Dweii Posted February 9, 2006 Share Posted February 9, 2006 I went off Lithium yesterday, because of extreme tremor and major weight gain. Weight gain and a former eating disorder doesn't go together. That could send me straight back to hell. At the same time my pdoc upped my Lamictal to 400 mg. Could that prevent classic BP1 manias? Is it enough? Link to comment Share on other sites More sharing options...
ncc1701 Posted February 11, 2006 Share Posted February 11, 2006 Heya Helena, Maybe. But probably not. According to the PI anyway. Lamictal is better than Li for lows, and Li is better than Lamictal for highs. Suppopsedly. YMMV. Be very vigilant about your prelude to mania. And diligent in the lifestyle stuff we're all supposed to be doing. Hope monotherapy works for you, but I wouldn't hang my hat on it. Ugh, I just read over that and it sounds really pessimistic, sorry! Try it and be vigilant, and you might need PRNs, but that's okay. --ncc-- Link to comment Share on other sites More sharing options...
seven Posted February 11, 2006 Share Posted February 11, 2006 one of our members is a pure manic BPI (no depressions) and she takes Lamictal as the stabilizer. works for her. but...everyone's different. Link to comment Share on other sites More sharing options...
Dweii Posted February 11, 2006 Author Share Posted February 11, 2006 Well, I'm hoping for the best. Even if I feel kinda pessimistic too... Worst case I can go back on Lithium I guess. Lamictal has been great for depression, but I have no idea if it prevents mania for me. Hoping for the best. Cross your fingers people! Link to comment Share on other sites More sharing options...
synthetic Posted February 13, 2006 Share Posted February 13, 2006 Lamictal has helped kill depression for me, but I don't think it has done much for the manic side, hence the recent addition of Seroquel. Hope it works for you, but be viligent for any manic outbreaks. Link to comment Share on other sites More sharing options...
NARS Posted February 13, 2006 Share Posted February 13, 2006 I looked at the BP consensus study a little while back. It's a survey of the more experienced pdoc recommendations for BP treatment. Here's a link: BP_2000.pdf. It's from a neat site: www.psychguides.com Sadly, updated 2004 report costs $$$--about $20 for a reprint. But the patient guide looks like the consensus is similar. Let me know if anyone gets it... The 2000 report says: 1. Lamictal isn't recommended for acute mania; pdocs would rather use Depakote or Lithium (slight preference for lithium for BPI and Depakote for BPII. 2. Lamictal is very high on the list as an adjuct to lithium for BPI and BPII. 3. Lamictal is very high on the list for maintenance therapy for both BPI and BPII. My take is that they don't recommend lamictal for acute mania (or acute mixed state) because it takes up to 2 months to get to a good stabilizing dose. But once the patient stabilizes, they consider lamictal a first choice in most cases to either switch to or use as an adjunct. It's a very interesting report, and the main site has "expert consensus guidelines" for treatment of several forms of mental interestingness. The archived ones are free, but it looks like new ones have to be paid for. Link to comment Share on other sites More sharing options...
tallulah Posted February 13, 2006 Share Posted February 13, 2006 from a personal perspective, over 200mg was manialand by itself. im now on a lamictal/topamax combination and it works VERY well for me... 275mg lamictal 225mg topamax Link to comment Share on other sites More sharing options...
NARS Posted February 13, 2006 Share Posted February 13, 2006 Tallulah, I'm glad things are working for you. I remember that for a while life was really hellish, so it must be huge to have found a combination that fits. Link to comment Share on other sites More sharing options...
tallulah Posted February 13, 2006 Share Posted February 13, 2006 Tallulah, I'm glad things are working for you. Link to comment Share on other sites More sharing options...
huttleston Posted February 15, 2006 Share Posted February 15, 2006 When I first got off Lithium (I had been pretty stable for 14 years on Lithium) and switched to Lamictal 200 mg, I had hypomanic reaction and sleeplessness/anxiety and so took 50 mg of Seroquel to sleep for a while. However, I could not tolerate the side effects of Seroquel. My nurse practitioner recently titrated the Lamictal up to 250 mg and I feel pretty stable today along with Klonopin and Wellbutrin. But who knows - I may have to go up to 300 Lamictal or even take an antipsychotic if I need to stay sane. It is interesting to hear about such good luck with the Topamax/Lamictal combo. I haven't heard of anybody taking this together. Link to comment Share on other sites More sharing options...
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