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Am I the only one this has happened to?


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jillebelle

No. You are not the only one.

Each time I titrated up, I had both rapid cycling and mixed states.  I am titrating back down from 300mg to 200mg and having the same reaction.

It took about 2 weeks for each titration to level out a little.

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Yep, me too, especially at the lower doses (before I hit 200).  I didn't get the same effect either when I went from 200 to 300 or from 300 to 400.

And the literature categorically denies that this takes place.  Rather they say it can cause some slight agitation.  I'm thinking that clinically they think that the reaction most of us have isn't technically "mania."  Maybe so--maybe it lacks some feature they think has to come with mania--but it sure feels like mania.  I had racing thoughts, pressured speech, and anxiety.  But I didn't get that right feeling behind my eyeballs, was conscious that the medication was causing it, didn't get paranoid or irritable, and I even slept really well.  Like Unregistered, the activating effects wore out within 2-3 days. 

Also, I eventually figured out that even though I did feel relief from depression very quickly it did take about 2 weeks for the new dose to fully take effect.  It's been a very good med for me, completely worth the transient effects.  I've heard of several people who got a PRN med to deal with the manic-like symptoms.  Did you get to try that?  Of course if you didn't get any benefit you might not want to try.  But if you only tried it at low doses you might want to...

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I'm sorry. I saw this last night, but I have been falling a little short of the 'functional' mark and am not really all there.

And the literature categorically denies that this takes place.  Rather they say it can cause some slight agitation.  I'm thinking that clinically they think that the reaction most of us have isn't technically "mania."  Maybe so--maybe it lacks some feature they think has to come with mania--but it sure feels like mania.

<{POST_SNAPBACK}>

Not entirely true.

[well, technically, true mania isn't med induced. but- fneh. What is that clever way to say ''if it looks the same..."?]

In the PI-

...adverse events which most commonly led to discontinuation of LAMICTAL were rash (3%) and mania/hypomania/mixed mood adverse events (2%). Approximately 16% of 2,401 patients who received LAMICTAL (50 to 500 mg/day) for Bipolar Disorder in premarketing trials discontinued therapy because of an adverse experience; most commonly due to rash (5%) and mania/hypomania/mixed mood adverse events (2%).
I don't remember what page, but around where the S/Es for BP start I believe.

Mania/Hypomania/Mixed Episodes: During the double-blind, placebo-controlled clinical trials in Bipolar I Disorder in which patients were converted to LAMICTAL monotherapy (100 to 400 mg/day) from other psychotropic medications and followed for durations up to 18 months, the rate of manic or hypomanic or mixed mood episodes reported as adverse experiences was 5% for patients treated with LAMICTAL (n = 227), 4% for patients treated with lithium (n = 166), and 7% for patients treated with placebo (n = 190). In all bipolar controlled trials combined, adverse events of mania (including hypomania and mixed mood episodes) were reported in 5% of patients treated with LAMICTAL (n = 956), 3% of patients treated with lithium (n=280), and 4% of patients treated with placebo (n = 803).

This is around page 36.

[And...

I totally checked out at this point.

I had more to say, and normally I would just feel like a jerk and give up and not bother because I feel dumb.I still feel dumb.

But I'm not going to trash the post just because of that. I'm sorry. I can't think. ]

If I could tell you more right now, I would. I wanted to say more about the stuff from the PI cause I think it is a bit unclear how they put it in there, but I can't say why just now.

...

Oh! I thought of one of the reasons:in the first quote about the adverse events that made people stop but don't seem to clarify who was from what group taking lamictal... [monotherapy, etc] It might make things a little clearer if that were presented.

...

But I wanted to give you that stuff from the sheet, and say:

Yes. This happens. It's not just you. You are not an alien. You are not alone.

This has come up a few times, and I first had only heard about it causing anxiety problems or insomnia which could both influence mood.

But there have been some people who have been sent hypo/manic by lamictal.

This thread is actually from the old board:

http://64.233.179.104/search?q=cache:oYRn3...us&ct=clnk&cd=4

~navy~

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When I switched from 125 to 150, where I am right now, I noticed a hypo effect that has just really abated about one month later. I actually kind of enjoyed it. My house was clean, errands were run, no ruminating on potential disasters. I did experience minimal sleep disruption and my pdoc gave me 25 mg seroquel prn, which I took once and then read the thread about it making you gain weight. Anyway, my young pdoc said he thought 125 was in the upper range for lamictal. I notice many here are on 300 and up.

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Oh, thank you so much , everyone, for your replies! And Navy, thank you so much for that research! I didn't think anyone was responding to this post, so I started a similar one in the Bipolar Forum. Oops! Well, I'm getting great responses from both boards! Thanks again!

JB

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Oh, thank you so much , everyone, for your replies! And Navy, thank you so much for that research! I didn't think anyone was responding to this post, so I started a similar one in the Bipolar Forum. Oops! Well, I'm getting great responses from both boards! Thanks again!

