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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 25 of 38. This is the beginning of the thread.
Posted by tensor on November 12, 2006, at 9:28:11
Fifth day on Lamictal 200mg, my depression is getting worse and have increased anxiety and I have developed panic attacks. Anyone know if Lamictal is causing this, or suggestions what to do?
/Mattias
Posted by ronaldo on November 12, 2006, at 9:45:38
In reply to Depression is getting worse, posted by tensor on November 12, 2006, at 9:28:11
> Fifth day on Lamictal 200mg, my depression is getting worse and have increased anxiety and I have developed panic attacks. Anyone know if Lamictal is causing this, or suggestions what to do?
>
> /MattiasHi Mattias,
I was wondering how you were getting along with your new Lamictal. Is it monotherapy? If not what else are you taking? Seems like Lamictal is the culprit here. What happens if you stop it? Or don't you want to stop it just yet?
Dr Ivan Goldberg lists the s/e's of Lamotrigine at point no. 13 at the following web site but no mention of deteriorating depression or panic attacks. You need to speak to your pdoc, Matt.
http://www.psycom.net/depression.central.lamotrigine.html
Could it be an interaction with something else you are also taking?
Sorry I can't be of much use to you.
....ronaldo
Posted by blueberry on November 12, 2006, at 10:01:37
In reply to Depression is getting worse, posted by tensor on November 12, 2006, at 9:28:11
I keep daily notes in a depression diary. I looked back through my notes of when I tried lamictal back in 2005. I had the same things happen to me. It gave me an immediate boost of good mood on the first day, followed by a worsening of mood from the second day on, actually quite a bit worse than where I had started. Lamictal was abandoned in a week.
I guess if someone had the time to just sit around and wait it out and give it a real long trial and they were able to endure the worsening of conditions to see if they eventually got better, that might be one thing. But I have a daily job to perform at and a family to support financially, so somehow my medication trials have to fit into that. Lamictal was not able to do that. I worsened very quickly with lamictal.
Posted by tensor on November 12, 2006, at 10:21:06
In reply to Re: Depression is getting worse » tensor, posted by blueberry on November 12, 2006, at 10:01:37
I called the hospital and talked to a nurse, my pdoc will call me later this evening. How much side effects of this kind is one meant to endure. I feel sick, and I don't know if I dare take Lamictal tonight.
Posted by tensor on November 12, 2006, at 10:34:16
In reply to Depression is getting worse, posted by tensor on November 12, 2006, at 9:28:11
Just talked to my pdoc, i'm going to see him tomorrow. I'm putting together a list with questions to him. If you can come up with a question that I really should ask, please let me know.
/Mattias
Posted by Meri-Tuuli on November 12, 2006, at 10:49:57
In reply to Re: Depression is getting worse, posted by tensor on November 12, 2006, at 10:34:16
Good luck with the appointment, Mattias! I can only offer general support, I have no knowledge of lacitmal.... Well the weather has been getting to me recently, man, its so grey and drizzly and cold.... anyway, take care
Meri-Tuuli
Posted by ronaldo on November 12, 2006, at 11:02:10
In reply to Re: Depression is getting worse, posted by tensor on November 12, 2006, at 10:34:16
Hi Mattias,
How about this? Take 100 mg tonight. Did you have any of these symptoms on 100 mg - I think not. So IF it is the Lamictal you should see an improvement in your symptoms. If it is not the Lamictal then you have only gone down by 100 mg and you can quickly continue to acclimatise to the 200 mg. But it sounds to me like Lamictal is not for you. Are you taking any other anti-convulsant? They can interact with each other.
"Valproate has the ability to double plasma levels of lamotrigine. Because of that, when lamotrigine is started in people taking valproate, the initial dose should be approximately one-half as much as is usually initially prescribed."
http://www.psycom.net/depression.central.lamotrigine.html ....see point 10
Don't make this Lamictal a stick to beat yourself with (like I did with the Zyprexa).
