Sad and confused. Currently impatient. Doctor is thinking about trying Lamictal

[Britton]

Hello all. Things have been tough for the past 6 months. I went impatient at my local psych hospital end of December, but they were unable to help me. 

 

3 weeks ago I checked myself into Menninger Clinic in Houston. I am still here. My diagnosis is still up in the air, not sure if its extreme anxiety/panic/ocd and depression, or if I fall somewhere on the bipolar spectrum.

 

The symptoms that have me here are derealization, anxiety, panic, insomnia, depression and vertigo which may be part of the anxiety/derealization and insomnia or may be medical, the doctors are unsure.

 

 I came into Menninger on zoloft 50 mg, geodon 40 mg, lithium 100 mg and remeron 22.5 mg and Ativan.

 

They pretty abruptly took me off everything except the ativan.,  I do sometimes beg for a 20 mg geodon some nights since i "think" it helps level me out. But the doctor would like me to not use it at all as he does not think it helps. The only thing they have added is 75 mg of Elavil, which isn't doing anything for my sleep or my depression, and melatonin. oh ya, they also started me on the restless leg medication requip hoping it would calm the physical anxiety down in my body to help me sleep. Jury still out on that one. 

 

On Friday the doctor put me on Nalprexone (I think tha'ts what's its called) the opiate antagonist to hopefully help with the derealization. I took it for two days and felt terrible. I felt like I was on an LSD trip minus the visual hallucinations. (I had this same reaction to neurontin 5 years ago. weird as I know they are completely different medications) This morning i refused to take the naltrexone again.

 

Today I feel horrible. Dizzy, sad, withdrawn, can't eat, physical and mental anxiety, confusion......

 

The doctor mentioned Lamictal to me last week. I am thinking that when I see him tomorrow, he may want to start me on it. I'm just so worried. I am so sensitive to medications and am afraid that in the vulnerable state I am in, it could throw me over the edge. I'm afraid of it making me feel like I'm on LSD again. 

 

I have heard that Lamictal can be a tough drug to go on to....irritability, insomnia etc. etc. I'm in a really bad spot and feel that I am willing to try anything, but at the same time, I am scared of everything. I just don't know what to do anymore. 

 

Any positive experiences with Lamictal? Is it really that hard to start it? I've been constantly in this state for 6 months. I'm at my wits end. I was really hoping they would be able to help me figure this out, but I feel pretty much the same now as I did when i came here 3 weeks ago. 

 

Thanks for reading

 

 

[tryp]

I have a lot of trouble with medications and once I got used to it, Lamictal has almost no side effects for me.  I think maybe it's contributing to my gum recession.  Otherwise, nothing.  And it stabilized my mood when nothing else did.

 

It is pretty hard and slow to start.  It takes a long time to get up, and while you're going up, you can get a fair bit of destabilization.  It was worth it for me, because when it started working, it worked really well.  What helped me was taking it in divided doses - sometimes they prescribe it all taken once a day and then I get bad mood swings and stuff, but if I take half in the morning and half at night, I don't.

[melissaw72]

Lamictal really helps me with my mood, and if my head races/I am thinking too fast, it calms it down a little.  I have no side effects.  I started it a long time ago, but I dont remember having a hard time titrating up.  My pdoc went slow ... 25 mg to 50 to 100 etc, over a long period of time. 

 

Currently on 200 mg (100 mg twice a day), sometimes 300 mg (depends on the time of the year).

[Britton]

Thanks for the replies:) I'm "ok" with side effects, or at least have to be open to them, I'm just afraid of the LSD like feeling, or feeling worse than I already do. That is what is scaring me. Can it be a calming drug? God knows I need calming. The Ativan doesn't touch the physical and mental anxiety/irritability I have been having these days....

 

Lamictal is the only other drug he has mentioned, so I am assuming he is going to be starting it tomorrow.

 

I had the "LSD" feeling from neurontin, just an overall bad feeling from zyprexa and when i tried depakote last month, it made my symptoms much worse. Is lamictal different enough from these drugs that I shouldn't be worried?

[jt07]

I take 200 mg. For me, it is neither calming nor activating - really kinda neutral. To be honest, I did have a rough titration, but I stuck it out because I knew it would get much better once I hit my target dose and didn't change every couple of weeks. Now I have no side effects at all. Zero.

