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Dr. Bob is Robert Hsiung, MD,
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Posted by SLS on December 30, 2011, at 21:20:52
In reply to lamictal +prozac/prozac onset of action, posted by n_shrimpie on December 30, 2011, at 21:01:53
> I've been on lamictal for years. At first it worked extraordinarily well as an antideppresdant and for my mild bipolar. After about 6 months, it stopped working completely,so i stopped taking it, and several months later i started up again. It worked for a while, then stopped again, but i stayed on it because going off sent me into the abyss. if i don't take it for 2 days, i'm miserable, but when i restart, it works for 2 days then stops again. I think I get desensitized to it. I added 20 mg of prozac on 10/27, and after a month i was unable to have sex and it wasn't working, so i stopped. Oddly enough, after a week off of it I started feeling much better. My cognitive faculties and sex drive returned, and my anhedonia dissipated for the first time in many months. This went on until 12/20, and then, in the course of one day, i went back to ground zero, so i restarted on 12/21, felt great on 12/23, then the anhedonia returned on 12/24. why did i feel the best when it was leaving my system? Did it take 5 weeks to start working even though i'd only taken it for 4? It worked when it was leaving my system and my blood levels decreased, so maybe i need less, like 10mg? i feel so hopeless, i cannot function, i can't work, I spend 7 hours a day in bed, i'm numb and I can't think clearly or read.
I'm sorry that you are going through such hell right now. It seems that your brain is somewhat responsive to drug treatment. This is a good thing. My guess is that you will find something that works - just not today. :-(Your experience with Lamictal (lamotrigine) is not so rare. I am taking Abilify along with Lamictal. They might be complimentary, as they both increase limbic dopamine activity, albeit through different mechanisms.
- Scott
Posted by n_shrimpie on December 31, 2011, at 9:31:39
In reply to Re: lamictal +prozac/prozac onset of action » n_shrimpie, posted by SLS on December 30, 2011, at 21:20:52
maybe i should ask my doctor for abilify instead of prozac. did you experience poop out on the lamictal too?
Posted by SLS on December 31, 2011, at 9:51:29
In reply to Re: lamictal +prozac/prozac onset of action, posted by n_shrimpie on December 31, 2011, at 9:31:39
> maybe i should ask my doctor for abilify instead of prozac. did you experience poop out on the lamictal too?
Not really. Unfortunately, some people do.
By itself, Lamictal doesn't do very much for me. In combination with antidepressants and Abilify, I am improved.
- Scott
Posted by Phillipa on December 31, 2011, at 10:13:44
In reply to Re: lamictal +prozac/prozac onset of action » n_shrimpie, posted by SLS on December 31, 2011, at 9:51:29
Lamictal still being used to augment an ad? Phillipa. Low dose?
Posted by SLS on December 31, 2011, at 10:39:45
In reply to Re: lamictal +prozac/prozac onset of action » SLS, posted by Phillipa on December 31, 2011, at 10:13:44
> Lamictal still being used to augment an ad? Phillipa. Low dose?
I am using the dosage that usually works best for depression - 200 mg.
I think Lamictal is a necessary component to my regime.
Currently:Parnate 80 mg
nortriptyline 150 mg
Lamictal 200 mg
Abilify 10 mg
lithium 300 mg
prazosin 3 mg
- Scott
Posted by n_shrimpie on December 31, 2011, at 11:02:02
In reply to Re: lamictal +prozac/prozac onset of action » n_shrimpie, posted by SLS on December 31, 2011, at 9:51:29
is it possible that as a mood stabilizer the Lamictal is blunting the effects of my AD's? I'd rather be hypomanic than feel anesthesized.
Posted by SLS on December 31, 2011, at 12:10:48
In reply to Re: lamictal +prozac/prozac onset of action, posted by n_shrimpie on December 31, 2011, at 11:02:02
> is it possible that as a mood stabilizer the Lamictal is blunting the effects of my AD's?
That seems unlikely to me.
> I'd rather be hypomanic than feel anesthesized.
I totally understand.
Lamictal is a "top-down" mood stabilizer. It starts out as more of an antidepressant and stabilizes mood from there. Depakote is more of a "bottom-up" drug. Lamictal is not the best anti-manic in the world. Depakote is much more effective for this purpose.
