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Dr. Bob is Robert Hsiung, MD,
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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
Posted by poop'd-out on December 8, 2003, at 12:10:37
In reply to Re: Lamictal- dosage recommendations for depression?, posted by linnette on November 23, 2003, at 14:04:52
> 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
>Hi Linette,
Sorry this took so long to reply to. I really do
appreciate all the info I can get.I am currently on 100mg of Zoloft, so far the confusion hasn't been much of a problem, but I do see my doc today so I am going to mention the Lam/zoloft interactions.
I have finally reached 100mg on Lam, and I think I am starting to feel better, I will keep my fingers crossed.
It is very complicated with all the different meds that we are on to figure whats doing what and whats interacting with what, that's why we see Docs, right? But, we have to do our own research and take care of ourselves, we are the ones on all this stuff, huh? I like my doc but I guess he's only human so I let him know everything I learn and he listens and appreciates the input I give him.
How are you feeling these days, let's try to keep in touch.
Take care,
Beth
Posted by zenhussy on December 8, 2003, at 12:41:56
In reply to Re: Lamictal- dosage recommendations for depression?, posted by poop'd-out on December 8, 2003, at 12:10:37
>>From November 22, 2003>>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.
>From December 8, 2003> I have finally reached 100mg on Lam, and I think I am starting to feel better, I will keep my fingers crossed.
Hi Beth,
From what I can gather you began augmenting your Zoloft with Lamictal back in mid October? And now you are finally at the 100 mg mark? What increments have you been increasing with?
As with any cocktail it can be difficult to distinguish what medication is causing what se. I'm beginning to wonder about how spacey the lamotrigine might be making me. I've only been on a bit under a month and am discouraged by the molasses like titration. I fully understand the reasons for going so slowly but dang it is such a long haul.
It helps tremendously to read about how it can and does help people if they are patient enough to get up to a therapeutic dosage that is right for them! The patience part is one thing I'm not feeling very positive about at the moment.
Good luck with your pdoc today.
zenhussy
Posted by poop'd-out on December 9, 2003, at 0:09:01
In reply to Re: Lamictal- dosage recommendations for depression? » poop'd-out, posted by zenhussy on December 8, 2003, at 12:41:56
> >>From November 22, 2003>>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.
>
> >From December 8, 2003> I have finally reached 100mg on Lam, and I think I am starting to feel better, I will keep my fingers crossed.
>
> Hi Beth,
>
> From what I can gather you began augmenting your Zoloft with Lamictal back in mid October? And now you are finally at the 100 mg mark? What increments have you been increasing with?
>Hi zenhussy,
Yes, it was the first week in Oct that I started. I have had to go slow because of minor skin issues. I was doing 12.5 mg increases to begin with then after 50mg, 25mg increases every two weeks(Docs order) or 12.5 every week if I wanted.
> As with any cocktail it can be difficult to distinguish what medication is causing what se. I'm beginning to wonder about how spacey the lamotrigine might be making me. I've only been on a bit under a month and am discouraged by the molasses like titration. I fully understand the reasons for going so slowly but dang it is such a long haul.
>As you read, I was feeling the exact same way as you were not that long ago, I didn't reach 75 til almost at a month and a half. So you are getting there quicker than I did! I did feel extremely spacey almost verging on dopiness, also just wanting to sleep all the time, not fun at all. I just read what alot of other people were doing and decided to just hang in there.
It is very discouraging to wait while you feel like crap. I wouldn't quit yet unless you are having severe reactions. I really did have to force myself to hang in there. From what I read alot of people did not get relief til they reached 200mg(so far away).
> It helps tremendously to read about how it can and does help people if they are patient enough to get up to a therapeutic dosage that is right for them! The patience part is one thing I'm not feeling very positive about at the moment.
>Believe me I felt the same way. I just keep telling myself, it's just another few months out of my life, and I don't feel that sparkling anyways, and and... what if it does work and I didn't give it a chance.
> Good luck with your pdoc today.
>Thanks, I did see him and we have decided to hang with 100mg for now. I don't feel bad today, but not great either. That could be a pms thing though. Haven't found a cure for that. I would definitely say I am MUCH better than I was a month ago. I am about 2 months into this thing now. I hope this helps, another poster was one of the reasons I decided to stay on the Lam just a little bit longer.
