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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by wcfrench on February 20, 2003, at 16:25:16
Hi
How is everyone? I am getting ready to start Lamictal and am currently on 2x500mg Depakote nightly, and my pdoc suggested that I stop Depakote and wait a week before starting the Lamictal. What do you think about that? Couldn't I start it sooner, I don't want to be without anything for a solid week (plus the weeks it takes for Lamictal to be effective)... ? Life is dealing me so many events and changes and I don't want to be five different people during these times!! I'm sure you all know what I mean.
I am stopping the Depakote because I have been craving all junk foods, chocolate, sweets, and have been pigging out and not getting full at all, a drastic change from before starting it, plus I am more on the "depressed" side of Bipolar II and I think Lamictal has a better reputation as a mood stabilizer/antidepressant. If anyone has thoughts on this I would love to hear them!
Any advice very welcomed.
Take care all,
Charlie
Posted by Ron Hill on February 20, 2003, at 18:36:36
In reply to Question about starting Lamictal w/ Depakote?, posted by wcfrench on February 20, 2003, at 16:25:16
Charlie,
I hope I'm not telling you something you already know, but here goes. A potential side effect of Lamictal is skin rash, or worse, the life threatening Stevens Johnson Syndrome (SJS). The risk can be reduced by starting at a very low dose of Lamictal and ramping up slowly.
The risk of rash and/or SJS escalates dramatically if Depakote and Lamictal are in the patient's body simultaneously. Thus the need for the Depakote wash-out prior to the beginning of the low-and-slow Lamictal trial. And yes you are correct; this process will leave you without a moodstabilizer fully in place for a period of time.
I don't know how you feel about taking a lithium medication, like Lithobid for example, but one possible way of making the switch from Depakote to Lamictal, without the gap in moodstabilization, would be to add Lithobid to your Depakote, pull the Depakote and wait for it to clear completely from your body, add Lamictal low-and-slow, and then pull the Lithobid once the Lamictal is fully ramped up. Boy, how about that for a run-on sentence! Best wishes.
-- Ron
------------------------------------------
> Hi
>
> How is everyone? I am getting ready to start Lamictal and am currently on 2x500mg Depakote nightly, and my pdoc suggested that I stop Depakote and wait a week before starting the Lamictal. What do you think about that? Couldn't I start it sooner, I don't want to be without anything for a solid week (plus the weeks it takes for Lamictal to be effective)... ? Life is dealing me so many events and changes and I don't want to be five different people during these times!! I'm sure you all know what I mean.
>
> I am stopping the Depakote because I have been craving all junk foods, chocolate, sweets, and have been pigging out and not getting full at all, a drastic change from before starting it, plus I am more on the "depressed" side of Bipolar II and I think Lamictal has a better reputation as a mood stabilizer/antidepressant. If anyone has thoughts on this I would love to hear them!
>
> Any advice very welcomed.
>
> Take care all,
> Charlie
Posted by Ritch on February 20, 2003, at 23:24:31
In reply to Question about starting Lamictal w/ Depakote?, posted by wcfrench on February 20, 2003, at 16:25:16
> Hi
>
> How is everyone? I am getting ready to start Lamictal and am currently on 2x500mg Depakote nightly, and my pdoc suggested that I stop Depakote and wait a week before starting the Lamictal. What do you think about that? Couldn't I start it sooner, I don't want to be without anything for a solid week (plus the weeks it takes for Lamictal to be effective)... ? Life is dealing me so many events and changes and I don't want to be five different people during these times!! I'm sure you all know what I mean.
>
> I am stopping the Depakote because I have been craving all junk foods, chocolate, sweets, and have been pigging out and not getting full at all, a drastic change from before starting it, plus I am more on the "depressed" side of Bipolar II and I think Lamictal has a better reputation as a mood stabilizer/antidepressant. If anyone has thoughts on this I would love to hear them!
>
> Any advice very welcomed.
>
> Take care all,
> Charlie
I echo what Ron said about avoiding taking Depakote and Lamictal simultaneously. The risk of the rash is increased a lot and also the addition of the Lamictal will shoot your blood levels of Depakote up dramatically as well and you might get pretty loopy. I've gotten a fairly significant withdrawal syndrome from stopping Depakote previously. It is kind of like stopping a benzo suddenly. Racing thoughts, restlessness, insomnia, etc. I would talk to your doc about a GABA-ergic "cover" drug to use such as Klonopin or Ativan (fairly high dose) while you are withdrawing from the Dep. and titrating on the Lamictal.