- Scott
Posted by n_shrimpie on December 31, 2011, at 13:55:30
In reply to Re: lamictal +prozac/prozac onset of action » n_shrimpie, posted by SLS on December 31, 2011, at 12:10:48
that makes perfect sense. the lamictal started out as an ad and pooped out but continues to work as a mood stabilizer. i'm consistently depressed but i'm not as reactive, prone to temper tantrums, and sensitive. i'm atypical, and nardil worked, but seemed to make me a little hypomanic, which is preferable to my current condition. unfortunately, the nardil made me fat (which in and of itself was depressing) and tired, and the trazadone induced hangovers were unbearable, but i'm so desperate for relief from my cognitive issues and memory problems (i literally can't work) that i'm considering going back on it if low dose prozac doesn't work. sexual side effects of 20mg are intolerable- i can forget about the possiblity of ever having a relationship at that dosage. also considering that nahd supplement (i've already forgotten the name in last 2 hours). anyhow, thanks for listening to my long winded complaints.
Posted by SLS on December 31, 2011, at 13:59:53
In reply to Re: lamictal +prozac/prozac onset of action, posted by n_shrimpie on December 31, 2011, at 13:55:30
> thanks for listening to my long winded complaints.
I'm sure you'll return the favor one day.
Don't forget about Parnate. It is usually weight-neutral.
- Scott
Posted by n_shrimpie on December 31, 2011, at 14:04:53
In reply to Re: lamictal +prozac/prozac onset of action » n_shrimpie, posted by SLS on December 31, 2011, at 13:59:53
i tried the parnate and the side effects were intolerable. i was passing out constantly, and had chills all the time. if i go off the prozac i'll have to wait 4 weeks until i start nardil, and then 4 weeks for the awful nardil side effects to subside. i don't know if i can handle 2 more mos of this. maybe exercise will counteract the nardil naps, weight gain and 4-5pm exhaustion? my doctor said that trazadone was the only nonaddictive sleep aid. Are you atypical? do you know of any other ad's to treat it? my doc said selegeline doesn't work.
Posted by SLS on December 31, 2011, at 14:17:46
In reply to Re: lamictal +prozac/prozac onset of action, posted by n_shrimpie on December 31, 2011, at 14:04:53
> i tried the parnate and the side effects were intolerable. i was passing out constantly,
This usually passes within a few weeks.
> and had chills all the time.
I don't know what that's all about. It might be some autonomic thing.
> my doctor said that trazadone was the only nonaddictive sleep aid.
I don't believe that this is a valid concern. If you need something over the long-term, what's the difference? Trazodone is not an ideal answer. Do you have trouble falling asleep or staying asleep?
> Are you atypical?
Bipolar depression.
> do you know of any other ad's to treat it?
Hmmm. That's a tough one. Have you tried Effexor (venlafaxine)?
> my doc said selegeline doesn't work.
It is not a high-percentage treatment for MDD. It might be helpful for people who have a more anxious depression. It seems to have some anxiolytic effects.
- Scott
>
Posted by n_shrimpie on December 31, 2011, at 16:23:37
In reply to Re: lamictal +prozac/prozac onset of action » n_shrimpie, posted by SLS on December 31, 2011, at 14:17:46
> > i tried the parnate and the side effects were intolerable. i was passing out constantly,
>
> This usually passes within a few weeks.
>
> > and had chills all the time.
>
> I don't know what that's all about. It might be some autonomic thing.
>
> > my doctor said that trazadone was the only nonaddictive sleep aid.
>
> I don't believe that this is a valid concern. If you need something over the long-term, what's the difference? Trazodone is not an ideal answer. Do you have trouble falling asleep or staying asleep?
>
> > Are you atypical?
>
> Bipolar depression.
>
> > do you know of any other ad's to treat it?
>
> Hmmm. That's a tough one. Have you tried Effexor (venlafaxine)?
>
> > my doc said selegeline doesn't work.
>
> It is not a high-percentage treatment for MDD. It might be helpful for people who have a more anxious depression. It seems to have some anxiolytic effects.
