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I've been depressed for a couple of years now, varying degrees, treatment resistant. I started on Lamictal a few weeks ago. I've been on 50mg for close to a week now. When I got to 50mg I noticed that my motivation picked up but not nessecarily (Damn, I can't spell anymore-how do I make the spell check here work?) my body. I'm picking up more around the house and organizing

paperwork, sleeping less but I still don't want to go anywhere or talk to people much on the phone. My thyroid T4 & T3 are pretty low and I am currently being treated for it and that takes about six weeks to make a difference (so I'm told) I've got a teensy bit of hope now but don't want to expect too much because, well, you know. My anxiety is aggravated by the Lamictal....or could it be the increase in thyroid meds? What stable dosage is best for Lamictal? My body is still so fatiqued.

Any response from anyone is very much appreciated. Thanks.

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typical effective dosage is 100-200mg but may be as high as 400 per manuf'r. at least two members have been at 500mg!

not well documented but often reported here at CB, lamictal may cause some initial irritability, or be energizing/hypomanic for bipolars. This typically drops off after the first month.

muscular aches and pains and limb heaviness are quite common initially, as are headaches. Best advice is to delay dosage titration until any major side effects have eased up. There is NO HURRY to titrate. Rushed titration will only exacerbate side effects. Being slow and deliberate also reduces the chances of having any rash effects. Oh, yes, lamictal tends to exacerbate any existing skin conditions you have. again, this drops off with time and can be reduced by deliberate titration.

Lamictal is a quite subtle med and takes time to reach full effect. My personal observation is that it took right at 3 months. I could see slow improvements each week, in hindsight.

good luck. am. Its a good med.

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Lamictal is a wierd med for me, one I'm ambivalent about. It's definitely my go to for depressions, as it will pull me out of them more reliably and quickly than any AD ever has, without any of the mixed state wierdness I've gotten (at best) from AD's. I'm back on it right now, in fact, titrating up right along with you, Sunshine. It is, as usual, working well on the depression that had just been getting started, so that's good. I'm also having some of the lamictal anxiety, which will hopefully be passing ASAP, we'll see.

In the past, I've had problems with lamictal seeming to kind of exacerbate hypo/manias, or make it harder to get them under control, or something. So I'm not altogether sure what the longterm plan's going to be as far as my staying on lamictal, as I usually tend to be much more hypo/manic-ish than depressed, except for over the summer, because I'm just contrary that way, I guess.

But lamictal can be really amazing for a lot of people. Maybe esp. for those who lean more towards the depressed end of the spectrum? Though the slow titration is really a pain.

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Air Marshall and SashaSue,

Thank you so much for your replies! They were very helpful! I've generally been feeling a little better @ 50mg but I really had a bad day yesterday which caught me by surprise. I assume that is not abnormal, to have good days and bad days at this point. Maybe even after I've stabilized......It seems that some side effects are kicking in...headaches, nausua. I had not thought of maybe slowing the titration...duh...that was good information. Yeah, the long period of titration sucks. But I am willing to do whatever it takes to give this medication a really good chance. When I suggested it to my Pdoc, she was really happy and indicated that she really wants me to stick with it till we get to the therapuetic dosage, I assume because so many treatments have failed the depression. Apparently, way back when, ( I forgot) I had tried it twice before and stopped because of a rash (I don't think it was THE rash) and because I thought I was getting more depressed. But then, I was so incredibly ill and all kinds of meds were being thrown at me, that I probably could not really tell what was what.

So, thank you again for your responses. They really helped me.

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  • 3 weeks later...
Guest Cindy Bellezzo

Lamictal causes extensive hair loss, be aware. It also made me very irritable, and did nothing for my depression.

My doc believed I was not yet up yo a therapeutic dose (100mg) so he upped me to 200mg iwithin a week, and all I got was a terrible itchy red rash that swelled my eyes almost shut. I immediately went back down to 50mg, and the rash went away in two days.

I am now off Lamictal, doctors should STOP prescribing it for depression only, it DOES NOT WORK ALONE!!!

