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Is It Possible That Lamotrigine Reduces Sleep Duration?


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#1 Überpolarbear

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Posted 06 March 2010 - 05:48 PM

i posted this on crazymeds.us some time ago but got no replies what so ever. lets see if i get some here. so here is some copy/pasta for you :)
Hi.
Here is the story. i'm ill (now much less so than like 5 years ago though) and no one really knows what it is. some say it's a psychosomatic and other's say it's bipolar, schizophrenia or both. but that doesnt really matter in this thread much. medwise i rather benefit from bipolar meds so lets assume i'm bipolar.just for info: i'm on 20mg zyprexa (but effectively on 10mg because carbamazepine reduces zyprexa level by 50%) carbamazepine (tegretol) 600mg and wellbutrin (bupropion) 300mg (guess what carbamazepine messes with it's level too!) (but that doesnt matter much in this thread either :) )

so here is the thing. i was on lamictal till 2 years ago. and at the time i was on lamictal, i had perfect sleep pattern. no matter what else i was on, i could stand up relatively early without any problem. i was even on CLOZAPINE (theoretically the most sedating shit on earth mind you) and even in the time they were titrating it up on me i stood up at 06:00 and took a long ride to the daily hospital without ANY problem. i was on huge doses of zaprexa (30mg) to for some time and i slept 8 hours and after 8 hours i woke up automatically.

then my doc thought it might be a good idea to try lithium so he exchanged lamictal with lithium and i dont really know when exactly it happened but some time later i realized i'm sleeping from 10pm to 3pm (it sneaked up on me) and even standing up on 10am (where i have therapy once a week) is quite a torture (which doesnt make sense because i'm really feeling better OTHERWISE). i also gained lots of weight on lithium. particularly in my face and on my neck and throat. my belly aint that bad though but i have a moon face now (you will see later why it's important ;) ) 2 months ago i asked my doc about wellbutrin for depression and also i was hoping that it might by good hypersomnia. ok it's fabulous for depression (update. it doesnt work for depression either) but i sleep like 1 hours less which is not really a breakthrough.
here is what i think where it's coming from:

1. i've gained weight particularly in my face and neck so now i have Sleep apnea and sleep much because the quality of my sleep is shitty. (which is unlikely, because i recorded my snoring one night (and had fun with a 12 hours long audio file) and altghough i snore, i snore regularly and there are no stops or pauses in it like the people with apnea have)

2. I NEED LAMICTAL

i tried to google "lamotrigine sleep" but the only thing i could find was that lamotrigine doesnt have any adverse effects on sleep and some say it increases the sleep quality but nothing about reduced sleep duration so i depend on personal experience of people taking it.

update: i found one single case report where the dude with kleine-levin syndrome got better on it but there is no abstract or whatever ANYWHERE so posting link is futile.

cheerz
polar bear

Edited by Überpolarbear, 06 March 2010 - 05:50 PM.

"humor is therapy" (Viktor Frankl)
Diagnosis: [/size][/size]bipolar ultradian rapid cycling, schizophrenia NOS, being a pervert. Yes. this is bipolar. fuck the docs who say i'm schizo. ok maybe it's schizo, Clearly Schizoaffective disorder. Spooky shit!
meds: Lithium 675mg, valproic acid (generic depakote) 1200mg, Clozapine 300mg, Trazodone 50mg, Zyprexa 20mg, Carbamazepine 600mg, lamictal 50mg, valproate (generic depakote stuff) 1750mg Seroquel 600mg (soon to be 800 probably). Zyprexa 30mg, Solian (Amisulpride (AAP)) 600 mg, Lyrica 150mg, Topamax 150mg
, lamictal 25mg
 

 



#2 LunaRufina

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Posted 06 March 2010 - 06:53 PM

"Most common adverse reactions (incidence >5%) in adult bipolar clinical studies were nausea, insomnia..."

-From the Lamictal PI Sheet




And I know people have said HERE that it has been activating for some of them, and that some people have changed the time of day they take it due to this. However, in some people it can cause fatigue or somnolence and so they change the dosage or time of day they take the medication as well. For some people, it is not activating or sedating.




IF this effect that you are describing- the sleeping more or, alternately, having more "normal" sleeping patterns- somehow involves the Lamictal it could be due to two things.




One: the effect that Lamictal may have on some people's energy level/sleep patterns. You may have been subject to fatigue or excessive sleeping from the other meds, but then getting an opposite effect from the lamictal and it somehow balanced out. I know that's not very scientific, but it's REALLY hard to tease it all out when you are on a multi-med regimen.