Hang in there,
Beth
Posted by linnette on December 9, 2003, at 2:32:31
In reply to Re: Lamictal- dosage recommendations for depression?, posted by poop'd-out on December 8, 2003, at 12:10:37
Hi Beth,
Thanks for following up. I'm not doing too well as of mid week last week. Very agitated, sick to my stomach, anxious, tearful, terrible insomnia, (ie depression). I suspect my other meds in my cocktail (zoloft and nortriptyline) have finally washed out of my system, so here I sit with this. I hate this. I had an appt with my pdoc last Tuesday, and he upp'd my dose of lamictal to 250 and I just couldn't tolerate it.I have also had the flu so it is hard to tell what is causing all of this distress.
But right now I feel like I need something just to make me sleep for awhile. The little bit of xanax that I take, isn't cutting it, and neither does adding a little. I will see how the rest of the week goes.
Linnette
Posted by katia on December 10, 2003, at 0:09:16
In reply to Re: Lamictal- dosage recommendations for depression?, posted by linnette on December 9, 2003, at 2:32:31
I seem to be gaining weight since starting Lamictal - I'm at 175mg. I"m also on 7mg of Seroquel and 600-900 of Neurontin for sleep.
anyone else experience weight gain?
katia
Posted by girl1969 on December 11, 2003, at 19:25:43
In reply to Weight gain on Lamictal anyone?, posted by katia on December 10, 2003, at 0:09:16
I just switched to lamictal from zyprexa due to weight gain. I have lost 20 pounds in the month since I switched. I would guess that the seroquel is responsible for the weight gain - it happened to me, too.
Good luck!
Posted by poop'd-out on December 12, 2003, at 14:45:51
In reply to Re: Lamictal- dosage recommendations for depression?, posted by linnette on December 9, 2003, at 2:32:31
> Hi Beth,
> Thanks for following up. I'm not doing too well as of mid week last week. Very agitated, sick to my stomach, anxious, tearful, terrible insomnia, (ie depression). I suspect my other meds in my cocktail (zoloft and nortriptyline) have finally washed out of my system, so here I sit with this. I hate this. I had an appt with my pdoc last Tuesday, and he upp'd my dose of lamictal to 250 and I just couldn't tolerate it.
>
> I have also had the flu so it is hard to tell what is causing all of this distress.
>
> But right now I feel like I need something just to make me sleep for awhile. The little bit of xanax that I take, isn't cutting it, and neither does adding a little. I will see how the rest of the week goes.
>
> LinnetteHi Linnette,
I am so sorry you are feeling so badly. I am at the opposite end of the spectrum right now where all I want to do is sleep. Maybe we should get together and even eachother out.
How long have you been off your other meds? I'm sure alot of what you are feeling is some withdrawals, it always takes awhile for my system to adjust to that. From what I remember it was your decision to discontinue these, were you feeling that badly? I know alot of times when I add a new med I have to tweak around with what drugs I take and at what time to find a balance. Were you taking all of the meds at the same time? I take my zoloft(100mg) at night. I was taking 50 at lunch and 50 at night. I have had to do this many times, figure out what to take when etc.. alot of times just changing when you take what, and what you take with what can make a world of difference. That has been my experience anyway. Whew, that sure was alot of 'what with whats'.
I am sorry to hear you have the flu, that can really make it hard to tell how you are truly feeling. So many times I have had the flu and I am not even sure if its the flu or depression or just me and on and on...my depression can be very physical(can't hardly move, pain, extreme weariness) same symptoms as the flu.
I don't think I could tolerate the Lamictal without other meds. I sometimes get very irritable(more like rage) when I am depressed and other times just can't move don't want to do anything depressed. I definitely have felt the agitation the Lamictal can cause, and I really think my tegretol keeps it somewhat under control.
Of course, at this point all of what your experiencing could just be getting the other meds out of your system, oooh what we have to go through. You poor thing, it just sounds like you need a good night's sleep, I wish I could help. The only thing I can offer is my experience, I never have trouble sleeping, but the times that I did were when I have gotten off meds(for about 2 weeks at least), but the Lamictal is notorious for causing insomnia from what I have read with other posts. I'm sure you knew that though.
Keep in touch please and maybe we can help eachother through this. My hope is that by the time you read this you will be doing much better!!