....ronaldo
Posted by Phillipa on November 12, 2006, at 11:12:56
In reply to Re: Depression is getting worse » tensor, posted by ronaldo on November 12, 2006, at 11:02:10
Tensor so what happened? Are you still on the lamicatal? Love Phillipa
Posted by tensor on November 12, 2006, at 11:17:03
In reply to Re: Depression is getting worse » tensor, posted by ronaldo on November 12, 2006, at 11:02:10
>How about this? Take 100 mg tonight. Did you have any of these symptoms on 100 mg
That's actually what me and my pdoc decided. I don't think the anxiety and the panic attacks were a problem at 100mg, however, I did lack energy more than before Lamictal.
>Don't make this Lamictal a stick to beat yourself with (like I did with the Zyprexa).
I know, it's easily happened.
/Mattias
Posted by tensor on November 12, 2006, at 11:21:49
In reply to Re: Depression is getting worse, posted by Phillipa on November 12, 2006, at 11:12:56
>Tensor so what happened? Are you still on the lamicatal?
Yes i'm still on Lamictal, but I will reduce to
100mg tonight. My pdoc wants to see me tomorrow, so nothing is decided yet. I have taken extra doses of clon so most of the panic feelings have diminished./Mattias
Posted by tensor on November 12, 2006, at 11:23:27
In reply to Re: Depression is getting worse, posted by Meri-Tuuli on November 12, 2006, at 10:49:57
> Good luck with the appointment, Mattias!
Thank you Meri-Tuuli.
>I can only offer general support
That's worth a lot, thank you.
/Mattias
Posted by ronaldo on November 12, 2006, at 15:03:23
In reply to Depression is getting worse, posted by tensor on November 12, 2006, at 9:28:11
> Fifth day on Lamictal 200mg, my depression is getting worse and have increased anxiety and I have developed panic attacks. Anyone know if Lamictal is causing this, or suggestions what to do?
>
> /MattiasDo you think a more gradual increase to 200 mg might be better? Say 100 mg then 125 mg for a week or ten days or two weeks? You seem to be ultra sensitive around the 200 mg mark. Your ideal dose might be 150 mg but by going from 100 mg directly to 200 mg you have leapfrogged 150 mg. Then again your ideal dose for Lamictal might be 125 mg? You will only find out by increasing very gradually with patience. Take this all with a dose of salt because I don't really know what I am talking about as I have never taken Lamictal, but there again neither have most doctors.
....ronaldo
Posted by ronaldo on November 12, 2006, at 15:19:11
In reply to Re: Depression is getting worse » tensor, posted by ronaldo on November 12, 2006, at 15:03:23
> > Fifth day on Lamictal 200mg, my depression is getting worse and have increased anxiety and I have developed panic attacks. Anyone know if Lamictal is causing this, or suggestions what to do?
> >
> > /Mattias
>
> Do you think a more gradual increase to 200 mg might be better? Say 100 mg then 125 mg for a week or ten days or two weeks? You seem to be ultra sensitive around the 200 mg mark. Your ideal dose might be 150 mg but by going from 100 mg directly to 200 mg you have leapfrogged 150 mg. Then again your ideal dose for Lamictal might be 125 mg? You will only find out by increasing very gradually with patience. Take this all with a dose of salt because I don't really know what I am talking about as I have never taken Lamictal, but there again neither have most doctors.
>
> ....ronaldosee here for Dr Ivan Goldberg's view on titrating Lamictal
http://www.dr-bob.org/babble/20061104/msgs/701604.html
Posted by tensor on November 12, 2006, at 15:28:12
In reply to Re: Depression is getting worse » tensor, posted by ronaldo on November 12, 2006, at 15:03:23
>Do you think a more gradual increase to 200 mg might be better?