Two: The Lamictal helped your mood in the way that that aspect of your functioning was balanced out. I don't know how you were doing mood wise or why your doctor thought you might want to try lithium- maybe it was less expensive at the time? [I'm not quite clear on the timeline, if this was before the generic came out] But you might want to talk to your doctor about this.







Did your doctor tell you that Lamictal doesn't ever interfere with sleep?




If you were doing well on the lamictal, you should consider going back.

I'm doing that myself. Tried lithium. Liked it, but now it's making me stupid, so going back to lamictal. [I hope I hope I hope.]


ETA:
What's happening with the sleep apnea?
Are you treating it at all?

There are, at least for a minimal treatment, oral appliances you can buy at the store. They aren't as good as a professionally made one, but might help at least a little.
"...what you spend years building may be destroyed overnight.
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"

#3 danceintherain

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Posted 06 March 2010 - 08:27 PM

Like Luna, I've heard stories all over the board on lamictal and sleep...that some find it sedating, some find it energy-inducing, and some put it as neutral. So there seems to really not be a consensus. I take it at night b/c I was having a sedation effect, but I'm not a good one to ask about it's impact on sleep (i.e. better duration) b/c I still take a sleep med.

I second the question about the switch from lamitcal to lithium--what benefit were you hoping to get out of lithium that you weren't getting from lamictal (e.g., did you need the higher mood stabilization?)? It might be worth talking about the reason, so you can figure out if it would make sense to go back.
bipolar I ish. Used to have some ptsd-like crap, but that's resolved.

current RXs: Ativan (1 mg), Lamictal (300mg, split); WellbutrinXL (150mg); geodon (20mgs w/ food). Also levothyroxine (75 mcg), levosertralizine, and
birth control.

Past Rxs: zoloft (like a sugar pill); lexapro (hit an akathesia problem or something else nasty like that); seroquel; ambien; sonata (all worked at different points in time, just changed for different reasons); effexorXR (wonderful for helping to yank me out of an episode; stopped after a few years b/c it seemed to be causing some agitation).

#4 Catnapper

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Posted 06 March 2010 - 09:13 PM

Lamictal has good anti-depressant properties, and from what I've read here and elsewhere, has different effects on people's sleep. I find it sedating so take it before bed, but some (most) find it activating so take it in the morning, and some split the dose time-wise. My pdoc said in a very unoffcial study of his patients, about 20% find it sedating. Sorry if I'm not making sense, time for bed....
New Improved Diagnosis: Probably BP II (instead of MDD recurrent), or as the pdoc said, "There's clearly some sort of cycle going on." The more I think about it, the more I think he's right. I've started a mood stabilizer and feel better, so I have my fingers crossed I'll stay far away from the abyss.

RX: Generic versions of Lamictal 200 mg, Wellbutrin SR 300 mg, Ambien 10 mg, Gabapentin 900 mg (for hot flashes), lots of vitamins and fish oil tablets.
RX Graveyard: Prozac, Topomax, Zoloft, Vivactil, Adderall, Provigil
DX: Previously DXed with Major Depressive Disorder, Recurrent, Without Psychotic Symptoms; still enjoying Dysthymia and Binge Eating Disorder

"All persons, living and dead, are purely coincidental." Kurt Vonnegut, Timequake

#5 Überpolarbear

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Posted 07 March 2010 - 02:32 PM

The lithium story:
at some point i had some symptoms i cant remember (i might have considered myself manic) and my doc took me off lamictal and put me on lithium. i took it for one and a half year because doc kept telling me "it takes time to work". nothing happend. at some point we had to add valproate for excessive agitation which showed up for some unknown reason. later i found out that valproate reduces the serum level of zyprexa quite a bit (which i was taking all the time at doses 15-30mg) so i thought i may have huge benefit of the 30mg zyprexa alone if i actually stop valproate (which would indirectly increases the amount of zyprexa in my brains) so we did that, which went wrong. i got all agitated and shit went to ER and whatever. they were looking at me as if i'm an alien or something like DUDE YOURE ON 30 MG ZYPREXA?!??! (i looked rather on speed basicly). so i go back to the pdoc the day after that and said "i think i'm not going to be well without an anticnnvalsant" and i knew valproate wa good but not THAT good so i pushed the doc towards carbamazepine which worked. at some point i went off lithium and nothing EVER happend. lithium didnt have any effect on me what so ever, positive or negative. nothing! (ok it had an effect on my belly ;) )
carbamazepine helps me really really much. more than any other med.
btw my sleep pattern didnt change a bit while doing all these experiments on me.

sleep apnea:
as i said, i dont believe i have sleep apnea. i just snore. there are no 30sec pauses in between of my inhaling and exhalings. they are very regular as opposed to my father who stops breathing altogether for one minute at times. i recorded my snoring for one whole night and i have the .wav file. it's some gigabytes :)

Edited by Überpolarbear, 07 March 2010 - 02:35 PM.

