![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 3 to 27 of 27. Go back in thread:
Posted by Racer on April 13, 2008, at 23:40:20
In reply to Re: mood stabilized as hostile. i need meds for th, posted by elanor roosevelt on April 13, 2008, at 16:39:53
With Lamictal, it's very important to titrate up slowly. There are no short cuts, there is no way around that requirement.
My advice is to minimize variables -- don't start more than one medication at a time, and don't swap out Adderall and Provigil. Horrible as it is, I'd strongly suggest sticking it out with Lamictal until you get up to the therapeutic range, usually around 200mg. Don't speed up the titration schedule -- go with what your doctor prescribed.
I'm sorry you're going through this, and I hope it gets better soon.
Posted by elanor roosevelt on April 14, 2008, at 0:15:02
In reply to Re: mood stabilized as hostile. i need meds for th, posted by Racer on April 13, 2008, at 23:40:20
thanks for your reply racer
this latest med experience is quite alienating
i am actually about 10 days behind in the titration because of the irritation complications
i don't have any adderall left and the provigil surely doesn't brighten anything for me
are you saying i just wait out the titration of the lamictal w/o stimulants? i haven't heard of anyone doing well on lamictal alone. but i'm game to give that a try.
a few days.
Posted by Racer on April 14, 2008, at 17:22:55
In reply to Re: mood stabilized as hostile. i need meds for th, posted by elanor roosevelt on April 14, 2008, at 0:15:02
>
> are you saying i just wait out the titration of the lamictal w/o stimulants? i haven't heard of anyone doing well on lamictal alone. but i'm game to give that a try.
>Yes, I'm suggesting titrating up on Lamictal without stimulants, but not necessarily with the idea of using Lamictal as monotherapy. Just with the idea of limiting the variables. How about I offer up my thinking on it, and you can decide if it's worth paying any attention?
First of all, the adjustment phase of many medications is very, very different from what they show down the road. We all know this, but it's easy -- for me, at least -- to be in such a hurry about feeling better to forget that little piece of it. There are no short cuts to speed that up -- it's just something we have to get through. If you're starting multiple medications at one time, you're going to be getting adjustment phase problems from each one, in all likelihood, so starting one at a time makes a lot of sense to me. That way, you'll at least know what each drug is contributing.
My own experience with Lamictal is that it changes radically as you titrate up. Sticking to the schedule is a good idea -- too fast and you risk some of the truly scary adverse effects; too slow and you may spend more time in a bad range longer than you need to. It may be that increasing the dose will relieve some of the irritability for you. (And I really do know that it's easy to say that, and I've been in places where I just could not stay on a medication, even if it might have gotten better, because I was just too freaked out.)
Also, I was told -- I don't know how accurate this is -- that Lamictal is more likely to cause reactions if you start anything new before you've acclimated to it. In fact, I was told not to change soaps, detergents, shampoos, toothpastes, etc. I don't know how over-cautious that doctor was being, but I figured it was worth paying attention to that -- with the seriousness of the potential adverse effects, I figured it couldn't hurt to be cautious. (Besides -- I get rashes from a lot of products, so I rarely change things like soaps. Isn't it nice when it's so easy to be good?)
I'm also thinking it's worth limiting things for reasons that probably have more to do with projection than anything you wrote: I know that I get into this state where I'm so desperate for relief that I want to triple everything I take in order to feel better NOW. That, of course, isn't an effective strategy. I don't actually follow it -- but I do get so frustrated by the length of time it takes to get the benefits of these medications that it would be easy to quit prematurely. What helps me when that happens is reminding myself that it's a drug trial, that it's going to take as long as it takes, that I've been through it before, etc. I also keep a little diary of the medication's effects, day by day, which helps me both track progress -- if any -- and record what may be adverse effects or simply my overactive imagination. That system works pretty well for me.
I hope something I've offered in here helps.