>
>
> - Scott
>
>
> >i could try the parnate again, maybe i didn't give it enough time for the side effects to abate. i'll have to check my records and see how long i took it.maybe he meant that with other sleep aids you need a higher dosage as time goes on, and suffer withdrawal when dosage is decreased because it can't be increased indefinitely. My former doctor was head of the depression clinic at cornell presbytarian in nyc and teaches at columbia, so i usually trust him. unfortunately i can't afford him anymore. on nardil i had trouble falling and staying asleep without the trazadone.
tried effexor but it never started working. then again i only gave it four weeks. pretty bad withdrawal from it for a few days,so am reluctant to try again. same think with pristiq. wellbutrin made me horribly anxious and irritable but maybe a tiny dose would work as an adjunct to the prozac to increase my motivation and anhedonia? i think i still have some. does it work immediately or take time to kick in? i wish i had a good doctor i could go to with these questonis, but the last one i could afford (hospital gave me financial aid) was so mean, unprofessional and horrible that i reported him to the licensure board.
I'm definitely atypical, but think i'm also mildly bipolar two because the lamictal really smooths me out, keeps me from slipping into the abyss, and curbs my temper and over sensitivity. My manic episodes have been very mild and seem to be medication induced. without meds i'm consistently depressed. when the nardil caused some hypomania i tried lithium and it was awful, felt SO drugged.
What has your experience with lamictal been?
i may have no choice but to start the nardil and exercise like a maniac to curb the exhaustion and weight gain. Nardil makes me so tired the LAST think i feel like doing is exercising, but i need to force myself.
>
>
Posted by n_shrimpie on December 31, 2011, at 16:33:56
In reply to Re: lamictal +prozac/prozac onset of action » n_shrimpie, posted by SLS on December 31, 2011, at 14:17:46
> > i tried the parnate and the side effects were intolerable. i was passing out constantly,
>
> This usually passes within a few weeks.
>
> > and had chills all the time.
>
> I don't know what that's all about. It might be some autonomic thing.
>
> > my doctor said that trazadone was the only nonaddictive sleep aid.
>
> I don't believe that this is a valid concern. If you need something over the long-term, what's the difference? Trazodone is not an ideal answer. Do you have trouble falling asleep or staying asleep?
>
> > Are you atypical?
>
> Bipolar depression.
>
> > do you know of any other ad's to treat it?
>
> Hmmm. That's a tough one. Have you tried Effexor (venlafaxine)?
>
> > my doc said selegeline doesn't work.
>
> It is not a high-percentage treatment for MDD. It might be helpful for people who have a more anxious depression. It seems to have some anxiolytic effects.
>
>
> - Scott
>
>
> > problem with exercise is that sometimes i can't even will myself to get out or bed or shower. but i managed on the nardil because i wasn't as immobilized and i had a personal trainer who would be infuriated when i missed appts. i do recall telling my doctor that exercise really helped me, so i must will myself to do it even when the nardil exhausts me. which is SO much easier said than done. what has been your experience with exercise?
>
>
Posted by Phillipa on December 31, 2011, at 19:50:48
In reply to Re: lamictal +prozac/prozac onset of action » Phillipa, posted by SLS on December 31, 2011, at 10:39:45
Scott I didn't know that it had antidepressant effects first. I wish could have continued it but at 50mg got that excress salivation can't walk around constantly spitting. And when googled saw was a rare side effect. Phillipa
Posted by Phidippus on January 1, 2012, at 19:57:49
In reply to lamictal +prozac/prozac onset of action, posted by n_shrimpie on December 30, 2011, at 21:01:53
>After about 6 months, it stopped working completely
It is more likely you had worsening of symptoms that the Lamictal was not adequate to treat.
>if i don't take it for 2 days, i'm miserable, but >when i restart, it works for 2 days then stops >again.
Lamictal doesn't work like this. It does not just stop working, then start working. Your symptoms are worsening and the Lamictal isn't enough to treat them.
>Oddly enough, after a week off of it I started >feeling much better...This went on until 12/20, >and then, in the course of one day, i went back >to ground zero
While you were off the lamictal, you probably had a bipolar upswing, which is why you ended up at ground zero, soon after-bipolar mood downswing.
>so maybe i need less, like 10mg?
This isn't even therapeutic. You need to be taking at least 200 mg to be receiving t he full benefit of the drug. No wonder you're having so many problems with your mood.
