Lamictal - When is it time to increase dose?

[tek]

I've asked my pdoc the same question and she always gives me the same answer...the same thing we all know about Lamictal...that it is a "strange drug" and that there's not really any set dose increase schedule once you get to the initial theraputic dose (150 for me). I thought I was feeling better after 2 weeks on Lamictal, but that only last about a week so my pdoc guessed that I was activated for some reason but it stopped, so I'm back to poop-land.

By poop-land, I mean I'm not suicidal but I can still see the edge from where I'm standing. I'm socially withdrawn, unmotivated, not getting a whole lot of satisfaction or pleasure from doing things, generally disinterested, irritable, etc. You get the idea. It seems I never get better from "here"...even on drugs in the past. I get just above suicidal, then stuck in this state of blah. That goes on for months until I can't take how shitty I feel and then back down into the black pit. I'd really like to avoid that this time, so of course I want to know how long one needs to wait on a particular dose of Lamictal before it's time to try an increase?

I WILL say, however, that my moods are more stable. That's a plus, but I want some interest and pleasure out of life- or what's the fucking point?

Ideas? Feedback? Whatever?

Thanks!

[Velvet Elvis]

Did you read over this (or the same text elsewhere)?

http://www.rxlist.com/cgi/generic/lamotrigine_ids.htm

[Unregistered]

So stable is good. Once you're really stable, your pdoc can play with other stuff to slowly bring up your 'baseline' mood. Hang in there.

[tek]

Did you read over this (or the same text elsewhere)?

[link=http://www.rxlist.com/cgi/generic/lamotrigine_ids.htm" target="_blank]http://www.rxlist.com/cgi/generic/lamotrigine_ids.htm[/link]

Yes, I read over what I could (that is, what seemed to apply to me the most...since none of them really do). I'm not being treated for BP, and I'm not being treated for epilepsy so I'm still not clear on what my max dosage is supposed to be. My pdoc says Lamictal is "supposed to be" my antidepressant, so we won't be adding anything on for the time being. Especially since I've had pretty bad reactions to the three ADs tried in the last couple of years. It really sounds like there is no certain criteria for dosage increase, and it's all really up to the pdoc to determine these things. I just don't feel like fucking hanging out on 150mg for two months before she gets the hint. We've done this with other drugs, but Lamictal is supposed to be completely different so I don't see the need to wait weeks. At least, I've not ready anything that implies it takes weeks for anything to happen. It's so "weird" that nobody knows!

[tek]

So stable is good. Once you're really stable, your pdoc can play with other stuff to slowly bring up your 'baseline' mood. Hang in there.

You make a good point. I don't think I'm as stable as I should be, but as I said above, I'm not about to go kill myself or anything. I've just been here before and I know where it goes. My concern is making the same mistake with yet another drug and "waiting it out" to see if it will be "the one", then it's too late and I'm already extremely depressed again. It's like some never-ending cycle from shitty to suicidal to shitty to suicidal. That's really no way to live. At least my pdoc understands that. I've tried to be as clear as possible that I'm not just impatient...I really feel time is of the essence. Each time I get back into the pit, it's worse than before. I had at least four serious attempts this last time, and I have no doubt that if something doesn't change for the better relatively soon, I'll end up dead. I've even brought up ECT and TCAs. Again, I swear I'm not impatient. I've just been miserable for most of my life and it's only getting worse and less tolerable. Each time a drug "fails", I lose more hope. I explained to the pdoc that I don't feel I have another couple of years to try another dozen meds. I'll be dead by that time. I'm sorry if it sounds like a pity party, it's just how I see things I guess.