[Always Unstable]

I be been on Depakote and Lamictal and I can say that, for me, Lamictal was loads better than Depakote. Depakote really didn't do a whole lot for me. There was a big difference between the two of them for me.

Also, if you are starting it in hospital then you may find the titration easier, less stressful etc.

[Teagan]

I didn't have any side effects when I went on Lamictal. I was on it for awhile. I didn't think it helped me but my doc tends to disagree. I took it during a rough time in my life....right before I entered an outpatient program where I ended up staying for about 6 months. I was struggling with MDD, anxiety, panic and major insomnia at the time. I'm "very" sensitive to medications and usually have horrible side effects but did not have any with Lamictal.

[rowan77]

I take Lamictal 300mg (200mg am and 100mg pm). I really like it. It has really helped my mood and I have no side effects whatsoever.

 

It really is worth giving a try as it may be the medication that helps you!

 

Good luck with seeing your pdoc tomorrow and if you are commenced on Lamictal, all the best with that too. As others have said the titration is slow, but I honestly think it's worth the wait if you can hang in there for a while.

[Britton]

Thanks for the good vibes all! This has been quite a rough road. I'm ready to get a handle on it so that I can start living again. I have already been in the hospital for 3 weeks, so I'm not sure how long i can stay for the titration, guess I'll figure that out with the doc tomorrow. I just hope it doesn't make me "trip out' like sop many other meds have done to me. It's so scary :-/ Where is the line between "this is a side effect that will go away, I can handle this", and "whoa, this is really jacking me up Im not sure I can do this"

 

I dont want to give up to early, but I'm afraid of feeling worse than I already do, or going nuts from a new med

[melissaw72]

 

I dont want to give up to early, but I'm afraid of feeling worse than I already do, or going nuts from a new med

 

I think it is one of those things that you won't know how it will affect you until you try it.

[Britton]

So I got the lamital ordered for tonight at bedtime (8-9 pm) I am very nervous, but hopeful. I would do anything to get out of the state I am in. My diagnosis is currently up in the air. Definitely severe anxiety,derealization and depression, possibly somewhere in the bipolar spectrum. The doctor is hoping that it will help with derealization. He says that it has been shown in some studies to help. He is also hoping it will help level my moods, whether or not they are bipolar related. I'm kind of confused. I hope he's right. I know it can cause agitation and anxiety when you start it. how long does this tend to last? Can it cause night terrors and insomnia?  I am hoping to God these don't happen to me as my anxiety and agitation is already through the roof. Does this anxiety happen to most people? Excited to try something new, but scared to death of it making me feel like I'm losing my mind :-/ I already feel like I'm losing my mind.....I'm so scared right now

Edited May 14, 2015 by Britton

[melissaw72]

Try not to be scared.  Everything may turn out ok, and without side effects.  I didn't have agitation and anxiety when starting Lamictal.  I didn't have night terrors and insomnia that was worsened either ... I had already had these when starting lamictal, but they didn't get any worse.

[rowan77]

I'm sorry that you are so scared. Try to relax and keep positive, although I know only too well that is far from easy.

Lamictal has helped countless people here on CB so try to hold on to that. And it is a great mood stabiliser for me too, particularly with depression.

Also I had no anxiety, agitation, night terrors or insomnia. Looking back I would say that my anxiety actually improved when I was on it a while, probably as a result of my depression lifting.

Anyway, all the best and I am hoping that you have a positive experience and get some relief from your symptoms.

Take care

[Britton]

Thanks so much. I took 25 mg last night. Sleep was so-so, but that's been my story for the past 6 months anyway. Pretty sure I didn't have any disturbing dreams which was nice. 

 

As I think I already mentioned in my initial post, my diagnosis is a bit up in the air. But what i can tell you is that i am experiencing extreme physical and mental anxiety, derealization and vertigo, which I believe is spiking the anxiety, insomnia, likely caused by all of it, and of course depression because I am tired of feeling this way. I'm completely spent and scared. It's been constant for 6 months. I am afraid that I am going to be stuck this way forever:(

 

My doctor here at Menninger said that Lamictal can help with derealization. Have any of you heard of this? Can it help with anxiety and ruminating thinking? By balancing out mood, can it help with insomnia?? Depression? Even if I am not bipolar, can Lamictal still be beneficial to me?

