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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 25 of 64. This is the beginning of the thread.
Posted by 3 Beer Effect on March 22, 2002, at 1:05:37
I've been on Lamictal 100 mg for about two months. Its the only anti-depressant I can tolerate (SSRIs make me manic/insomniac, Remeron doesn't work for me, & Effexor XR made me feel like I was dying).
Anyways, I know Lamictal is supposed to be a fairly weak anti-depressant, but what dosages are effective for depression? Right now, at 100 mg, it feels like a placebo pill except that it makes me very slightly drowsy (but nothing like Neurontin 900 mg which made me a somnolent zombie). I have no side effects, but no perceptible effects either, even after 2 months.
What side effects other than a rash appear as you take higher dosages? On my next visit I was hoping my doctor would titrate my dose by 25 mgs per week to 150 or even 200 mgs. Are dosages of 150 mg or 200 mg effective as an anti-depressant? (I found Zoloft 100 mg was a great & strong anti-depressant but caused insomnia/mania/sexual side effects for me- At what dosage does Lamictal have an equivalent anti-depressant response to Zoloft 100 mg?).
This is my current med combo:
Lamictal 100 mg/day once at bedtime;
Klonopin 2 mg 1 hour before bedtime,
& 1 mg breakfast, & 1 mg lunch.
Provigil 200 mg/day when I wake up in the morning (I am probably going to have the provigil changed to Dexedrine Spansules since the Provigil has "pooped out".)
Posted by JohnX2 on March 22, 2002, at 1:41:20
In reply to Lamictal- dosage recommendations for depression?, posted by 3 Beer Effect on March 22, 2002, at 1:05:37
Hi 3BE,I see a lot of people push the lamictal medicine into the 150-300+ mg range. 100 mg is a low dose. Don't be afraid to push 300+ mg if the side effects are tolerable. I just got mild skin irritation, slurred speech and stupor, but it usually went away a few days after each increase (and I got those at the low dose). I also found that the 1st 100 mg was much harder to dose into than the next 100mg+.
As far as AD effect goes, I've heard mixed reports. Some people have found it to be the only safe haven. Other people report it to be a mild AD. I suggest pushing the dose and just see how it goes. I noticed that when I bumped the dose over my usual 150 mg I start to get noticeable differences.
Best Regards,
John
> I've been on Lamictal 100 mg for about two months. Its the only anti-depressant I can tolerate (SSRIs make me manic/insomniac, Remeron doesn't work for me, & Effexor XR made me feel like I was dying).
>
> Anyways, I know Lamictal is supposed to be a fairly weak anti-depressant, but what dosages are effective for depression? Right now, at 100 mg, it feels like a placebo pill except that it makes me very slightly drowsy (but nothing like Neurontin 900 mg which made me a somnolent zombie). I have no side effects, but no perceptible effects either, even after 2 months.
>
> What side effects other than a rash appear as you take higher dosages? On my next visit I was hoping my doctor would titrate my dose by 25 mgs per week to 150 or even 200 mgs. Are dosages of 150 mg or 200 mg effective as an anti-depressant? (I found Zoloft 100 mg was a great & strong anti-depressant but caused insomnia/mania/sexual side effects for me- At what dosage does Lamictal have an equivalent anti-depressant response to Zoloft 100 mg?).
>
> This is my current med combo:
> Lamictal 100 mg/day once at bedtime;
> Klonopin 2 mg 1 hour before bedtime,
> & 1 mg breakfast, & 1 mg lunch.
> Provigil 200 mg/day when I wake up in the morning (I am probably going to have the provigil changed to Dexedrine Spansules since the Provigil has "pooped out".)
Posted by Janelle on March 22, 2002, at 1:53:25
In reply to Re: Lamictal- dosage recommendations for depression? » 3 Beer Effect, posted by JohnX2 on March 22, 2002, at 1:41:20
As you may or may not recall, I'm in the process of titrating up on Lamictal (I'm at a whopping 20 mg so far!) ... last time I was on it I reached 100mg, which I notice in your message to 3BE you said is a low dose. Interesting. Anyway, I'm curious what dose of Lamictal you're on? Thanks!
