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Lamictal and Wellbutrin for BP II?


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I'm on Lamictal right now, 350 mg a day.  It keeps me pretty stable, but I still get pretty depressed sometimes.  My MD suggested Wellbutrin, but I'm wary of extra drugs so I didn't go for it.  Now I'm wondering if I should give it a try for a while.  I'm wondering if there is anyone else out there who has tried it?  My last AD experience was not good, so I don't want to screw up again.  But depression is just as bad.  Help!

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yes, i will admit, i too have had bad AD experiences in the past.  Among other meds, I am on Lamictal and Wellbutrin.  The Lamictal I have been on for a while.  I am actually in the process of decreasing my dosage from 400mg to 300mg due to some adverse reactions on my part.  I can't tell you a whole lot about the combo because i have not been on wellbutrin for all that long and am only on 150mg at the moment (which will be increased once the Lamictal gets to a steady dosage).

I don't think that it would be a bad idea to try it.... I'm still alive to tell the tale, ya know?  If you are still wary about trying it, I will keep you updated on my progress...

good luck

~Ophelia

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I've been on WB for years along with depakote with great success.  I'm now switching from tegretol + WB to lamictal + WB.  My pdoc says I may be able to reduce my WB once I'm up to therapeutic levels with lamictal and completely off of tegretol, but because I have the depressive type of BPII, I probably will still need it.  The key is being on a mood stabilizer at all times; WB on its own is bad for me.

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Nars. I am kinda sleepy so forgive me if it is obvious, do you take the depakote along with the WB + Lamictal?  Or does the Lamictal take the place of the depakote? Curious, Sulu.

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I think we're all different! I took Lamictal (200mg) with Paxil (30mg) and Wellbutrin at 300mg AND Seroquel at 200mg for the longest time with no problems. Eventually my pdoc removed the Wellbutrin and then the Seroquel.

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Lamictal, Wellbutrin, lithium, Seroquel.  Low doses (100/100/750/25), the first two reduced from 137/300 (hallucinations and mania, respectively. 

I really like, and seem to need, the Wellbutrin front-brain boost; without it, the thought cycle is "I can't do anything --> despair!".  I took myself off of it, too fast, twice, because I didn't want to admit I might still need it, and because I'd taken the side of the purists in the antidepressant controversy.  Bad idea.  Now my plan is six months' stabilization followed by a 10% titration -- no more free falls.  Good news is, it's worked very quickly each time I've put it back.

I do need the "downer meds" in addition to the Lamictal (lithium was my first, and when I cut it too much, I get weird), but YMMV.

Good luck,

sg

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Sorry, my post was confusing.  I'm now taking the following:

lamictal (at 100, titrating up)

tegretol (at 600, soon to titrate down)

wellbutrin (450 SR)

Previously, I was just taking depakote and wellbutrin.  Had to drop the depakote entirely.

On just tegretol and wellbutrin, the tegretol was such a downer that I couldn't even feel any effects from the wellbutrin; thus the increase to 450 WB.  Lamictal seems to be reversing that. 

I now feel that barring bizarre events, once I get off the tegretol, I'm going to feel quite good.  Might have to play with the wellbutrin dosage, but lamictal is quite the AD for me.  And no cycling, probably because I was so squashed by tegretol.

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  • 3 years later...
Guest meghan

I had been taking Wellbutrin for a year and a half, which at first was combined with Effexor. My psychiatrist wanted me to come off of the Effexor because of my inability to shake my severe anxiety. Weaning off Effexor was one of the most physically difficult things I have ever done; I experienced what many patients know as "the shocks" during which I felt like an electrical shock was going through my brain (i was evening seeing flashes of light when I would close my eyes); this was especially prevalent while trying to go to sleep.

Eventually I stopped taking the Effexor and started taking Lamictal along with the Wellbutrin. This seemed to be a better cocktail, but a couple months went by and my anxiety was back where it used to be. My psychiatrist said that Wellbutrin, of all antidepressants, is more likely to cause anxiety along with its positive effects. Strange how a drug prescribed for depression can actually cause anxiety (which often leads to depression).

Anyway, I am now taking only 200mg of Lamictal a day, and I am feeling much better. I finally feel something I haven't felt in a long time-- it can only be described as in-body experiences, finally feeling like I am alive. I hope this works.

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I am on Lamictal and took Wellbutrin when I started down the slippery slope. It wasn't strong enough to keep me from hitting rock bottom, I ended up on Wellbutrin and Cymbalta, and then my Dr. dropped the Wellbutrin, but it wasn't a scary combo for me at all. For a while it actually worked a bit. Good luck with it!

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  • 2 weeks later...
Guest lostinthoughandjaded

RE: Wellbutrin and Lamictal for BP2

I've got your average, non-classic BP2... antidepressants cause my to anxiety to spike, but without them, I am crushed to the ground... as a result, I've tried a BUNCH of different stuff, to try and work out the catch 22... Celexa, Effexor (*reels in disgust at the mere mention of the word*), clonazepam, lorazepam, Prozac, Lamictal and Wellbutrin- either alone or in combo...

The addition of Lamictal was the first thing that made a REAL difference for me, as far as "reigning in the crazy" goes... it compressed my moods so that I didn't just swing from one extreme straight to the other... adding Prozac to the Lamictal helped a lot with the depression, but it still geared me up really bad and I would chew through a lot of Ativan to get me through it...

So, now I'm trying a 150 Wellbutrin/150 Lamictal combo... and so far, so good.

I probably use less than 1/4 the ativan I was needing to take on Prozac... and for the most part, my OCD tendencies haven't come back too bad since dropping the Prozac, mostly I think because the Wellbutrin is a calmer version of all the anti-d's I've tried before...