Hard to say, if there were any improvement in energy, I could stay at 200mg and use benzos(high dose) to combat the anxiety attacks for a period. As I said I'm going to take 100mg tonight. The pdoc I'm going to see tomorrow is a very experienced old school guy i think, he's retired but jumps in now and then for other pdocs. He's really calming and seems to be a nice type of person. If he says "don't worry, it'll be okay" it calms you down more than 2mg of clon.
I've never met him in person but I've spoke to him over phone a few times.Thanks for your input.
/Mattias
Posted by ronaldo on November 12, 2006, at 15:31:28
In reply to Re: Depression is getting worse, posted by ronaldo on November 12, 2006, at 15:19:11
here it is, Dr Ivan Goldberg:
9. How is treatment with lamotrigine initiated?
In people not taking carbamazepine or valproate, lamotrigine is usually initially prescribed at an initial dose of 12.5 or 25 mg a day and the dose increased by 12.5 or 25 mg every week or two.
In people taking valproate the initial dose of lamotrigine is often 12.5 mg/day and the drug is increased by 12.5 mg every ten days or two weeks.
In people taking carbamazepine somewhat larger initial doses and more rapid increases in dose are possible.
http://www.psycom.net/depression.central.lamotrigine.html
I hope this helps. I know I posted it before; please don't think I am rubbing salt in the wound.
...ronaldo
Posted by tensor on November 12, 2006, at 15:48:04
In reply to Re: Depression is getting worse - sorry wrong link, posted by ronaldo on November 12, 2006, at 15:31:28
>Dr Ivan Goldberg:
9. How is treatment with lamotrigine initiated?But isn't the slow titration a way of minimizing the risk of rash rather than avoiding anxiety and depression? TCA's for example, has more s/e than Lamictal and the titration rate for them is often a doubling of dose every third day.
/Mattias
Posted by ronaldo on November 12, 2006, at 16:36:58
In reply to Re: Depression is getting worse - sorry wrong link » ronaldo, posted by tensor on November 12, 2006, at 15:48:04
> >Dr Ivan Goldberg:
> 9. How is treatment with lamotrigine initiated?
>
> But isn't the slow titration a way of minimizing the risk of rash rather than avoiding anxiety and depression? TCA's for example, has more s/e than Lamictal and the titration rate for them is often a doubling of dose every third day.
>
> /MattiasPsychotropic drugs are powerful but not all people react to them in the same way. You need to find the right dosage for you which is not the same thing as the right dosage for anyone else. You can only find the right dose if you try all of them, slowly, one by one, until you hit on the one that is right for you. IOW you have to be careful and patient and you have to monitor your reactions and note them down if necessary...
Good luck, Lamictal might still have good things in store for you. I hope so. I may be taking the Lamictal route myself in the near future. I hope to take my own advice when the time comes...after I have tried it out on someone else, lol.
...ronaldo
Posted by BryanII on November 12, 2006, at 16:39:55
In reply to Re: Depression is getting worse » tensor, posted by blueberry on November 12, 2006, at 10:01:37
> I keep daily notes in a depression diary. I looked back through my notes of when I tried lamictal back in 2005. I had the same things happen to me. It gave me an immediate boost of good mood on the first day, followed by a worsening of mood from the second day on, actually quite a bit worse than where I had started. Lamictal was abandoned in a week.
>
> I guess if someone had the time to just sit around and wait it out and give it a real long trial and they were able to endure the worsening of conditions to see if they eventually got better, that might be one thing. But I have a daily job to perform at and a family to support financially, so somehow my medication trials have to fit into that. Lamictal was not able to do that. I worsened very quickly with lamictal.
I also kept a daily diary. After increasing to 100 mg my mood deteriorated. Depression, negative ruminations, low focus and energy. This passed after 5-7 days. Ultimately I ended up at 200.I'm not saying this will be the case for you, just offering my experience. Lamictal may not be for you. Best to monitor closely, work with Pdoc, and wean off it if it's really not good.