Posted by JohnX2 on March 22, 2002, at 4:04:38
In reply to JOHNX2: what dose of Lamictal R U on? » JohnX2, posted by Janelle on March 22, 2002, at 1:53:25
I do fairly well in the 150-225 mg range. Less than 150 mg and I get no good AD effect. Over 225 and weird things happen. It seems a lot of people do really well though pushing the medicine as high as 300 mg+ however.Regards,
John
> As you may or may not recall, I'm in the process of titrating up on Lamictal (I'm at a whopping 20 mg so far!) ... last time I was on it I reached 100mg, which I notice in your message to 3BE you said is a low dose. Interesting. Anyway, I'm curious what dose of Lamictal you're on? Thanks!
Posted by SLS on March 23, 2002, at 14:13:30
In reply to Re: JOHNX2: what dose of Lamictal R U on? » Janelle, posted by JohnX2 on March 22, 2002, at 4:04:38
>
> I do fairly well in the 150-225 mg range. Less than 150 mg and I get no good AD effect. Over 225 and weird things happen. It seems a lot of people do really well though pushing the medicine as high as 300 mg+ however.
>
> Regards,
> John
>
>
> > As you may or may not recall, I'm in the process of titrating up on Lamictal (I'm at a whopping 20 mg so far!) ... last time I was on it I reached 100mg, which I notice in your message to 3BE you said is a low dose. Interesting. Anyway, I'm curious what dose of Lamictal you're on? Thanks!
I need a minimum of 300mg of Lamictal for me to experience any benefit from it. I've tried lowering the dosage several times - no go. When I first reached 300mg, I remember having problems with memory (paradox?). They dissipated within a month or two.
- Scott
Posted by fred lamb on November 15, 2003, at 14:44:54
In reply to Re: Lamictal- dosage recommendations for depression? » 3 Beer Effect, posted by JohnX2 on March 22, 2002, at 1:41:20
I would consult doctor and not take advice on dosage from anyone.300+ is high dosage.I have two relatives on 300mg and they are bipolar I severe.It helps them alot.
I take a antidepressant and a week later i,m agitated and flying(hypomanic).
I have had them all and depakote was worst.Lithium low dose not bad.Trileptal helped but had big weight gain.Topamax made me brain dead.everyone is different.I take .5 klonopin as needed and it helps.
No more than 3-4 day.not every day.
Over 1mg. and you can have problems my doc says.Always see your doc.
Posted by catnice on November 18, 2003, at 10:10:51
In reply to Re: Lamictal- dosage recommendations for depression?, posted by fred lamb on November 15, 2003, at 14:44:54
I was put on lamical 200mg(with depokate)(because of severe depression)...starting at 25mg a week increased slowly until 200mg. At that point I became extremely hyper-active, and lost weight with a loss of appetite.(which isnt bad) The lamictal gave me the feeling like I was having electric shocks in the brain...and little ceizures when increased. It was a strange high that was scary, but I was afraid to lose the kick...by stopping the med. I did stop using it when my hair started falling out terribly. It was unsure whether that was because of depokate though.
Posted by Flipsactown on November 18, 2003, at 22:09:15
In reply to Re: Lamictal- dosage recommendations for depression?, posted by catnice on November 18, 2003, at 10:10:51
I am in my 8th week of lamictal at 300mg. I started out at 25mg and worked up to 300mg. I started noticing a lifting of my depression on my 6th week and now into my 8th week, I feel even better. I have unipolar depression partly caused from chronic back pain. I am also on 100mg of prozac and 45mg of remeron. I have had no noticeable side effect other then maybe a slight headache and dry mouth. From my research online, I understand it is in the higher dosage of 200mg to 500mg where lamictal works best as an A/D. I have been on A/Ds 12yrs. I have taken zoloft or prozac with desipramine for the longest time until both combo finally pooped out. I have taken wellbutrin, paxil, celexa, effexor and elavil but they either pooped out or ineffective.
