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sbdivemaster

Gapapentin and Lamotrigine and Ruminations, Oh My!

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I am currently on 400mg lamotrigine monotherapy.

Been ruminating up a storm lately, with a side of suicidal ideation.

Went to the quack earlier this week, he suggested gabapentin or escitalopram.  With SSRI induced mania flip making me nervous, I chose gabapentin.

So, I thought I might pose a few questions to the community before diving in:

Tell me about side effects - which ones? how severe? anything unusual?

Titration - he's starting me on 1200mg, spread out over 300mg am, 300mg pm, and 600mg qhs.  He said to start with just the 600 qhs, see how groggy I am, then add in the daytime doses depending on grogginess.  Too much? Too fast?

Anyone else try gabapentin for ruminations/suicidal ideations?  Did it work?

Anyone else take it as an adjunct to lamotirgine?  How well do they play together?

Anything else anyone wants to add... all input is greatly appreciated!

 

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So...I started Gabapentin at 100mg.  After a week it was increased to 200, then 300, then 600.  I never took more than 600, though I know that's a really low dose for the medication (i.e. eventually arriving at the target dose you mentioned doesn't surprise me).  I was in a PHP at the time, so they technically could have gone more aggressively.  I'm not sure whether my titration is typical, though.  I think the grogginess is a possibility because one of the reasons I was taking it was to help with my sleep architecture. 

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Had to Titrate as well in 100 mg intervals. Never went over 600 mg per day which in the grand scheme of things is a low dose.

No sides aside from dose dependent itching. Originally for sleep but moodwise closest thing ive had to a silver bullet. Completely got rid of suicidal thoughts. Didn't remove ruminations entirely  but I was able to control them better, if that makes any sense.

 

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What's ur Dx? Just bipolar? It's interesting that he suggested gaba as that's not usually a first line mood stabilizer. I went up to 600x3 and had basically no side effects (but not really any effects for that matter) starting on That much seems quite aggressive but I'm sure ur pdoc has done it before. Have u tried many other things with the monotherapy? 

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4 hours ago, Iceberg said:

What's ur Dx? Just bipolar? It's interesting that he suggested gaba as that's not usually a first line mood stabilizer. I went up to 600x3 and had basically no side effects (but not really any effects for that matter) starting on That much seems quite aggressive but I'm sure ur pdoc has done it before. Have u tried many other things with the monotherapy? 

Bipolar 2, social anxiety disorder, general anxiety disorder.  I'm already on 400mg lamotrigine, gabapentin will be adjunct.  I asked about upping lamotrigine; he's not too hip with that. Haven't tried anything else.  I'm thinking his initial dosage is kinda up there...  I've been seeing him for years, he seems to be up on his stuff.  I've talked about other meds with him, but never felt real need to tinker until more recently.

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Yeah I agree with him that it doesn't make a ton of sense to up the lamictal. Interesting he picked gabapentin and you've never tried anything else tho 

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I take diazepam PRN, and it's groovy, but that's probably not the best for long term... ;)  He did offer up escitalopram, but mania flip is a concern.

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I love my gabapentin. My story is long like everyone’s, but I just had an episode thanks to a quack that had me on meds that made me worse. Stick with it. It’s working for me.

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1 hour ago, Artsygirlms said:

I love my gabapentin. My story is long like everyone’s, but I just had an episode thanks to a quack that had me on meds that made me worse. Stick with it. It’s working for me.

What's your DX? BP? MDD?

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OK, I'm getting ready to start (kind of apprehensive to mess with meds)...  how's the grogginess?  It's the one thing the quack really mentioned.

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45 minutes ago, sbdivemaster said:

OK, I'm getting ready to start (kind of apprehensive to mess with meds)...  how's the grogginess?  It's the one thing the quack really mentioned.

Minimal to none in my experience. Something as benign as an antihistamine, like benadryl is orders of magnitude worse.

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I tried it to help with sleep and it didn't.  It was supposed to though, so I can see why your doctor would warn you about it.

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Thank you both for input.

If you had any side effects, how long did they last?  (I'm traveling next week, not sure if I want to be adjusting while away from home...)

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I didn't have anything noticeable.  It wasn't exactly a sugar pill, but it was pretty close for me.  Maybe some mild anxiety reduction.

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18 minutes ago, sbdivemaster said:

Thank you both for input.

If you had any side effects, how long did they last?  (I'm traveling next week, not sure if I want to be adjusting while away from home...)

Itching which is dose dependent and completely handled by taking an anti-histamine prophylactically. Otherwise no side effects to speak of. 

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