lithium + anticonvulsant combos - any takers?

[domovoi]

Hi everyone

I'm on lithium + other meds (in sig) for BP I. All of this is great, and works to some extent. Especially lithium. It takes the edge off of manias and stabilizes in general. Now, the problem is that (a) I'm an (ultra) rapid cycler, and (b) I'm BIG on mixed states. As some may know, lithium has not been found to be too effective for those two problems. However, for what it's done for me (and what trying to get off of it has done to me) I am very hesitant... actually frankly against getting off of it and simply switching to an anticonvulsant. I have a very good pdoc and we raised the question of adding an anticonvulsant to lithium instead. Before lithium I took a good dose of valproate (Depakote) for 5 years and it didn't do much, at least by itself (hence my devotion to lithium). Has anyone here also experienced these BP complications (rapid-cycling, mostly mixed) and/or is taking lithium+AC, can you share your experiences? Thanks so much, sorry if this is a repeat of a similar question, nothing came up in search...

Edit: yes, just remembered, I realize I am taking Lamictal with lithium, but that mostly works for depression for me, and here I am talking about clearing the mixes and lengthening cycles, which is pretty much Depakote or Tegretol

[etkearne]

Hello. I have BP- Rapid Cycling, mostly mixed with heavy psychosis.

I take Lithium and I have also taken Lamictal, Trileptal, and both, with Lithium. To my disappointment, the cycling didn't slow noticeably, nor did mood symptoms improve worth the cost from the side effects (although very few) from the anticonvulsants.

However, research supports the combination resoundingly, especially for Rapid Cycling. So, I would go for it. You did ask for our experiences, and I gave you my negative ones, but look at the research. Just google Depakote/Tegretol/Trileptal with Lithium and you'll get a lot of results.

[AnneMarie]

I was pretty much in the same boat on the same meds for a few years. Loved Lithium for what it did for mania and depression. Loved Lamictal for what it did for depression. Tried other meds in addition to try to stop the cycling. Depakote slowed it. Tegretol stopped it. I've been stable since.

I had to stop Lithium due to other non-psych med interactions. In the end, it turned out that Lamictal, Tegretol and Risperdal hold be stable w/o the Li. Anyway, I'd try Tegretol as your added a/c. It can be a rough med to start, so hang in there for a couple months if that's the way you go. It may be worth it. It was for me.

[domovoi]

sorry to resurrect this, just wanted to say: Stacia, you know what's funny - saw pdoc today, she d/c'd lithim, upped lamictal, added risperdal and planned the switch to tegretol in the next 2 weeks. i swear i didn't suggest anything, either! funny, huh?

[6un6silent6]

I'm also on Lithium and quasi-stable for 3 months with it at 900mg/day. My Pdoc decided to put me on Lamictal as a safetynet/adjunct to my therapy. I'm only at 12.5mg/day titration so we'll see what happens as I up the dose. So far it's been really bad panic attacks but I'm not sure if that's the Lithium, Lamictal, or my worry about the new med coming on.

[mj1127]

I've done Li and Tegretol, but I was such a zombie on it I couldn't get past 400mg. Not surprisingly it didn't help much, though anxiety and migraines were both less. Li and Depakote and I was even more depressed - but this is what Depakote does to me. Li and Lamictal was not really any better than Li by itself, but I've come to the conclusion after two trials that Lamictal just doesn't work for me.

[6un6silent6]

I've done Li and Tegretol, but I was such a zombie on it I couldn't get past 400mg. Not surprisingly it didn't help much, though anxiety and migraines were both less. Li and Depakote and I was even more depressed - but this is what Depakote does to me. Li and Lamictal was not really any better than Li by itself, but I've come to the conclusion after two trials that Lamictal just doesn't work for me.

The depakote drove me into depression which I've never experienced (I'm a manic-cycler not depressive at all). I'm not sure that the Lamictal will help since I don't get depressed but he insists that it's a good adjunct therapy for Lithium users. I'll continue with it for now, I'm just being cautious about my titration.

[6un6silent6]

I'm on Li and Topamax. Does that count? I used to be on Li and Lamictal but I couldn't take the headaches anymore and had to quit. I've done Li and Depakote but that didn't do much at all for me. Then there was Li and Trileptal. Had to stop that one too. I'm going to stop listing them now.

I was on Lithium and Topamax. I was barely on 50mg of Topamax and I ended up forgetting where I was on the freeway 3x and thinking I was 3 states away where I used to live as a kid. That med was evil for me. All in all, I think Lithium + an anticonvulsant can be very effective but it's tough finding the right combination.

[domovoi]

I've done Li and Tegretol, but I was such a zombie on it I couldn't get past 400mg.

haha... i'm prolly not zombie enough!! been (hypo)manic for 3 months now, haven't slept in ooooooffff soo long