PenguinDishwasher

Lamictal-Is a low dose effective?

20 posts in this topic

Hello all!  

I have been diagnosed with "Mood disorder-unspecified" as well as "moderate depression"...so, not a lot to go on.  I also suspect that I suffer from Quiet BPD, and/or some form of cyclothymia.  

I went on Lamictal to combat my anger/agitation/rage explosions, as well as SSRI-resistant depression.  I was on 25mg for 2 weeks, and immediately felt a difference.  I had energy and hope.  When situations would come up that usually would throw me into either a rage or crying fit, I was able to analyze the situation better, and the emotions would swell, and then eventually pass.  I felt a lot better, and thought that an increased dose (as ordered by my PDOC) would bring even greater results.  

I increased to 50mg yesterday, and to put it simply, I feel like total crap.  I have a headache, intense bloating and gas, I feel hungover, and suddenly have depression and zero motivation.  I feel like I took a giant step backwards.  Any hope I had of feeling better has been dashed.  I feel like I can barely handle my 4-year old son, let alone just be awake and functioning. 

 Has anyone heard of Lamictal/mood stabilizers working at a low dose?  I know that the therapeutic dose is near 100mg or so, but I can't imagine increasing it if I'm going to keep feeling like this.  Does it get better, or should I talk to my PDOC about staying at 25mg?

Thanks.  I just want to feel hope about this again.  

Share this post


Link to post
Share on other sites

they can but lamictal needs to reach a certain blood concentration of at least 2.0 to be effective therapeutically

Share this post


Link to post
Share on other sites

My doc says that level is only when it's used for seizures 

But I'm not saying that I would trust a low dose 

Share this post


Link to post
Share on other sites

Well 200 is supposed to be the "bipolar dose" but i wasn't in that range, but when I went up to 400 people tell me it's too high

Share this post


Link to post
Share on other sites

The majority of people require at least 100 mg to be effective. It is normal to feel like crap after increasing your dose while titrating up. Lamictal titration is very rocky. For me, I had mood swings and severe anxiety while going up until I reached my target dose and stayed there. Then things got MUCH better.

Share this post


Link to post
Share on other sites

i had a blood concentration of 0.9 at 350 mg. it never got effective for me i couldn't go higher it was messing with my renal sysem

Share this post


Link to post
Share on other sites

But that's my point, doc's don't go over 400 but that's not therapeutic level for some but I can't imagine it's doing nothing

Share this post


Link to post
Share on other sites

i didn't feel a thing truthfully or not much i was told by 2 docs that it wasn't doing much for me if my levels were that low

Share this post


Link to post
Share on other sites

But wouldn't you think that would mean people would need huge doses to have any effect on bipolar to get therapeutic, even though the max is like four hundred? 

Share this post


Link to post
Share on other sites

Posted (edited)

Ug.  I just can't imagine going through this every time.  Since the original post I've been dealing with racing thoughts, extreme anxiety, crying hysterically, and disassociation.  All while my poor son is in the other room being occupied with TV.  I just feel so hopeless right now.  SSRIs didn't touch my depression, and I was finally feeling better on 25mg.  If a higher dose will continue the relief, I would like that, but I don't know that I can deal with feeling like this every time I increase.  

Since I haven't been diagnosed as Bi-polar, I don't know that I would need such a large dose.  Maybe people who are using it for depression are helped with even a smaller dose?

How long did the increase side effects last for you until things evened out?

Edited by PenguinDishwasher
Forgot information.

Share this post


Link to post
Share on other sites

Could you ask for benzo use to help temporarily manage the symptoms during the titration? In not sure of the dosing for non bipolar, I'm not sure there's a set guideline

Share this post


Link to post
Share on other sites

When I mentioned that the majority of people find that the effective dose is 100 mg and higher, I was talking about people with depression. For bipolar the effective dose seems to be around 200 mg more or less.

Tell yourself that this feeling like crap is temporary because it is. It does get MUCH better. For me the side effects resulting from a dose increase while titrating up lasted for about 1 week  or so. Just when things started to settle down, it was time to increase the dose again. But I made it through. You can too. And if Lamictal works for you, it will have fewer side effects than most antidepressants. You just have to get through the initial titration.

Share this post


Link to post
Share on other sites
19 minutes ago, Iceberg said:

But wouldn't you think that would mean people would need huge doses to have any effect on bipolar to get therapeutic, even though the max is like four hundred? 