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Lamictal causes extensive hair loss, be aware. It also made me very irritable, and did nothing for my depression.

My doc believed I was not yet up yo a therapeutic dose (100mg) so he upped me to 200mg iwithin a week, and all I got was a terrible itchy red rash that swelled my eyes almost shut. I immediately went back down to 50mg, and the rash went away in two days.

I am now off Lamictal, doctors should STOP prescribing it for depression only, it DOES NOT WORK ALONE!!!

Sorry you had such a rough time on Lamictal.

However it is crucial to differentiate the personal from the general. I'm coming off Lamictal myself, after a range of very unpleasant side-effects that got increasingly severe. I'll go into detail about that at a later date. But despite that, I'm very conscious that just because I have had negative experiences with a drug, it doesn't mean everyone else has, or will.

In fact the majority of people tolerate Lamictal very well. In some cases, where all else has failed, Lamictal was the drug that turned their mental health around. Especially for the depressive side of the bipolar spectrum, and for mixed states. Some use Lamictal as monotherapy with very good results.

It is always very tempting to lash out at drug that was prescribed with the best of intentions, but which you, unfortunately, didn't tolerate very well. There's an extraordinary range of possible reactions to medications depending on the idiosyncracies of your own neurobiology; I had a friend who had a bizarre, toxic reaction to a psychiatric drug and died suddenly. It wasn't the drug's fault. It wasn't his psychiatrist's fault. It was just one of those things. And as upsetting as it was, I didn't slander that medication to anyone that would listen; or his psychiatrist - who is clinically excellent and a really good guy; wish I could afford him!

I can only hope that if Lamictal didn't do it for you, you have since found a medication that gives you the results you are looking for. And if you haven't found it, hopefully you do.

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Lamictal causes extensive hair loss, be aware. It also made me very irritable, and did nothing for my depression.

My doc believed I was not yet up yo a therapeutic dose (100mg) so he upped me to 200mg iwithin a week, and all I got was a terrible itchy red rash that swelled my eyes almost shut. I immediately went back down to 50mg, and the rash went away in two days.

I am now off Lamictal, doctors should STOP prescribing it for depression only, it DOES NOT WORK ALONE!!!

Sorry you had such a rough time on Lamictal.

However it is crucial to differentiate the personal from the general. I'm coming off Lamictal myself, after a range of very unpleasant side-effects that got increasingly severe. I'll go into detail about that at a later date. But despite that, I'm very conscious that just because I have had negative experiences with a drug, it doesn't mean everyone else has, or will.

In fact the majority of people tolerate Lamictal very well. In some cases, where all else has failed, Lamictal was the drug that turned their mental health around. Especially for the depressive side of the bipolar spectrum, and for mixed states. Some use Lamictal as monotherapy with very good results.

It is always very tempting to lash out at drug that was prescribed with the best of intentions, but which you, unfortunately, didn't tolerate very well. There's an extraordinary range of possible reactions to medications depending on the idiosyncracies of your own neurobiology; I had a friend who had a bizarre, toxic reaction to a psychiatric drug and died suddenly. It wasn't the drug's fault. It wasn't his psychiatrist's fault. It was just one of those things. And as upsetting as it was, I didn't slander that medication to anyone that would listen; or his psychiatrist - who is clinically excellent and a really good guy; wish I could afford him!

I can only hope that if Lamictal didn't do it for you, you have since found a medication that gives you the results you are looking for. And if you haven't found it, hopefully you do.

Sorry Cindy I was half awake earlier when I responded to your post. Everything I said before still stands except for that "small matter" I skimmed past in your post with regard to your doctor jacking up your Lamictal dosage from 100 mg to 200 within the week. If that is what he did, then he's a moron. Lamictal has to be titrated very slowly.

As for hair loss - that can happen occasionally with other anticonvulsants but it is fairly unusual for Lamictal - though it does happen. The irritability is the real bitch: it usually resolves itself after a few days or week or two on a new dose while titrating, but for a small minority the irritability, racing thoughts, and a weird sort of dysphoric hypomania never seems to abate. That is what was happening with me.

