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Lamictal and cymbalta


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#1 cymbalta

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Posted 07 March 2008 - 04:18 PM

I am brand new to this so I hope I am doing this right. I have been taking 200 mg of Lamictal and 60 mg Cymbalta for bipolar type 2 depression for about 3 months. I told my psychiatrist I was feeling flat, fuzzy and amd sleeping more frequently and maybe I need my Lamictal decreased. (He started my Lamictal first and I noticed it was making me sleepy.) He said I dont seem flat even though he's only known me for three months. He told me not to change anything. I increased my Cymbalta to 90 mg thinking it might help with the flatness. I feel a bit more tired and sedated. I was wondering if anyone else has had these effects and if it is dangerous to be on that much of each drug. I also should say that I have had depression now for a while but never any mania. Thank you for your help.


#2 SashaSue

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Posted 07 March 2008 - 05:08 PM

It sounds like you increased your Cymbalta on your own without your psychiatrist's knowledge. If so, that kind of thing is really pretty much never a good idea.
Dx: Bipolar I, ADHD<br />
Rx: Seroquel, 800mg, Lamictal, 150mg, Effexor, 325mg, Wellbutrin, 450, Dexedrine ER, 60mg

#3 cymbalta

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Posted 07 March 2008 - 05:34 PM

Actually, I should have explained that my family doctor recommended it when I explained my symptoms. she also wanted me to decrease the Lamictal to 150. Then I got different advise from the psychiatrist. I'm now trying to educate myself and hear from others what their experiences are. I dont understand why I would have gotten two very different ideas.

#4 LunaRufina

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Posted 07 March 2008 - 06:02 PM

Actually, I should have explained that my family doctor recommended it when I explained my symptoms. she also wanted me to decrease the Lamictal to 150. Then I got different advise from the psychiatrist. I'm now trying to educate myself and hear from others what their experiences are. I dont understand why I would have gotten two very different ideas.



Because they are two different doctors trained in two different things. You should let your psychiatrist deal with your psych medications. They have the training for it. Your family doctor does not have the training to deal with medicating bipolar.

You should also, as a rule, not be incorporating two different doctors' advice. It can be dangerous AND piss off both doctors.


Lamictal doesn't make me sedated but I have heard from a couple other people that it made them sedated. It should wear off with time.

Cymbalta could also be making you feel sedated.

I take both and neither have made me feel flat, but Your Mileage May Vary is something you may see a lot around here, as there are various side effects you can experience from different meds and you may or may not experience any number of them.

What I would suggest you do, if you aren't doing it already is either track your moods [moodtracker.com is good for this] or keep a mood journal and jot down how you are feeling in the morning and at night. This way it will be easier for you to see how the meds are effecting you and whether it's related to anything external.

Do tell your psychiatrist that you have changed your dosage per your GP's orders if you haven't done so already. They need to know what is going on with you and what your dosages are.


Feeling flat may just be related to sedation, it may pass, but it may take a while. Longer than three months.

How long have you been on the Cymbalta at 90mg?

Luna

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Build anyway.

People really need help but may attack you if you do help them.
Help people anyway.

Give the world the best you have and you'll get kicked in the teeth.
Give the world the best you have anyway.”

― Kent M. Keith, The Silent Revolution: Dynamic Leadership in the Student Council"

#5 AirMarshall

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Posted 07 March 2008 - 07:32 PM

Some people find Lamictal slightly sedating. If so, then take it in the evening. Some people find Lamictal slightly energizing (me!), so I took it in the morning so it didn't wreck my sleep.

Cymbalta is going to be a bit sedating. I recommend taking it in the evening as well (thats what I do).

Lamictal is a subtle medication, and most people don't report any strong side effects, cognition wise. It doesn't kick in quickly, and my experience was that it took nearly 3 months (12 weeks) for it to slowly build up to full effect.

So, look at when you last increased your dose to 200mg, and count from there.

The flat effect is probably from the Lamictal rather than the Cymbalta. I, like most never took Lamictal alone, so its hard to absolutely say that is the cause. Lamictal has a wide range of effectiveness from 50mg -200mg typical, but some as high as 400 or 500mg. You will have to work with your pdoc to find the best dosage. Dropping 50mg sounds reasonable.