Good luck
Posted by tensor on November 12, 2006, at 16:47:17
In reply to Re: Depression is getting worse, posted by BryanII on November 12, 2006, at 16:39:55
> I also kept a daily diary. After increasing to 100 mg my mood deteriorated. Depression, negative ruminations, low focus and energy. This passed after 5-7 days. Ultimately I ended up at 200.
This is very interesting, maybe I went up to 200mg too quickly, as ronaldo also suggests. Will tell my pdoc about your experience.
> I'm not saying this will be the case for you, just offering my experience. Lamictal may not be for you. Best to monitor closely, work with Pdoc, and wean off it if it's really not good.It could be the case for me and thanks for sharing.
> Good luck
Thank you, I will keep you updated.
/Mattias
Posted by rovers95 on November 12, 2006, at 20:11:49
In reply to Re: Depression is getting worse » BryanII, posted by tensor on November 12, 2006, at 16:47:17
Are you supplementing with folic acid??
Its just iv read in numerous places that lamictal results in folate loss, and seen as low folic aid is implemented in lots of depressions anyway........this could lead to a further worsening of the folic acid deficiency and therefore the depression!
"Between 15% and 38% of people with depression have low folate levels in their bodies and those with very low levels tend to be the most depressed"
Obviously i am not a medical expert and everyone reacts differently to meds......this is just a suggestion!!
mark
Posted by Phillipa on November 12, 2006, at 21:32:31
In reply to lamictal - folic acid?, posted by rovers95 on November 12, 2006, at 20:11:49
Would an MVI take care of the folate? Love Phillipa
Posted by stargazer on November 12, 2006, at 22:52:11
In reply to Re: lamictal - folic acid? » rovers95, posted by Phillipa on November 12, 2006, at 21:32:31
Last visit to my pdoc, he rec. taking 800 mcg of folic acid, most MVI has 400 mcg. He also rec taking fish oil, but can't remember amount he rec.
I've got too many things to think about right now, I just want a med to work, don't psychiatrists know what they're doing? Don't they get any training to know how to determine what meds will work for one person and not for another? And with every new med developed the process gets trickier and trickier.
Is anybody getting better for longer than a brief time on these meds? Perhaps they do only work briefly and that is why we are live on Psychobabble. Except Psychobabble is wearing me out, Good night......................SG.
Posted by tensor on November 13, 2006, at 5:22:34
In reply to lamictal - folic acid?, posted by rovers95 on November 12, 2006, at 20:11:49
Yes I do take folic acid, 200microg/day as supps.
Do you know if it's enough?/Mattias
Posted by rovers95 on November 13, 2006, at 8:50:49
In reply to Re: lamictal - folic acid? » rovers95, posted by tensor on November 13, 2006, at 5:22:34
> Yes I do take folic acid, 200microg/day as supps.
> Do you know if it's enough?
>
> /MattiasThink crazymeds recommends 800mcg, so i take 2 x solgar 400mcg capsules along with my multivitamin.
mark
Posted by rovers95 on November 13, 2006, at 8:56:06
In reply to Re: lamictal - folic acid?, posted by stargazer on November 12, 2006, at 22:52:11
> Last visit to my pdoc, he rec. taking 800 mcg of folic acid, most MVI has 400 mcg. He also rec taking fish oil, but can't remember amount he rec.
>
> I've got too many things to think about right now, I just want a med to work, don't psychiatrists know what they're doing? Don't they get any training to know how to determine what meds will work for one person and not for another? And with every new med developed the process gets trickier and trickier.
>
> Is anybody getting better for longer than a brief time on these meds? Perhaps they do only work briefly and that is why we are live on Psychobabble. Except Psychobabble is wearing me out, Good night......................SG.
I prefer to think that the people who have got better from these meds have deserted us on psychobabble as they now live a "normal" life again!!i agree about the meds thing, its ridiculous - sometimes it seems whatever your symptoms, a med that a doc has succesfully prescribed for others before will be prescribed to u!! it seems to be to much of a trail and error thing.............with way too much error!!!
mark
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