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1 hour ago, crazyguy82 said:

So lamictal and lyrica are nothing alike? 

Correct. Lamictal affects the glutamate system (decreases glutamate) and is a sodium channel blocker.

Lyrica and its stablemate, Neurontin, are GABA analogues and are calcium channel blockers.

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On 12/25/2018 at 3:17 PM, HydroCat said:

Lamictal and Valproate are both of the same class.

Nope, if I am understanding you. Valproate is in a class with several drugs, they are all called Valproates. Lamictal is in a class by itself, Triazines.

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1 minute ago, notloki said:

Nope, if I am understanding you. Valproate is in a class with several drugs, they are all called Valproates. Lamictal is in a class by itself, Triazines.

I'm guessing they just meant both are Anti epileptics compared to lyrica 

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4 hours ago, notloki said:

Nope, if I am understanding you. Valproate is in a class with several drugs, they are all called Valproates. Lamictal is in a class by itself, Triazines.

I meant that they are both anti-convulsants/mood-stabilizers.

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11 hours ago, Iceberg said:

I'm guessing they just meant both are Anti epileptics compared to lyrica 

Lyrica started as an anticonvulsant, too. Pregabalin 

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Well I’ve had the medical report I’m going to see my GP on Tuesday. The doctor has suggested stating on 25mg and increasing by 25mg every 10-14 days up to 200-300mg depending on tolerance. 

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On 12/24/2018 at 11:06 AM, crazyguy82 said:

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! 

Yes it has been used for "normal" depression. I have not seen it used for GAD.

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On 12/24/2018 at 1:06 PM, crazyguy82 said:

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! 

I came over to this subforum looking for a topic just like this.

My pdoc has bounced around different diagnoses for me - MDD, then BPII, then "atypical depression."  He admits he really doesn't know.  I do have severe episodes of depression without a doubt.  A couple times I'm almost certain I went hypomanic for several days at a time.  The curious thing is that I rapid cycle (or whatever you want to call it).  I started with a longer period of depression for a few months.  Then I started treatment.  After trying a few things, we found that bupropion works wonders for my depression.  After awhile I settled into short cycles of depression, maybe a week or so, with a couple weeks of remission in between.  And there were a couple hypo periods scattered in there.

My pdoc gave me lamictal to try to reduce the cycling.  It has worked great!  I've been on it months now and the worst I've had were a few days of depression a couple times, and in all cases it was triggered.  So for me it seems that it does help the depression a bit (in conjunction with bupropion), but where it really shines is the stabilization and reduction of cycles.  The downside (which is really an upside) is that I've convinced myself that it's keeping me from going hypomanic, and I want to be hypomanic again (I seem to forget the bad and only remember the good).  I've been tempted to stop it, but knowing that I would have to start over with titrating it back up keeps me from doing my little "experiment."

I do struggle with my dx, since I don't really have one... we know something is wrong, it's just hard to put a name on it.  If lamictal was shown to do nothing for folks who aren't bipolar I would be inclined to view that as a clue I'm really BPII.  But it seems that it can work for unipolar depression.  Maybe lamictal is preventing me from having a without-a-doubt hypo episode to confirm a dx.  Even though I'm certain I was hypo a few times, it only lasted 4-5 days each.  I know that meets the criteria, but it's abnormal.

Kinda got off on a tangent, but at least there is some context for how lamictal can help in atypical cases.

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Posted (edited)

My official dx is depression + anxiety. Pdoc is gun shy with lamictal as I tend to be pretty rash prone. He said it would have been his first choice as the next step, but due to the rash concerns, he'd try some AAPs first.

His opinion, as while i'm MDD + anxiety, that i need some sort of mood stabilizer. I suppose the concept of using a mood stabilizer with MDD might be questionable if following the nosology of MDD, but so it goes. Shades of grey.

Edited by argh
more thoughts.

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24 minutes ago, crazyguy82 said:

So started today on 25mg of lamictal is it likely to cause any weight gain?

Most find it weight neutral.

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On 1/8/2019 at 1:18 PM, argh said:

I suppose the concept of using a mood stabilizer with MDD might be questionable if following the nosology of MDD, but so it goes. Shades of grey.

In treatment-resistant depression (TRD) everything is a shade of grey. Nothing is really ever black or white lol. This is why lithium as an add-on to an antidepressant is a popular "second-line" for TRD after perhaps Abilify or Seroquel.

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Thought I would come back and fill in how it’s been going.

I’m on my second day of 50mg. No sign of any rash or skin problems not really any side effects a little bit of nausea. I did find it hard to get to sleep last night but did manage to drop off and had a good 7 hours!

My mood has improved I’m not sure if that’s because of lamictal as 50mg seems A tiny dose, or if I’m just having a better time. I do hope it continues as I’m going back to work next Monday!

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