JB

<{POST_SNAPBACK}>

Once I hit my therapeutic dose (which for me is 250 mg) I stopped cycling and having that hypomanic/anxiety/insominia effect.  It was quite a switch after being on Lithium for 14 years, but I persevered.  Now after a year on Lamictal, I realize it really is working.  I am grateful to be stable today.

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Oh, thank you so much , everyone, for your replies! And Navy, thank you so much for that research! I didn't think anyone was responding to this post, so I started a similar one in the Bipolar Forum. Oops! Well, I'm getting great responses from both boards! Thanks again!

JB

<{POST_SNAPBACK}>

I am grateful to be stable today.

<{POST_SNAPBACK}>

I'm glad you're doing well now, and that Lamictal was the drug for you.

Best wishes,

JB

Edited to add that I was on the drug for over 8 months....Oh well...

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jillebelle

No. You are not the only one.

Each time I titrated up, I had both rapid cycling and mixed states.  I am titrating back down from 300mg to 200mg and having the same reaction.

It took about 2 weeks for each titration to level out a little.

<{POST_SNAPBACK}>

I has this same experience.  Now that I've been on 200mg for a few months, I am doing much better and more stable that I remember being, ever.

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Hi, jillbelle, the same thing happened to me.  In fact, I was sent to the hospital for the first time a few months ago while taking Lamictal.  My NP said it's just not working for me, she said nothing about it being the cause.  She is an excellent physician and I trust her opinion.  So, it's back to Depakote for me.  The side effects suck ass, but I was much more stable on it.  Good luck with  your next med!

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  • 2 weeks later...

This is soooo weird.

I personally think it's gotten worse when I started Lamictal. That's when things really started going downhill. Things have been going downhill all my life, pretty much, but this was really noticable.

Of course, none of the doctors I've talked to accept my theory. I've been on it since december so I know I need to give it a longer time. I'm now on 500 mg, which doesn't help shit. My other medicines help, so I'm still stable. But I would like to skip the Lamictal since I suspect it's making things worse.

BUT, doctors haven't heard about this at ALL, so of course they reject my theory, since Lamictal has such a good reputation.

Did anyone found any studies on this?

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This is soooo weird.

I personally think it's gotten worse when I started Lamictal. That's when things really started going downhill. Things have been going downhill all my life, pretty much, but this was really noticable.

Of course, none of the doctors I've talked to accept my theory. I've been on it since december so I know I need to give it a longer time. I'm now on 500 mg, which doesn't help shit. My other medicines help, so I'm still stable. But I would like to skip the Lamictal since I suspect it's making things worse.

BUT, doctors haven't heard about this at ALL, so of course they reject my theory, since Lamictal has such a good reputation.

Did anyone found any studies on this?

<{POST_SNAPBACK}>

Add me to your theory!!  I'm sitting at the bottom of the hill now too!!!  I am absolutely hating Lamictal.  I had such a shitty time titrating up on this med.  Sick...sick...sick....cycle...cycle...cycle...I did have some moments of stability, but they have NEVER lasted more than a couple weeks...maybe a month!!!  I am more crazy NOW on this medication than before any BP med!!! 

I have constant headaches, ear aches, loss of hearing, bout's of nausea, actually I think I practically live in a migraine state now...not to mention the MASSIVE panic attacks...the fact that I am losing handfulls of hair DAILY!!  My worthless (I have given him more than enough patience)  Pdoc says he doesn't think the Lamictal would be causing me such issues...not the migraines...not the anxiety...well the hair loss could be related, so take some multivitamins!!!  Can you believe that?  The months I have been faithful to this idiot!!  The months I spent trusting his treatment options!!  I just kept jumping through his hoops...trying every pill he threw at me!!     

At my last pdoc visit, as I sat there sobbing (isn't Lamictal supposed to be great for the depressive side of BP?), he gives me Lexapro!!  I'm done.  I am SLOWLY tapering off the EVIL Lamictal and I have decided not to continue the Lexapro. 

The last 7+ months of my life have been so much more out of control on Lamictal than before.  I have yet to decide if I want to take mood stabilizing meds...yeah, I know...stupid move...not to me...I was able to handle my moods much better before...on my own!  My husband says he has actually feared for my safety more on BP meds that before!!!  That is how out of control my experience on Lamictal has been!!!

Please don't lecture me.  I need to see if I can make it in my life without drugs!!!

aimee

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This is soooo weird.

I personally think it's gotten worse when I started Lamictal. That's when things really started going downhill. Things have been going downhill all my life, pretty much, but this was really noticable.

Of course, none of the doctors I've talked to accept my theory. I've been on it since december so I know I need to give it a longer time. I'm now on 500 mg, which doesn't help shit. My other medicines help, so I'm still stable. But I would like to skip the Lamictal since I suspect it's making things worse.

BUT, doctors haven't heard about this at ALL, so of course they reject my theory, since Lamictal has such a good reputation.

Did anyone found any studies on this?

<{POST_SNAPBACK}>

Helena,

Show them Navy's post in this thread. She included the patient information sheets which clearly indicate risks for hypomania, mixed states, etc.

I hope this helps!

Jill

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