Alien Navel Cord Posted December 27, 2016 Share Posted December 27, 2016 I really don't think my lamictal works. I go up and down, up and down. I have irritable and aggressive mania and mixed episodes frequently. Rapid cycle-y type stuff. I'm on 250mg of Lamictal, 300 XL of Wellbutrin, and 7.5 mg of Abilify. I think the Abilify helps the most. But the Lamictal, is it being a sugar pill to me now? The pdoc doesn't want to mess with my cocktail, saying it's the best one so far (least amount of side effects). (Except I am a female losing my hair from the lamictal). What should I do to persuade both her and my gf that I need to change something? What do I say? They don't seem to want to listen that I don't feel well 85% of the time. I want my life back. Link to comment Share on other sites More sharing options...
saintalto Posted December 27, 2016 Share Posted December 27, 2016 A few years back I was taken off both wellbutrin (taken for over 10 years) and abilify (taken for around 5). The welbutrin was pushing me up both mood-wise (I tend towards rapid cycling or mixed states) and it was exacerbating the psychosis too. The abilify was causing me a lot of anxiety. When I stopped both those drugs, my mood evened out hugely, and the psychotic stuff was easier to deal with. Lamictal, if anything, is a huge part of why I have so little issues with mood currently. I have been on it for approximately 14 years. I'm not sure if its the same with lamictal, but I lost heaps and heaps of hair on levothyroxine, which it turns out is a rare side effect (usually its the hypothyroidism that takes the hair not the meds for it). Anyway I couldn't be taken off the thyroid med so I just had to wait it out. Eventually the hair loss stopped and its been growing back. Hopefully that's the case with lamictal. You can find the side effects in detail online to check. Just my experience of course. Link to comment Share on other sites More sharing options...
Alien Navel Cord Posted December 28, 2016 Author Share Posted December 28, 2016 yeah I looked it up once and found that it is a side effect. Maybe if I tell her tat it is an unwanted efect she will put me on something else... Link to comment Share on other sites More sharing options...
browri Posted December 29, 2016 Share Posted December 29, 2016 If you're having issues with cycling, have you tried any other antipsychotics? Lamictal helps to delay episodes and make them shorter, but if you're already cycling, manic, or in a depressive episode, Lamictal doesn't really do much. If anything that's the one that should stay. When lumped in with SSRIs and SNRIs, Wellbutrin is actually the least likely to cause mania or rapid cycling. However, if it is already happening, Wellbutrin could exacerbate the problem. I just came off Lamictal recently, but that's only because we introduced Trileptal which helps better with aggression and explosiveness. Together the two of them were making me tired and foggy. It was worth my while to keep Trileptal instead of Lamictal because I have my cycling under control with the meds listed in my signature. Have you ever considered changing your antipsychotic? I love loxapine. It's very settling. Very few side effects at the low dose that I take and it helps a ton with anxiety and quieting intrusive or racing thoughts. Don't let the fact that it's a typical antipsychotic scare you away. In present day it's dosed low instead of it's original higher doses (5-50mg instead of 60-125mg) and that helps mitigate against a lot of the problems with typicals like movement disorders. Every once in awhile I'll have twitches in my face but I almost don't even notice it's happening. How long have you been on this current cocktail? Link to comment Share on other sites More sharing options...
Alien Navel Cord Posted December 29, 2016 Author Share Posted December 29, 2016 I''ve been on this cocktail for about 2 years, and in those 2 years I've rapid cycled back and forth, back and forth - usually the depressions are kept in check and don't go to extremes (anhedonia and flatness is about what it goes to) but the mania does go bonkers. I have tried many AP's before but the side effects for them all were a bugger for me so I had to change to abilify which is the only one I can seem to tolerate. I try different doses and now am trying 10. We'll see if it works. I e-mailed my pdoc about changing to a different mood stabalizer to see what she thinks. Maybe she'll tell me to stay on the lamictal who knows. I pleaded my case pretty well, or so I think, that I'd like a change. After all, it is MY body, not anyone else's. Link to comment Share on other sites More sharing options...
Alien Navel Cord Posted January 4, 2017 Author Share Posted January 4, 2017 My pdoc wrote back to me, saying she will see about lithium. I can't get in until February 2nd, so until then, later this month I am going to see a different doctor in the interim (while my usual pdoc gets back from maternity leave). He will be under advisement from my regular pdoc about the lithium switch, and I can talk to him about all the side effects. Link to comment Share on other sites More sharing options...
Micho Posted January 16, 2017 Share Posted January 16, 2017 On Thursday, December 29, 2016 at 6:32 AM, browri said: If you're having issues with cycling, have you tried any other antipsychotics? Lamictal helps to delay episodes and make them shorter, but if you're already cycling, manic, or in a depressive episode, Lamictal doesn't really do much. If anything that's the one that should stay. When lumped in with SSRIs and SNRIs, Wellbutrin is actually the least likely to cause mania or rapid cycling. However, if it is already happening, Wellbutrin could exacerbate the problem. I just came off Lamictal recently, but that's only because we introduced Trileptal which helps better with aggression and explosiveness. Together the two of them were making me tired and foggy. It was worth my while to keep Trileptal instead of Lamictal because I have my cycling under control with the meds listed in my signature. Have you ever considered changing your antipsychotic? I love loxapine. It's very settling. Very few side effects at the low dose that I take and it helps a ton with anxiety and quieting intrusive or racing thoughts. Don't let the fact that it's a typical antipsychotic scare you away. In present day it's dosed low instead of it's original higher doses (5-50mg instead of 60-125mg) and that helps mitigate against a lot of the problems with typicals like movement disorders. Every once in awhile I'll have twitches in my face but I almost don't even notice it's happening. How long have you been on this current cocktail? Loxapine even comes as 2.5mg. I have those and 5mg. Really helps. I like it as well. Link to comment Share on other sites More sharing options...
