Something Comparable to Lamictal?

[troop111]

Greetings,

 

I know that Lamictal is the "Gold Standard" for people with Bipolar II depression. Lamictal worked beautifully for me for almost a year, but then stopped, and I've been increasing it ever since. Now I'm almost at the max dose of 400mg/day and I need to have a plan B.

 

Are there any other anti-convulsants that treat BP II?

 

I'm cycling weekly into depressive crashes, and based on my research, most of the remaining ACs that I have to choose from are geared more toward controlling mania/BP I. This is very troubling, as I want to stay away from atypical anti-psychotics, as I've had bad experiences with them in the past.

 

Does anyone have any info that can help me in my search for finding a new AC to treat my bipolar depression?

 

Thank you very much

 

troop

Edited May 28, 2014 by troop111

[melissaw72]

I don't have any advice, but wanted to say FWIW I was on 600 mg Lamictal at one point, so there is a little room to go up in dose.

[swim]

its simple. Glaxosmithkline makes the Trade name, and its not going generic for 5 years at least.  

 

LAMICTAL XR.  i switch to XR versions of meds when the patent expires on the real med(until xr goes generic, but it takes typically 10 years after the drug is released.  you'll probably only need 200mgxr too.

 

 

hope this helps, it helped me

 

Kyle

[mcjimjam]

I had a similar thing happen where Lamictal worked great for a year then stopped working. I switched to lithium and have been very happy with it. It has less side-effects for me than I had with Lamictal. I do need to take an antidepressant with it. It was not enough on it's own for the depression.

[swim]

just switch to XR, it streamlines, and its mainly for depression assoc. with bipolar

[swim]

lithium destroys your thyroid, even tho its the number 1 mood stabilizer in the usa, makes me wonder????????

 

just switch to XR, it streamlines, and its mainly for depression assoc. with bipolar

 

just switch to XR, it streamlines, and its mainly for depression assoc. Lithium is the most commonly used mood stabilizer, but over 50% of ppl that have used it, are on thyroid meds now, for hypo.      correlation? no causation.  it worked for me a lil, but killed my thyroid and im an athlete.   the drs shouldnt lie about these things, and the medical community should coalesce with the pdocs by now. 

 

[jt07]

swim, we are not doctors here and we don't prescribe. I appreciate that you found relief with the extended release version of Lamictal, but that doesn't mean that it will work for everyone. It's ok to relate your experience, but please don't push one particular med as THE answer.

[troop111]

Is the extended relief Lamictal really that much better?

[dianthus]

I wouldn't count on ER being much better, if at all, unless you happen to be a weirdo like me for whom brand drugs work better than generics.  In that case, however, regular brand Lamictal would be fine.  I found that I cratered when going from brand Lamictal to generic years ago, and felt a lot better when I got back on the brand name drug.

 

I'm on Depakote ER (generic), which I started when Lamictal wasn't doing it for me anymore.  It works well for anxiety, depression, and whatever mania-type things I might get (which are rare).   There are a lot of other ACs you can try.  Some of the AAPs are also very effective for treating BP II.  Lithium helps many people with the depression end as well.

Edited May 31, 2014 by dianthus

[melissaw72]

When I take the generic lamictal in pill form, I need a higher dose than when taking the name brand one.  I have the ODT ones (the disolvable ones under your tongue), and I was able to lower the dose by 200 mg because of it.

[troop111]

Well that is quite impressive! I guess I need to start getting Name Brand then? That's nuts

 

What is the effectiveness of using, say, a low dose of Lamictal with a low dose of Depakote? Would they synergize? Of course, I'm going to run all these things by my Pdoc first, but I'd like to continue to get your feedback, you guys on the front lines!

 

Do you think I should really try for Name Brand Lamictal?

 

Thanks guys!

 

troop

[melissaw72]

 

What is the effectiveness of using, say, a low dose of Lamictal with a low dose of Depakote? Would they synergize?

 

I think it depends on the person.  Everyone reacts differently.

 

 

Do you think I should really try for Name Brand Lamictal?

 

If I had known this years ago I would have definitely tried it so I could decrease my dose.

[San]

Lithium doesn't necessarily destroy the thyroid. I was on it for 8 years and never had a bad thyroid check. My doctor checked both values every 3 months. You can also get lithium in long acting form. It did a number on my kidneys, but my family is known for having bad kidneys. I ended up with water diabetes (technical name: diabetes insipidus). Stopping lithium and taking a diuretic (which works opposite in diabetes insipidus) helped. Just a note on lithium. I'd take it again in a heartbeat if my kidneys were co-operative.

 

You can go up on lamictal.

Depakote is great for bipolar 1 and mania, not so much for depression.

Tegretol is hit or miss.

Trileptal can dump your sodium.

Gabapentin can help with anxiety, it's used off label for bipolar.