Eric
Posted by SLS on January 1, 2012, at 22:58:50
In reply to Re: lamictal +prozac/prozac onset of action » n_shrimpie, posted by Phidippus on January 1, 2012, at 19:57:49
> > if i don't take it for 2 days, i'm miserable, but >when i restart, it works for 2 days then stops >again.
> Lamictal doesn't work like this.
Actually, it can. Several people, including myself, have experienced this phenomenon. It seems you can get a blip improvement upon dosage adjustments either up or down.
- Scott
Posted by n_shrimpie on January 2, 2012, at 0:37:31
In reply to Re: lamictal +prozac/prozac onset of action » Phidippus, posted by SLS on January 1, 2012, at 22:58:50
exactly. the longer go without, the better it takes upon resumption. i've only been taking the prozac for about 7-10 days, my second course and it seems to have started working. i give up, there's no rhyme or reason, there's no predictable pattern, which leads me believe i'm more bipolar than i thought i was.i don't feel manic at all, i just feel normal. completely normal. but the sad thing is it makes me recognize what i;m missing, what normal people have every day of their lives, and it only makes me sad to have a reference point for something thati will probably eventually lose. scott i know it's hardm i'm not trivializing what you're going through but at least you've never lost your cognitive faculties. i've lost them, ive become downright stupid at times, i can't even come up with words, and that makes my bad mood evern worse, and i become obsessed with it. and sometimes my mood improves, but the cognitive problems remain. i've always been so smart, so the loss of my intelligence, the ability to feel pleasure, jsut turns me into a nothing, like a shell that just happens to be alive, but nothing more. now i feel good, at this moment, and because i feel good i emotionally don't expect it to end, but i know it will.
Posted by n_shrimpie on January 2, 2012, at 0:44:08
In reply to Re: lamictal +prozac/prozac onset of action, posted by n_shrimpie on January 2, 2012, at 0:37:31
wanted to clarify that now i'm cognitively fine, have had a complete remission of all symptoms. but it's too good to be true long term. and i'm not looking to be unreasonably happy, i just want to not feel sad and dead. what i meant about the lamictal is that it has an immediate effect. if i miss it for 6 hours i notice, and if i take it it kicks in 6 hours later. the longer i miss it the better and longer it works when i take it again. here as the prozac isn't like that. it makes me feel worse and better more gradually. maybe not everyone has had my experience with lamicatl, but some patterns are unique, and doctors can only fix the common ones, so where does that leave me? usually just grasping at straws and hoping some crapshoot works.it's awful. how can i enjoy the normal states when it makes me truly realize how much of my life, years, years, that i've lost to depression? and to know that it's only temporary, that it will eventually return> is there no escape?
Posted by n_shrimpie on January 2, 2012, at 0:45:12
In reply to Re: lamictal +prozac/prozac onset of action » n_shrimpie, posted by Phidippus on January 1, 2012, at 19:57:49
just to clarify, i'm taking 400 mg of lamictal.
Posted by n_shrimpie on January 2, 2012, at 0:49:29
In reply to Re: lamictal +prozac/prozac onset of action » n_shrimpie, posted by Phidippus on January 1, 2012, at 19:57:49
sorry, i mistook your post. you're right, i probably had an upswing when i stopped. when i asked if i should reduce to 10 mg i meant the prozac, not the lamical. because it seemed i was best 1 week after i stopped the prozac, when it was leavint my system. but when it was completely gone, i felt awful. and when i stopped the lamictal i improved, but only to the point where i felt normal, not manic. but sadly , maybe normal is the best i'll ever get, even as a bipolar person. and if my moods are modulated, and normal is considered a "high" then moderate baseling is just moderately depressed as opposed to catatonic, right?
Posted by n_shrimpie on January 2, 2012, at 1:00:26
In reply to Re: lamictal +prozac/prozac onset of action » Phidippus, posted by SLS on January 1, 2012, at 22:58:50
thank you so much scott and eric. you've given me a lot of clarity, which is something my last dr. failed miserably at, so it's a relief to not feel so alone, and to know there is some sort of pattern that other recognize., if theres a pattern then maybe it identifiable and treatable. i knew this site would help, but for so long it felt too overwhelming to even register, that's how bad i've been. but i got so desperate that i forced myself, and it really has helped. but maybe its the meds, because when you're chemically depressed nothing, no amount of commiserating, winning the lottery, nothing helps. i give you credit anyhow!