Beth = )
Posted by zenhussy on December 13, 2003, at 19:56:07
In reply to Re: Lamictal- dosage recommendations for depression?, posted by poop'd-out on December 12, 2003, at 14:45:51
I've now been on lamotrigine for almost four weeks. This Tuesday I move up to the 37.5 mg mark for another two weeks. People around me are reporting that I seem much more 'here' and 'present' and vibrant as of late. I personally feel the same waffliness of moods as always. Perhaps not as severe but I just don't know. *sigh of frustration*
Has anyone had any experience with sudden sleepiness on lamotrigine about 3-5 hours after taking it?
I'm missing life due to sleeping now. I'm used to the insomnia but to have almost a week spent sleeping four or so hours midday is ridiculous.
Does this pass? What experiences do people have with taking this medication at nighttime?
Yawn,
zenhussy
Posted by Flipsactown on December 14, 2003, at 10:49:12
In reply to Re: Lamictal----sudden sleepiness? , posted by zenhussy on December 13, 2003, at 19:56:07
I have been on lamictal, currently at 400mg, nearly 3 months and have not experienced the sleepiness you are referring to. I also take prozac and remeron and I know remeron has a sedating effect, so it could be that I am sleeping so well with remeron which I take at bedtime that I don't get sleepy during the day.
Flipsactown> I've now been on lamotrigine for almost four weeks. This Tuesday I move up to the 37.5 mg mark for another two weeks. People around me are reporting that I seem much more 'here' and 'present' and vibrant as of late. I personally feel the same waffliness of moods as always. Perhaps not as severe but I just don't know. *sigh of frustration*
>
> Has anyone had any experience with sudden sleepiness on lamotrigine about 3-5 hours after taking it?
>
> I'm missing life due to sleeping now. I'm used to the insomnia but to have almost a week spent sleeping four or so hours midday is ridiculous.
>
> Does this pass? What experiences do people have with taking this medication at nighttime?
>
> Yawn,
> zenhussy
Posted by katia on December 14, 2003, at 15:22:52
In reply to Re: Lamictal----sudden sleepiness? » zenhussy, posted by Flipsactown on December 14, 2003, at 10:49:12
anyone out there on Lamictal get very dizzy and nauseous at 200mg?
I'm so dizzy like an inner ear thing is going on - also my stomach is not feeling well. Everything going right through me in the liquid form...
A queazy nervousness in my stomach...
I'm also on 11ish g. of fish oil.
I also started the ATkins Diet four days ago - however I was feeling this before then. It's awful. I constantly feel as if I could throw up. AND NO I'M NOT PREGNANT. A sex life - what's that?
So it could be from one of the above or something else. But it's awful. And I don't think it's a cold or the flu b/c it's been going on for a week now, esp.in the last three days...Atkin's?
How would eliminating carbs do this to me?As far as sleepiness on Lam. - it's the opposite for me.
Anyone have insights, comments???
thanks.
Katia
Posted by Flipsactown on December 14, 2003, at 16:50:56
In reply to Lamictal dizziness or nauseousness?, posted by katia on December 14, 2003, at 15:22:52
Sorry to hear that you are having problems with your meds, specifically lamictal. I have been on lamictal nearly 3 months now, currently at 400mgs, and have not experienced any of the side effects you are referring to. However, everyone reacts differently to meds. Could it be the combo of lamictal and the fish oil? I don't know but that would be my guess. Good luck.
Flipsactown
> anyone out there on Lamictal get very dizzy and nauseous at 200mg?
> I'm so dizzy like an inner ear thing is going on - also my stomach is not feeling well. Everything going right through me in the liquid form...
> A queazy nervousness in my stomach...
> I'm also on 11ish g. of fish oil.
> I also started the ATkins Diet four days ago - however I was feeling this before then. It's awful. I constantly feel as if I could throw up. AND NO I'M NOT PREGNANT. A sex life - what's that?
> So it could be from one of the above or something else. But it's awful. And I don't think it's a cold or the flu b/c it's been going on for a week now, esp.in the last three days...Atkin's?
> How would eliminating carbs do this to me?
>
> As far as sleepiness on Lam. - it's the opposite for me.
>
> Anyone have insights, comments???
> thanks.
