Considering Lamictal

[tryp]

So I've been on nothing but Seroquel for the past week or so and I've been really symptomatic with BPD and MDD stuff - really bad mood swings, suicidal ideation, depression, all kinds of nastiness.

I stopped taking my Celexa because it was in the middle of crapping out. I was very depressed on it, and I also had pretty bad sexual side effects, so it no longer seemed worth staying on it. Of course, as soon as I stopped taking it, a whole bunch of other symptoms resurged and I'm left looking for a way to treat them.

I've tried 3 ADs in the past - Remeron didn't really do jack, Wellbutrin made me paranoid and Celexa was good for a while but crapped out after a few months, at least in terms of the depression stuff.

I've been reading Phelps' stuff on soft bipolar signs and how some variants of MDD respond better to mood stabilizers (specifically lamictal) than ADs. I haven't been though an absurd number of ADs, but enough to think that it might be worth trying something else.

I spoke to my pdoc about it, and she wants to try Seroquel monotherapy first - up to 400 mg (she's against going higher than 400 mg for some reason). I'm on 350 mg right now and I'm still pretty miserable.

Her idea was to try another SSRI - sertraline or back on celexa, but when I mentioned lamictal she said she would be open to it.

So I'm working what people's experiences have been with lamictal without an additional antidepressant. Because most of the available studies for MDD are on using it with an anti depressant. I'd be using it with around 300-400 mg of Seroquel, but that's not exactly the same thing. So I guess I'm wondering if it would be worth trying lamictal for MDD without an antidepressant on board.

Also, if anyone with BPD has taken it, it would be nice to hear if it has had any impact on those symptoms. The studies look promising in that direction. Almost more so than for MDD.

[thedramapolice]

Can I get back to you on this?

Pdoc wants to try Lamictal starting tomorrow it looks like and I was advised not to take another AD. I'd be more than happy to be the guinea pig and do the experiment for you Tryp.

In the meantime I feel your pain with the depression stuff. Hang in there, sister.

-Bells

[tryp]

I'll be interested to see how that works out for you

[jarn]

I don't have BPD (though I did initially get a provisional dx of that was removed), but I'm on both Seroquel and Lamotrigine.

I have found Lamotrigine to be good for depression - I started it the second time (first time was years ago as monotherapy, got a rash, got taken off) after going on Invega since it depressed me. It really helped, and it was all I was using for the depression, I don't take anti-depressants.

I've stayed on Lamotrigine after moving back to Seroquel because it has been helpful and while a higher dose of Seroquel (800mg) was enough to stabilize my mood before, I don't have issues with side effects from Lamotrigine and why go off something that takes so long to titer up if I don't need to. I think being on Lamotrigine now is one reason I'm on a lower dose (700mg) of Seroquel now.

Hope that helps, though maybe not BPD specific enough.

[tryp]

Hey Jarn

Thanks for replying - it's cool that you're also on the Seroquel + Lamictal combo.

I posted on crazymeds about this and people seemed to think that lamictal would be pretty useless for MDD without an AD. But God forbid I mention the Borderlinez over there

I guess my plan would be to try lamictal and if it doesn't help enough, consider raising my seroquel again or adding back Celexa, though I'd really prefer to stay off that shit if at all possible.

[tryp]

Thanks Di I am so obsessive when I'm unstable

[isthisit]

Lamictal was the first med that actually worked well for me. I mean, things felt clear and under control when it was working for me. I think I was on it a year and a half before it pooped out on me. It did sooo much for depression and with me (surprisingly) it had zero side effects. It was gentle on me. Being BPII and have BPD it worked. Just sucks that it stopped working.

[juxtaposer]

I'm currently on Lamictal for Bipolar II/Cyclothymia/Bipolar Depression/whatever else they're trying to diagnose me with. I think it works well - I seem to be bouncing back from depression much quicker than I used to, so I'm not staying down for weeks at a time. Aside from the jitteriness when I first started the med, there are NO side effects that I can notice now.

[lavender]

Like your idea about starting Lamictal first then adding AD later if needed. I think when you add or change more than 1 med at a time it becomes confusing as to which one is the culprit (in the case of side effects) or which one is really helping. I do take Remeron, not sure if it helps depression or not, it does regulate my sleep. Lamictal really helps my mood lability and I gotta believe that's a good thing for the depression as well.

[_Just_A_little_off_]

Hey hun, Are you feeling any better now?

[dancesintherain]

Although round 2 of depression involved an effexor/lamictal combo (as you can see in my signature), I was on lamictal by itself for round one and maintenance for a good five years. I (supervised) went off meds. When the second episode hit, they tried effexor first but gradually phased lamictal in when that wasn't enough. So the AD combo is really more because of hte order in which I was trying things. My pdoc is fairly convinced that I can go down to lamictal alone since it kept me out of depression for five years solid.

[tryp]

I'm doing okay. I've been upping my Seroquel to 400 as my pdoc recommended and I'm doing a bit better. I'm still having a lot of mood swings, but the amplitude is lesser and the suicidal ideation has diminished quite a bit. Now I'm just sort of lethargic and apathetic about everything, and seriously irritable, as opposed to suicidally depressed.

It's difficult for me because I know what normal feels like, but when I'm like this, I have this voice in my head telling me that maybe this is the best I'm going to get and maybe I'm just fooling myself to believe that I ever felt any better than this.

But I really want to see if Lamictal would be the kick in the ass that would catapult me back to normalcy.

[Catnapper]

I love Lamictal, see my signature for my MDD dx changed to BP II. My mood has been fine and no side effects, other than headaches as I was titrating up. So make sure you have some asprin/ibuprofen on hand just in case. I had headaches for a few days after each increase in dosage, but they only lasted a few days and the benefits are so huge that the headaches were a minor and short-lived annoyance.

I was on Wellbutrin when I started, but I have been on WB for over ten years, augmented with a variety of things during my times in the abyss. I recently asked my pdoc if I could stop the WB, and he said no, since I had been on it so long and had no side effects, and since my mood is good, he thinks it would be a bad idea to stop it.

If I were you I would try the Lamictal and then add in an AD if you need it later.

[tryp]

That's what I'm thinking.

I'm sort of struggling with the question of how badly I have to be suffering to continue tinkering with my meds.

I saw pdoc on Tuesday and I had bruises on my arms from self-harm, but I was pretty nonchalant about it because I wasn't cutting or scratching or headbanging. And pdoc said "You know, I think we can do better for you than that."

At this point I'm no longer really a danger to myself but I'm not really functional either. Just have to keep telling myself I deserve to/can feel better than this.

[tryp]

Well, the 350 mg of Seroquel helped a bit, but when I went to 400, the irritability hit hard and I swear I had a bit of akathesia. Couldn't sleep because my arms and legs were so restless and needing to move. Backed down to 350.

Now I just get to hang out until Thursday for pdoc.

[enough]

I went from just Celexa, with occasional Xanax, to Celexa and Lamictal, to just Lamictal.

Celexa stopped working and GP had me as possible BP, so I added in low doses of Lamictal. Didn't make a bit of difference. Weight gain and anxiety started getting really bad, along with sexual side effects, so pdoc had me work off of Celexa and doubled the lamictal.

Basically, I feel the same now, as I did with Celexa, when it felt like it wasn't working. Weight actually went up a bit more, anxiety is still very high, if not higher, but the other side effects are gone.

I guess its a long way of saying from Celexa to both to Lamictal, I haven't noticed a lick of difference, except for the loss sexual side effects. Still seeking something that works. I think the dx is wrong.