Posted by elanor roosevelt on April 14, 2008, at 21:29:47
In reply to Re: mood stabilized as hostile. i need meds for th » elanor roosevelt, posted by Racer on April 14, 2008, at 17:22:55
this is all helpful Racer
i thank you
i will nix the provogil and see what goes
i thought i had the lamictal concept down before i decided to go ahead
but now i am worrying that "more time between episodes" will be like a long boring cranky commercialactually i am not sure i exist "between episodes"
thanks again
i will keep trying
on my 3rd day of 50mg
Posted by elanor roosevelt on April 16, 2008, at 1:05:39
In reply to Re: mood stabilized as hostile. i need meds for th, posted by elanor roosevelt on April 14, 2008, at 21:29:47
Racer
I thought I was being a nice person
but I was alone all day
cranky as soon as i come into contact with other beings
day 4 50 mg
Posted by elanor roosevelt on April 16, 2008, at 1:14:20
In reply to Re: mood stabilized as hostile. i need meds for th, posted by elanor roosevelt on April 14, 2008, at 21:29:47
Lamictal seems to make me horny and anorgasmic
ah life
just read some old posts here about Ginko
any other suggestions?
Posted by Quintal on April 16, 2008, at 8:06:20
In reply to a question about Lamictal and sex, posted by elanor roosevelt on April 16, 2008, at 1:14:20
I've noticed a similar thing with Lamictal re: sex. It seems to be making me somewhat anorgasmic. It's hard to reach the top plateau of sexual excitement - 'panting dog sex' as I call it. This was the main reason I quit Lithium. Horny goat weed might be worth a try.
Q
Posted by SLS on April 16, 2008, at 9:56:48
In reply to Re: a question about Lamictal and sex » elanor roosevelt, posted by Quintal on April 16, 2008, at 8:06:20
> I've noticed a similar thing with Lamictal re: sex. It seems to be making me somewhat anorgasmic. It's hard to reach the top plateau of sexual excitement - 'panting dog sex' as I call it. This was the main reason I quit Lithium. Horny goat weed might be worth a try.
>
> QAlso, cyproheptadine (Periactin), and perhaps yohimbine (Aphrodyne). Maybe even amantadine (Symmetrel).
- Scott
Posted by dbc on April 16, 2008, at 14:08:11
In reply to Re: a question about Lamictal and sex, posted by SLS on April 16, 2008, at 9:56:48
One of the proposed methods of lamictals actions is adrenagenic. I have to agree because when ever i up the dose i get very wired and high strung but when i hit a plateau and keep a dose at a normal level for an extended period of time the wired high strung feeling goes away.
It does go away and especially when you hit the higher doses and the mood stabilizing properties kick in. It seems only when changing doses does the whole high strung wired feeling happens.
Take benzos if you have them and chill out or drink moderately or knit or whatever it is you do to relax. Time is the enemy with medication but eventually it should pan out.
Lamictal has really helped me and im not bipolar at least in any normal sense.
Posted by elanor roosevelt on April 16, 2008, at 21:50:25
In reply to Re: lamictal and anger/being high strung, posted by dbc on April 16, 2008, at 14:08:11
well i have a week of 50mg ahead of me so hopefully the anger will subside it's a busy week for me
i have just asked my daughter to help me get up mornings and i make a point to never ask her to take responsibility for me
but i am slammed into a stupor before i can finish my coffee or take any meds
layed still listening to the phone ring knowing i was missing an appointment
i have to battle my way out of it
i am wondering if i take the Lamictal later or earlier in the day if that will help
i usually take it around 10amwent to my pdoc today and got some adderall to help get me out of bed and to keep me somewhat socially acceptable
also purchased some horny goat weed
i so appreciate the support i am getting here
i don't think i would be able to hang in without so many of you telling me how well it works for you once you get to full dose
Posted by elanor roosevelt on April 19, 2008, at 1:56:20
In reply to lamictal and anger/llethargy, posted by elanor roosevelt on April 16, 2008, at 21:50:25
almost logged on this morning to say i was feeling good
but i got into the cranky mode before i had the chance
Posted by atmlady on April 20, 2008, at 20:12:23
In reply to i was afraid to say so, posted by elanor roosevelt on April 19, 2008, at 1:56:20
((((((((((elanor))))))))) hang in there, kiddo! We're all rooting for you!
Posted by Amigan on April 20, 2008, at 20:17:30
In reply to mood stabilized as hostile. i need meds for this?, posted by elanor roosevelt on April 12, 2008, at 22:14:42
I might be wrong but i seem to remember that another person in the medication board was complaining about lamictal-induced psychosis..