> Katia
>
Posted by katia on December 14, 2003, at 17:29:35
In reply to Re: Lamictal dizziness or nauseousness? » katia, posted by Flipsactown on December 14, 2003, at 16:50:56
Hi,
I think I got to the culprit = cheese. I don't normally eat it and on the Atkin's Diet I'm eating an oz. every day. I think that's the one - I'm slightly allergic. Hopefully that's it anyway. You just never know what's doing it when there are so many variables.I've heard conflicting stories about dosage for Lamictal. I've heard that over 200mg there really isn't a difference. You're at 400mg - what has been your experience at the dose increases after 200mg? Are you bipolar? Are you on any other meds?
Katia
Posted by Flipsactown on December 14, 2003, at 19:19:12
In reply to Re: Lamictal dizziness or nauseousness? » Flipsactown, posted by katia on December 14, 2003, at 17:29:35
Hello,
I have been on 400mgs less than 2 weeks, but I do noticed that I have never felt as depression free as I have since the time I first took prozac around 12 years ago when I experienced a dramatic lifting of depression. I am currently on 100mgs prozac and 90mgs of remeron along with lamictal for unipolar depression.
Flipsactown
> Hi,
> I think I got to the culprit = cheese. I don't normally eat it and on the Atkin's Diet I'm eating an oz. every day. I think that's the one - I'm slightly allergic. Hopefully that's it anyway. You just never know what's doing it when there are so many variables.
>
> I've heard conflicting stories about dosage for Lamictal. I've heard that over 200mg there really isn't a difference. You're at 400mg - what has been your experience at the dose increases after 200mg? Are you bipolar? Are you on any other meds?
> Katia
Posted by zenhussy on December 14, 2003, at 23:18:18
In reply to Re: Lamictal----sudden sleepiness? » zenhussy, posted by Flipsactown on December 14, 2003, at 10:49:12
Posted by katia on December 15, 2003, at 1:50:21
In reply to Re: Lamictal dizziness or nauseousness? » katia, posted by Flipsactown on December 14, 2003, at 19:19:12
ARe you bipolar?
Posted by Flipsactown on December 15, 2003, at 5:28:47
In reply to Re: Lamictal dizziness or nauseousness? » Flipsactown, posted by katia on December 15, 2003, at 1:50:21
Posted by zenhussy on December 15, 2003, at 14:39:33
In reply to Re: Lamictal- dosage recommendations for depression? » zenhussy, posted by poop'd-out on December 9, 2003, at 0:09:01
> Hi zenhussy,
> Yes, it was the first week in Oct that I started. I have had to go slow because of minor skin issues. I was doing 12.5 mg increases to begin with then after 50mg, 25mg increases every two weeks(Docs order) or 12.5 every week if I wanted.
> As you read, I was feeling the exact same way as you were not that long ago, I didn't reach 75 til almost at a month and a half. So you are getting there quicker than I did! I did feel extremely spacey almost verging on dopiness, also just wanting to sleep all the time, not fun at all. I just read what alot of other people were doing and decided to just hang in there.
> It is very discouraging to wait while you feel like crap. I wouldn't quit yet unless you are having severe reactions. I really did have to force myself to hang in there. From what I read alot of people did not get relief til they reached 200mg(so far away).
> Believe me I felt the same way. I just keep telling myself, it's just another few months out of my life, and I don't feel that sparkling anyways, and and... what if it does work and I didn't give it a chance.
> Thanks, I did see him and we have decided to hang with 100mg for now. I don't feel bad today, but not great either. That could be a pms thing though. Haven't found a cure for that. I would definitely say I am MUCH better than I was a month ago. I am about 2 months into this thing now. I hope this helps, another poster was one of the reasons I decided to stay on the Lam just a little bit longer.
> Hang in there,
> BethBeth,
Thank you so much for the encouragement. Spoke with my pdoc this a.m. and was told to switch taking the lamotrigine at night to avoid this daytime sleepiness. "I did feel extremely spacey almost verging on dopiness, also just wanting to sleep all the time, not fun at all." That is exactly how I've been feeling since being at the 25 mg mark. Sheesh!! Dopey and spacey...what fun!
Since I do not appear to be having major se's from this med. I will continue this tiny titration in hopes that it kicks in and lifts some of this confounded darkness.
Your feedback is invaluable. It has been a long time since I've been on the med board because my cocktail was the same for so long. Now I've been going through adjusting every dang med since October. I'm glad that better living through chemisty exists. Now if I could just have some of that 'better living'!!