And that's all I have to say about that...

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  • 4 months later...
Guest DarwinsMunky

They build up lamictal so slowly because of the deadly rash that can come if you increase your dose too quickly. 200 mg of lamictal is the universal final dosage. More than that has been proven to have no effect so anyone taking more than that needs to stop playing doctor or get a new one.

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They build up lamictal so slowly because of the deadly rash that can come if you increase your dose too quickly. 200 mg of lamictal is the universal final dosage. More than that has been proven to have no effect so anyone taking more than that needs to stop playing doctor or get a new one.

Lamictal actually doesn't have a "universal final dose." It's a squirrely med that's hard to pin down. On it's own, some people benefit at doses over 200mg. I've seen multiple users at 300mg and know someone who benefited from increasing to 500mg. When paired with a med like Tegretol, 400mg is roughly a 200mg equivalent due to the way Tegretol speeds up Lamictal's clearance rate. Anyway, there are no hard a fast rules on upper limit, although 200mg often is the point of diminishing antidepressant returns.

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couple things:

1) wanted to make sure that everyone gets that most of this thread is from 2005, just so you know-- it's still relevant conversation to us, but IDK about the OP, you know? ;)

2) I love my wellbutrin (450mg xl) and lamictal (100mg) combination and I think it can be really helpful for people, especially BPers who might not be able to pull off an SSRI even with a mood stabilizer. do however keep in mind that my dx is still basically MDD and not any flavor of BP officially-- I also take 150mg of zoloft and about 50mg of adderall, which might send your average bipolar (is there average?) person through the manic roof. But speaking from my own experience and what I've read here over time, it can be a very useful combo for keeping fluctuations and depression at bay.

that's pretty much it, gotta uh..work since I'm at work (whoops)

m

edited to fix dosage typo (gosh I wish I only took 45mg of wellbutrin rather than the ceiling dosage..oi.)

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  • 2 weeks later...
Guest upandown

woke up depressed this morning and I am one those people who thinks I can manage my dramatic mood swings by "taking action" until, like this morning, I don't care much about anything except what info. might be on the web about my latest idea re: meds, the combination of lamictal and wellbutrin. Glad to have gotten some nice hits here as I relate to much of what has been said. After a recent disaster treatment by a doctor who I thought was oh sooo qualified, I went back to my previous doctor who knows me the best and the longest and once had me on a combination of wellbutrin (low dosage - 75mg) and lamictal (100 mg). At the time, I went off of that because my purist attitude resurfaced and I really believed that I could deal with my mood swings (not to mention the wreckage of my past, including addiction) through more spiritual means. My latest justification is that I am beginning therapy (yes, I am even resistant to that due to trust issues), so . . . "the therapy alone will surely take the place of meds". So, I'm taking my current mood and the positive response from the web search as "a sign" that perhaps I should be open to taking that starter dose of lamictal along the wellbutrin to give this combination a chance once again. BTW, I've been on Klonopin long term for anxiety, so that will be in the mix. Crazymeds will be a place where I can write about what's going on in my head and explore yet another tool to deal with my mental health issuess. Glad you are all out there ;)

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  • 1 month later...

I'm on Lamictal right now, 350 mg a day. It keeps me pretty stable, but I still get pretty depressed sometimes. My MD suggested Wellbutrin, but I'm wary of extra drugs so I didn't go for it. Now I'm wondering if I should give it a try for a while. I'm wondering if there is anyone else out there who has tried it? My last AD experience was not good, so I don't want to screw up again. But depression is just as bad. Help!

I am on 200 mg Lamictal and 300 mg Wellbutrin XL per day, and I drink 50 mg Topomax at night.

Since I stabilised on that, I have slowly but surely cut out all other meds, and only take Ivedal sleeping meds every week-end, to get a 12-hour sleep when I can.

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At first the Lamictal / Wellbutrin was doing its gjob and doing it right. I got off Lamctal because of relentless side effect if dizzines/nausea 24/7. Now I take lithium 300 x 2, Wellbutrin Xl 300 am, Adderall 15 & Wellbutrin 150 noon. In the evening Klonopin & Estazolam.

But right now nothing really works.

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lamotrigine and bupropion (generics for lamictal and wellbutrin) are currently saving my ass. i have never felt this stable, not since going nuts in 1996. it took more than ten years to figure that out. nobody will ever convince me this cocktail is a bad idea!

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Quick addition to my further posts:

I've tweaked my meds even further, and I think I've found something I'm gonna try to stick with for a while... I was finding that the Prozac was speeding me up quite a bit, so I switched to Wellbutrin, but that just wasn't quite doing the trick... I asked doc several timse about tweaking my Lamotrigine dose, but he really didn't think it was the right approach, so he suggested I add Prozac back into the mix...

The reasoning behind that is that I know my brain's serotonin levels are shot, and that greatly affects levels of anxiety, not just depression... so in order to combat the "speedy" feeling it gives me, we added tiny little doses of clonazepam that I take throughout the day, to keep the edge off.

So in total, I take 150 Lamotrigine, 150 Wellbutrin, 20 Prozac and 1mg Clonazepam (broken up throught out the day).

One of the absolute keys for me (especially being a former drug user) is that I can't handle being able to feel the drugs kick in or out, that's when I get into trouble. So I'm noticing the specific combo I'm on kinda works all in balance to keep me saturated at the right levels, as consistently as possible, and so far I've been remaining surprisingly stable. I have also had to accept that my version of "stable" is still a little fucked up, but I have some wicked coping mechanisms that I can rely on as long as my meds are doing their job.

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