 

I've been here impatient for 3 weeks and feel the same, if not worse, than when I came in. I have 1 more week. I am hoping I will begin to see a shift with the Lamictal and that we do not spend this last week on a med that is not suited for my symptoms. I guess only time will tell....

thanks again

Edited May 12, 2015 by Britton

[tryp]

I am not bipolar and Lamictal has helped a LOT with my depressive symptoms.  Particularly with mood.  I haven't noticed any effects on anxiety or insomnia except that when I'm not depressed, I sleep better in general and am less anxious.  Haven't noticed any impact on my dissociative symptoms.

 

I said this before but I REALLY like Lamictal.  I did pretty badly on antidepressants - nothing really helped until Lamictal.

[melissaw72]

For me, if I do have any anxiety along with my mind starting to race and my thoughts feel out of control, increasing the lamictal helps just about every time.  Eventually we lower it (just so we can increase it again if needed) and usually I am ok.  When my mind slows down enough (too much) is when we try lowering it back to the current dose.

 

You said you have one week more ... Do you have to leave in a week even if you aren't feeling ok enough to leave?

[anon0422]

My outpatient pdoc is going to be putting me on Lamictal, starting tomorrow. I'm also a bit nervous, but also excited as I haven't tried out many mood stabilizers (the only one I tried was Topamax) and I'm really hoping this one will help calm my moods, as Topamax didn't.

[Britton]

I dont think they'll kick me out in a week, but financially, a week more is about all i can do. Of course, if need be, I'm sure i can find a way to stay longer. Tonight is my 3rd dose of lamictal 25 mg. I haven't noticed any difference. My derealization and anxiety is VERY bad, but it's been bad since Friday when i tried Nalprexone, so I'm still not sure on the lamictal, definitely hasn't helped any. Because I'm on a bit of a time crunch, I am going to give it until friday to see if i can feel any difference either bad or good. If it doesn't seem to be helping, I'd like to try something new before the doctor leaves for the weekend. 

 

Any other suggestions on calming medications, other than benzos? I believe that if i can get my anxiety and panic under control, I will see a slow improvement with the derealization. The doctor off handedly mentioned Sapharis today, but said he didn't want to go there yet.....

 

When I got here, my doctor took me off of everything I came in on...remeron, low dose lithium, zoloft, he did let me keep 20 mg geodon and ativan. He added elavil and melatonin for sleep, but it isn"t helping much. And is not touching the depression..

 

Melissaw- I saw that lamictal has helped with your anxiety. Is this a typical effect of lamictal, or just luck? 

 

How long before you feel "something" from lamictal? At this point I would say I'm either feeling nothing, or it's making my symptoms worse. Boo:(

 

Pearlzandlace- good luck with the lamictal!!! I know how exciting and nerve racking trying a new med can be. That's why i went impatient...to scared to do it alone at home. I've had too many bad reactions from meds.  

Edited May 14, 2015 by Britton

[jt07]

It would be rare if you felt anything from 25 mg of Lamictal except maybe side effects. It generally kicks in around 100 mg, maybe a little more or a little less. Lamictal is a long-term commitment due to its slow titration.

 

There really aren't any psych meds that are going to work in the time frame you want them to unless we are talking benzos or some of the antipsychotics. 

[melissaw72]

 

Melissaw- I saw that lamictal has helped with your anxiety. Is this a typical effect of lamictal, or just luck? 

 

How long before you feel "something" from lamictal? At this point I would say I'm either feeling nothing, or it's making my symptoms worse. Boo:(

 

 

Have you tried propranolol?  It is a blood pressure med but also for anxiety.  Worked really well for me but I had to go off of it because it messed with my thyroid.

 

Idk about the anxiety as a typical side effect or not of Lamictal.  For me it mainly calms my mind down and I *think* it goes along with the klonopin and xanax to help anxiety. But not 100% sure about that.  Just a guess.

 

To be honest I don't remember how I felt when I first started lamictal, and how fast I felt something.  I was going through hell at the time when everything was messed up in my life, so what I experienced could have been from any of what I was going through.

[Britton]

Ya, the doctor said that in a few studies, lamictal has shown some result for derealization. He was hoping that the naltrexone would work, but it didn't. I felt like i was on an unwanted LSD trip for 2 days. Very strange and scary.