Take care. Glad you had good visit with pdoc. Let us know how the 100 mg treats you.
zenhussy
Posted by linnette on December 17, 2003, at 0:33:31
In reply to Re: Lamictal- dosage recommendations for depression?, posted by poop'd-out on December 12, 2003, at 14:45:51
Hi Beth,
Thanks so much for your kind words and encouragement. I have found that this board has been the best thing for me, and I am happy to have found such supportive people out there that share similar experiences.
I am doing somewhat better, although I am back at "what the hell is doing what.?" I think you are right that the lamictal is hard to tolerate without the other meds on board, and that is probably what has back-fired on me here. And the trying to figure out when to take what.. Boy the lamictal can be so activating, but also can give make me very tired sometimes. I am holding a 200 mg now, and have added 30 mg nortriptyline at night mainly for sleep.
I relapsed after only 3 or so weeks off of my AD's. Yes, it was my decision to stop the AD's, (a bad decision I think). My pdoc didn't think it such a bad idea, just to see how I would do with a MS alone. My appetite and energy was better before I went off of my AD's. And now both are in the toilet. I should have left well enough alone. At least I am sleeping now, but wake up a little anxious still..
Your symptoms sound much like my own.. I can totally relate to the wanting to sleep, just sleep, and not caring about anything else. Although right now I am at the tail end of an agitated depression, or maybe a mixed state, I do know what you are feeling. And like yours, my depression is also very very physical. Since I have gone off of my AD's my back and my joints have been killing me, and I even think part of my flu was due to the other meds washing out of my system. Then I resumed my AD and miraculously my back feels so much better.
Your comments about the irritability or rage, yes, I can totally relate. And that is the main reason I have hoped that a mood stabilizer would help me.
Beth, you are on tegretol too? And zoloft, right? Did you have trouble getting adjusted to the tegretol? I tried 2 times to take it with no success, but maybe I should have stuck it out. Do you think it makes you less irritable, and what benefit does it have over the lamictal for you? Also do you ever find that the lamictal reacts with the zoloft in any way, such as puts you in a very confused anxious state. Probably not, if you are on 100 mg. I think the effect I had a year ago with the 2 of them was somewhat rare.
So now I am taking 200 mg lamictal, 30 mg nortriptyline, xanax 1.5 mg day. I guess that isn't so bad. Oh and a little dexedrine that I take for ADD. Right now it just helps me get my butt into work in the morning and that is about it, although I have missed days and have been late on several occasions.
Anyway, bring me up to date, and hoping you are sleeping less, and feeling a little more energetic. The holidays can sure aggravate things. I will keep you posted.
Linnette
Posted by poop'd-out on December 17, 2003, at 15:07:37
In reply to Re: Lamictal- dosage recommendations for depression? » poop'd-out, posted by zenhussy on December 15, 2003, at 14:39:33
> Beth,
>
> Thank you so much for the encouragement. Spoke with my pdoc this a.m. and was told to switch taking the lamotrigine at night to avoid this daytime sleepiness. "I did feel extremely spacey almost verging on dopiness, also just wanting to sleep all the time, not fun at all." That is exactly how I've been feeling since being at the 25 mg mark. Sheesh!! Dopey and spacey...what fun!
>
> Since I do not appear to be having major se's from this med. I will continue this tiny titration in hopes that it kicks in and lifts some of this confounded darkness.
>
> Your feedback is invaluable. It has been a long time since I've been on the med board because my cocktail was the same for so long. Now I've been going through adjusting every dang med since October. I'm glad that better living through chemisty exists. Now if I could just have some of that 'better living'!!
>
> Take care. Glad you had good visit with pdoc. Let us know how the 100 mg treats you.
>
> zenhussy
>
>
>
Zenhussy,Well, the 100mg didn't last that long. Into the second week I began to have the extreme somnolence that I had had previously. It was a little discouraging. I decided to go ahead and increase the dose again by 25mg. That was 3 days ago, and it has helped alot. I have already decided that I am going to stay on the lamictal til I at least reach the 200mg point.
This is a strange drug. It can be very motivating and helpful or the complete opposite depending on what dose you are at.
Have you had any positive experience with it or has it just made you feel mopey? I know with me I had to wait til at least after the 50mg mark before I saw any benefit, and when it does help it really makes a big difference. If only a little consistency, please!
I'll keep you posted, so far so good!
