Posted by Racer on April 14, 2008, at 17:22:55
In reply to Re: mood stabilized as hostile. i need meds for th, posted by elanor roosevelt on April 14, 2008, at 0:15:02
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> are you saying i just wait out the titration of the lamictal w/o stimulants? i haven't heard of anyone doing well on lamictal alone. but i'm game to give that a try.
>Yes, I'm suggesting titrating up on Lamictal without stimulants, but not necessarily with the idea of using Lamictal as monotherapy. Just with the idea of limiting the variables. How about I offer up my thinking on it, and you can decide if it's worth paying any attention?
First of all, the adjustment phase of many medications is very, very different from what they show down the road. We all know this, but it's easy -- for me, at least -- to be in such a hurry about feeling better to forget that little piece of it. There are no short cuts to speed that up -- it's just something we have to get through. If you're starting multiple medications at one time, you're going to be getting adjustment phase problems from each one, in all likelihood, so starting one at a time makes a lot of sense to me. That way, you'll at least know what each drug is contributing.
My own experience with Lamictal is that it changes radically as you titrate up. Sticking to the schedule is a good idea -- too fast and you risk some of the truly scary adverse effects; too slow and you may spend more time in a bad range longer than you need to. It may be that increasing the dose will relieve some of the irritability for you. (And I really do know that it's easy to say that, and I've been in places where I just could not stay on a medication, even if it might have gotten better, because I was just too freaked out.)
Also, I was told -- I don't know how accurate this is -- that Lamictal is more likely to cause reactions if you start anything new before you've acclimated to it. In fact, I was told not to change soaps, detergents, shampoos, toothpastes, etc. I don't know how over-cautious that doctor was being, but I figured it was worth paying attention to that -- with the seriousness of the potential adverse effects, I figured it couldn't hurt to be cautious. (Besides -- I get rashes from a lot of products, so I rarely change things like soaps. Isn't it nice when it's so easy to be good?)
I'm also thinking it's worth limiting things for reasons that probably have more to do with projection than anything you wrote: I know that I get into this state where I'm so desperate for relief that I want to triple everything I take in order to feel better NOW. That, of course, isn't an effective strategy. I don't actually follow it -- but I do get so frustrated by the length of time it takes to get the benefits of these medications that it would be easy to quit prematurely. What helps me when that happens is reminding myself that it's a drug trial, that it's going to take as long as it takes, that I've been through it before, etc. I also keep a little diary of the medication's effects, day by day, which helps me both track progress -- if any -- and record what may be adverse effects or simply my overactive imagination. That system works pretty well for me.
I hope something I've offered in here helps.
poster:Racer
thread:822987
URL: http://www.dr-bob.org/babble/neuro/20080204/msgs/823279.html