Flipsactown
> I was put on lamical 200mg(with depokate)(because of severe depression)...starting at 25mg a week increased slowly until 200mg. At that point I became extremely hyper-active, and lost weight with a loss of appetite.(which isnt bad) The lamictal gave me the feeling like I was having electric shocks in the brain...and little ceizures when increased. It was a strange high that was scary, but I was afraid to lose the kick...by stopping the med. I did stop using it when my hair started falling out terribly. It was unsure whether that was because of depokate though.
Posted by catnice on November 19, 2003, at 6:41:57
In reply to Re: Lamictal- dosage recommendations for depression? » catnice, posted by Flipsactown on November 18, 2003, at 22:09:15
Does one have to take valporic acid to make lamictal work?
Posted by linnette on November 20, 2003, at 0:06:48
In reply to Re: Lamictal- dosage recommendations for depression? » catnice, posted by Flipsactown on November 18, 2003, at 22:09:15
Hi Flipsactown,
Did you notice a lifting of your depression at the 300 dosage, or before. I am into my 10th week, now at 200 and appear to be having poop- out, after noticing a definite lifting of my depression up until last week. I know I could increase, and have an appt with my pdoc on 12/2, but I guess it could also be that I am coming off of zoloft and nortriptyline.
Also does anyone know if lamictal is has significant AD properties, or just mild AD properties..I notice that a lot of folks on this board are also on AD's with their lamictal.
Today I finally broke down an took some dexedrine, which I haven't had to take during my lamictal trial, and I must admit the dex came through for me again.
I remain hopeful and welcome your feedback.
Linnette
Posted by Flipsactown on November 20, 2003, at 0:38:42
In reply to Re: Lamictal- dosage recommendations for depression?, posted by linnette on November 20, 2003, at 0:06:48
Hello Linnette,
I noticed a dramatic lifting of my depression at 200mgs in my 6th week. At 300mgs, I felt even better. However, I am also on 100mgs prozac and 60mgs of remeron. I saw my pdoc today and he explained to me why I need the remeron. Remeron is the only A/D that prevents serontin level from dropping and keeps it in the higher levels, thus a decrease in depression. That makes sense because on my own, since I got excellent relief from lamictal, I figured that I could wean off the remeron and possibly the prozac later on. Last Wednesday I had totally discontinued the remeron after about 2 weeks on 15mgs. Well, come Saturday, my depression had returned. Little did I know that remeron played a big part of decreasing my depression. I wanted to get off the remeron because of weight gain. I gained 15 lbs on remeron, but since I need to take it to be depression free, I will have to go on a diet and watch my food intake. Hopefully, the appetite increase is only a temporary thing.
Also, since you were going off the zoloft would definitely have something to do with your depression returning because zoloft is just like prozac. I know if I go off the prozac even very slowly, my depression returns. Hope this helps.Flipsactown
> Hi Flipsactown,
>
> Did you notice a lifting of your depression at the 300 dosage, or before. I am into my 10th week, now at 200 and appear to be having poop- out, after noticing a definite lifting of my depression up until last week. I know I could increase, and have an appt with my pdoc on 12/2, but I guess it could also be that I am coming off of zoloft and nortriptyline.
>
> Also does anyone know if lamictal is has significant AD properties, or just mild AD properties..I notice that a lot of folks on this board are also on AD's with their lamictal.
>
> Today I finally broke down an took some dexedrine, which I haven't had to take during my lamictal trial, and I must admit the dex came through for me again.
>
> I remain hopeful and welcome your feedback.
>
> Linnette
Posted by Flipsactown on November 20, 2003, at 3:06:38
In reply to Re: Lamictal- dosage recommendations for depression?, posted by linnette on November 20, 2003, at 0:06:48
Linnette,
In my research on lamictal online, I remember reading that lamictal has an anti-depressant effect in the higher dosage. In fact one of our posters, I forgot her name, indicated she was on 400 mgs for three years and has had excellent lifting of depression with no side effects. Look through the recent posts on lamictal because I remember asking her if her doctor was going to increase her dosage and she said she was doing fine on 400mgs and did not know what the maximum dose for lamictal was.