Think it depends on yoir

metabolism

Share this post


Link to post
Share on other sites

I just mean that If it was all based on level some people might need well above 400 which never happens for bipolar 

Share this post


Link to post
Share on other sites

Some take other AED's that lower their Lamictal level so they end up with higher doses.

Share this post


Link to post
Share on other sites

So after all that discussion we come back to the fact that the effective dose is in the hundreds, not 25 mg or 75 mg. This is well established. Certainly some people will turn up that need more Lamictal (genetics plays a big role in metabolizing it) and then there is no problem. We have decades of data on Lamictal and its effect on the body. Just to give you a comparison the usual maintenance dose for seizures is 600 mg and some take up to 1,200 mg without problems. I find it amusing that people get into a bother about 100-200 mg.

There is therapeutic drug monitoring for Lamictal, a blood test to find the level of Lamictal in the body. There are standard level ranges specific to seizures, I don't think there are official level ranges for bipolar; but your doctor may have specific ranges in mind.

Share this post


Link to post
Share on other sites
3 hours ago, notloki said:

So after all that discussion we come back to the fact that the effective dose is in the hundreds, not 25 mg or 75 mg. This is well established. Certainly some people will turn up that need more Lamictal (genetics plays a big role in metabolizing it) and then there is no problem. We have decades of data on Lamictal and its effect on the body. Just to give you a comparison the usual maintenance dose for seizures is 600 mg and some take up to 1,200 mg without problems. I find it amusing that people get into a bother about 100-200 mg.

There is therapeutic drug monitoring for Lamictal, a blood test to find the level of Lamictal in the body. There are standard level ranges specific to seizures, I don't think there are official level ranges for bipolar; but your doctor may have specific ranges in mind.

i just went by what pdoc said , appears she was conservative 

Share this post


Link to post
Share on other sites

I've had it both at 50mg and 100mg. 50 wasn't enough but it was helping when I was going down in risperidone. I've been on 100 mg for a while now and it works really well. I've never had any side effects with lamotrigine.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!


Register a new account

Sign in

Already have an account? Sign in here.


Sign In Now

  • Similar Content

    • By TranscendedRealms
      Emotions are actually a sense like sight.  They allow us to see the values that things and situations hold in our lives.  It is only our positive emotions that allow us to see the positive qualities of life (i.e. the good values) while it is only our negative emotions that allow us to see the negative qualities of life (i.e. the bad values).  Having neither positive nor negative emotions would be no different than a blind person.  No value judgment can allow this blind person to see just as how no value judgment or mindset can allow us to see the values in our lives.
    • By Unburdened
      One of my most problematic symptoms is the voice that says horrible things to me. It can be either silent just in my head or I can say it out loud. Examples are: Everybody hates you. You're pathetic. You stupid bitch. You're useless. You fucking idiot. These insults are relentless and happen when I'm alone. Often it's when I'm in bed and I have to yell out something like shut up get out of my head. But this is endless and the voice will come back, guaranteed. What are some good strategies for when the voice speaks to you? It's really torturing me and the constant criticism is destroying what little self esteem I have. 
    • By Just a dude
      Hello! I this is my first post and I want to talk about some personal issues going on with my life that is associated with coming of age (I think?), but I'm not sure why they are happening and if it is normal.
      I am a 16 year old teen living in Australia with an Asian background. When I was young, I used to be pretty happy as I lived in a townhouse and mainly played with any kid in the town. We all got really close, I went to a school close to me, had a school friend growing up with me in the same area, went to a lot of school clubs and played an instrument. My mum and dad were nice as well as I had a 'passion' for studying I guess, so I got the DUX award at my school (Top of junior school, eh).
      Then in grade 8, I went to another school and moved to another townhouse (school was still 5 minute drive from my house). My friend I grew up with also came to my school (so it just me and him facing the world together!). At first, I was shy and all that but I gradually made a lot of friends and we actually played the same games (League of Legends if you're interested) and went out and had lots of fun as well as my work ethics from my first school helped me a lot to study. I made closer friends than back in my first school and we talked all night on Skype and studied together and live as if we were close brothers and sisters. In fact, at this time in my schooling life I managed to have a nice girlfriend (which we ended) and another one in grade 9. This bits a bit weird. From my first breakup I felt this state of depression because it questioned who I was. The only reason we broke up was because of who I developed in society (a kind, smart dude but didn't really think about myself properly or others). So from then on, my close friend I grew up with, his mother was a Christian (I don't want to offend anyone when I say this, but she took the Bible literally). I wanted to become a Christian too so I can rediscover my true self without hiding my inner self, so I just listened to everything she said and just copied the same thing. It changed my mind in a wrong way as she told me stuff like "No working or studying on Sunday" or "The government is evil" and like "The queen is bathing in the blood of babies to keep her alive" in addition to the the Bible. This caused conflict within my family and I guess I lost that encouragement and warmth from my parents from that day on, even when I broke up with my friend and her mum as they remember of what I did. 
      All this chaos made me really want to change schools, so I thought about going to Queensland Academy of Science Mathemetics and Technology, which is the top school in Queensland, Australia. I applied and everything and took the test and got in, and I thought I can start a new life and rediscover myself. And we bought a house this time, but it is one and a half hours away from school by bus with a lot of transfers in between. 
      Long story short, I found out me trying to discover myself stopped me from finding myself this whole time, and I became me I guess. But, with that, I lost all these emotions. Also, I've been working harder than normal and not getting good grades (this school is number one in academic so maybe I'm just stupid .-.), so I thought that my 'Fake self' had good principles, such as being always positive and having a passion for study instead of me right now, doing work for the heck of it, reading Webtoons and occasionally playing basketball and thinking about a girl I have a crush right now. I also got Facebook to talk to others, but all I just see is everyone posting how good their life is while I'm just laughing at memes about relatable problems. 
      So, I'm asking anyone whose reading this, is this a normal thing in life to be like, or did I stray from being normal. And also, is this what they mean by the stereotype that teens are moody and rebellious and becoming adults?
      I'd like any responses cos I'm curious (btw, not suicidal at all, just pooped with life) and thank you if you do read this and can respond!
       
