Lamictal causing irritability at low dose

[Chantho]

I think I may remember having this problem the last time I started Lamictal, but I'm not certain. I know it happened with some med that I was on in the past year. I started 25 mg Lamictal two days ago. My irritability has gone through the roof. I'm feeling extremely angry about every little thing. Anyone else experience this? I suppose it's possible I'm just cycling, but this feels worse than usual.

[uncomfortable thoughts]

Well, there are some cases of induced hypomania/mania trough lamotrigine, I think it's better to watch out, when I started at 25mg it caused me a lot of headaches and insomnia but I wasn't just taking lamotrigine for mood.

Now that I'm only on lamotrigine for mood at 100mg, I'm irritable and edgy, I have to be careful to my reactions, I guess I'm on this dosage for more than a couple months, this is something that if not goes away I'm going to discuss with my pdoc.

[crtclms]

A titration of Lamictal can be difficult. You may have swings in mood, headaches, back and leg pain, anxiety, and that is just some of the things. Most of those side-effects go away when you reach a therapeutic dose. It takes a long time to get there, because you can't go up too fast for fear of your getting Stevens Johnson Syndrome, a very serious rash. Anti-convulsants are known to cause rashes, but SJS is an emergency. If you get a rash, first, don't panic, and second, call your pdoc as soon as you can.

Usually, therapeutic doses start at 150mg, and all those annoying side effects should go away, although sometimes you have to go up a little higher than 150mg. Some people respond at lower dosages.

Uncomfortable, I know we were just talking about this, but if you are really irritable, you could need to raise your dosage. Some people do respond at 100mg, but it is not generally considered therapeutic until you reach 150mg. It could be that Lamictal is not for you, but you aren't at a point where you can really make a final decision about that.

[uncomfortable thoughts]

 

Uncomfortable, I know we were just talking about this, but if you are really irritable, you could need to raise your dosage. Some people do respond at 100mg, but it is not generally considered therapeutic until you reach 150mg. It could be that Lamictal is not for you, but you aren't at a point where you can really make a final decision about that.

Well, 

The lamotrigine therapeutic dose for bipolar starts at 100mg.

I gave what you just mentioned a thought... that I'm probably irritated because it's the bottom and I could benefit from it in a larger dose but just a month ago my pdoc took me out of ritalin and saphris, both cold turkey, that definitely can cause my irritability, can't it?

I'm willing like I said on the other post to increase my dosage but I'm in no hurry, I'm still very insomniac since the start of lamotrigine and upping the dosage would make it worst, my irritability can't be addressed clearly yet. I replied the post mostly to alert that lamotrigine can cause hypomania and even mania, the person who made the post described the irritability through the roof, that's not what I'm experiencing, I'm irritated in occasions that it's a normal reaction but I would expect that a mood stabilizer soothed my reaction, nothing major.

When suggested by my pdoc to raise more 25mg of lamotrigine, he wasn't aware of my insomnia and constant headaches, so, with the withdrawal from two medicines and my side effects he decided to stay on 100mg for this month as it was a reasonable request. 

Just to give you an example, last month when he decided to up just 25mg he wanted to check on me on the following week after raising just to be sure I didn't flip to mania or hypomania.

Edited October 9, 2015 by uncomfortable thoughts

[crtclms]

Yes, I can see how coming off both those meds could be making you irritable. I forgot about insomnia, because I just always have it. Would your pdoc be willing to give you something to sleep, like ambien or a low dose of seroquel?

[uncomfortable thoughts]

Yes, I can see how coming off both those meds could be making you irritable. I forgot about insomnia, because I just always have it. Would your pdoc be willing to give you something to sleep, like ambien or a low dose of seroquel?

He gave me stilnox, here it's the ambien brand name for zolpidem, I'm taking every night since September 14, I even started a post about it with some of my concerns. ^^

Well, I'm taking 2mg of rivotril, brand name of klonopin (clonazepam), usually by 7 or 9 p.m. to help me with relaxing and giving me the mood for getting into bed.

My pdoc wants me off antipsychotics, I even asked him if he could just give me a prescription just to have it around, because I feel safe having, well, we worked this way in the past, he tried a lot of antipsychotics, specially atypical, I used to always have at least a 25mg seroquel around but not this time and it has something to do with my body dysmorphic disorder and the way I respond with AP and APP therapy when not in an acute episode.

[in_media_res]

I think I may remember having this problem the last time I started Lamictal, but I'm not certain. I know it happened with some med that I was on in the past year. I started 25 mg Lamictal two days ago. My irritability has gone through the roof. I'm feeling extremely angry about every little thing. Anyone else experience this? I suppose it's possible I'm just cycling, but this feels worse than usual.

Yes. I tend to have issues controlling emotions, but they were much more frequent when I was trying Lamictal. Both times. I don't know that it ever went away, but I only ever barely reached what was considered a therapeutic dose before quitting for reasons I don't recall. Probably that it was making me a basket case and not working. Many people report issues with titration, but from what I've seen it seems to work for a lot of people and they like it once they get the dose right.

Good luck, hopefully it will get better for you as you go up.