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Lamictal titration - 1 month to recover from each dosage increase???


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Sorry for the weird post above. A contraindicated medication means a medication that might cause serious side effects if taken at the same time as another med. Actually, both meds would be contraindicated against each other. Sorry, I know I'm being a bit incoherent.

But sometimes you can work around contraindicated meds. That's why I was able to be on Depakote and Lamictal at the same time. I also used Imitrex, which is contraindicated for people with Sulfa allergies, and I never had an issue with it.

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  • 1 month later...

OK so here are my adventures in going up from 75mg to 100mg:

  • Wks 1-3 = Felt pretty good, with good energy.  A few ups and downs and tired a couple of days, but overall pretty good.
  • Wk 4 = Depressed, very tired and exhausted.  Lots of negative thoughts and anxiety, and very irritable.  Not able to concentrate at work, etc.
  • Wk 5 = Same as week 4, just not quite as intense.
  • Wks 6-8 = A good bit of face to face anxiety, but not very tired and not really depressed.  Overall feel better than normal, but still somewhat irritable.
  • Wk 8 = Feel good overall, finally feel leveled out and have more predictable (not perfect) moods.

I need to go up again soon, but as you can see it kind of wrecks me for a couple of months.  I'm wondering if I should just stay in that "good" area of weeks 1-3 and just keep titrating up until I get to 200mg, then suffer the 2 month long "regulation" period?

Thanks!
Heygrain

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2 hours ago, heygrain said:

I need to go up again soon, but as you can see it kind of wrecks me for a couple of months.  I'm wondering if I should just stay in that "good" area of weeks 1-3 and just keep titrating up until I get to 200mg, then suffer the 2 month long "regulation" period?

This is something I would bring up to your pdoc.  Maybe another med to help you get through the side-effects?

2 hours ago, heygrain said:

I need to go up again soon, but as you can see it kind of wrecks me for a couple of months.  I'm wondering if I should just stay in that "good" area of weeks 1-3 and just keep titrating up until I get to 200mg, then suffer the 2 month long "regulation" period?

This is something I would bring up to your pdoc.  Maybe another med to help you get through the side-effects?

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Depakote and Lamictal are not contraindicated ,you just need a dosage  adjustment  as one effects the others metabolism. The PI for Lamictal makles this clear, many ACE's need dosage adjustment when taken with Lamictal due to metabolism.

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1 hour ago, notloki said:

Depakote and Lamictal are not contraindicated ,you just need a dosage  adjustment  as one effects the others metabolism. The PI for Lamictal makles this clear, many ACE's need dosage adjustment when taken with Lamictal due to metabolism.

Notloki, I'm only on Lamictal, no other RX's.  Thanks.

 

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  • 2 months later...

Just an update:  I titraded up from 100mg to 125mg, and then two weeks later to 150mg.  I am now taking Lamictal 3 times a day 8hrs apart (split evenly).  I felt much better going up this time around, I think due to going up on the dosage during the day and not at night (I sleep WAY too deep when I take too much at night).

I have a question though:  I feel really good for the first week or two max and then the anxiety is back along with being super tired.   Once I get to the "right" dose will I stay in this "happy place" instead of only visiting there for a couple of weeks?  :-) 

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People do report there is a "sweet spot" for Lamictal and until you reach it you don't get lasting improvement; better only at first. Slow stepwise dosage escalation is the way to discover what the right dose for you, as you are doing.

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On 1/2/2017 at 10:07 AM, notloki said:

Depakote and Lamictal are not contraindicated ,you just need a dosage  adjustment  as one effects the others metabolism. The PI for Lamictal makles this clear, many ACE's need dosage adjustment when taken with Lamictal due to metabolism.

That's what I get for listening to my pdoc.

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8 hours ago, notloki said:

People do report there is a "sweet spot" for Lamictal and until you reach it you don't get lasting improvement; better only at first. Slow stepwise dosage escalation is the way to discover what the right dose for you, as you are doing.

Thanks for confirming Notloki!  ?

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  • 2 months later...

Well, I'm up to 175mg of Lamictal now and there are two big positives:  I'm not nearly as grouchy with my kids as I used to be, and I almost never lose my temper anymore.  The second thing is I'm no longer waking up on the "wrong side of the bed" every other day.  Before I went up it was like rolling the dice, I never knew how I'd feel in the morning... now I'd say 90% of the time I feel just fine in the mornings, which is a HUGE blessing to not have to find somewhere to take a quick nap during the day just to "reset" from the brain fog.

Now for the bad stuff:  Anxiety is much higher, depression seems much more intense, and I'm super forgetful all the time.  

Still, I think it's worth it and hopefully if I keep going up things will smooth out some.  We shall see.

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5 hours ago, heygrain said:

Now for the bad stuff:  Anxiety is much higher, depression seems much more intense, and I'm super forgetful all the time.  

Still, I think it's worth it and hopefully if I keep going up things will smooth out some.  We shall see.

Hopefully those side effects of the higher anxiety, worse depression, and being forgetful will wear off over time.

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Sometimes people take a benzo short-term to help with the rocky parts of LTG titration, the anxiety and activation/irritability. Or a small, say 25 mgs, dose of Seroquel. Maybe ask your doc about that?

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Lamictal was hell every time I titrated. 50 -> 100 was the worst, 100 -> wasn't so bad, it still sucked though. when I went from 200 to 300 I got manic. 300 to 400 I just got not depressed. 400 seems pretty good for me. I still have really bad anxiety some times, but not really any depression.

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I have found it really difficult moving up doses. Just changed from 100mg to 150mg. It leaves me feeling super anxious. I mentioned it to my psychiatrist and he suggested holy basil. He is really into natural supplements, but I have a feeling it's not gonna cut it. Anyone else been told to try holy basil for anxiety?

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45 minutes ago, Martian said:

I have found it really difficult moving up doses. Just changed from 100mg to 150mg. It leaves me feeling super anxious. I mentioned it to my psychiatrist and he suggested holy basil. He is really into natural supplements, but I have a feeling it's not gonna cut it. Anyone else been told to try holy basil for anxiety?

No, never.

 

I googled "holy basil" and I found this:

https://examine.com/supplements/holy-basil/

 

This has some information too:

http://www.webmd.com/vitamins-supplements/ingredientmono-1101-holy basil.aspx?activeingredientid=1101

 

YMMV with all of this though. 

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