    • By LifeLemonPie
      I'm pretty sure I have depression. I plan things to do to help it and then am unable to do them later because I feel down and alone. Every day is a lonely struggle. People don't understand, not that I can interact with many at the moment. The biggest problem might be my job. I work for the post office and every day is at least a 3 hour struggle of being out in the 110 degree heat, trying not to think and get down. It's nearly impossible. I'm sure there's techniques but I feel so alone and distant from everything. I barely have friends, I just got back together with my guy after some struggles but even with him of all people, I feel not good enough and like I'm just a waste of his time. I love him, he can find someone better. And yet I'm selfish, too sad and alone to let go and driving him crazy with my daily insecurities. The same ones over and over again. Am I okay? Am I okay? Am I okay? I'm constantly lonely, making shit worse and have no place to safely vent because it's a lot of negative and I might be okay one day, not half the day even and then just keep feeling the negative. I can't talk to people because of how down I feel constantly and I'm not doing anything interesting because of it so I don't have normal conversation to talk about. I feel lost and disconnected from everything. And trapped in a box. And ultimately alone and failing what little I have despite my efforts. I can't get the happy to stay in my head every day and people get frustrated and hurt that it doesn't and it makes me feel worse.
      Who ever is reading this, thanks for taking the time to do so. I just wanted to be heard, to talk to someone even though I sound pathetic. I hope your day was good and tanks for stopping by.
    • By DelRey
      So I was wondering how you deal with unemployment. I rely on my husband and family for financial support including my medication and this is an absolute torture because everyone is going through such an incredibly difficult financial situation, it makes me feel super useless, desperate, I just want to run and run and not stop. I cry and feel so useless, it's that combination of depression and anxiety at the same time where one simply wonders when is everything going to be over and if it's even worth trying harder. I am very close to getting a job, I think tomorrow will be my last interview and I am very positive I will get it, but if I don't get it I will be devastated and at an even worse position because I have applied already to all possible businesses which can hire someone with my skills and education and they have rejected me. How to keep anxiety and depression under control in these situations? There is no medication that can actually solve these issues. BTW it is rainy season in the country where I live, and thunderstorms can get pretty nasty, anyone else with thunderstorm phobia, I will get under a blanket with earmuffs, heart raising and can not do anything at all throughout the duration of the storm. Every day is a struggle when I see the sky cloudy.
      Thanks! Peace