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So I have been on a low dose of lamictal (50mg daily) since around August 2009. It had been thought I was BP2 but it took a very long time to finally work out a pdoc and now that I am seeing her, she says she doesn't suspect bipolar.

Now, the thing is, before the lamictal, I was having a hard time controlling my anger. I would get frustrated about things really easy, which isn't so great when you are basicaly the sole caregiver of an almost 5 year old. Once I started it I found I was MUCH calmer with him. Stuff that would normally have made me miserable and have gotten him stuck in his room, were no longer such a big deal and I was back to being able to, well, parent normally and get him to mostly do what he needed to without the freak outs on my end.

This week my pdoc decided more lamitcal might be helpful. Though originally she questioned how it could be useful for me at all given I am not seeming bipolar at all, but it DID really help the anger. I still have some anger issues, but moreso I just flip out over something silly and then stay mad for most of the day, before being 'fine' later.

I went to pick up the script today from my usual doc but he was out and a sub was there. First, he basically told me he knows nothing about psych meds, then he hauled out the big book looking for dosage. I told him how what i need (amount and how to raise it, etc) first he said I was wrong, then he found I was right in the giant book...

He then told me "you don't look depressed. The severely depressed patients I have seen couldn't even fake how you are acting, let alone have clean hair and clothes like you"

Um... thanks?

He also quesioned why I am taking this med if not BP and said usually it is a 'last resort' and wondered why I would need more.

Sigh.

So am I completely weird? I mean, it really DOES help that anger/frustration/irritability. But I don't have mania at all, so what does this all mean? Should I be taking something else? I have been on several AD's and they haven't done much of anything, and while this has done nothing for my depression, it has at least done SOMETHING, you know? All these non working meds make me worry that I am somehow making all of this crap up or something...but that's terrifying because I need this to go away so I can be normal-ish.

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Hey, if it works for you, it works for you.

That doc doesn't sound like someone I'd trust to muck with my meds.

P.S. I can think of several unipolar peeps around here that Lamictal has really helped, and that's just off the top of my head.

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Sigh. I am one of those unipolar peeps Lamictal has helped. From what I've heard. mood stabilizers can help with irritablity. I HATE when pdocs follow what is written in texts rather than what helps their patients. Some of us need non-standard dosing, unsual combinations, etc.

Signed,

the suicidal chick who always wears lipstick to her pdoc appointments

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A lot of drugs are prescribed for off label uses. I'm not psychotic but I was prescribed an antipsychotic because it helped with my cutting and bizarre thoughts. And as a side effect it improved my insomnia. I'll agree with the "if it works, it works" sentiment.

Plus I'm also one of those people who stay depressed in bed or on my couch for a week and doesn't shower. But I pull myself together to get clean before appointments.

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Another vote for "if it works, it works". It's not at all unusual for people who aren't bipolar to take Lamictal these days (and that's ignoring all the people taking it for seizures, which is what it was originally for). The reason it's not unusual is that people noticed a recurring pattern of it helping (some) other people, too. This should not be news to your doctor...

He then told me "you don't look depressed. The severely depressed patients I have seen couldn't even fake how you are acting, let alone have clean hair and clothes like you"

Also another vote for that doctor acting like a twat, at least in that situation. No matter how miserable I am, I will miss an appointment entirely before I'll show up without taking a shower and putting clean clothes on. If I've made it there in the first place, I'm presentable and don't look like I just rolled out of bed, even if I did just drag myself out of bed for the first time in a week.

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Maybe it's just my sour mood right now but what that guy said about "you don't look depressed" really makes me angry. I have serious problems and the only time I've ever gone like 5 days without a shower was when I lost a friend. He's judgmental and I don't know what else.

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I used to take Lamictal, and I do not have bipolar disorder. (Well, one doctor "diagnosed" me with bipolar NOS on the basis that I had a positive response to Lamictal, but his opinion doesn't count for various reasons. The pdoc that initially put me on it did not see bipolar, and my current one does not.) I was prescribed it with the theory that it could help with mood swings (non-manic) that had more of a borderline flavor (like going from normal mood to intensely angry/anxious/self-loathing/etc if my SO didn't return my phone call in what I thought was a reasonable time or in response to some kind of PTSD trigger). The other meds, like the SSRIs, that typically treat PTSD (which is my primary Dx) weren't doing the trick. It was actually my idea after having read some things about research on using Lamictal to treat PTSD and/or BPD. (It was separate studies...and I don't have links...I'm tired, and my brain isn't functioning now.) There's also research on using it for treatment-resistant depression. I actually found it to be more helpful with "abandonment issues" more than anything...and definitely was less angry. I only went off of it because it was messing with my periods (which in turn was messing with my moods.)

I'm with everyone else that says, if it works, it works. And it sounds like it's working!