As Luna said, don't play one doc off the other. The pdoc is the expert, not to mention the attending physician for your brain cooties. So, be open and honest with him, follow his directions, and don't make dosage changes on your own. If you do cheat, then fess up at your next visit to the pdoc. It's the only way to maintain trust.

Hope you feel better,

a.m.

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#6 Bumble

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Posted 07 March 2008 - 08:17 PM

I am not a fan of either med, but please keep in mind that YMMV.

I took 90mg Cymbalta for three years, when Lamictal was added because the C wasn't working and my pdoc suspected BPII. Lamictal (200mg) made me feel so flat that I couldn't take it. It wasn't a sedated feeling as much as a FLAT feeling -- I don't know how else to explain it.

-- B

Edited by Bumble, 07 March 2008 - 08:18 PM.

and a rock feels no pain. . . and an island, never cries.

Current dx: MDD, ADD (w/o H), Social Anxiety Disorder, mild OCD (some amusing stuff, actually)
Current rx: Lexapro 300mg, PRN Klonopin  .5mg,  Adderall XR 30mg x2

Past dx: I fired Dr Evil so I'm not BP anymore!

Past rx: Prozac, Adderall, Wellbutrin, Cymbalta (yuk), Lamictal(evil), Ritalin

Female, 49 years old.


#7 cymbalta

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Posted 07 March 2008 - 11:21 PM

Thanks so much everyone. This is a great board. Terrific feedback. I have been titrating up to the 200 mg of Lamictal now for about 3 months and I guess I got to the full dose about a month ago. I only started on the Cymbalta about two months ago and jsut went up to 90 mg a few days ago. I guess I need to give them more time to see if the flat affect and sedation wear off. I didnt know it could take that long.

And, yes, I will just let the Psych take care of things.

Thanks again!

#8 cymbalta

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Posted 08 March 2008 - 12:16 PM

I am not a fan of either med, but please keep in mind that YMMV.

I took 90mg Cymbalta for three years, when Lamictal was added because the C wasn't working and my pdoc suspected BPII. Lamictal (200mg) made me feel so flat that I couldn't take it. It wasn't a sedated feeling as much as a FLAT feeling -- I don't know how else to explain it.

-- B

Bumble,
I'm glad tohear that you know hwat I'm talking about--that flat feeling. It's a wierd thing but Im realizing I havent been on any of it long enough to ask about medication switches. I'll wait it out a few more months. Best of luck to you!!

#9 Thomas

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Posted 09 March 2008 - 08:43 AM

I've been on 300 mg. lamictal (bedtime) for about 2 years and it didn't seem to make me feel flat. I have also been on Cymbalta for just over 6 months and think it might be making me feel somewhat flat (at 120 mg., 60 in AM and 60 at bedtime), but it is so much better than feeling severely depressed.

Tommy
Dx:BP1, OCD, Diabetetes Type 2, Hypertension, Gastroparesis & kidney stones
Rx: Abilify 20 mg., Klonopin 6.0 mg., Restoril 30 mg. Cymbalta 120 mg. , Lamictal 400 mg., Cogentin 1.5 mg. Crestor 10 mg. hydrochlorothiazide 25 mg., Hyzaar 100/25 mg., domperidone 20 mg. and Levemir Insulin 40 units, Actos 45 mg.,Proprananol ER 80 mg., Hydrocodone/APAP 40 mg./4000 mg., tizanidine 1 mg., Fiorocet 3 mg.

#10 rainyeffingday

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Posted 09 July 2008 - 12:05 PM

I take 200 lamictal and 180 cymbalta
with some of us the reccomended doses for some meds are inadequate

dx:bipolar

     ocd personality

 

saphris 20mg, adderall 30mg ((2 times a day) to offset sluggishness from saphris), lamictal 200 mg, prozac 80mg, effexor 450mg

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The most merciful thing in the world, I think, is the inability of the human mind to correlate all its contents. We live on a placid island of ignorance in the midst of black seas of infinity, and it was not meant that we should voyage far. The sciences, each straining in its own direction, have hitherto harmed us little; but some day the piecing together of dissociated knowledge will open up such terrifying vistas of reality, and of our frightful position therein, that we shall either go mad from the revelation or flee from the light into the peace and safety of a new dark age.
The Call of Cthulhu H.P. Lovecraft






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