 

I'm extremely sensitive to meds, so I am hoping that by tomorrow I will at least know whether or not I can tolerate the lamictal. If not, I think he will be moving me on to an antipsychotic. 

 

As far as a beta blocker, I'm theoretically not supposed to take it due to an autoimmune disorder, but I will talk to my doctor about it. I would like to try it.

 

 Last night I had this horrible gut wrenching feeling that I was never going to be able to go home to my husband and son and that I was going to be committed for the rest of my life I was so scary because it felt so real. At this point in time I am not able to be around my son, it's just not fair to him. My poor husband has been out of work since december because I cannot be alone and he has had to be mommy. He is still off work taking care of our son while I am in the hospital.

 

I'm praying for a miracle.... that within the next couple weeks I will be stable enough to go home. Go Lamictal!!! 

Edited May 14, 2015 by Britton

[Always Unstable]

^ a more quiet mind, I found that with Lamictal also. I don't think that it really helped with my anxiety but it did quiet down my mind a lot. Which I think made it easier for me to deal with everything else.

I started Lamictal while in a mixed episode and it really helped to separate out my moods and thoughts. Ultimately, it wasn't the one for me but I did get benefit while I was on it. Around 100mg was when I really started to notice a difference in my mood.

[Britton]

So last night was my 4th night on Lamictal, 25 mg. I know I shouldn't feel anything, and I probably don't, but I feel terrible. I've been having very choppy sleep with unnerving vivid dreams. My body wakes me up every morning at about 4 am with extreme physical anxiety, but I'm so filled with fear, I can't bring myself to get out of bed so i lay there for hours. My depression has also spun out of control. I can't stop crying. I feel hopeless. I believe the lack of sleep is making the derealization worse. I just don't know what to do anymore. We have yet to find a medication that calms me down and helps me to get a restful sleep. I have tried everything. 11 years ago seroquel did a great job helping me sleep. I've tried to take it several times the past few months at different doses and it spins me out. I have racing disturbing suicidal thoughts and do not sleep. 

 

The doctor currently has me on Elavil and melatonin for sleep, but it isn't working at all. 

 

Five years ago i had a similar "episode" and after much trial and error, it was remeron that finally allowed me to sleep, calmed me down and I slowly healed. Sadly, the remeron abruptly stopped working in October and I have been a mess ever since. I wish there was a similar drug to remeron, but i know it's kind of in a class of it's own.

 

Does anyone have any thoughts on a medication to try? Sorry I got off track from the lamictal. I'm just desperate. If I weren't in a hospital, I don't know where I'd be right now.

[melissaw72]

I'm sorry lamictal hasn't worked and you feel so crappy.

 

First thing that comes to mind for me is that prozac works, not for sleep, but keeps me from being weepy ALL the time and from being suicidal.

 

What have you tried so far?

Edited May 15, 2015 by melissaw72

[Fluffypinkbunny]

I'm so sorry you're not feeling any better:( 

[melissaw72]

How are you doing? 

[Britton]

Hey all. I'm still in a really bad way.... I feel like I'm getting worse. I'm still on Lamictal, but I'm ready to call it quits. I have a request in to see the doctor today to let him know I want to stop the medication. All the other patients here have noticed how much I have changed since being on it, and of course I can feel it. I believe my biggest hurdle that I need to get over is to sleep. I haven't slept well in 6 months. Most nights i don't sleep at all.

 

None of the sleep meds work for me, they all do the opposite. Seroquel and trazadone worked for me years ago, but I have tried them both several times over the past several months and they don't work. When I first got here impatient, they gave me 50 mg seoquel. I was up all night with terrifying racing thoughts, including suicidal thoughts, it was really scary. When I tried trazadone (again) I was up all night with racing thoughts. Since being here I have also tried the new sleep med Belsomra and it didn't work, and tried Lunesta (again, I tired it years ago). Neither worked. My night on Lunesta was crazy weird. i had nonstop racing thoughts all night long. It was mentally exhausting and scary.

