200mg is the "sweet spot" for this drug when >treating depression.
> >
> > Is this from personal experience or from doing research? Would this apply for mood stabilization or just depression?
>
>
> 200mg was found to be the average effective dosage from very early in the history of investigations into using Lamictal for bipolar depression. By comparison, a range of 300-500mg has been used for epilepsy.
>
> Lamictal is often ineffective as an anti-manic agent. However, it can help penetrate a rapid cycling bipolar disorder, especially when combined with lithium.
>
> For me, personally, I have found no further *stable* improvement from increasing the dosage of Lamictal beyond 200mg. However, my cognition and memory are very much impaired at the higher dosages, especially when I combine them with Nardil or Parnate.
>
> For many, Lamictal feels pretty good each time they increase the dosage, but then watch the improvement fade away. People can even feel an improvement while taking as little as low as 50mg. But once you get to 500mg and are dissatisfied, what do you do? Lamictal does not usually make for a good antidepressant by itself. Now you add Nardil, which seems to amplify the cognitive side effects of Lamictal. How do you know how low to go with the Lamictal? I simply brought the dosage down to the maximum that would allow the cognitive side effects to disappear. For me, this just happens to be 200mg.
>
>
> - Scott
>
>
> ***********************************************************************
>
>
>
> 1: Pharmacoepidemiol Drug Saf. 2009 Feb;18(2):132-9.Click here to read Links
> Trends and changes in the clinical use of lamotrigine.
> Reimers A.
>
> Department of Clinical Pharmacology, St. Olavs University Hospital, Trondheim, Norway. [email protected]
>
> PURPOSE: To investigate long-term trends and changes in the pattern of use of lamotrigine (LTG). METHODS: Retrospective survey of a large, routine therapeutic drug monitoring database. RESULTS: Twelve thousand one hundred and seven samples from 4123 subjects were analysed from October 1999 to May 2007. Within this period, the mean daily dose rose from 183 to 253 mg, whereas the median dose remained unchanged at 200 mg. Females became the majority of LTG users, and they had a higher proportion of psychiatric diagnoses than male patients. The mean patient age increased from 34 to 41 years. The proportion of samples from psychiatric patients became larger than that of neurologic patients. A total of 130 different diagnoses were stated, most of them psychiatric off-label. The mean serum concentration was 3.8 mg/L and it remained quite stable during the whole observation period. Neurologic patients had a higher mean serum concentration than psychiatric patients. 30% of the neurologic and 41% of the psychiatric patients had serum concentrations below the reference range. Sixty-eight per cent of the patients used additional drugs. Females used a higher number of additional medications than males. The 10 most frequent co-medications consisted of seven psychotropic drugs, two anticonvulsants, and thyroxine. CONCLUSIONS: Significant changes in the pattern of use of LTG have taken place during the observation period and some significant trends could be identified.
poster:n_wolfie
thread:881215
URL: http://www.dr-bob.org/babble/20090223/msgs/882021.html