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Yeah I wasn't at all happy about that comment, because the truth is my social anxiety is what makes me 'get ready' every morning. I can't go out of the house without a shower, dry hair, make up. I just can't because I am afraid of how people will see me, you know? So to have him say that was kind of like "you're an idiot" because, yes, my hair is washed and I can joke around with you and smile- but I have perfected that over years of this, especially given I have a 5 year old and I am the one who is with him at all times. Just because I am not to the point where I need to be in the hospital means I am not 'depressed enough" for my 'severe depression' diagnosis? Which, I got after just three meeting with my pdoc. When I talk, I talk and tell them everything, because to look at me, I look fine but then they get to hear all the bad stuff.

Anyway, I am glad to hear that there are lots of you with unipolar depression on it too. I wasn't planning to stop taking it, but I was curious because it was the 2nd comment I got in 2 days about how 'unusual' it was that it would do anything for me at all. I think I needed validation, lmao.

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It's not surprising that Lamictal is helping with anger/irritability. Depakote is often used for such issues. Good to know that you respond to a low dosage. Lots of folks have to put up with a glacial titration schedule.

Don't ya just love it when you can make a doc look like a dumbass?

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Vanderk- you bloody well bet it felt good to be right when he didn't have a clue!

Does anyone know if it is okay to take it all in one dose? I prefer to just take it all at night before bed because I am really bad with remembering split doses, but this doctor kept telling to to take half in morning, half at night. What good is that if I keep forgetting one dose? lol Has it mattered for anyone else? I am still only at 75mg for 2 weeks at this point anyway, but just wondering. ;)

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When I used to take it, I took it all it one dose (150mg...in the AM actually, but everyone's different.) I've heard that split dosage is more important when it's used for seizure disorders, but that it doesn't matter as much with mood disorders. Perhaps you could experiment with taking split doses (with your real pdoc's approval) and see if it makes any difference, one way or the other. Or if the nighttime dosing is working for you, just stick with that.

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The half-life of it is long enough (over a day) that it stays in your system plenty long enough to get away with taking it once a day for most people. Some people feel better if they take it split between morning/night, or all at night, or all in the morning, but it's kind of an individual thing as to which works best. It generally doesn't hurt trying out different options to see what's good for you. Remembering to take all of it is probably a pretty good thing to do, regardless of when it happens. Heh.

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i'm about to restart it (not BP) after having been on and off it a couple times. each time it helped me get out of a depressive episode at a low dose (50 mg last time) like the OP.

i like to take it in one dose in the morning bc it seems to give me slight insomnia if i take it at night. i'm hoping to not go too high on it bc i don't want cognitive impairment.

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your docs comment was irresponsible. i've been miserable all my life but no one would guess it if they didn't know me very well. hell, even people that are close to me (as close as they can get) don't really know. a lot of the time that fact makes me feel even more isolated because i'm afraid people wouldn't believe anything was REALLY wrong. so, if a doc said that to me it would make me feel 100x worse. i'd feel so much more helpless than i did before. fuck him.

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Part of the reason my pdoc has decided that I probably have BP II is because of my good response to Lamictal. And anger and irritability are definitely symptoms of depression and bipolar. The comment from that doctor is asinine.

I take all my 200 mg before bed because I find it sedating, but lots of people here find it activating so take it in the morning.

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your docs comment was irresponsible. i've been miserable all my life but no one would guess it if they didn't know me very well. hell, even people that are close to me (as close as they can get) don't really know. a lot of the time that fact makes me feel even more isolated because i'm afraid people wouldn't believe anything was REALLY wrong. so, if a doc said that to me it would make me feel 100x worse. i'd feel so much more helpless than i did before. fuck him.

The reason it bugs me so much is because I am always afraid that I am somehow making this up. Like nothing is wrong with me, I am just so ill equipped for a normal life that I am making excuses for my failures. So to hear that makes me think "Well there, you are just a self indulgent brat who needs to just get over it" and of course I can't, and then I feel worse. ;)

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So to hear that makes me think "Well there, you are just a self indulgent brat who needs to just get over it" and of course I can't, and then I feel worse.

Hey, at least on the bright (?) side, if you weren't depressed before he said that, you are now, thanks to him...

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wtf.gif

Sure sounds like you stumbled onto a doc who doesn't know jack about dealing with MI. Would almost be forgivable if he wasn't a judgemental, self-righteous prick on top of it! If a person isn't having a health/MI issue, why the f*** would they be spending their time and money going to see a doc??? And how does he figure he has any right to second guess your regular doc who knows you better? You're not weird Keirelle, he's totally ignorant, insensitive and out of touch. If you can, try to blow it off, the "flaw" is all on him, not you. Lamictal can be taken in one daily dose, but would check with your regular doc, just so you're both on the same page. I take mine in divided doses, only 'cause it gives me vivid dreams and a headache otherwise. -Lav

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This was a GP? If so, he is an asshole. If he is a p-doc, it is practically malpractice.

And ask any depressive how long they can hide it from others, using tricks they have learned to compensate with over the years. We almost all have them. Plus, let's say for a minute you weren't depressed. That is what a MAINTENANCE DOSE does. It is taken to prevent a RELAPSE. That doctor is a moron.

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