CX5 Posted July 4, 2012 Share Posted July 4, 2012 Hi folks, Im looking for a feedback from anyone experience with this medication together. I cannot seem to get myself stabilized with this together, except if I take it with the sodium valproate. I am in Australia, we call Sodium valproate (epilim) I was previously on 500mg twice a day for my bipolar 1 mixed episode (dysphoric depression + hypomania) Because i was cycling between depressive episode and negative thinking. My pdoc and myself decided to try the lamictal treatment. to combat depressive episode in bipolar. initially he wants me to stop the epilim altogether and titrate the lamictal instead. I found that the lamictal alone does not help with the manic symptoms. I was very restless whilst sleeping, couldnt get a good nite sleep. so i ended up taking 500mg of the epilim in the morning and about an hour later the lamictal. I find that after taking the lamictal eg: 75mg it did made me feel good for a few hours.. but by the afternoon.. it seems to fade off. After taking the lamictal i noticed also it maight reduces the sodium valproate effect. Usually in the evening i have to take another lamictal at about the same dosage. its was meant to be taken in divided dosage. I cannot find myself to be stabilised even after taking 500 mg epilim in the morning / 75mg lamictal morning & 75mg lamictal evening. My question to expert and members should i consider taking the epilim at back to my inital dosage and take lamictal just once a day in a small dosage like 50mg or 75mg at night. I am really clueless and even my pdoc needs to open up his PI information for that whilst he is listening to me in his computer. What is the best treatment regiment you folks has find a benefit. I like the lamictal the serotorergic effect, i know about the interaction also between these two drugs. Thanks. Link to comment Share on other sites More sharing options...
confused Posted July 4, 2012 Share Posted July 4, 2012 I took the 2 together for awhile. The plan was to get me off valproate and onto lamictal, but I didn't feel stable. The 2 interact so you have to titrate slower on lamictal. I did fine as long as my valproate level was withing the therapeutic range and I never went over 200 mg lamictal. I changed pdocs and the new one took me completely off valproate and made some other changes and I was okay. Link to comment Share on other sites More sharing options...
CX5 Posted July 4, 2012 Author Share Posted July 4, 2012 taking the valproate in the morning at 500mg did help with my sleep later at night. it gave me a sense of calmness which the lamictal does not. Link to comment Share on other sites More sharing options...
CX5 Posted July 4, 2012 Author Share Posted July 4, 2012 thanks confused i thought about bringing the valproate back at the therapuetic level. I still need more assurance i guess. dont want to make a nasty mistake. when i bring the valproate to the therauputic level should i take the lamictal once a day or twice? Link to comment Share on other sites More sharing options...
confused Posted July 4, 2012 Share Posted July 4, 2012 These are really details you need to work with your pdoc on. Link to comment Share on other sites More sharing options...
CX5 Posted July 4, 2012 Author Share Posted July 4, 2012 okay thanks for that. Link to comment Share on other sites More sharing options...
AirMarshall Posted July 4, 2012 Share Posted July 4, 2012 There is no clear cut answer we can give as to what dosage you should take. Your doctor must make that decision. Lamictal is typically not a strong in suppressing mania. It is not unusual to combine one or more additional meds. Lamictal may be slightly sedating or engergizing for some people. If so, try taking it opposite the effect. If it is disturbing sleep, take in morning. If sedating, take at night. Lamictal has a variable half life that is different for each individual. However a typical half life is 32 hours, making it quite long for psych meds. Consequently there is usually no advantage to split dosing through the day, and less likely that people would experience peaks and troughs. Lamictal dosage response is quite variable by individual, hence there no 'standard' dosages; trial and experimentation is necessary. The manufacturer says effective dosages range from 50mg to 400mg, but even as high as 500mg. If it isn't quite working for you, a dosage change may be in order. Many members report finding a 'sweet spot' with the med from which higher or lower dosage is not as effective. ***Note: There are several significant drug interactions that can affect Lamictal, for example some birthcontrol meds. I'm pressed for time so I'll let you do the homework. Check with your pharmicist, read the patient info sheets. http://www.drugs.com/ Good interaction checker http://www.rxlist.com/ Good drug summaries Link to comment Share on other sites More sharing options...
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