Flipsactown
> Hi Flipsactown,
>
> Did you notice a lifting of your depression at the 300 dosage, or before. I am into my 10th week, now at 200 and appear to be having poop- out, after noticing a definite lifting of my depression up until last week. I know I could increase, and have an appt with my pdoc on 12/2, but I guess it could also be that I am coming off of zoloft and nortriptyline.
>
> Also does anyone know if lamictal is has significant AD properties, or just mild AD properties..I notice that a lot of folks on this board are also on AD's with their lamictal.
>
> Today I finally broke down an took some dexedrine, which I haven't had to take during my lamictal trial, and I must admit the dex came through for me again.
>
> I remain hopeful and welcome your feedback.
>
> Linnette
Posted by Flipsactown on November 20, 2003, at 3:17:02
In reply to Re: Lamictal- dosage recommendations for depression? » linnette, posted by Flipsactown on November 20, 2003, at 3:06:38
Linnette,
The poster is mnomad3 under lamictal side effects on 11/10/03, but she also takes prozac like I do, so maybe you are going to have to take prozac or go back on your zoloft to get the desired A/D effect.
Flipsactown
> Linnette,
>
> In my research on lamictal online, I remember reading that lamictal has an anti-depressant effect in the higher dosage. In fact one of our posters, I forgot her name, indicated she was on 400 mgs for three years and has had excellent lifting of depression with no side effects. Look through the recent posts on lamictal because I remember asking her if her doctor was going to increase her dosage and she said she was doing fine on 400mgs and did not know what the maximum dose for lamictal was.
>
> Flipsactown
>
>
> > Hi Flipsactown,
> >
> > Did you notice a lifting of your depression at the 300 dosage, or before. I am into my 10th week, now at 200 and appear to be having poop- out, after noticing a definite lifting of my depression up until last week. I know I could increase, and have an appt with my pdoc on 12/2, but I guess it could also be that I am coming off of zoloft and nortriptyline.
> >
> > Also does anyone know if lamictal is has significant AD properties, or just mild AD properties..I notice that a lot of folks on this board are also on AD's with their lamictal.
> >
> > Today I finally broke down an took some dexedrine, which I haven't had to take during my lamictal trial, and I must admit the dex came through for me again.
> >
> > I remain hopeful and welcome your feedback.
> >
> > Linnette
>
>
Posted by Peter S. on November 20, 2003, at 20:40:52
In reply to Re: Lamictal- dosage recommendations for depression? » Flipsactown, posted by Flipsactown on November 20, 2003, at 3:17:02
I take it once a day and sometimes notice a decrease in mood later.
Peter
Posted by poop'd-out on November 22, 2003, at 1:10:54
In reply to Re: Lamictal- dosage recommendations for depression? » linnette, posted by Flipsactown on November 20, 2003, at 0:38:42
>
> I noticed a dramatic lifting of my depression at 200mgs in my 6th week. At 300mgs, I felt even better. However, I am also on 100mgs prozac and 60mgs of remeron.Hi there,
Sorry to but in but I am really struggling with whether or not to stay on the Lamictal. I am only at 75mg right now, about 6 weeks.I was just wondering what you experienced prior to reaching the 200mgs. It seems like that is the number where most people experience relief.
Right now I am experiencing extreme tiredness, and just feel like a space cadet, not happy at all. Prior to this I experienced irritability and anxiety, go figure. Did you experience these symptoms also before you started feeling better?
I also take Zoloft, Neurontin and Tegretol, which I know affects the lamictal dosage. I may just be on too many meds I don't know. Having trouble typing this even. Any input would be soo appreciated!
Posted by linnette on November 22, 2003, at 10:33:52
In reply to Re: Lamictal- dosage recommendations for depression? » Flipsactown, posted by Flipsactown on November 20, 2003, at 3:17:02
Hi Flipsactown,
Thanks much for the feedback. I am doing a little better, still at the 200 mg, but look f/w to seeing my pdoc soon. I must say that it is encouraging to know that mayhe I have some room to go higher if things don't level out here soon moodwise. And it wouldn't be the end of the world if I had to restart and AD.On a postiive note, my appetite is much better, and it isn't so darn hard for me to get out of bed in the morning. So it must be working although very subtle. Thanks again for the feedback. I will keep you posted.