"humor is therapy" (Viktor Frankl)
Diagnosis: [/size][/size]bipolar ultradian rapid cycling, schizophrenia NOS, being a pervert. Yes. this is bipolar. fuck the docs who say i'm schizo. ok maybe it's schizo, Clearly Schizoaffective disorder. Spooky shit!
meds: Lithium 675mg, valproic acid (generic depakote) 1200mg, Clozapine 300mg, Trazodone 50mg, Zyprexa 20mg, Carbamazepine 600mg, lamictal 50mg, valproate (generic depakote stuff) 1750mg Seroquel 600mg (soon to be 800 probably). Zyprexa 30mg, Solian (Amisulpride (AAP)) 600 mg, Lyrica 150mg, Topamax 150mg
, lamictal 25mg
 

 


#6 Guest_Mama_*

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Posted 07 March 2010 - 10:20 PM

My daughter has bipolar II and I am a long-time lurker. I apologize that I am probably breaking the rules of the Board in responding to this post. However, I hope this information may be of some help to you.

My daughter has problems with insomnia. We always thought that it was a manifestatin of hypomania. However, hre psychiatrist recently determined that she has insomnia when she is depressed, not manic or hypomanic. It is not common but the p-doc apparently has treated a few patients with a similar symptom of depression. My daughter is trying trazadone along with her lamictal to help with sleep and depression. (She tried previously supplemented with Abilify but that was a disaster for her.)

If you are like my daughter, it may be that your insomnia has nothing to do with lamictal but is a symptom of depression that has not lifted.

#7 3Degree

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Posted 08 March 2010 - 11:24 AM

I was on wellbutrin xl and zyprexa. I came off the zyprexa and had a lot of trouble sleeping!!! Adding abilify after that made it very much WORSE! I have since quit the abilify and am titrating back up on lamictal.

I have been sleeping, but having interrupted sleep, ....still. Very intense dreams--like watching/participating in 8+ medium length movie shorts a night!!!! But waking up after each one and having to get BACK TO sleep again.

So, I would say that the lamictal is effecting my sleep, yeah.
"That which you manifest is before you". -Enzo "Somewhere the Zebra is dancing." -Enzo Enzo-isms via Garth Stein The Art of Racing in the Rain

Irritability, Anger Issues DX: Depression

Current Meds: Celexa(40mg) & Risperdal(1.0mg) Blood Pressure Meds, AntiCholesterol Med
Past Meds: Symbyax; Zyprexa (5mg) & Zoloft; Zyprexa & Effexor; Zyprexa/Effexor/Wellbutrin (300mg); Zyprexa/Effexor/Wellbutrin/Geodon
--Switched pdocs (hell coming off Effexor)
Wellbutrin (300mg) & Geodon ==> Ativan PRN; Wellbutrin & Lamictal (never got to 200mg in the titration); Wellbutrin & Lithium (450mg, blood level =0.3); Budeprion XL / Bupropion XL (Teva, & Watson) & Zyprexa (2.5mg); Bupropion XL & Abilify (2.5mg); Bupropion XL (Watson) 300mg, Lamotrigine (Mylan) made it up to 67.5 mg/wk ]; Bupropion XL (Watson) & Zyprexa (2.5mg), ditching the Z next, then the Wellbutrin.
BREAK!
Abilify (2.5mg-5mg); Strattera (60mg); Prozac (10-20mg), Prozac(20mg) & Risperdal (0.5mg);Celexa(20mg) & Risperdal(0.5mg)

#8 Überpolarbear

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Posted 09 March 2010 - 09:25 AM

ok i told the story to my doc and also that wellbutrin is not working anymore AT ALL and he said it's ok to try lamictal again. i took 25mg last night and i'm having a huge placebo effect or something. i'm feeling much better depression-wise (but i still slept for 13 hours). as i said somewhere else too he's a bit too brave because he thinks going up to 200mg in 14 days is ok. on the other hand i've taken it twice before so we know i'm not going to get the rash. lets see if it works for sleeping too much too....

BTW: i have hypersomnia not insomnia. hypersomnia is the opposite of insomnia. it means sleeping too much.

Edited by Überpolarbear, 09 March 2010 - 09:26 AM.