 

I don't know what is wrong with me. Why do I react opposite to medications? I am desperate to sleep, but nothing seems to work....Remeron worked wonderfully for me for me from 2010 until this past October when it abruptly stopped working. I've been a trainwreck ever since. Do any of you have any ideas?? Part of me wants to try seroquel at a higher dose, but the night I took it was so scary, I'm not sure it's such a good idea. 

 

I tried zyprexa ONE night in April at a super low dose, 2.5 mg, but I was up and down all night and had a migraine headache for the following 2 days. 

 

I know once I start sleeping, I will slowly begin healing. But I've been impatient here a month now, and we haven't figured anything out. I'm getting really scared. The derealization is out of control They have pretty much taken me off everything i came in on and I feel just the same if not worse.

 

Any thoughts or advice would be greatly appreciated 

[SchizoHH]

Sounds horrible. I don't have any advice but wanted you to know that I read your post and hope you feel better soon. Much love to you.

[dianthus]

 

I tried zyprexa ONE night in April at a super low dose, 2.5 mg, but I was up and down all night and had a migraine headache for the following 2 days. 

 

 

5-10mg will knock you on your ass.  2.5mg isn't enough to do much for most people.  I've never heard of Zyprexa causing migraines.

[San]

It seems like you're discontinuing medications before they have time to be effective. Lamictal has a long titration process and it sucks, and takes forever to get a therapeutic dose, but you're giving up on it because it didn't work instantly, IMO.

[jt07]

I also think that you are giving up on meds way too early. Lamictal can have some side effects at first but once you get to a therapeutic dose, you will not regret having pushed onward. You are not likely to notice any positive effects until you reach 100 mg or so.

 

Also, with regard to Zyprexa ... could it be a coincidence that you got a migraine right when took it? Zyprexa is a med that might be worth retrying since it can be very sedating and might help you sleep if you get to a high enough dose.

 

Nearly all psych meds take time to work (generally, weeks). Very few work after one or two doses.

[Wonderful.Cheese]

I think you are expecting a quick fix. There are none, unfortunately. You are bouncing around on meds far too quickly. It's no wonder you feel so rotten!

 

Lamictal is a great med for lots of people. But because of the titration period, it can take 10-14 weeks for you to feel something. Depending on what dose you find effective when it kicks in. But that is seriously the time frame you should give it. Unless you get "the rash" or a life threatening side effect.

 

And 2.5 mg of zyprexa is such a tiny, tiny dose. I took 20 mg for years and years. It knocked me out for 8 hours. And I was extremely manic even when I started it.

[rowan77]

Like others have said, you need to give medication a chance. Unfortunately lamictal does take a while to reach the therapeutic dose, and then takes a while to kick in. Sounds like you need something NOW. Maybe your pdoc can put you on a med that will ease the distress and help sleep whilst waiting for the lamictal to work??

 

I can honestly say that if I gave up on a medication as soon as I experienced a nasty side effect I would not be stable right now. For example Seroquel knocked me flat on my face, I had postural hypertension, was dizzy and nauseous and actually had to crawl to the bathroom one morning early in my treatment  These side effects went away and now I love Seroquel. If i had given up on it because of side effects I would be in trouble now.

 

Give your medications a chance to work and don't give up a medication because of side effects. Chances are that the side effects will lessen or go away, and after a while if the side effects don't improve, then consider stopping it......but give time for side effects to disappear first before quitting a potentially beneficial medication.

 

All the best. I truly hope that you find a medication that works out for you and alleviates your symptoms

[melissaw72]

Have you tried xanax or another benzo to help calm you down, possibly to help you sleep better?

[Fluffypinkbunny]

 Are they giving you anything to help with your anxiety?  If they can get the anxiety under control maybe the meds would be more tolerable.

 

I hope you're feeling better soon and that you're able to get some sleep.

[MiaB]

I recently went through a horrific period of major insomnia, in which I was averaging 2 hours a night if I was lucky.  I switched pdocs and the new one put me on clozapine, which kicked the insomnia in the butt.  It's not a very popular medication (mainly I think because it requires weekly blood tests), but that plus the addition of clonazepam has turned things around for me in a major way.

[RNwithISSUES]

Britton,

I know it's been awhile since you posted your question about Lamictal,  but I have just joined today and I read your responses. Did the Lamictal end up working out for you or were you able to stay on it long enough to get a therapeutic level in your system?  If not, what medications did you end up on and how are you doing today?