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Sunshine, everyone's brain is different so you don't want to take too much stock on one or two person's negative experiences with Lamictal. It has a very high success rate for BP depression, which is what I take it for. and mood stabilization. it doesn't work for me alone. I still have to take an AP, Benzo, and may have a small dose AD added for anxiety. It does take a long time to work. I take 300 mg, which is on the higher end of dosage for BP. I've been taking it for 2 1/2 yrs. So it's hard to say if it works good. I just got out of inpatient a month ago, but I guess w/ this disease, no matter what meds. you take, you will occasionally fall down. At least I'm still alive. I have to give partial credit to Lamictal, since i take it and that was my first hospitalization, which was voluntary. And I got a job-I threw that in for you, because you were so nice and supportive toward me. Thank you, I know you will feel better soon. Keep posting and letting us know how goes it. Take care, mel

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Everything I said before still stands except for that "small matter" I skimmed past in your post with regard to your doctor jacking up your Lamictal dosage from 100 mg to 200 within the week. If that is what he did, then he's a moron. Lamictal has to be titrated very slowly.

When starting Lamictal, I titrated slowly, and once I reached 100mg, my pdoc wanted me to stay there for a while to see if it was effective. I'd been at 100mg for a couple of months and I was still having, like you said, "irritability, racing thoughts, and a weird sort of dysphoric hypomania." The racing thoughts were the last to return, and that's when I knew this wasn't just me reacting to stressors in my life.

I've seen no evidence that my pdoc is a moron ;) but he suggested going right up to 200mg from 100mg. I knew that it could be too much at once and he acknowledged that we could titrate to 150mg first, but we decided just to go ahead and titrate to 200mg. (As always, I was to call him if there was a problem.) The increase was three days ago and so far, I really haven't noticed a difference except that on the first day I went up to 200mg, my irritability skyrocketed. It has mostly returned to what passes for normal for me, but hopefully it will decrease because my "normal" is set to 12 (11? Please). Oh, and I used to be able to have two mugs of coffee in the morning and not feel a thing because of my two other meds, but I feel it since going up to 200mg of Lamictal. I probably have no business drinking coffee, but caffeine's the only vice I have left... can't drink alcohol, won't smoke anymore...

But to answer SunshineOutside, I find that Lamictal is like a walk in the park on a gorgeous day after having had two antidepressant disasters back to back (Effexor and then Cymbalta... this was before I was diagnosed as BP). It has been very helpful for my depression. Until about a month ago, it was working wonders for my anger and my racing thoughts. I'm still hopeful that the dose increase will work. I hope it will be the answer for you. :)

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they could use me as a testimonial for lamictal. the stuff is the most important med i take and is responsible for me living right now. all i can say is good stuff about it.

i went up really slowly at first. even though i started at 25mg and then soon 50mg, i felt something in my brain. i can't describe it, but it did do something in my head that i could actually feel. i felt myself smiling more. by the time i got up to 100mg, i knew for sure it was for me. i had zero side effects, and for the first time in my life really felt happy. i take 400mg and have never felt better.

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I started Lamictal when I was nearly manic. Mixed states and depression were my norms, so pdoc wanted to do something about that and also not see me crash. I went up by 25mg every two weeks all the way to 200mg, where I am now. I also was started on Trileptal at the same time, not good, and then went thru failed trials of a few meds, which is why we went so slow on Lamictal. It's also why I can't tell you how my titration went. I have no idea which med did what, or what was the untamed illness. Now, lamictal is side effect free for me. I love this med. I've had very little depression in the last 10 months, which is a record for me.

Have patience. I hear it can be a rough ride up to 100mg, especially for those starting out depressed. It evens out somewhere over 100mg, so don't judge it by what you might experience the first couple months.

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I had no problem increasing my lamictal slowly up to 300mg. I never felt any noticeable side effects.

But then I was going manic and went to a partial hospital program and that doctor said that lamictal can go higher than people think and raised me up to 500mg in a few steps. Then my pdoc went to 600mg. I have a very high tolerance to medication. Anyways I came off that mania with a less severe depression than usual which I think was due to the lamictal.