"humor is therapy" (Viktor Frankl)
Diagnosis: [/size][/size]bipolar ultradian rapid cycling, schizophrenia NOS, being a pervert. Yes. this is bipolar. fuck the docs who say i'm schizo. ok maybe it's schizo, Clearly Schizoaffective disorder. Spooky shit!
meds: Lithium 675mg, valproic acid (generic depakote) 1200mg, Clozapine 300mg, Trazodone 50mg, Zyprexa 20mg, Carbamazepine 600mg, lamictal 50mg, valproate (generic depakote stuff) 1750mg Seroquel 600mg (soon to be 800 probably). Zyprexa 30mg, Solian (Amisulpride (AAP)) 600 mg, Lyrica 150mg, Topamax 150mg
, lamictal 25mg
 

 


#9 3Degree

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Posted 09 March 2010 - 03:18 PM

i posted this on crazymeds.us some time ago but got no replies what so ever. lets see if i get some here.

i realized i'm sleeping from 10pm to 3pm (it sneaked up on me) and even standing up on 10am (where i have therapy once a week) is quite a torture (which doesnt make sense because i'm really feeling better OTHERWISE).

i tried to google "lamotrigine sleep" but the only thing i could find was that lamotrigine doesnt have any adverse effects on sleep and some say it increases the sleep quality but nothing about reduced sleep duration so i depend on personal experience of people taking it.


lets see if it works for sleeping too much too....

BTW: i have hypersomnia not insomnia. hypersomnia is the opposite of insomnia. it means sleeping too much.


I understood that you are sleeping too much and know what hypersomnia vs. insomnia is. You asked about other people's experiences on Lamictal....... I have the opposite reaction with sleeping less and having a lot of interrupted sleep (but some of that may be since coming off the zyprexa after many years of use). Thus reinforcing the title of your post......

30mgs of Zyprexa would have knocked me out for a week. I had to come off the symbyax (extreme somnolesence) and go down to 5mg then down to 2.5 mg to get up and function without falling asleep again at work by 10am.....

Edited by 3Degree, 09 March 2010 - 03:20 PM.

"That which you manifest is before you". -Enzo "Somewhere the Zebra is dancing." -Enzo Enzo-isms via Garth Stein The Art of Racing in the Rain

Irritability, Anger Issues DX: Depression

Current Meds: Celexa(40mg) & Risperdal(1.0mg) Blood Pressure Meds, AntiCholesterol Med
Past Meds: Symbyax; Zyprexa (5mg) & Zoloft; Zyprexa & Effexor; Zyprexa/Effexor/Wellbutrin (300mg); Zyprexa/Effexor/Wellbutrin/Geodon
--Switched pdocs (hell coming off Effexor)
Wellbutrin (300mg) & Geodon ==> Ativan PRN; Wellbutrin & Lamictal (never got to 200mg in the titration); Wellbutrin & Lithium (450mg, blood level =0.3); Budeprion XL / Bupropion XL (Teva, & Watson) & Zyprexa (2.5mg); Bupropion XL & Abilify (2.5mg); Bupropion XL (Watson) 300mg, Lamotrigine (Mylan) made it up to 67.5 mg/wk ]; Bupropion XL (Watson) & Zyprexa (2.5mg), ditching the Z next, then the Wellbutrin.
BREAK!
Abilify (2.5mg-5mg); Strattera (60mg); Prozac (10-20mg), Prozac(20mg) & Risperdal (0.5mg);Celexa(20mg) & Risperdal(0.5mg)

#10 Überpolarbear

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Posted 10 March 2010 - 10:12 AM

I understood that you are sleeping too much and know what hypersomnia vs. insomnia is. You asked about other people's experiences on Lamictal....... I have the opposite reaction with sleeping less and having a lot of interrupted sleep (but some of that may be since coming off the zyprexa after many years of use). Thus reinforcing the title of your post......

30mgs of Zyprexa would have knocked me out for a week. I had to come off the symbyax (extreme somnolesence) and go down to 5mg then down to 2.5 mg to get up and function without falling asleep again at work by 10am.....


yeah i got you right. I was refering to "mama_guest" who said "your insomnia" whatever. it was not an answer to you basicly. your post is absolutely legit ;)

"humor is therapy" (Viktor Frankl)
Diagnosis: [/size][/size]bipolar ultradian rapid cycling, schizophrenia NOS, being a pervert. Yes. this is bipolar. fuck the docs who say i'm schizo. ok maybe it's schizo, Clearly Schizoaffective disorder. Spooky shit!
meds: Lithium 675mg, valproic acid (generic depakote) 1200mg, Clozapine 300mg, Trazodone 50mg, Zyprexa 20mg, Carbamazepine 600mg, lamictal 50mg, valproate (generic depakote stuff) 1750mg Seroquel 600mg (soon to be 800 probably). Zyprexa 30mg, Solian (Amisulpride (AAP)) 600 mg, Lyrica 150mg, Topamax 150mg
, lamictal 25mg
 

 






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