Posted by catmint on February 21, 2003, at 1:25:23
In reply to Question about starting Lamictal w/ Depakote?, posted by wcfrench on February 20, 2003, at 16:25:16
> Hi
>
> How is everyone? I am getting ready to start Lamictal and am currently on 2x500mg Depakote nightly, and my pdoc suggested that I stop Depakote and wait a week before starting the Lamictal. What do you think about that? Couldn't I start it sooner, I don't want to be without anything for a solid week (plus the weeks it takes for Lamictal to be effective)... ? Life is dealing me so many events and changes and I don't want to be five different people during these times!! I'm sure you all know what I mean.
>
> I am stopping the Depakote because I have been craving all junk foods, chocolate, sweets, and have been pigging out and not getting full at all, a drastic change from before starting it, plus I am more on the "depressed" side of Bipolar II and I think Lamictal has a better reputation as a mood stabilizer/antidepressant. If anyone has thoughts on this I would love to hear them!
>
> Any advice very welcomed.
>
> Take care all,
> CharlieCharlie,
I stopped Depakote and waited a week before starting Lamictal. You don't need to worry about the effects of Lamictal kicking in, you most likely will notice it right away. It gives many people an initial boost that feels really good, but also be aware that it will level out and you will need to increase the dose slowly. Many of us on Lamictal have had irritability during the first few weeks and some insomnia. Be patient, stick with it and above all else, start on the lowest dose possible, even the kiddie size pills if necessary (to avoid a rash). I started at a mere 2.5 mg. and am now at 45 mg. 3 1/2 months later.As Ritch said, you may need a benzo to help you along, provided your doc. will prescribe one (mine won't). Coming off Depakote and staring Lamictal can leave you quite edgy for a while.
I was a lot less irritable on Depakote, but way too depressed to continue. Lamictal is a phenomenal drug for bipolar depression, there's a trade off though. I personally would much rather be a tad bit irritable than depressed any day.
Hope this helps,
::Amy
Posted by wcfrench on February 21, 2003, at 3:44:23
In reply to Re: Question about starting Lamictal w/ Depakote? » wcfrench, posted by catmint on February 21, 2003, at 1:25:23
Well, thanks. That was all great advice. I did know about the rash and that depakote + lamictal equals an increase of something in the body but wasn't exactly sure. My doctor said to give it a week, and he set me up with a 4-week titrating sampling package. I think it's 25mg/day for week 1 and 2, then 50mg/day for week 2 and 3, then 100mg/day for week 5 (then a prescription). Hope that's not too much? I definitely think it will be a good change as far as the mood and depression goes, but I don't want to be snappy or irritable (I guess I'm more afraid of the "emotional sensitivity" to everything) I don't mind being a bit drab, but I don't want little silly things getting to me that normally shouldn't.. I hope not, because I work in a restaurant and my day is full of those kinds of events, and right now, I am go with the flow.
I have a scrip for Klonopin 1mg/day and I only use .5mg/day, and only on days I work.. so perhaps if I notice some increased irritability I take a little extra? Anyway thanks for all your help. It was great, Psycho bab rocks!
Take care,
Charlie
Posted by wcfrench on February 23, 2003, at 2:32:06
In reply to Thankya... irritability, oh no!, posted by wcfrench on February 21, 2003, at 3:44:23
My initial feeling is more of a negative disposition toward my events and activities in life. I don't feel very emotionally down, but more apathetic and less warm to things. I guess this would be described as a little edgy but I just feel more like I have a blah approach to things. I get angry a little more easily and seem to feel less compassionate toward others but I feel safe on the inside. Well, just seeing if anyone remembers this and can relate.
-Charlie
Posted by Ritch on February 23, 2003, at 9:54:38
In reply to A negative disposition?, posted by wcfrench on February 23, 2003, at 2:32:06
> My initial feeling is more of a negative disposition toward my events and activities in life. I don't feel very emotionally down, but more apathetic and less warm to things. I guess this would be described as a little edgy but I just feel more like I have a blah approach to things. I get angry a little more easily and seem to feel less compassionate toward others but I feel safe on the inside. Well, just seeing if anyone remembers this and can relate.
>
> -Charlie
Hmmm. That sounds like my attitude during dysphoric hypomania and temper spells. Kind of a feeling of *intolerance* about other people's mistakes? Kind of a pressured "type-A personality" trait? You mentioned something about working in a busy restaurant. That has to be fraught with all sorts of pressures to get everything right all the time. Depakote makes that completely vanish for me. I can see why you might be concerned about not taking it anymore. FWIW, there are some folks that take Depakote and Lamictal together. The trouble is the presence of both meds tends to increase (usually double) the expected level of both meds.
