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lamictal--2 questions


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#1 seven

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Posted 04 July 2005 - 03:28 PM

hi,

1) In http://www.bipolarch...tters/0506.html, the recommendation is made that to avoid hypomania, the lamictal dosage should be reduced. but according to crazymeds, it should be increased for true mood stabilization. which is it? go up or down?

(I edited this to highlight my underlying question.)

2) I've always wondered, what would happen to a normal person if they took Lamictal. How would it affect their mood, physical, etc. (still seeking evidence that I'm normal ;) )

thanks.

Edited by seven, 05 July 2005 - 04:14 AM.



#2 dollface

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Posted 04 July 2005 - 04:23 PM

hi,

1) Does anyone else get a minty chilly feeling from their Lamictal? It's very warm in this room (summer) yet I have this delicious chilly sensation inside. This is the activating feeling I get from it, in addition to fidgeting, knee-bobbing. Just curious. I've come to regard it as my morning coffee. (100mg/day)

2) I've always wondered, what would happen to a normal person if they took Lamictal. How would it affect their mood, physical, etc. (still seeking evidence that I'm normal ;) )

thanks.

<{POST_SNAPBACK}>



Hi seven..I am on Lamictal for seizures.  So far I am up to 400 mg. a day and I take it in the morning because it usually keeps me up.  I dont get a chilly feeling, but the figeting is there.  Headaches too, but of course everyone reacts differently.  I have no idea how a normal person would react if they took Lamictal, since I am not normal I cannot answer that question. :)
dollface

#3 seven

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Posted 04 July 2005 - 05:48 PM

Hi seven..I am on Lamictal for seizures.  So far I am up to 400 mg. a day and I take it in the morning because it usually keeps me up. 

<{POST_SNAPBACK}>


Now that I don't understand. If Lamictal is a CNS depressant, why is it activating? Particularly for epilepsy, wouldn't there be a chance that this stimulation could bring on an episode? Or hypomania for bipolar (which it does as we all know)...just doesn't seem to make sense for an anticonvulsant.

ah well, that's partly why i luv it,
7

Edited by seven, 04 July 2005 - 05:50 PM.


#4 dollface

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Posted 05 July 2005 - 09:05 PM

Hi seven..I am on Lamictal for seizures.  So far I am up to 400 mg. a day and I take it in the morning because it usually keeps me up. 

<{POST_SNAPBACK}>


Now that I don't understand. If Lamictal is a CNS depressant, why is it activating? Particularly for epilepsy, wouldn't there be a chance that this stimulation could bring on an episode? Or hypomania for bipolar (which it does as we all know)...just doesn't seem to make sense for an anticonvulsant.

ah well, that's partly why i luv it,
7

<{POST_SNAPBACK}>


Hi seven, I have heard that lamictal could go both ways, keeping a person awake or putting to sleep.  I couldnt take keppra or trileptal because those knocked me out...but I do know its prescribed for seizures and bp.
dollface

#5 NARS

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Posted 05 July 2005 - 11:17 PM

I deeply apologize for being too zonked to remember where I read this--was it crazymeds' lamictal page?  Psycheducation?  Hell if I know.

Anyhow what I remember is that lamictal effects seratonin reuptake or something, even at low doses, thus the antidepressant effect, which without mood stabilization can be activating or cause cycling in us BPers.  But at higher levels, which vary with the individual, lamictal's mysterious mood stabilizing magic kicks in.  Thus the sudden higher-dose stabilization after cycling madly at low doses.  Again for BPers.

I have not a clue about how it works for seizure activity. 

As for keeping one awake or putting one to sleep, I think those are more accurately side effects.  My mood is up, but I'm a zombie right now, so somnolent I sometimes wonder if my heart is still beating.  I'm hoping that wears off soon.  I feel kinda like I did when I had pneumonia and was so tired I wasn't even bored sleeping all day on the couch.
Dx: BP II; Psychmeds: lamictal 300mg, wellbutrin xl 300mg, ambien CR (5mg), provigil 100.


You don't have to believe everything you think

#6 Ruby

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Posted 07 July 2005 - 03:35 PM

[/quote]

Now that I don't understand. If Lamictal is a CNS depressant, why is it activating? Particularly for epilepsy, wouldn't there be a chance that this stimulation could bring on an episode? Or hypomania for bipolar (which it does as we all know)...just doesn't seem to make sense for an anticonvulsant.

ah well, that's partly why i luv it,
7

<{POST_SNAPBACK}>

[/quote]

7
Lamictal is a bottom up mood stabilizer, which means it treats bipolar from the depression side of the spectrum, and works its way up towards stabilization. So, until a BP hits that magic target, Lamictal works a lot like an AD. Most of us BPs who take an AD usually swing over to the manic side, since the AD is helping with the depression. This is just my theory, based on personal experience with Lamictal.