Beth
Posted by poop'd-out on December 17, 2003, at 16:49:05
In reply to Re: Lamictal- dosage recommendations for depression?, posted by linnette on December 17, 2003, at 0:33:31
>
> I relapsed after only 3 or so weeks off of my AD's. Yes, it was my decision to stop the AD's, (a bad decision I think). My pdoc didn't think it such a bad idea, just to see how I would do with a MS alone. My appetite and energy was better before I went off of my AD's. And now both are in the toilet. I should have left well enough alone. At least I am sleeping now, but wake up a little anxious still..
>I understand about not having an appetite. When I'm depressed I would prefer not to eat anything. Everything tastes like cardboard. But, I learned a long time ago that I feel even worse when I don't eat, so I force myself to. I hope you are eating, it is really important to your physical and mental health. I find protein to be very important. I have to have my carbs though, or I get very cranky. The protein really tempers the carbs so you don't get that sugar crash. I like a nice juicy steak, makes me happy, truly. Sorry if you are a vegetarian. =)
> Your symptoms sound much like my own.. I can totally relate to the wanting to sleep, just sleep, and not caring about anything else. Although right now I am at the tail end of an agitated depression, or maybe a mixed state, I do know what you are feeling. And like yours, my depression is also very very physical. Since I have gone off of my AD's my back and my joints have been killing me, and I even think part of my flu was due to the other meds washing out of my system. Then I resumed my AD and miraculously my back feels so much better.
>You were still probably experiencing some of the w/d's from you AD's. I think alot of the agitation you are experiencing might be from the lamictal.
> Your comments about the irritability or rage, yes, I can totally relate. And that is the main reason I have hoped that a mood stabilizer would help me.
>
I don't think the lamictal is enough of a mood stabilizer on its own. From what I have read most people have ended up having to take it with either an AD or another MS. You could throw that idea out to your Doc?> Beth, you are on tegretol too? And zoloft, right? Did you have trouble getting adjusted to the tegretol? I tried 2 times to take it with no success, but maybe I should have stuck it out. Do you think it makes you less irritable, and what benefit does it have over the lamictal for you?
Yes, I had a rough time of it. I don't know why I actually ended up staying on it except that I had tried everything else and didn't know where else to turn. Also, my Doc had said that it may take 6mos-yr to work(yikes). The initial SE's that I had made the lamictal SE's like a walk in the park. It was so long ago I will try to remember what happened.
I was also on the neurontin then(and now). Initially, I ended up taking 4 tabs(800mg) all at night. That did not work at all. Tegretol is supposed to be long acting, but I knew that my body processes meds very quickly. So, since that wasn't working I decided to take it throughout the day instead. When I finally started combining it with my neurontin that is when it finally started working for me.
It wasn't always the best cocktail but I was alot less angry and my anxiety was all but nil. Eventually, we added the zoloft and that is another story!
This has been my staple cocktail for several years. Not the best but much much better than I was prior, alot of sweat and tears to get here!
>Also do you ever find that the lamictal reacts with the zoloft in any way, such as puts you in a very confused anxious state. Probably not, if you are on 100 mg. I think the effect I had a year ago with the 2 of them was somewhat rare.
>I don't think that I had that. Maybe at the very beginning. I also did some switching around with my meds(again). I used to take 50mg zoloft in the day and 50mg at night, I have switched it to 100mg at night taken with 300mg of neurontin. I don't take it concurrently with the lam so maybe that was your problem(if you did that).
> So now I am taking 200 mg lamictal, 30 mg nortriptyline, xanax 1.5 mg day. I guess that isn't so bad. Oh and a little dexedrine that I take for ADD. Right now it just helps me get my butt into work in the morning and that is about it, although I have missed days and have been late on several occasions.
>The dex and lam could probably interact to cause some of your agitation also. How long have you been on the nortriptyline? You might just want to chill until it kicks back in and see how you are from there? (In regards to adding any other meds at this time).
> Anyway, bring me up to date, and hoping you are sleeping less, and feeling a little more energetic. The holidays can sure aggravate things. I will keep you posted.
>I have just increased to 125mg of lam and feel much better! For how long, I don't know.
Just for your info this is how my complicated med schedule goes:(I don't eat 1 hour before of after taking tegretol or I just get tired and depressed)
Morning: 1-1/2 teg 200mg tabs
with 1 neurontin 300mg
Mid morn: 75mg lam with 1 neurontin
Lunch: 50mg lam with 1 neurontin
hour or
so after: 1-1/2 teg with 1 neurontin
2 or 2-1/2
hours later
or after
small snack: 1 teg with 1 neurontin
Dinner: sometime after and before bedtime
zoloft 100mg with 1 neurontinI like the neurontin as sort of a buffer to the other drugs. I'm not exactly sure how it helps, it just seems to compliment the other meds. It has a very short half-life so I take it all day long. My tummy also gets upset by most meds and I have found it to really helpful in that department.
