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Can lamictal make you feel worse before you feel better?

So I've been BP2 for 18 years, and I've been lucky to be mostly stable for the better part of it.  I was on a cocktail of Trileptal, Welbutrin & low dose Ritalin for years.  After I had my first baby I sort of stayed in a low level depression for a few years.  Anyway, my new Pdoc and I decided to try lithium as a low does add on, which was great except suddenly they discovered I was severely hyponatremic and took me off the lithium (still dont get that--shouldn't that have helped? we know the trileptal kept me low end anyway).  Now we've added some lamictal to see if that can give me a little AD boost.  I started it 1 week ago, and admittedly wasn't feeling super at the time, but it seems to be getting worse.  I'm still at 25mg (though I'm on BC so I'm not sure that's a true 25mg dose).  I can't tell if this is from the lamictal, just the result of the downswing I was starting before, or possibly a combo.  I really REALLLLLY want the lamictal to work, I've heard it's like magic for many bp 2s.  But I've felt zero activation, zero positive effect.  I'm willing to hang and deal with this for a while if it's part of the process, but if this is a bad sign I'd rather save myself the misery. FWIW, this was an add.  I haven't stopped any of my other meds.

Can anyone advise?

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Took me three months to feel better on it, increasing my energy and becoming less depressive.

It flipped me to a insomnia -hypomania state after a semester or just a little bit more.

It has a target dosage that works usually at least at 100mg for most people, for me it become to much activating, even decreasing to 75, 50, 25...

In my own experience I never took any med for depression that worked fast than a few months.

In this case, because of the possibility of a deadly skin reaction, they up it slowly but you're far from the 100mg standard minimum dosage.

I've heard about Trileptal hypothermia are more common than Lithium.

I'm just speculating that maybe it wasn't a low dosage of lithium, but everybody reacts in different ways.

For me, lithium is great for mania/hypo, overall it increases life quality given me more endurance to my problems and not acting impulsive.

I never felt anything direct related to lithium and depression, to be honest, lithium leaves me too chilled about things.


I'll would give it more time and reach the point that usually is close or beyond 100mg if the hypothermia stopped when you stopped lithium it probably was the lithium.

I think it's worth too wait on lamictal.


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  • 2 weeks later...

Allegedly Lamictal doesn't have much efficacy until 100mg and beyond (so says the pdocs I've seen) but maybe that's just me. It never did much but give me a headache, even at 400mg. It never touched my depression, and I stayed on it (at longest) for over a year.

Supposed to be the gold standard for BPII depression.

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Lamictal titration is often rough. Lots of people report once they get to a stable dose or 100 mg things settle down. I did not feel anything when I started Lamictal, no side effects. Above 400 mg I had language and cognitive side effects. Fortunatly the dose range used for Lamictal in psycharity is much lower than what is used for seizures.so generally Lamictal is well tolerated if you are not titrating.  

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