Posted by n_shrimpie on January 2, 2012, at 1:06:35
In reply to Re: lamictal +prozac/prozac onset of action, posted by n_shrimpie on January 2, 2012, at 0:44:08
this post may have been lost. i was referring to going down to 10 mg of prozac, not lamictal. i've been on 400 mg of lamictal (and still am) for months and months. there is not doubt that when i miss a day my mood immediately sinks. no doubt at all.
Posted by henryo on January 3, 2012, at 3:26:34
In reply to lamictal +prozac/prozac onset of action, posted by n_shrimpie on December 30, 2011, at 21:01:53
I have taken Lamictal for over 10 years. For a long time 250mg daily. I do have days when I wonder if it is doing anything at all. ADs are far better at preventing depression than curing it. I know from painful experience not to go off meds when I suspect they may not be doing anything. I will say that when I added Deplin to my Lamictal several years back, I had to cut my Lamictal dose in half because I found Deplin so activating. So I take 7.5 Deplin and 100mg Lamical with enough fish oil to get 1000mg of DHA. Thats my daily regimen. That is just one loan person's experience. I'd say I am 80 percent depression free at least three weeks a month. I get weird and feel some sort of nameless pressure now and then. But, compared to decades of persistent mental anguish that is very damn good.
Posted by n_shrimpie on January 9, 2012, at 20:00:02
In reply to Re: lamictal +prozac/prozac onset of action » Phillipa, posted by SLS on December 31, 2011, at 10:39:45
> > Lamictal still being used to augment an ad? Phillipa. Low dose?
>
> I am using the dosage that usually works best for depression - 200 mg.
>
> I think Lamictal is a necessary component to my regime.
>
>
> Currently:
>
> Parnate 80 mg
> nortriptyline 150 mg
> Lamictal 200 mg
> Abilify 10 mg
> lithium 300 mg
> prazosin 3 mg
>
>
> - Scotthi Scott,
not sure you recall, but we spoke a few years ago about my cognitive impairments while on Lamictal and Nardil, posted under n_wolfie. As you know, i've restarted my Prozac and have been on for two weeks, and i don't think i'm depressed, but my horrible cognitive issues remain, (which are paralyzing) and from reviewing our former exchanges it seems that it's been your experience that high levels of lamictal (400mg) that are cause memory impairments, and mine are severe. This summer i left my dog tied up outside hte grocery store. he's my most prized possession, and i didn't remember until i got home. luckily he was still there. but it was scary. Right now I can't even tell if i have anhedonia/depression, i don't know if can't enjoy anything because i'm CONSTANTLY obsessing and anxiety ridden over my bad memory or if it's anhedonia. and how can i tell if my cognitive problems are depression or lamictal related? Today, since i'm feeling spacy but not particularly depressed, i reduced my lamictal from 400 to 200mg. do you think it will help?
Posted by SLS on January 10, 2012, at 6:29:24
In reply to Re: lamictal +prozac/prozac onset of action, posted by n_shrimpie on January 9, 2012, at 20:00:02
> hi Scott,
Howdy.
I responded to your post further up on the board.
http://www.dr-bob.org/babble/20120108/msgs/1006858.html
I recall always being in a state of upset over my cognitive decline when I was on dosages of Lamictal over 200 mg. Even 250 mg was too much. At the time, I could not be sure that it wasn't the depression that was causing me to feel so spacy.
Do you have difficulties walking a straight line? Ataxia? If you do, I would consider that an indication that you are taking too much Lamictal.
Nardil. During the first few weeks of treatment, I always feel kind of weird - spacy. It goes away. That spacy feeling always seems to portend a favorable response for me.
You have nothing to lose by reducing your dosage of Lamictal. The worst thing that can happen is that you begin to relapse for a few days. Reduce the dosage gradually. Dropping the dosage precipitously can produce a temporary rebound depression. You might get scared and run back up to the higher dosage. Reduce by 50 mg every three or four days?
Good luck.
- Scott
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