Take care of yourself. I hope I helped and didn't make things more confusing for you.
Beth
Posted by zenhussy on December 18, 2003, at 19:58:12
In reply to Re: Lamictal- dosage recommendations for depression? » zenhussy, posted by poop'd-out on December 17, 2003, at 15:07:37
>Zenhussy,
>Well, the 100mg didn't last that long. Into the second week I began to have the extreme somnolence that I had had previously. It was a little discouraging. I decided to go ahead and increase the dose again by 25mg. That was 3 days ago, and it has helped alot. I have already decided that I am going to stay on the lamictal til I at least reach the 200mg point.Beth,
This kind of firsthand experience is so valuable. Thank you. Sorry you had that draggy feeling for a few days but encouraging to hear that bumping up the dose has an almost immediate effect.
>This is a strange drug. It can be very motivating and helpful or the complete opposite depending on what dose you are at.Yeah it seems to go up and down with the doses I'm at as I titrate up.
>Have you had any positive experience with it or has it just made you feel mopey? I know with me I had to wait til at least after the 50mg mark before I saw any benefit, and when it does help it really makes a big difference. If only a little consistency, please!Feedback from my family is that I already sound different. My brother commented I sounded like I used to when he was talking to my mum. I guess that is a good thing. We all refer to things as predepression. Acupuncture makes me more 'me' i.e. more like I was before major depression tackled me a decade ago.
I'm going so slowly doing only 12.5 increases every two weeks so I'm still at 37.5 for another little bit. I feel spacey. Like out of it spacey. The sudden sleepiness thing was taken care of almost instantly with switching the dose to nighttime. Haven't had to take sleeping pills in a while either. Bonus!
>I'll keep you posted, so far so good!
>BethI'm very happy to hear that this is having a positive effect in your life. We should all be so lucky with finding that right combo!!
Please do keep checking in. Most other meds I've run through over the years I just dealt with and didn't really have an outlet like this or need to ask questions. Lamotrigine is one funky mood stabilizer. I'm hoping that there are no major bumps between where I'm at now and whatever level my pdoc deems therapeutic.
Take care and pave that way with the Lamictal advice!!
zenhussy
Posted by katia on December 19, 2003, at 20:27:58
In reply to Re: Lamictal- dosage recommendations for depression? » poop'd-out, posted by zenhussy on December 18, 2003, at 19:58:12
Hi Beth,
I too, like you, titrated up SLOWLY! and I'm at 200mg now and don't feel much. I was on Depakote while I was at the lower titration levels and every small increase, I'd go into a nice hypomanic state for a couple of days. It was great. Once the Depakote finished, I lost those buzzy feelings, but at each increase felt "normalish" for a few days then it would drop off - wouldn't stick. I went into a horrible mixed state on Monday, so I"m still cycling. I just saw my pdoc today and I'm starting Lithium with the Lam. today.
hope 200mg works for you.
katia
Posted by poop'd-out on December 20, 2003, at 22:54:29
In reply to Re: Lamictal- dosage recommendations for depression?, posted by katia on December 19, 2003, at 20:27:58
> Hi Beth,
> I too, like you, titrated up SLOWLY! and I'm at 200mg now and don't feel much. I was on Depakote while I was at the lower titration levels and every small increase, I'd go into a nice hypomanic state for a couple of days. It was great. Once the Depakote finished, I lost those buzzy feelings, but at each increase felt "normalish" for a few days then it would drop off - wouldn't stick. I went into a horrible mixed state on Monday, so I"m still cycling. I just saw my pdoc today and I'm starting Lithium with the Lam. today.
> hope 200mg works for you.
> katia
I know that is what I am worried about. I will feel good for a few days, then I'm back to blah, yucky again. I don't know, I am also on other meds so I was hoping that might give me the edge I need. Please let me know how the Lithium does for you, that seems to be a nice combo from what I've read. Oh, and yes I am starting to notice an increase in my weight as well as thinning of my hair. It totally sucks!Take care,
Beth
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