 

Etc

 

Then you're looking into atypical antipsychotics that can work as mood stabilizers, such as Seroquel, Geodon, Latuda, Saphris, and so on. Anti-convulsants are generally better, but work better on mania. Lithium works well on mania AND depression. It's the only true mood stabilizer. It's something to discuss with your pdoc. 

 

There is also the option of adding an antipsychotic on to the combination which could augment the lamictal and maybe kick start it.

[dianthus]

Depakote is great for bipolar 1 and mania, not so much for depression.

Personally I haven't had significant depression since starting depakote 3 years ago. I am bipolar II on paper, but I have more issues with depression and anxiety than anything. As with any drug, everyone responds differently, and with ACs it seems especially so. Obviously there are guidelines for what will work on various sets of symptoms, but there's nothing definitive with these drugs.

 

Re: switching to brand name, it may make a difference, it may not. I wouldn't switch to brand if generic is working simply to lower the dosage. Switching may do nothing for you, could make things worse in theory. Most people see no appreciable difference between brand and generic drugs most of the time.

My pdoc doesn't like prescribing ACs together because he sees a lot of side effects that way. He may be in a minority, however.

[troop111]

As always, you guys are GREAT!

 

Thank you very much, this is very helpful for me

 

 

troop

[Bytheskinofmyteeth]

Greetings,

 

I know that Lamictal is the "Gold Standard" for people with Bipolar II depression. Lamictal worked beautifully for me for almost a year, but then stopped, and I've been increasing it ever since. Now I'm almost at the max dose of 400mg/day and I need to have a plan B.

 

Are there any other anti-convulsants that treat BP II?

 

I'm cycling weekly into depressive crashes, and based on my research, most of the remaining ACs that I have to choose from are geared more toward controlling mania/BP I. This is very troubling, as I want to stay away from atypical anti-psychotics, as I've had bad experiences with them in the past.

 

Does anyone have any info that can help me in my search for finding a new AC to treat my bipolar depression?

 

Thank you very much

 

troop

It sounds like you have tried everything.  I know some people who are  undergoing shock therapy and are having amazing results with it.  Don't let the movies scare you.  Modern day shock treatment is not that scary.  On a side note, how did the Lithium help?  I have Bipolar depression and just started 600 mg of Lithium, 50mg of Zoloft, trazadone, and Atarax. 

[mcjimjam]

 

lithium destroys your thyroid, even tho its the number 1 mood stabilizer in the usa, makes me wonder????????

 

just switch to XR, it streamlines, and its mainly for depression assoc. with bipolar

 

just switch to XR, it streamlines, and its mainly for depression assoc. Lithium is the most commonly used mood stabilizer, but over 50% of ppl that have used it, are on thyroid meds now, for hypo.      correlation? no causation.  it worked for me a lil, but killed my thyroid and im an athlete.   the drs shouldnt lie about these things, and the medical community should coalesce with the pdocs by now. 

 

 

 

Hypothyroidism is a risk with lithium. It doesn't happen to everyone and when it does happen, it just means you need to take a thyroid supplement. It is not a huge deal in the grand scheme of long-term risks with meds.

[domovoi]

i know you asked about ACs, but i would like to add to the AAP suggestions in this thread. seroquel or zyprexa. those did wonders for my BP depression, and i mostly have issues with depression. i see from your sig you're taking some zyprexa, have you tried seroquel? 300mg/night was great. the only thing is, they do tend to have more severe side effects for many people than ACs. either way, best of luck.

[San]

Thanks di, I was giving my experience with Depakote. I'm glad to hear its helped with your depression as well. 

[crtclms]

I took Depakote when it was a name brand with no XR, and could only handle 500mg, or it was vomit-o-rama. When I took it the second time, I took a generic XR, and took 1500mg+. I took it for migraine, and it had no effect on my mood at all. Neither did tegretol, but a LOT of people on the boards love tegretol. Tegretol was weight neutral for me, unlike Depakote. I went all over the place weight wise, fluctuated 75 lbs in both directions.

 

My husband had slightly low sodium levels on tri-leptal, but he is now in a third phase trial for a med related to Keppra, but without the mood problems. Remember when I wanted the divorce from Keppra? This new med is like a fucking miracle (as those of you who have followed the saga of my husband probably know). He hasn't had a seizure in almost 3 months. But since that was added, he has *really* struggled with his sodium levels. They tell him to salt everything like crazy, and it has gotten better, but they are still fussing about it.

 

Anyhoo, Tri-leptal works for some people, but you have to watch your sodium levels. It seems on CBs, Tegretol (which is Tri-Leptal's precursor) is the favorite of the two.

 

Oh, and I have been on Lithium for two years. Thyroid problems run in my family. My thyroid is totally normal, and I makes sure to get it checked often, because of my family history. Last month, my level landed right thunk in the middle of proper thyroid levels.

 

Aspirin can be fatal for some people. Those goddamn pharmaceutical companies.