Posted by wcfrench on February 23, 2003, at 12:56:08
In reply to Re: A negative disposition? » wcfrench, posted by Ritch on February 23, 2003, at 9:54:38
Yes, that is a very good description. I usually read several terms on here such as "dysphoric hypomania" and usually don't look into them unless I find myself wondering, and for this I did, and it seems to fit the bill. An unnaturally Type-A personality seems to describe it exactly... I find myself silently a bit angry or my subconscious saying "when will this person shut up?" I knew I would have use for these old Metallica tapes. Thanks for helping me through this.
Take care,
Charlie
Posted by Ritch on February 23, 2003, at 16:21:04
In reply to Re: A negative disposition? » Ritch, posted by wcfrench on February 23, 2003, at 12:56:08
Posted by Jumpy on February 23, 2003, at 17:29:12
In reply to Re: A negative disposition? » Ritch, posted by wcfrench on February 23, 2003, at 12:56:08
> Yes, that is a very good description. I usually read several terms on here such as "dysphoric hypomania" and usually don't look into them unless I find myself wondering, and for this I did, and it seems to fit the bill. An unnaturally Type-A personality seems to describe it exactly... I find myself silently a bit angry or my subconscious saying "when will this person shut up?" I knew I would have use for these old Metallica tapes. Thanks for helping me through this.
>
> Take care,
> Charliehahaha ... these are my top metallica songs to deal with my anger and frustration
"Nothing Else Matters"
"Creeping Death"
"Fade to Black"
"Turn the Page"Once I am feeling better, I end up listening to Hootie and Blowfish ... lol
Jumpy
Posted by wcfrench on February 24, 2003, at 3:34:05
In reply to Metallica therapy, posted by Jumpy on February 23, 2003, at 17:29:12
You HAVE to listen to Master of Puppets and Battery, (the whole Master of Puppets album, really) and also Damage, Inc. which is on that album also. Very good stuff for these times. Master of Puppets was one of my favorite songs for a long time.. it's actually a very good song overall from a musical perspective, nice flow.
I can set these up so you can D/L them if you want, let me know.See ya,
Charlie(PS They go well with Xanax ? ... to make this relevant)
Posted by Jumpy on February 24, 2003, at 19:00:12
In reply to Re: Metallica therapy » Jumpy, posted by wcfrench on February 24, 2003, at 3:34:05
> You HAVE to listen to Master of Puppets and Battery, (the whole Master of Puppets album, really) and also Damage, Inc. which is on that album also. Very good stuff for these times. Master of Puppets was one of my favorite songs for a long time.. it's actually a very good song overall from a musical perspective, nice flow.
> I can set these up so you can D/L them if you want, let me know.
>
> See ya,
> Charlie
>
> (PS They go well with Xanax ? ... to make this relevant)Hey Charlie,
"Master ... Master ... Just call my name cause I’ll hear your scream"
Actually Master of Puppets was my first Metallica cd. "Master of Puppets" is a classic and of course "Welcome home Sanitarium" and "Battery" are my favorites. I have seen them twice in concert. I would love to download the songs.
Go James and Lars!
Later,
Jumpy
PS I like them better with klonopin rather than Xanax ... lol
Posted by ace on February 24, 2003, at 19:02:24
In reply to Re: Metallica therapy ?wcfrench, posted by Jumpy on February 24, 2003, at 19:00:12
Posted by Dr. Bob on February 25, 2003, at 0:58:16
In reply to Re: Metallica therapy » Jumpy, posted by wcfrench on February 24, 2003, at 3:34:05
> I can set these up so you can D/L them if you want, let me know.
Please remember that this site should not be used to facilitate any illegal activities, thanks.
Bob
PS: Follow-ups regarding posting policies should be redirected to Psycho-Babble Administration.
Posted by wcfrench on February 25, 2003, at 12:43:41
In reply to Re: Metallica therapy » wcfrench, posted by Jumpy on February 24, 2003, at 19:00:12
In lieu of Dr. Bob's illegal activity post, we shouldn't share music! :) Not to poke fun, but it seems silly given the ease of being able to download xxx and get whatever song you want in a matter of minutes.
It is my second day on Lamictal and I feel a little different already.. it definitely has more of an antidepressing feel to it than Depakote did. I am on 25mg for the first couple of days, having stopped the Dep about 6-7 days ago. I do feel a bit "loopy" for a little while but it seems to level out.
See ya!
-Charlie
Posted by Dr. Bob on February 25, 2003, at 16:57:58
In reply to Re: Metallica therapy » Jumpy, posted by wcfrench on February 25, 2003, at 12:43:41
> In lieu of Dr. Bob's illegal activity post, we shouldn't share music! :) Not to poke fun, but it seems silly given the ease of being able to download xxx and get whatever song you want in a matter of minutes.
It may seem silly to you, but still I'm going to block you from posting for a week now.
Bob
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