Alien Navel Cord Posted January 16, 2017 Author Share Posted January 16, 2017 It's just that the Abilify is the only AP drug I've taken without any side effects. Every single other one (I've tried about 6 before the Abilify) gave me something horrendous. So I'd like to adjust my dose of Abilify to 10mg, because that is what I am on right now and *crosses fingers* I seem to be ok. I don't give the lamictal ANY credit though. I've been on it since 2006 with a 6 month period of trying just an AD and an AP in there somewhere, and if it doesn't seem to be balancing my moods very well and working with the other 2, then I think I need a change. Lamictal was really good at first. But the past 5 years have been difficult and while everyone is hesitant to change my cocktail, I think it is time. Link to comment Share on other sites More sharing options...
browri Posted January 16, 2017 Share Posted January 16, 2017 4 hours ago, Alien Navel Cord said: It's just that the Abilify is the only AP drug I've taken without any side effects. Every single other one (I've tried about 6 before the Abilify) gave me something horrendous. Latuda only mostly helped my depression, did nothing for my mania and gave me akathisia. Saphris gave me akathisia even at the lowest dose and made me zoned out all the time. Abilify put me in a cold stony mood, gave me akathisia. Fanapt made my heart pound out of my chest and Zyprexa increased by blood sugar and cholesterol. Loxapine has had virtually no side effects and is so much better at stabilizing me without making me feel medicated. Be open to change. I wasn't for the longest time, and if I hadn't opened up, I wouldn't have taken a chance on an older antipsychotic which actually was a total game changer for me. Link to comment Share on other sites More sharing options...
Alien Navel Cord Posted January 16, 2017 Author Share Posted January 16, 2017 I can definitely ask! I had never heard of Loxapine before. I'll have to look into it. Thanks! Link to comment Share on other sites More sharing options...
browri Posted January 16, 2017 Share Posted January 16, 2017 @Alien Navel Cord Loxapine is an older medication. It's classified as a typical antipsychotic but it behaves like an atypical. Structurally it's very similar to clozapine and in the brain it binds to receptors in the same way that olanzapine (Zyprexa) does. It's very tolerable at 10mg. Does make you drowsy, so you have to take it at night. But I now don't need anything to help me sleep because of it, which is great. I haven't gained any weight of note. I actually went onto it from Zyprexa so I lost quite a bit of weight right out of the gate. A big problem for me is my thoughts spinning out their tires. I can't quiet my mind enough to focus on the tasks at hand. It was affecting work for me because I couldn't get anything done while I'm sitting at my desk stewing and ruminating over finances or my relationship or whatever else I'm "worried" about that day. Loxapine helps to quiet my thoughts, and therefore it helps with my anxiety. And I have to guess that it at least has some antidepressant effect because they took one of its metabolites and turned it into the antidepressant amoxapine which is in the same class of medications as Remeron. I've only been diagnosed as bipolar for the past 3-4 years and seeing the same psychiatrist in that time. Being close-minded to other medication options got me into quite a few ruts where I kept telling myself that I should have listened to my pdoc. Loxapine was the first time that I finally threw up my hands and said, "I'm gonna just hope this guy knows what he is doing". I was pleasantly surprised. Getting off Lamictal may not be the wrong decision. It may be the right thing to do. If you need an anticonvulsant that's more calming, then trying Trileptal could be a good option. I don't notice it as much anymore, but in the beginning as I was getting used to it, it felt like a very soothing, warm, fuzzy feeling when I would take it. Eventually, that smoothed out......and I smoothed out. Don't know how else to say it. For me, the Trileptal and loxapine do a better job of calming my thoughts and calming me down physically as well, than Lamictal did with any other antipsychotic that I tried. Link to comment Share on other sites More sharing options...
Alien Navel Cord Posted January 17, 2017 Author Share Posted January 17, 2017 I am glad you have been having successes with your medications! I hope to find that real soon, too. Link to comment Share on other sites More sharing options...
WinterTidings Posted January 18, 2017 Share Posted January 18, 2017 (edited) So, for first attempt I'd ask the pdoc (done). If that fails, then tell the pdoc you're stopping it & stop taking it, if it's having these kind of effects. Ultimately, it's your body; If you find the side-effects more impactful than the positives, then it's your decision whether to continue with the med, not your pdocs. You're the one who's going to have to live with it. If they're dragging their heels, don't feel shackled to their opinion if it's damaging your body & mental wellbeing. It might even prompt them to actually think the situation through if you make it clear this is a Hard Limit, and not a 'Could you maybe possibly.. Oh, no. Okay', which a lot of pdocs seem to read any patient input as. I'd say you need to put your foot down & take back control of the situation. It is your body, and any boundaries you lay out as to what others may do to it are valid boundaries. Tri Edit: Whatever you do, do it safely. ^^; - Whis Edited January 22, 2017 by WinterTidings Link to comment Share on other sites More sharing options...
Alien Navel Cord Posted February 10, 2017 Author Share Posted February 10, 2017 Just an FYI I am on lithium now. Link to comment Share on other sites More sharing options...
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