Things got better last year so I dropped down to 400mg. But recently with this depression, my lamical went back up to 600mg and I did feel a slight mood lift. Even a slight lift is important in a severe episode.

Oreo

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Lamictal is a drug that reacts to practically everything in your body. So when you first start taking it, it's almost like it attempts to recognize what exactly you are. When I first started this med my doctor titrated me up slowly each week by 25mg. However once I hit 50mg I became horribly ill. Along with irritability, I caught a vicious cold which led to very bad bronchitis, I had practically all the minor side-effects in one shot. Recalling the extremely dry mouth, that only caused my bronchitis to last longer. The minor side effects wore out within a week, but my physical illness lasted longer. I hadn't been sick like that for over a year, so I know that it was the Lamictal that caused it. After that I was completely side effect free. I get the odd muscle tenses, and an occasional migraine, but that is about all.

It can definitely take a toil on some people when first titrating. This initial phase is different for everyone, but is harder for people who are currently taking other meds. As I said before Lamical has the ability to react to everything, some drugs more that others. But the more drugs it has to recognize only causes the dosage changes to become harder and more irritable. Like you said the smallest mood change can make all the difference

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I don't want to be annoying or redundant, I am wondering if anyone would be willing to describe more specifically the positive effects of Lamictal, especially during the early stages of titration? I hope this might help others as well myself, to know what to look for, having just started on Lamictal late in July.

I am building up to 100mg for depression and anxiety by increasing by 25 mg every 2 weeks and currently am taking 50mg. I have tried several other medications before but noticed no positive effect and barely even any side-effects. That is while following the prescribed dose and length of time. I am wondering if maybe the effect of medication is more subtle than I have been expecting and if anyone could offer some insight as to when and what some of the signs are that Lamictal, in this case, would be useful and worth remaining on?

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  • 4 weeks later...

I don't want to be annoying or redundant, I am wondering if anyone would be willing to describe more specifically the positive effects of Lamictal, especially during the early stages of titration? I hope this might help others as well myself, to know what to look for, having just started on Lamictal late in July.

I am building up to 100mg for depression and anxiety by increasing by 25 mg every 2 weeks and currently am taking 50mg. I have tried several other medications before but noticed no positive effect and barely even any side-effects. That is while following the prescribed dose and length of time. I am wondering if maybe the effect of medication is more subtle than I have been expecting and if anyone could offer some insight as to when and what some of the signs are that Lamictal, in this case, would be useful and worth remaining on?

I second this... I'd like to hear what it was like for folks, even if it was bad. I just started a little over a week ago, and even though I'm very hopeful about this med (due to the astounding number of rave reviews), I still want to "keep it real".

My experience so far: I've felt fucking awful for the last week, and blamed it all on the final steps down from 150mg of Effexor XR. I had zero withdrawal symptoms until I dropped to 37.5mg, then it hit like a ton of bricks (seems this is typical). Because I started Lamictal only 2 days after that Effexor decrease, I can't be sure which med is the culprit for how crappy I've been feeling. The three most prominent "withdrawal symptoms" have been severe anxiety (the first panic attacks I've ever had in my entire life), completely fucked-up sleep (trouble falling asleep even with Ambien, vivid dreams, night sweats, night PANIC, constant waking, early waking, not feeling the slightest bit rested in the morning), and a sudden jump in irritability (total irrational cranky bitch from hell). After reading this thread, I wonder if the latter isn't due to dear old Lamictal instead of Effexor? ;) As a side note, I was also intrigued that some folks felt hyped up during their Lamictal titration. I was given the impression that the risk of zooming "up" on Lamictal was nearly non-existent.

