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Lamictal for unipolar depression, is it worth it?


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Hello,

I read that some psychiatrists use mood stabilizers even in unipolar depression.

This got me interested especially because so far no antidepressant which I tried helped me (lexapro,wellbutrin,remeron,stablon,cymbalta,anafranil).

I have depression,ocd,GAD,adhd.

Now I thought about trying lamictal but I'm scared. The drug seems to be much more serious than antidepressants.

What especially scares me is that I read that if you've been on it for a long time it may happen that you get seizures when you want to get off it.

This is really scary. Can this drug basically make your brain more prone to seizures in general!?

What also scares me is that I read that some people are hooked on it and cannot get off it anymore cause if they try to taper down they become

suicidal! :o

This is the last thing I need.

 

I really dont know what to do. I have nothing against trying out new meds but what scares me is what if I go on something and then I feel even worse

and cant even get off it anymore? If I went on lamictal I'd also not want to go on high doses. I think 100mg would be the maximum.

 

I have been on high doses Lexapro for a few months and after getting off I got withdrawal symptoms which really sucked. Since this happened I'm

not willing to go on high doses of any drug for a long time.

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I've been on and off Lamictal from 200mg and have never had a seizure. The only thing you really can't do is go off of it cold turkey-- THAT is what raises your risk of seizures. I don't think that it makes you more seizure-prone overall once you taper off slowly.

I had no problems coming off of it, and scores of people here have come off of Lamictal for various reasons. I don't think you get "hooked" on Lamictal anymore than you would any other drug.

You're letting your anxiety run your treatment plan. I'm really good at that myself, but if you're going to get better you need to stick to your doctor's advice and not let anxiety dictate your mental health.

Withdrawal sypmtoms happen, but they're temporary, and I found that withdrawal from SSRIs was much worse than withdrawal from any anticonvulsant.

I wouldn't box yourself in to 100mg only because that may not be effective for you.

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Hello,

I'm just not sure if I should try Lamictal. I mean so far I only took antidepressants. Moving to a different class of drugs is scary.

I mean the brain is so complex and nobody can predict what might happen if I introduce a certain drug. This is always scary.

 

Why is titrating difficult? Is it because the pills cannot be divided so that you can move really slow or is it because Lamictal can behave unpredictably

when you raise the dose? I read that a few times. People wrote that when they for example moved from 75 to 100 mg suddenly they felt worse! This is also scary.

I mean if there's something like a sweet spot and if you go above it then the drug makes you feel worse then this is really problematic. Usually when you reach your

sweet spot with an antidepressant going above it doesnt make you feel worse.

 

My pdoc isn't really a fan of me trying lamictal. He said it has more side effects than antidepressants.

 

Do you know if lamictal could be taken with stimulants for adhd or would this be a problem?

And can you still drink alc when on it?

Edited by alecc
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In regards to alcohol, i really dont think that you should be drinking while on any type of medication. That's just my opinion. I think that you really won't get the best out of your medication.

In regards to Lamictal, if your doctor thinks that it will be a good idea to try and you trust your doctor then I definitely would try it. It's always good to be informed about risks and side effects but every medication has risks. I think that it's important not to get so hung up on what *might* happen. You need to decide if the benefits are going to outweigh the risks.

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Alecc, I take Lamictal and Ritalin with no issue. My pdoc didn't blink an eye at my taking Vyvanse with the Lamictal (I was on Vyvanse before starting Lamictal). I'm on Ritalin now for unrelated reasons.

 

My diagnoses are similar to yours: depression, gad, social anxiety/phobia, add

 

Lamictal makes a huge difference for me. When I started it I was on Effexor for my antidepressant (now I take Parnate). I have taken up to 350mg/day of Lamictal, though I'm currently taking 300. I found at 350 I was getting foggy brain. 300 is a balance between foggy and less depressed.

 

Anyone who was seeing benefit from Lamictal will find a return of symptoms when they come off of it. I would attribute the suicidal feelings to the severity of the MI, not the medication. 

 

Lamictal is known to have a rocky titration. Many people don't start seeing benefits until they get up to 100 or 150. You sound anxious about this. You need to focus on trusting your doctor. Your pdoc has years of schooling and experience. There's a reason you pay to go see them, right? If s/he thinks Lamictal is a good thing to try, it's worth listening to. 

 

It is scary to realise that SSRIs and SNRIs are not enough to treat your illness. That doesn't mean you're untreatable. You'll find most people here are on multiple meds from different classes. Like others you've been on, Lamictal is safe if you take it as directed. 

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Hi, I dont drink that much, but I need at least 1 beer or 1 glass of wine before bed otherwise I can't fall asleep and I dont want to take any sleeping pills cause they seem even more

dangerous to me. My doc once wanted to give me an antipsychotic as sleeping pill! No way.

 

So is it likely that when you start with Lamictal you first only get side effects and NO benefits until you reach the sweet spot? That's not good. I thought this stuff would instantly work

and get better over time.

 

And what do you do if you think you found an effective dose? Do you then keep raising to see if it gets better or worse and if it gets worse you go back?

 

And does it make sense to start Lamictal on its own? Cause currently I dont know which antidepressant I should try next. I don't have that many options left.

Effexor and Paxil are no options cause of withdrawal issues.

Prozac is also not really an option because it doesn't mix well with many drugs because of drug interactions. Prozac + amphetamines for example doesn't work.

