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Reached lamictal target dosage, how much to wait for it to work


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I've been having some mood dips just after I raise the dose also. Yet so far have been adapting ok after several days. It takes a long time to get a stable therapeutic dose going with lamictal. I've heard from many the very slow titration is the most frustrating part (you start obsessing and analyzing every symptom whether it's the med or not) but as you adapt to the medication it should bring more stability. Wish I could say more, I'm bit in the same boat, waiting it out.

There are many people that go above the 100-200mg target dose. My doc said they would check my blood level after I've been on 100mg for awhile and then assess whether to increase. Also, I've heard from many others, the effects start out very subtle (you don't think it's doing anything or you feel worse) and then within 1-2 months at a stable dosage, you'll eventually wake up and realize that you're stable and not triggered about the everyday things that upset you in the past (that's what people say anyway) It's not an instant fix thing like a benzo.

Hang in there!

Edited by cloudmonger
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As a general thing, after 6-8 weeks you'll most likely know whether the med is going to help you or not.  It is one of those things where you need to be patient (easier said than done though).

2 hours ago, cloudmonger said:

I've heard from many the very slow titration is the most frustrating part (you start obsessing and analyzing every symptom whether it's the med or not) but as you adapt to the medication it should bring more stability.

I agree with this.

Like cloudmonger said and I agree ... Hang in there! 

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It's possible that 100 mg isn't enough for you - lots of people don't get full effects until 150-200 mg, and others need to go even higher. Give it a few weeks and then talk to your pdoc about whether you should try 150 or 200 mg.  

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59 minutes ago, thunder said:

It's possible that 100 mg isn't enough for you - lots of people don't get full effects until 150-200 mg, and others need to go even higher. Give it a few weeks and then talk to your pdoc about whether you should try 150 or 200 mg.  

OliverB said he was on 100 mg 3x/day ... (300 mg total) ... But I agree with you ... in a few weeks talk to your pdoc about either lowering of increasing the dose.

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3 hours ago, melissaw72 said:

OliverB said he was on 100 mg 3x/day ... (300 mg total) ... But I agree with you ... in a few weeks talk to your pdoc about either lowering of increasing the dose.

I am taking it once a day, what I take, or better, I took 3x day whast gabapentine, but I am stopping it since it's causing me suicidal urges and the anti-anxiety effect has dissapeared. I don't know what I will do with lamotrigine, pdoc said no more than 100mg a day.

 

There is something that's making me feel awful, I don't know if it's both gabapentin o lamotrigine.

Edited by OliverB
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22 minutes ago, OliverB said:

I am taking it once a day, what I take, or better, I took 3x day whast gabapentine, but I am stopping it since it's causing me suicidal urges and the anti-anxiety effect has dissapeared. I don't know what I will do with lamotrigine, pdoc said no more than 100mg a day.

 

There is something that's making me feel awful, I don't know if it's both gabapentin o lamotrigine.

Oh, I'm sorry (and sorry to @thunder, too) ... in the OP you said how you were taking it 100 mg since 3 days, and I interpreted that to be 100 mg 3x/days.  My apologies!

With the lamotrigine, if you do want to go off of it, you might want to go down to 50 for a couple days or something ... ask pdoc about that.  If you've been on a med for more then a couple days, you might want to wean down.

Idk what is making you feel awful, and not knowing which med it is makes it harder to figure out. 

IME, going off one med at a time helps because you won't know which med is effecting you unless you only come off one (not 2).  I mean maybe it is both added together, but I would still suggest going off one med at a time ... But, I'd run all this by your pdoc, or at least your nurse.  They might have some suggestions that no one has thought of yet.

 

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I cannot talk to them since I am not welcome in the day hospital, but I left a note.

I have to stop them now, they are acumulating in my blood at too high concentrations and I am getting poisoned, I feel phisically sick and my blood too dense.

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3 hours ago, OliverB said:

I cannot talk to them since I am not welcome in the day hospital, but I left a note.

I have to stop them now, they are acumulating in my blood at too high concentrations and I am getting poisoned, I feel phisically sick and my blood too dense.

Why aren't you welcome in the day hospital?

I'm sorry you are feeling sick from having the meds in you.  I hope things start to get better for you.

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5 hours ago, thunder said:

Sorry to hear that your current meds are making you feel sick, and that you're trouble with your treatment team.  Do you know why your pdoc said no more than 100 mg of lamictal

Because he thinks more won't be helpful in my case.

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2 hours ago, cloudmonger said:

Is your doc taking you off both medications now or just the Gaba? I hope he tapers you down, so you don't get even more destabilized. How are you feeling today?

I am taking both off. I couldn't wait until the next appointment. I left a note telling him.

 

I don't take any since Thursday. I am feeling better.

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2 hours ago, OliverB said:

I am taking both off. I couldn't wait until the next appointment. I left a note telling him.

Will your pdoc be very upset that you just dropped the meds cold turkey? If I may ask, I'm curious, what symptoms do you feel were getting worse (delusions, psychosis, anxiety, panic, depression?)

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1 hour ago, cloudmonger said:

Will your pdoc be very upset that you just dropped the meds cold turkey? If I may ask, I'm curious, what symptoms do you feel were getting worse (delusions, psychosis, anxiety, panic, depression?)

anxiety, panic, aphaty, negative symptoms of psychosis, nausea, dizyness, headache, ...

I guess he wouldn't mind since I told him I wanted to try lamotrigine and he always says he is not interested that I take any med.

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Go slow & steady, and give it time at each dose (especially if you are very sensitive to meds and currently unstable). Lamictal is one of the slowest meds to titrate up on. Unfortunately it doesn't work well if you are in a crisis situation and need instant relief! Usually for 2-3 days after increasing dose you will feel some of the side effects (but they immediately have gone away for me)

I felt a very mild (but noticeable) stabilizing effect after a week at 50mg. The stabilizing effect continues to improve the longer I'm on it. At 75mg, It has a nice gentle hold on my mood (no emotional upsets at all) and even better, it doesn't make me feel sedated or drugged like a zombie. I feel like a normal, emotionally healthy ME!! (totally calm, less depressed/upset about things) I'm really quite hopeful now that it will help, and plan to stay at the 100mg dose, but we'll see....

Edited by cloudmonger
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It took me 200mg. I've been on it since Fall of 2013 now. And yes, as everyone has said, Lamictal isn't really a med that you can "tell it's working". It's so subtle that one day you just realize that your waves aren't so tumultuous. That you still sometimes have swings but they are shorter, less intense, or both. I found that was the case for me. At 200mg, Lamictal didn't eliminate everything, but it did a major job of calming the waves. It didn't stop me from having episodes but it prevented them from lasting a while or turning into full blown uncontrollable episodes. It only gave me more control, but it wasn't enough for my depression, racing thoughts, or irritability. I needed other meds for that. But Lamictal is more like a foundation for me, not the whole building.

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