Although Lamictal is an AC, it is in a class all by itself. I took many other ACs (Depokote, Tegretol, Trileptal, Topomax, Keppra, Abilify...that's all I can remember) and Lamictal is so different, to me. I swore I'd never take another AC before Lamictal.

I luv it, 2, 7!

#7 number_6

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Posted 07 July 2005 - 06:07 PM

Lamictal is a bottom up mood stabilizer, which means it treats bipolar from the depression side of the spectrum, and works its way up towards stabilization. So, until a BP hits that magic target, Lamictal works a lot like an AD. Most of us BPs who take an AD usually swing over to the manic side, since the AD is helping with the depression. This is just my theory, based on personal experience with Lamictal.

Although Lamictal is an AC, it is in a class all by itself. I took many other ACs (Depokote, Tegretol, Trileptal, Topomax, Keppra, Abilify...that's all I can remember) and Lamictal is so different, to me. I swore I'd never take another AC before Lamictal.

I luv it, 2, 7!

<{POST_SNAPBACK}>


I have to disagree with that statement.

I'm BP1-hypomanic, and I take Lamictal 300mg for mania, only.  Rapid cycling, specifically (as in, cycling between full blown mania to hypomania). 

If Lamictal were only working from the depressive side of the house, it wouldn't be working for me at all.  I believe it is simply a mood leveler, whatever that mood may be.

From the CrazyMeds Lamictal Page:
How Lamictal Works in Your Brain:  Lamictal (lamotrigine) works on binding to voltage sensitive sodium and maybe calcium channels in the brain.  The calcium bit is a matter for debate. It also invokes glutamate which is a major excitatory neurotransmitter in the brain which is responsible for sending messages from neuron to neuron in 85% of the brain. It also lightly brushes the 5-HT3 serotonin receptor and the sigma opioid receptors, which probably account for its lovely antidepressant properties. Nothing like a combined serotonin and opiate reaction. As to precisely where in your brain Lamictal does its sodium and calcium channel magic, that's a mystery.

Layman's terms?  Erm, Kassi?  Seriously... the serotonin receptors getting brushed are what (usually) brings a person up from a depressed state, and touching the sigma opioid receptors are (usually) what brings down a manic.  As Jerod points out, the mechanism for this isn't understood (hell, we don't even understand aspirin!).

As to stimulation (or not), that is just a quirk of the drug.  Some people get it, some people don't.  Some get it when they first start taking it (like I did - very badly), and don't later (like now) or vice versa, or always, or never.

From the CrazyMeds Lamictal Page:
Lamictal's Not So Common Side Effects: <snip> Don't be surprised if you get anxious or have other hypomanic effects if taking it for bipolar disorder.  Another not-so-common effect is a type of insomnia where you're tired, but you can't sleep.

BP varies over time, your response to meds varies over time, and every permutation in between.

As to the seizure stuff, I haven't a clue, but I would postulate that, since epilepsy has to do with neural misfires, the anti-convulsant action of Lamictal comes from the sodium and calcium channel "magic" as Jerod calls it.  I just have this gut feeling about salts, elementals and electrical charges, even tho' people always tell me I'm wrong....

6
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#8 seven

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Posted 08 July 2005 - 02:02 AM

Hi guys, you're all very sweet for taking a moment to answer my essentially nerdy questions...but insomniac minds want to know. The word "invokes" in "...invokes glutamate..." threw me until I read elsewhere that it "inhibits" as in "inhibits glutamate and aspartate"--so if glutamate is not the activating magician, my other suspect is the serotonin, or perhaps I'll be content with "quirky side effect."

6, I think what Ruby meant is the reason it's working for you is because you are at a higher dose (200 and above is the rule of thumb, I believe?) Nevertheless, I tend to agree with you that at most any dose, it can level mood for some. Even at a mere 50, it often put a ceiling and a floor to my swings.

As for my 2nd question, I asked my pdoc and was told "probably nothing." I did find a study of the effects of an antidepressant on normals:

A study at the University of California...looked at the effects of the serotonin-enhancing antidepressant Paxil among normal volunteers, randomly assigned to either Paxil or a placebo...Compared with the placebo, Paxil reduced hostile feelings and slightly increased social affiliation. But Paxil did not make the normal people any happier. In short, no drug - recreational or prescribed - comes close to creating the stable euphoria of hyperthymic people.