Posted by elanor roosevelt on April 22, 2008, at 18:50:23
In reply to Re: mood stabilized as hostile. i need meds for th, posted by Amigan on April 20, 2008, at 20:17:30
i have to deal with clients the next 3 days
wish i could wear sunglasses so they can't see me give them dirty lookshad nightmares all last night
i up my dose in a few days
Posted by elanor roosevelt on April 27, 2008, at 15:03:15
In reply to Re: mood stabilized as hostile. i need meds for th, posted by elanor roosevelt on April 22, 2008, at 18:50:23
when does the lamictal kick in?
i'm just about over it
i am wasting a lot of time lately
falling behind in every aspect of my life it seems
tomorrow I go up to 100mg
Posted by Quintal on April 27, 2008, at 15:19:04
In reply to therapeutic range?, posted by elanor roosevelt on April 27, 2008, at 15:03:15
150mg is supposed to be the lower end of the therapeutic range, but I've noticed some benefit already at 75mg.
Q
Posted by elanor roosevelt on May 2, 2008, at 11:02:54
In reply to Re: therapeutic range? » elanor roosevelt, posted by Quintal on April 27, 2008, at 15:19:04
i'm at 100 mgs and i hate how i feel
Posted by elanor roosevelt on May 10, 2008, at 23:03:50
In reply to at what dosage do i give up, posted by elanor roosevelt on May 2, 2008, at 11:02:54
i am up to 200mgs
might be a good change
too early to say
i've been nasty and aggressive
also i never laugh
my smiles are fake
i experience almost no pleasure
if the lamactil at this dose does allow me to be civil once again,
what can i take to elevate my mood
adderall doesn't help nor does provigal
i miss me
Posted by Sigismund on May 11, 2008, at 8:51:56
In reply to still mean, posted by elanor roosevelt on May 10, 2008, at 23:03:50
So there's a good change somewhere maybe?
Tell us about it if and when it turns up.
Posted by elanor roosevelt on May 11, 2008, at 9:22:58
In reply to Re: still mean » elanor roosevelt, posted by Sigismund on May 11, 2008, at 8:51:56
well, this is my last week if it doesn't change for the better in a big way
if i feel any better
have to go to the pdoc and act angry and miserable and lie that i am still at 100mg
get an okay to increase to where i am now at 200mg
either way i have to go to the pdoc for other meds
might toss in some lexapro for a few days to see if i can get a lift
lexapro melted down on me bad
but sometimes i can get a few good days
and i can get up in the morning
what do meds do to keep you abed?
it's beyond being drowsy
Posted by elanor roosevelt on May 12, 2008, at 23:14:14
In reply to Re: still mean, posted by elanor roosevelt on May 11, 2008, at 9:22:58
have begun avoiding everything
try very hard to stay in the apartment
dull and sad
it's a couple of months now
gloom
nasty
Posted by Sigismund on May 13, 2008, at 1:54:21
In reply to i feel awful on lamictal, posted by elanor roosevelt on May 12, 2008, at 23:14:14
>it's a couple of months now
My goodness.
Do you think it might be worse than useless for you?
Posted by elanor roosevelt on May 13, 2008, at 20:39:45
In reply to Re: i feel awful on lamictal » elanor roosevelt, posted by Sigismund on May 13, 2008, at 1:54:21
i took lexapro last night so i could get up in the morning(lexapro has an immediate effect on me that doesn't last)
what a change
got to my class i have skipped for the last few weeks and
dialed the phone and made an appointment with my pdoc for tomorrow
the lamictal has me staring
Posted by atmlady on May 15, 2008, at 22:31:12
In reply to Re: i feel awful on lamictal, posted by elanor roosevelt on May 13, 2008, at 20:39:45
Goodness, girl! Why aren't you taking Lexapro as a rule if it works so well? It works wonders for me but I'm not taking it either, due to the side effects, I just wonder why you aren't. I have done the same thing, been at the end of my rope and start popping the lexapro as a last resort to pull myself out of the dark hole. When is your appointment? Get in there now! And keep us posted, for shizzle. I will be watching for your posts. Keep with the lexapro until you get to the pdoc, k?
Love ya, ely!
Posted by elanor roosevelt on May 15, 2008, at 23:27:17
In reply to Re: i feel awful on lamictal » elanor roosevelt, posted by atmlady on May 15, 2008, at 22:31:12
thanks for your message
if lexapro didn't melt down on me i would have never stopped taking it
i just took some so i could wake up
my mornings were awfuli am now on 100mg of lamictal
10mg lexapro
provigal
adderall
xanax occassionally
ambien nightlypulling out of my state of despair
not able to focus well on tasks at hand
This is the end of the thread.
Psycho-Babble Neurotransmitters | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
[email protected]
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.