 

From the SSRIs only Zoloft is left. Fluvoxamine is also no option because you cant drink coffee while on it and I drink a lot of coffee.

Brintillex would be another option but I don't think that it's worth trying. The reviews don't impress me.

 

TCAs are also not really an option anymore cause I didn't tolerate more than 50mg Anafranil. My doc said that other TCA would also not work for me.

 

MAOI are no option at this time.

 

@ geek

 

You're on a pretty hardcore combo. Is your doc a specialist?

I don't think my pdoc even prescribes real MAOI.

And mixing parnate with ritalin and abilify sounds like he must really know what he's doing cause an unexperienced doc wouldn't

even touch this.

The problem is my pdoc doesn't really have that much experience. I think he only prescribes the standard stuff (ssri,snri,tca,ritalin,aurorix).

But he never mentioned parnate.

Edited by alecc
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My experience with Lamictal was that it was much more effective and had FEWER side effects than ADs did.   That may or may not be the case with you, however.  I have never done well on ADs.

 

You're asking a lot of questions where the answers are only going to be found IF you ever let yourself try the drug. No one here (or anywhere) can predict how you'll respond to any drug. It's like you want someone to tell you exactly how it will be.

 

I didn't find that Lamictal had a sweet spot-- I was on a few doses that all worked pretty well and ended up on the lowest effective dose for a few years.  But everyone has a different experience.

 

I found that, during my titration, I had to get used to each step up for a week or two because I would get anxious and a bit agitated.  Nothing I couldn't handle, however, and it was a good drug for me for many years.  I made sure to do a very slow titration.  I personally knew Lamictal was going to work for me at 50mg-- I started feeling better within a couple days of starting it at that dose.  That's not the case for everyone, however.

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This sounds good.

Can you describe how it feels? I mean how do you notice that it does something?

Do you feel happier or do you feel less depressed? What exactly does it do?

Does it mess with your memory or cognition? Cause that would be a REAL issue. That's why I didnt dare to go on Lyrica.

 

And did you get any skin rashes during the titration?

And how low did you start? I read in a book written by a pdoc that he likes to start with 5mg and then increase 5mg every week. This is very low and slow.

Is this even possible to start that low? I mean do they have 5mg pills?

Edited by alecc
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I agree with Dianthus, we can't tell you exactly how Lamictal will effect you, that's something you won't be able to find out unless you actually try it. Medications are so different for everyone.

I started on 25 mg of Lamictal. I'm now on 50 mg. I've had no rash, just itching and mild headaches which are helped with Tylenol from time to time. The first few days I cried a lot but that passed. Personally, I've actually found the titration to be much easier than most ssri's/ ssnri's. I still feel like shit but I can tell that this will most likely be a drug that does help me in the long run.

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It only lasted a few days though. And I don't know for sure if it was the Lamictal, it could have also been influenced by stopping depakote and starting to taper off of celexa.

You seem to have a lot of anxiety about medications. Maybe try focusing less on the start up side effects and try to think about the possible long term benefits aswell.

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I know you have a pdoc, but do you also have a therapist?

 

Talking about all that you are questioning and scared of etc on this thread might really help you with any concerns you might have.  Maybe print out this thread, and bring it with you, so your therapist/pdoc can see all of your concerns, and can maybe help to make you more comfortable in trying a new medication.

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No therapist. I made too many bad experiences.

Besides this talking to a therapist who is no doctor about my fears of drug side effects would make absolutely no sense.

This is like talking to the mailman about car problems.

Imo therapy is pretty much a joke. The "advice" I was given were so insanely shallow and stupid that it only made me furious.

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You seem to have a lot of excuses of why you can't get well - why you can't take this medication or that medication, why you don't want to go to therapy...

 

What exactly do you plan to do to get healthy?  I get that you have anxiety, and I'm sympathetic to that, but you're going to have to take a leap and do something or you will just stay stuck, fearful, and ill.

 

Starting new meds is scary.  I get that.  I've been on lots.  But you need to work through why you are throwing up so many roadblocks to the things that will bring you wellness (meds, therapy) and what it is that you think will result.  Are you going to be happy with those results?

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I agree with Melissa. You are so anxious about meds that you seem to have blocked off all options.

 

A therapist can help you explore why you are so worried and teach you skills to lower your anxiety.

 

I repeat: you need to start trusting your pdoc. Your doctor has years of experience and that's what you pay them for. You are not being a partner in your care. 

 

My tdoc says in any situation we have three choices: accept it, change it or stay miserable. You're choosing to stay miserable. You say you want help but you're not actually accepting any. Own it and move on.

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Doctors also make mistakes. I have often times asked doctors things and they gave me answers which I knew were wrong. This doesn't really build trust.

 

lol, a therapist can't explore why I am anxious. I have always been anxious. What shall he do? Take me back to my childhood? Oh boy.

I guess I can as well make 200 appoinments for the next 4 years cause this is going to take a lot of time. I'm sure at the end everything will be fine and I'll be a new

person. Yay.

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In 2009, I was unable to do the following:

 

-get on an airplane

-change meds

-have surgery

-have a full-time job

 

There's more.  But I can do all of those things now without much anxiety.  I partially credit meds that I WAS SCARED OF TAKING AND THEIR SIDE EFFECTS and I greatly credit therapy.  No, things didn't improve overnight, but my quality of life has improved drastically.

 

Therapy is probably bullshit for you because you have a really shitty attitude.  So, stay stuck where you are.  Ah, well.

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