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After recent appointment with PDoc he wants to prescribe Lamictal for depression and anxiety. I’ve had ton of previous meds I’m a bit unsure of trying this med. It seems to be given for BP and I just have “ normal” depression. It it likely to have any effect on MDD and GAD?

Many thanks! 

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I take it for depression/anxiety/OCD, along with Effexor.

Magic stuff, very effective very fast and no side effects.

Everyone is different but I definitely recommend.

There is the risk for the rare rash, so watch out for that. And don't miss doses, its half life is not very long, so you will feel it if you skip.

Edited by HydroCat

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200mg (100 AM + 100 PM). Usually the brand Lamictal, sometimes generic.

I started from 25, which is really small, just to make sure I don't get some weird side effect.

Edited by HydroCat

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There is not a titration schedule from the manufacturer for depression but there is for Bipolar. 25 mg/day for weeks 1-2 50mg/day for weeks 3-4, week 5 200/day mg. This titration schedule is required to avoid serious complications including rashes. It also assumes you are not on another drug which interferes with metabolism, like a Valproate. 

Lamictal is a rocky ride up to 100 mg then it usually smooths out. Lamictal often ends up having few if any side effects at 100-200 mg. I had none at 300 mg.

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26 minutes ago, notloki said:

There is not a titration schedule from the manufacturer for depression but there is for Bipolar. 25 mg/day for weeks 1-2 50mg/day for weeks 3-4, week 5 200/day mg. This titration schedule is required to avoid serious complications including rashes. It also assumes you are not on another drug which interferes with metabolism, like a Valproate. 

Lamictal is a rocky ride up to 100 mg then it usually smooths out. Lamictal often ends up having few if any side effects at 100-200 mg. I had none at 300 mg.

No side effects, but did it improve your depression at all?  I kinda want to try this based on what I've read... 

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Especially if you've cycled through other medication and can't find anything that works quite right for you, Lamictal is definitely worth a shot. For some people with anxiety, you need to directly increase GABA with benzos or the like, but with Lamictal you instead reduce glutamate (GABA's opposite) and this could have an indirect downstream effect on anxiety and depression.

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I’m definitely going to give it try. I’ve got to wait for the report to get to my GP so will be starting in the new year. I’m sure the doctor said it would be 50mg per day initially but I’m not 100% sure.

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1 hour ago, crazyguy82 said:

I already take moclobermide and seroquel so in a combination.

So sounds like uve tried most of the first line options? 

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I’ve taken so many types of tablets I’ve lost count! I’m basically treatment resistant. I was given the option of valproate or lamictal. The lamictal seems a little less harsh but I can give valproate a try at a later date if lamictal isn’t any help.

Ive taken Moclobermide for a number of years it’s not like the other MAOIs it doesn’t have the dietary restrictions like the non selective MAOIs. SSRIs and SNRIs did nothing to help but Moclobermide has been helpful. 

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12 minutes ago, crazyguy82 said:

I’ve taken so many types of tablets I’ve lost count! I’m basically treatment resistant. I was given the option of valproate or lamictal. The lamictal seems a little less harsh but I can give valproate a try at a later date if lamictal isn’t any help.

Ive taken Moclobermide for a number of years it’s not like the other MAOIs it doesn’t have the dietary restrictions like the non selective MAOIs. SSRIs and SNRIs did nothing to help but Moclobermide has been helpful. 

I think u made a good call with lamictal over the valproate If that was ur only choice 

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I did have the choice of imipramine but I really didn’t want to come off the Moclobermide.I feel that’s the only thing that’s keeping me going at the moment. The lamictal did seem the best option, I hope I don’t get any stimulation for it! Lyrica didn’t cause any stimulation so fingers crossed the lamictal is the same! 

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Lamictal and Valporate are both of the same class. Lamictal leans toward the antidepressant side while Valporate is more on the anti-manic side.

Lyrica is a GABA analogue, different but similar to Gabapentin. If anything, it is the opposite of activating.

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On 12/24/2018 at 4:21 PM, gb84 said:

No side effects, but did it improve your depression at all?  I kinda want to try this based on what I've read... 

It is very variable as to who finds this med to have antidepressant actions. I took it for 5 years for seizures. It was not effective at 300 mg and I could not stand the standard dose of 600 mg/day. I never found it affected my mood but I was in remission for depression so we were not looking for a boost in the mood arena. Lamictal came on the market as an anticonvulsant only and still today Lamictal and Keppra are the most used 2nd generation AED's. Keppra is interesting. As several anticonvulsants (Depakote, the Valproates,Topamax, Klonopin and others) are also used in bipolar it would be interesting to see if Keppra would work for bipolar. It is largely free of side effects for most, more so than Lamictal, and there is a large family of meds that end in -racetam (Levetiracetam is Keppra) that all have similar actions. Several, including Keppra, have been shown to improve cognition. The prototype nootropic (smart drugs, improves cognition) is Pramiracetam which also works as an anticonvulsant.

Edited by notloki
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My not-in-any-way-scientific explanation:

There is some balance between the excitatory Glutamate and the inhibitory GABA in the brain. The brain of course needs both, but when there is too much Glutamate activity or too little GABA activity, you get all kinds of symptoms.

The GAD enzyme converts some of the Glutamate into GABA.

Lamictal reduces Glutamate activity, which also indirectly reduces GABA but it is good for cases of excessive Glutamate.

Lyrica is a GABA analogue,  it is supposed to act like GABA on certain receptors. It was also found to increase the expression of GAD, which causes more conversion of Glutamate into GABA.

They are different but can work pretty well together.

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