#9 number_6

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Posted 08 July 2005 - 06:56 AM

Nevermind

Edited by number_6, 10 November 2005 - 11:53 AM.

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#10 Ruby

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Posted 08 July 2005 - 11:02 AM

I have to disagree with that statement.

I'm BP1-hypomanic, and I take Lamictal 300mg for mania, only.  Rapid cycling, specifically (as in, cycling between full blown mania to hypomania). 

If Lamictal were only working from the depressive side of the house, it wouldn't be working for me at all.  I believe it is simply a mood leveler, whatever that mood may be.

From the CrazyMeds Lamictal Page:
How Lamictal Works in Your Brain:  Lamictal (lamotrigine) works on binding to voltage sensitive sodium and maybe calcium channels in the brain.  The calcium bit is a matter for debate.   It also invokes glutamate which is a major excitatory neurotransmitter in the brain which is responsible for sending messages from neuron to neuron in 85% of the brain. It also lightly brushes the 5-HT3 serotonin receptor and the sigma opioid receptors, which probably account for its lovely antidepressant properties. Nothing like a combined serotonin and opiate reaction. As to precisely where in your brain Lamictal does its sodium and calcium channel magic, that's a mystery.

Layman's terms?  Erm, Kassi?  Seriously... the serotonin receptors getting brushed are what (usually) brings a person up from a depressed state, and touching the sigma opioid receptors are (usually) what brings down a manic.  As Jerod points out, the mechanism for this isn't understood (hell, we don't even understand aspirin!).

As to stimulation (or not), that is just a quirk of the drug.  Some people get it, some people don't.  Some get it when they first start taking it (like I did - very badly), and don't later (like now) or vice versa, or always, or never.

From the CrazyMeds Lamictal Page:
Lamictal's Not So Common Side Effects: <snip> Don't be surprised if you get anxious or have other hypomanic effects if taking it for bipolar disorder.  Another not-so-common effect is a type of insomnia where you're tired, but you can't sleep.

BP varies over time, your response to meds varies over time, and every permutation in between.

As to the seizure stuff, I haven't a clue, but I would postulate that, since epilepsy has to do with neural misfires, the anti-convulsant action of Lamictal comes from the sodium and calcium channel "magic" as Jerod calls it.  I just have this gut feeling about salts, elementals and electrical charges, even tho' people always tell me I'm wrong....

6

<{POST_SNAPBACK}>

[/quote]

Like I said, this is my THEORY. I have read many posts from other Lamictal users that they have had the same experience.

And, yeah, I've already read all the stuff on Lamictal on crazymed.org.  Remember that information is someone's else's opinion and based on their experiences as well. None of us are doctors here.

Maybe when I get to a higher dosage like you, I will agree with your opinion, but until then, I disagree with you. Lamictal is actually classified as an antidepressant over in Europe. It has definitely helped my depression, but made me more hypomanic. I am just trying to help 7.

#11 number_6

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Posted 08 July 2005 - 12:06 PM

Like I said, this is my THEORY. I have read many posts from other Lamictal users that they have had the same experience.

And, yeah, I've already read all the stuff on Lamictal on crazymed.org.  Remember that information is someone's else's opinion and based on their experiences as well. None of us are doctors here.

Maybe when I get to a higher dosage like you, I will agree with your opinion, but until then, I disagree with you. Lamictal is actually classified as an antidepressant over in Europe. It has definitely helped my depression, but made me more hypomanic. I am just trying to help 7.

<{POST_SNAPBACK}>


Nope, none of us are doctors.  And Jerod's opinions are his own, however well researched.

I just happen to be an incredibly OCD researcher myself.

From GlaxoSmithKline's UK website (they have no "European" website), referencing Lamictal (Lamotrigine):

http://emc.medicines...ACEUTICAL_PARTS

4.1 Therapeutic indications
Epilepsy: Monotherapy in adults and children over 12 years of age:

Simple partial seizures
Complex partial seizures
Secondarily generalised tonic-clonic seizures
Primary generalised tonic-clonic seizures
Monotherapy in children under 12 years of age is not recommended until such time as adequate information is made available from controlled trials in this particular target population.
Add-on therapy in adults and children over 2 years of age

Simple partial seizures
Complex partial seizures
Secondarily generalised tonic-clonic seizures
Primary generalised tonic-clonic seizures
Lamictal is also indicated for the treatment of seizures associated with Lennox-Gastaut Syndrome.

Sounds like it is classified as an AED to me, but that could just be my opinion.

6
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