During this past week, when I'm not feeling horrid physically, I've found myself turning up music real loud to sing along (even dancing around the house one morning), doing LOTS of shit around the house (like rearranging my entire living and dining area), and feeling way more social. I'd love to think maybe that's just the depression lifting, but I've also been very weepy and even suicidal on some days. I'm supicious, maybe even paranoid, that some of this stuff is hypomania peeping through (even though I'm not officially Dx'd BP because the only hypomanic symptoms I've experienced were on my highest doses of Effexor and Adderall). It just seems like these behaviors make no fucking sense right now. My body feels like a pile of turds that has been run over a million times and I'm upset and crying at any given moment. That does not add up to feeling unable to resist dancing around the house with a huge grin for a couple of hours. :) On the bright side, my thoughts are not racing or disjointed. I don't feel confused or like I'm running on an engine that I have no control over...so I'm guessing it's nothing to worry the pdoc over just yet. I'm open to any advice, though.

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I second this... I'd like to hear what it was like for folks, even if it was bad. I just started a little over a week ago, and even though I'm very hopeful about this med (due to the astounding number of rave reviews), I still want to "keep it real".

My experience so far: I've felt fucking awful for the last week, and blamed it all on the final steps down from 150mg of Effexor XR. I had zero withdrawal symptoms until I dropped to 37.5mg, then it hit like a ton of bricks (seems this is typical). Because I started Lamictal only 2 days after that Effexor decrease, I can't be sure which med is the culprit for how crappy I've been feeling. The three most prominent "withdrawal symptoms" have been severe anxiety (the first panic attacks I've ever had in my entire life), completely fucked-up sleep (trouble falling asleep even with Ambien, vivid dreams, night sweats, night PANIC, constant waking, early waking, not feeling the slightest bit rested in the morning), and a sudden jump in irritability (total irrational cranky bitch from hell). After reading this thread, I wonder if the latter isn't due to dear old Lamictal instead of Effexor? ;) As a side note, I was also intrigued that some folks felt hyped up during their Lamictal titration. I was given the impression that the risk of zooming "up" on Lamictal was nearly non-existent.

During this past week, when I'm not feeling horrid physically, I've found myself turning up music real loud to sing along (even dancing around the house one morning), doing LOTS of shit around the house (like rearranging my entire living and dining area), and feeling way more social. I'd love to think maybe that's just the depression lifting, but I've also been very weepy and even suicidal on some days. I'm supicious, maybe even paranoid, that some of this stuff is hypomania peeping through (even though I'm not officially Dx'd BP because the only hypomanic symptoms I've experienced were on my highest doses of Effexor and Adderall). It just seems like these behaviors make no fucking sense right now. My body feels like a pile of turds that has been run over a million times and I'm upset and crying at any given moment. That does not add up to feeling unable to resist dancing around the house with a huge grin for a couple of hours. :) On the bright side, my thoughts are not racing or disjointed. I don't feel confused or like I'm running on an engine that I have no control over...so I'm guessing it's nothing to worry the pdoc over just yet. I'm open to any advice, though.

Wow, your experience is exactly like mine was a couple weeks ago when I went off Cymbalta. I, too, am going up on Lamictal and had just upped it to 50 mg when I quit the Cymbalta. I had the anxiety, sleep disruptions, irritability. I was also wondering if it was the Cymbalta or the Lamictal. I wonder if maybe it was a combination of both? Ive also been very weepy, but not depressed, which is kinda weird. Now Im up to 75 mg on Lamictal. My racing thoughts are gone (Im also on 160 mg Geodon), my anxiety is better, my sleep is much better, my irritability is going away, though its still there some. I have so much good energy, not manic energy. Im able to get stuff done. Im really feeling pretty good now. It's been 2 weeks since I stopped the Cymbalta and about 5 weeks since I started the Lamictal. Hopefully Lamictal will work well for all of us.

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Great. Down on one (whacky withdrawals!) up on another (whacked out uppiiness!).

In this case, it is just impossible to suss out the one from the other. Sad to say, all you can do at this point, reasonably speaking, is to...keep on keeping on. Something will give (hopefully not you!) and I have full confidence that given time the bad effects will go away and the goos lamictal effects will show through.

Actually kinda reminds me what I'm going through now--dropping lithium, going on topamax--right now almost no benefits yet but shitloads of crap. Must...tough...out. Oh well, at least I get the fun effects of SMOKING A BOWL OF CRACK without the cost or illegality!