Linnette
Posted by flipsactown on November 22, 2003, at 12:03:43
In reply to Re: Lamictal- dosage recommendations for depression? » Flipsactown, posted by poop'd-out on November 22, 2003, at 1:10:54
Unknown Poster,
Yes, I did experience the extreme tiredness you are referring to. Hang in there until you are at 200mgs before you make up your mind whether to stay on lamictal or not.
Flipsactown
> >
> > I noticed a dramatic lifting of my depression at 200mgs in my 6th week. At 300mgs, I felt even better. However, I am also on 100mgs prozac and 60mgs of remeron.
>
> Hi there,
> Sorry to but in but I am really struggling with whether or not to stay on the Lamictal. I am only at 75mg right now, about 6 weeks.
>
> I was just wondering what you experienced prior to reaching the 200mgs. It seems like that is the number where most people experience relief.
>
> Right now I am experiencing extreme tiredness, and just feel like a space cadet, not happy at all. Prior to this I experienced irritability and anxiety, go figure. Did you experience these symptoms also before you started feeling better?
> I also take Zoloft, Neurontin and Tegretol, which I know affects the lamictal dosage. I may just be on too many meds I don't know. Having trouble typing this even. Any input would be soo appreciated!
Posted by SLS on November 22, 2003, at 13:37:25
In reply to Re: Lamictal- dosage recommendations for depression? » linnette, posted by Flipsactown on November 20, 2003, at 0:38:42
> I noticed a dramatic lifting of my depression at 200mgs in my 6th week. At 300mgs, I felt even better.
Hi.At 300mg, did you experience any trouble with memory or feel stupid and numb to things around you?
Thanks.
- Scott
Posted by SLS on November 22, 2003, at 13:47:18
In reply to Re: Lamictal- dosage recommendations for depression? » Flipsactown, posted by poop'd-out on November 22, 2003, at 1:10:54
> I also take Zoloft, Neurontin and Tegretol, which I know affects the lamictal dosage. I may just be on too many meds I don't know. Having trouble typing this even. Any input would be soo appreciated!
The interactions between these drugs are rather complicated. How is the level of Lamictal affected by the other drugs?
- Scott
Posted by Flipsactown on November 22, 2003, at 14:47:38
In reply to Re: Lamictal- dosage recommendations for depression? » Flipsactown, posted by SLS on November 22, 2003, at 13:37:25
No, I did not "have trouble with memory or stupid and numb to things around me." I feel fine and depression free. I have to attribute being depression free with the higher dose of lamictal combined with the prozac and remeron. When I tried to stop remeron, the depression came back and when I was only on prozac and remeron I was depressed because of the poop out factor. Bottomline, at least for me, lamictal works best when taken with other A/D or A/D's.
Flipsactown
>
> > I noticed a dramatic lifting of my depression at 200mgs in my 6th week. At 300mgs, I felt even better.
>
>
> Hi.
>
> At 300mg, did you experience any trouble with memory or feel stupid and numb to things around you?
>
> Thanks.
>
>
> - Scott
Posted by SLS on November 22, 2003, at 14:50:23
In reply to Re: Lamictal- dosage recommendations for depression? » SLS, posted by Flipsactown on November 22, 2003, at 14:47:38
Thanks for responding.
> Bottomline, at least for me, lamictal works best when taken with other A/D or A/D's.
That's been my experience too.
- Scott
Posted by poop'd-out on November 22, 2003, at 23:50:15
In reply to Re: Lamictal- dosage recommendations for depression? » poop'd-out, posted by SLS on November 22, 2003, at 13:47:18
> > I also take Zoloft, Neurontin and Tegretol, which I know affects the lamictal dosage. I may just be on too many meds I don't know. Having trouble typing this even. Any input would be soo appreciated!
>
>
> The interactions between these drugs are rather complicated. How is the level of Lamictal affected by the other drugs?
