zenbean Posted November 10, 2007 Share Posted November 10, 2007 OK, I'm having a host of skin problems, which recently led to three biopsies, all of which came back benign. But because my skin's going crazy (as opposed to my mind, for a change), dermatologist and pnurse agree I should taper off Lamictal just to make sure that's not causing it. This is scaring me, because Lamictal's the only thing that's ever worked well for me. This is the time of year I tend to get really depressed (living up here in the dark, cold north country), and ADs alone make me really manic. Just wondering - is Li with an AD my only other option? Anyone had success controlling BP with a combination that doesn't include either Lamictal or Li? I'll be discussing this with the pnurse on December 10, and just want to make sure I'm as informed as I can be. (I'm starting to taper the Lamictal right away, but may have to wait until December to replace it - not sure - the pnurse asked me to call back on Monday, when she'll have consulted with the pdoc.) Stories, thoughts, suggestions would be all be appreciated. Thanks. Link to comment Share on other sites More sharing options...
AnneMarie Posted November 11, 2007 Share Posted November 11, 2007 That sucks having to bail on Lamictal. Timing doesn't sound too good, either. You do have options, so don't give up. I like Lithium. If you haven't been on it before there are a few things that you should know. It is the most neuroprotective med for bipolar, and it also may promote new cell growth. That's a huge consideration if you ask me. It's efficacious w/o significant side effects for about 50% of those who try it, which is pretty fair odds. It has it's own anti-d properties, albeit weaker than Lamictal. It augments ADs well for many. Last, it's been around forever so docs know all about how to manage it to minimum health issues. That cannot be said for any of the newer AAP meds, and only on a mid-term basis for many of the ACs. So, if you are writing it off because of stereotype, do a little research and think it over again. I'm far from the only one who really likes and respects Lithium. If you've been there, done that, and it sucked, well, that's a different story. If not Lithium, then perhaps an AC (Depakote, Trileptal, Tegretol) with an AAP like Abilify or Geodon or even Seroquel at higher doses if the sedation doesn't wipe you out. If you can tolerate ADs, then one of the ACs with an AD that works for you. Whatever you do, work closely with your pdoc. Oh, and non-urgent Lamictal d/c is pretty much the same way you increased dosage... 200 to 100 to 50 to 25. (I did a 25mg all the way up to 250mg and would probably come off more slowly than the standard, but that's my med titration issues.) Link to comment Share on other sites More sharing options...
Avis Posted November 11, 2007 Share Posted November 11, 2007 Hi Zenbean I recently had to go off of lamictal. It is no picnic. I will give you a cyber hug now. I had to go off not too long ago because, as so many of my bp meds do, it went from being a perfectly useful med to morphing into something that made me crazier, massively manic and totally confused. Going off, for me, was more difficult than expected. I tried tapering down for about 10 days. The result was that my body just craved what it was missing, Lamictal, and made me foggy, groggy, clumsy and more. I did ultimately make the mistake of deciding one Friday (at around the 10th day of withdrawal) to just chuck my Lamictal into the toilet and start on the new med that my pdoc had decided to replace it - Neurontin. Neurontin was not a good med. Some nasty side effects. I made a quick change to Lithium, which co-insided with a new med from my PCP, and all ended up with me in the ER (I have a post on that too . Everyone responds differently to meds, changes in dosage, changes in meds, etc. I do, however, feel that getting off lamictal was more difficult than the various other psych meds I have had to get off of. PRIORITY ONE - stick close to your pdoc and his/her recommedations. As for the Lithium. I am off it for now. When I was in the ER my levels were checked and the numbers were perfect (I still don't have the lithium lingo down) but I see pdoc in 4 days and I hope to restart it after having some time to clear out my system. Someone responded in a post to me that lithium was the "gold standard" and I would like it if the gold standard worked for me. Best of luck. Regards, Avis Link to comment Share on other sites More sharing options...
OreoKitty Posted November 12, 2007 Share Posted November 12, 2007 (I'm starting to taper the Lamictal right away, but may have to wait until December to replace it - not sure - the pnurse asked me to call back on Monday, when she'll have consulted with the pdoc.) Stories, thoughts, suggestions would be all be appreciated. Thanks. I take Lamictal and Lithium, so I would think if the pdoc thinks lithium is a good choice maybe you could start it right away. I don't know if that would help with withdrawal. Oreo Link to comment Share on other sites More sharing options...
AirMarshall Posted November 12, 2007 Share Posted November 12, 2007 I was on Lithium and Lamictal and did pretty well for over 2 years. But we dropped the Lamictal and added Cymbalta which really helped with anxiety and intrusive/obsessive thoughts. I do like Lithium, it gives me a noticeable "stable" feeling. Taper off the Lamictal if at all possible, to avoid any possibility of seizures. good luck. a.m. Link to comment Share on other sites More sharing options...
Loon-A-TiK Posted November 12, 2007 Share Posted November 12, 2007 once i had a break in my lamictal because i wasn't on the patient assistance program yet and the clinic i go to ran out of samples, so i feel your pain. i saw i was running out and tapered off of it myself. i had a rather bad manic episode, so my advice is to replace it with something while you're coming down, to avoid a gap in coverage. i'm worried about the possibility of you having seizures if you stop lamictal too soon or too quickly. my pdoc was really hard-core about that. no stopping lamictal for me! abilify has been submitted to the FDA (according to my pdoc) for use as both an anti-manic (already approved) and AD in the bipolar. it's good stuff. an increase in abilify just got me out of a depressive episode. i also like lithium, but you have to be careful with it and maintain it well, and that can be hard if you don't have insurance or time to get blood tests. it made me dumber than a pile of rocks, but i don't remember ever having heard of anyone else who has gotten that particular side effect. headaches are common, and you need to drink tons of water. however, it works really well. if lamictal ever poops out on me or i can't take it anymore, i'll probably either try to stick it out with abilify solo or add lithium again. yes, lithium made me dumber than dumb, but it works. Link to comment Share on other sites More sharing options...
zenbean Posted November 12, 2007 Author Share Posted November 12, 2007 Thanks for all the feedback. I really appreciate it. Lots to think about. I'll let you know how it goes. Link to comment Share on other sites More sharing options...
sun_zoom_spark Posted November 12, 2007 Share Posted November 12, 2007 I tried Lamictal twice, once w/o Li the second time w/ Li. I quit taking it both times after severe rashes. Both times cold turkey. I had to take APs both times to handle really bad withdrawals. Supplemented APs for a year after second withdrawal and have been doing ok on Li ever since. SZS Link to comment Share on other sites More sharing options...
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