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What is therapeutic dose for lamotrigine in bipolar depression?


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I was taken off my anticonvulsants ( Valproate and lamotrigine) last December when I was having ECT. As soon as i finished with the ECT my pdoc put me back on Valproate and built it up to a therapeutic dose. She was very slow to do the same with the lamotrigine and i am now slipping into a depression and she has just increased the dose from 75mg to 100mg. Is this a therapeutic dose for bipolar depression??

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1 minute ago, rowan77(2) said:

I was taken off my anticonvulsants ( Valproate and lamotrigine) last December when I was having ECT. As soon as i finished with the ECT my pdoc put me back on Valproate and built it up to a therapeutic dose. She was very slow to do the same with the lamotrigine and i am now slipping into a depression and she has just increased the dose from 75mg to 100mg. Is this a therapeutic dose for bipolar depression??

Yes if you are still on the valproate. When taking them together, the lamictal dose is usually half of what it is when taking lamictal aloneĀ 

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  • 3 weeks later...
On 5/19/2020 at 7:42 PM, Iceberg said:

Thats tough to nail down. Typically, it is not considered to be a super rapid onset, but some people here have started to feel the effect in a few weeks

Additionally, valproate and lamotrigine interact with each other's metabolism like @Iceberg. Valproate inhibits lamotrigine, but lamotrigine can increase or decrease valproate levels as well. So the first few weeks will be an adjustment, but once you're at 100mg of lamotrigine, that's where you stay until your body evens out.

EDIT: Oh and yes 100mg is the highest you can go on lamotrigine while taking valproate. Or at least you aren't SUPPOSED to go any higher, but I'm sure there's a pdoc out there who has because he was using low doses of valproate.

Edited by browri
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