>
>
> - Scott
Hi Scott,The only thing that I know is that tegretol supposedly does the opposite of what depakote does. Instead of doubling the amount of lamictal in your system(depakote), the tegretol halves the amount of lamictal. But, the lamictal also increases the amounts of zoloft and tegretol, by how much I don't know.
This is just from literature that I have read and from what my Doc confirms.Beth
Posted by poop'd-out on November 23, 2003, at 0:03:36
In reply to Re: Lamictal- dosage recommendations for depression? » poop'd-out, posted by flipsactown on November 22, 2003, at 12:03:43
> Unknown Poster,
>
> Yes, I did experience the extreme tiredness you are referring to. Hang in there until you are at 200mgs before you make up your mind whether to stay on lamictal or not.
>
> Flipsactown
>
>
>
Flipsactown,Thank you for your response. Sometimes it is sooo hard to hang in there before the benefits kick in. I think I have a habit of giving up too soon.
Today was actually much better. Of course, I didn't get much sleep last night, and that sleep deprivation thing really seems to help me. I just can't do it all the time because my body suffers, bummer.
Unfortunately, I have had to increase the dose much slower than you did because I have had some benign skin issues at the beginning.
Thank you for your feedback, it really did help and gives me hope. We all need a little hope!
Thanks again,
I'm Beth by the way, I don't want to be unknown poster!
Posted by SLS on November 23, 2003, at 9:57:20
In reply to Re: Lamictal- dosage recommendations for depression? » SLS, posted by poop'd-out on November 22, 2003, at 23:50:15
> > > I also take Zoloft, Neurontin and Tegretol, which I know affects the lamictal dosage. I may just be on too many meds I don't know. Having trouble typing this even. Any input would be soo appreciated!
> >
> >
> > The interactions between these drugs are rather complicated. How is the level of Lamictal affected by the other drugs?
> >
> >
> > - Scott
>
>
> Hi Scott,
>
> The only thing that I know is that tegretol supposedly does the opposite of what depakote does. Instead of doubling the amount of lamictal in your system(depakote), the tegretol halves the amount of lamictal. But, the lamictal also increases the amounts of zoloft and tegretol, by how much I don't know.
> This is just from literature that I have read and from what my Doc confirms.
>
> Beth
Hi Beth.I can't find anything that describes an increase of either Tegretol or Zoloft by Lamictal. However, there have been reports of Zoloft increasing levels of Lamictal to the point of toxicity. I have a chart that indicates the following:
lamotrigine - reduced by carbamazepine; increased by sertraline
gabapentin - no changes
sertraline - increased by carbamazepine
carbamazepine - increased by sertraline
- Scott
Posted by linnette on November 23, 2003, at 14:04:52
In reply to Re: Lamictal- dosage recommendations for depression? » poop'd-out, posted by SLS on November 23, 2003, at 9:57:20
Hi Beth,
I currently am on 200 mg lamictal. Like Scott, in my research (and personal experience), I discovered that the zoloft increases the amount of lamictal in the bloodstream for some people and last year I think that is what happened to me.
Last year I was on 150 mg zoloft and only at 75 mg of lamictal. I was so confused that I could only sit on the sofa, and it was very scary, and also felt very close to blacking out on several occasions.
I did some research and when I showed my pdoc the article I found about zoloft increasing lamictal, my pdoc took a copy, handed it back to me and said not another word.
I knew that the lamictal was helping me, but my pdoc wouldn't listen. I am now off zoloft and primarily on lamictal, and although it is still a bumpy road, I think I will be ok, and haven't had a repeat of last year's experience.
I am not saying that this would happen to all people on this combination, but rather that it could be the case. How much zoloft are you taking? Depending on that, you may just want to either decrease the dose of zoloft,(with your doc's approval of course).
I am so far overall impressed with the lamictal. But as Flipsactown and Scott advised, some folks do need to be on and AD along with their lamictal. I guess I was just tired of trying to figure out what med was doing what, so am giving the lamictal a go on it's own. If I should have to re-add the zoloft, I will.
Everyone's experience is different. What works for one may not work for another but input and support is good.
Hope this helps some. Good luck to you and hang in there.
Linnette
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