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Lamictal (lamotrigine), first night - need reassurance

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I've posted to this board before about being terrified to take Lamictal - that was months and months ago and tonight I *finally* got up the courage to take some. I have that starter pack and I took a 25 mg pill and cut it in half with a knife, but my leftover half ended up crumbling and so anyway I prob. ended up only taking a quarter if that.

Is it dangerous to take it all crumbly ike this?

I'm really anxious about all psychiatric drugs b/c I've had some really bad trippy experiences on anti-depressants and well, I'm an anxious person anyway. I've been told I might be bipolar so now I'm testing out the mood-stabilizer route.

Reading some of these posts on Lamictal has freaked me out even more. Can someone please tell me if I have much of a chance of waking up tomorrow in a huge state of panic (due to the Lamictal)? This happened to me on Paxil, and I've never quite recovered from that memory. I know this is a diff. class of drugs but I'm just scared.

Also, if I do get really panicky, is it ok to take Klonopin right now?

Thank you all.

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Hi Blue...

I am not a doctor, and I don't know anything about your DX or reactions to other drugs but I can tell you that I started taking Lamictal (same little started pack!) ~ 5 weeks ago, and I do feel that it's making me feel better. My diagnoses are: MDD, ADHD and GAD, for which I've been taking Effexor (300 MB/day) Xanax (1.5 mg/day) and Adderall XR 60 MG/day with some success. However, I was still having some ups and downs, though I've never been formally diagnosed as Bipolar. It just always felt as if I didn't quite have a grip on myself.

Based on what I read on these boards, I requested a trial of Lamictal last month. I had the same kind of trepidation as you (well, maybe not QUITE as much) and my Pdoc agreed to give it a try.

As of today, I am up to 75 MG/day...I'm sure you know you need to titrate up slowly to avoid "the rash". I do have to say that I generally feel calmer, more even and just in better control of myself. I feel more "activated" but have not had any panic...in fact, quite the opposite since starting. I've not even taken all of my Xanax some days.

It's pretty normal to be anxious when starting a new drug...not only because of the potential serious side effects, but also because I sometimes think "If this drug doesn't work, then my situation is hopeless." Of course, that's not true, but when you've been on the med-go-round for years, it becomes an automatic thought.

You do sound VERY anxious. Again, with the caveat that I am not a doctor, I can't see where taking that Klonopin would do any hard. It would probably make you feel better!

As for the worries about panic, you are right that Lamictal is a totally different kind of drug than Paxil. So it seems that your fears of a similar reaction (panic) on Lamictal may be baseless.

Also, I can't imagine that the crumbling of the pill will do any harm either. I've noticed Lamictal seems to be a bit crumbly...but it sure does get crumbled once it's in your gullet, so I can't see how it could make a difference!

Hope Lamictal helps you...as it SEEMS to be helping me...at least for now....

Of course, if you have any funky reactions or a rash/swelling/etc., get medical help right away, as I'm sure you know. In the meantime, try to relax.

Best of luck,


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First--the part about the crumbly bits. No, it's not dangerous; however, as you've kinda noted, you won't get the full dose due to loss of the smaller bits. But, in the case of Lamictal and other splittable meds, it's OK if they crumble, just so long as they end up in your bloodstream.

Panic--no, Lamictal shouldn't have that effect at all, though I can't say that with 100% certainty as people can have exttrme variations in reactions. But, Paxil and other meds in that class are well known for having effects such as that, particularly in bp patients. Panic, being pushed into mania, all sortsa things along those lines when SSRIs are involved. Lamictal deals with totally different parts of the brain, and is called the "bipolar antidepressant" because of the very fact that it won't set us off like ADs.

I do want to mention, though, that the more you rumniate on what could happen, the liklier it is that you could push yourself into a state of panic. I remember back when I was 14, and was scared to death of a booster shot based on what happened when I was SIX. Never mind that, as a diabetic, I'd been taking injections for 6 1/2 years at that point, and needles should have held no fear. (Well, not true--I've had some pretty nasty needles since then...the ones they use for testosterone are MASSIVE) At any rate, I worked myself up so much that I puked at the doctor's office. Sad thing is, the booster shot was no worse than my regular insulin shots. All that stress, over nothing.

So try what I do: just swallow the pill. Pay attention as you're titrating up. But don't pay so much attention that you think every little thing is some side effect/ Just watch out for them, and if they happen--then deal with them. I say, don't worry about what may (and, indeed, likely won't) happen. Me, I've had absolutely zero probs on Lamictal. I never worried about The Rash or any other stuff I read about, and I'm glad, because that would have been wasted time and effort. Hell, I cold-turkeyed off it a month ago, and I didn't once worry about any seizure probs. (Of course, for a while I was either unconscious or so out of it that such a thought wouldn't occur, but still...)

At any rate, what I'm trying to say is--don't worry so much. You'll likely feel silly for it later. And, just because ADs treated you bad, doesn't mean any other psych meds will. After all, ADs+bipolar (if you, indeed, are) tends to be a bad mix. Been there, done that; in fact, a lot of us have. And i think it's safe to say that we have "issues" with ADs, but not other head meds. So take it easy, and good luck!

PS: instead of using a knife, find thee a pill splitter at your pharmacy or in the pharmacy section of your grocery store. It's far easier to split your meds, and you're less likely to have any crumbling issues.

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Sorry you have had med problems before. All I can say is that Lamictal has helped my husband tremendously. Plus, it is the only med he has even been compliant with because of the low side effects factor.

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After trying numerous mood stabilizers, Lamictal has worked very well for me.

My chemicals seem to play musical chairs sometimes, and one time, when I was taking my regular dose of 200mg, I tried to go up and it made me a little anxious, so I stopped. The effect lasted just that day. Now, the music has started and stopped again, so I am up to 300mg and no anxiety this time.

I had a lot of anxiety and used Klonopin to manage when needed until I found the dose that...well....stabilized my mood!

Before being DX'ed with BP, I freaked out on Prozac and Lexapro both. Now I take Lexapro, too, and it's also worked well. SSRIs can be death without a mood stabilizer, but very helpful with one.

Of course, these are just my experiences.

I hope that helps.


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Thank you all for writing. I did have a really horrid panic attack after I took the Lamictal, but I'm hanging in there and I'm going to manage the anxiety with Klonopin even if it means I'll be a zombie during the day. . better that the feeling I'm losing my mind. . .oh, and I did buy a pill-cutter.

This board is a comfort - well, sometimes a trigger, but often a comfort! How did people with mental illness get by before the internet?!

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Blue - I love Lamictal - it changed my life. I think it's smart of you to deal with your anxiety in order to take it...it could help you so much...and if it doesn't - then you'll know to try another MS. But you must try..it was like night and day for me. I wouldn't do without it. nu-huh. A pill splitter is a good idea for dosing. Tirate up as your doc prescribed. You just may surprise yourself!!!

Best wishes always


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I just started on lamictal two weeks ago in the hospital. We increased from 25 to 50 after just 4 days because the doc wanted to see if it started to get me stable before they let me go home. So far, no side effects.


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I have been up to 300mgs of Lamictal for 2 weeks now, and I am more stable than I have probably ever been in my life. I have tried other mood stabilizers, which were just worthless to me. But Lamictal has really changed me for the better.

I sure hope we have helped ease your mind about taking it, and that you can enjoy it's benefits and not be so anxious about it. Lots of luck to you, hope it helps you out.

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