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Thanks for your replies... I think the Effexor crap is finally easing up. Yesterday was my second day without any, and my sleep was MUCH improved last night. I actually feel almost rested this morning. Hopefully the trend sticks.

My racing thoughts are gone (Im also on 160 mg Geodon), my anxiety is better, my sleep is much better, my irritability is going away, though its still there some.

I've been on 1mg Risperdal since the Hypomanic SurpriseTM hit a month ago, which obliterated the zoom within two days. I've been wanting to get rid of it since the zoom disappeared, but now I'm glad pdoc decided to keep me on it until I've finished titrating up on Lamictal. She never mentioned the possibility of getting hyped up during the titration period, but obviously she knew it could happen and played it safe. Go, pdoc, go.

Anyway, I've done my duty and read through most of the Lamictal threads in this sub-forum. I haven't seen very many posts that describe the titration experience in detail, so I'm still on the bandwagon with the OP ("What to Expect?"). ;)

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I don't want to be annoying or redundant, I am wondering if anyone would be willing to describe more specifically the positive effects of Lamictal, especially during the early stages of titration? I hope this might help others as well myself, to know what to look for, having just started on Lamictal late in July.

I am building up to 100mg for depression and anxiety by increasing by 25 mg every 2 weeks and currently am taking 50mg. I have tried several other medications before but noticed no positive effect and barely even any side-effects. That is while following the prescribed dose and length of time. I am wondering if maybe the effect of medication is more subtle than I have been expecting and if anyone could offer some insight as to when and what some of the signs are that Lamictal, in this case, would be useful and worth remaining on?

I second this... I'd like to hear what it was like for folks, even if it was bad. I just started a little over a week ago, and even though I'm very hopeful about this med (due to the astounding number of rave reviews), I still want to "keep it real".

My experience so far: I've felt fucking awful for the last week, and blamed it all on the final steps down from 150mg of Effexor XR. I had zero withdrawal symptoms until I dropped to 37.5mg, then it hit like a ton of bricks (seems this is typical). Because I started Lamictal only 2 days after that Effexor decrease, I can't be sure which med is the culprit for how crappy I've been feeling. The three most prominent "withdrawal symptoms" have been severe anxiety (the first panic attacks I've ever had in my entire life), completely fucked-up sleep (trouble falling asleep even with Ambien, vivid dreams, night sweats, night PANIC, constant waking, early waking, not feeling the slightest bit rested in the morning), and a sudden jump in irritability (total irrational cranky bitch from hell). After reading this thread, I wonder if the latter isn't due to dear old Lamictal instead of Effexor? ;) As a side note, I was also intrigued that some folks felt hyped up during their Lamictal titration. I was given the impression that the risk of zooming "up" on Lamictal was nearly non-existent.

During this past week, when I'm not feeling horrid physically, I've found myself turning up music real loud to sing along (even dancing around the house one morning), doing LOTS of shit around the house (like rearranging my entire living and dining area), and feeling way more social. I'd love to think maybe that's just the depression lifting, but I've also been very weepy and even suicidal on some days. I'm supicious, maybe even paranoid, that some of this stuff is hypomania peeping through (even though I'm not officially Dx'd BP because the only hypomanic symptoms I've experienced were on my highest doses of Effexor and Adderall). It just seems like these behaviors make no fucking sense right now. My body feels like a pile of turds that has been run over a million times and I'm upset and crying at any given moment. That does not add up to feeling unable to resist dancing around the house with a huge grin for a couple of hours. :) On the bright side, my thoughts are not racing or disjointed. I don't feel confused or like I'm running on an engine that I have no control over...so I'm guessing it's nothing to worry the pdoc over just yet. I'm open to any advice, though.

As someone who's gotten off 300mg of Effexor in the past as well as dump Lamictal, I would think your problems would stem from the Effex. Granted, I had nothing like what most people describe, but yeah, getting off Effex was a bagillion more times painful than Lamictal, especially that last 37 millogram jump. It will go away though, I promise. :cussing:

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