alen Posted October 13, 2017 Share Posted October 13, 2017 I am currently taking 100 mg of Lamictal on my way to 200 mg in a week and so far, I have not felt a change in my flat mood or fatigue. I'm not actively sad or suicidal, just apathetic and flat most of the time. I can't seem to get elevated or excited about things (I'm usually very excitable!) and experience anhedonia a lot (a lack of pleasure from enjoyable activities/hobbies). My question is: can Lamictal restore my emotions to their normal baseline and help with fatigue/apathy/anhedonia? How long am I supposed to wait for it to kick in? (I started titrating up in the beginning of September.) I know it can take months for medication to work but I've read so many posts of people saying that they felt quick results in under a month. Maybe it's just my brain? I am wondering if I need 300 mg for it to reach its therapeutic dosage. Link to comment Share on other sites More sharing options...
Blahblah Posted October 13, 2017 Share Posted October 13, 2017 Lamictal mainly acts as a mood stabilizer, less of an antidepressant. It does have light antidepressant effects and works to bring down mania. It should bring you to a stable baseline mood (not up nor down). I don't find it activating or sedating. In my experience, It's not a potent antidepressant with mood brightening properties. It makes me feel more stable/resilient, but has not done much of anything towards lifting my chronic anhedonia. Many people add something to it to create a more effective combo...I noticed the stabilizing effects once I reached 100mg, but the recommended range is typically anywhere between 100mg-300mg. As always, your mileage may vary. 1 Link to comment Share on other sites More sharing options...
crtclms Posted October 13, 2017 Share Posted October 13, 2017 100mg is on the low end, and you may not feel an effect until you get to 150mg. I take 400mg, so there's a ways for you to go if you are seeking a therapeutic level. I'm going to move this to mood-stabilizers. 1 Link to comment Share on other sites More sharing options...
Iceberg Posted October 13, 2017 Share Posted October 13, 2017 Yeah some people feel if fast but unfortunately for some people it takes forever. Maybe an add on would help until things get stable Link to comment Share on other sites More sharing options...
phidippus Posted October 15, 2017 Share Posted October 15, 2017 What are the symptoms you're trying to treat with the Lamictal? Link to comment Share on other sites More sharing options...
alen Posted October 17, 2017 Author Share Posted October 17, 2017 @phidippus I'm trying to treat Bipolar I depression. Link to comment Share on other sites More sharing options...
Blahblah Posted October 18, 2017 Share Posted October 18, 2017 (edited) 13 hours ago, alen said: @phidippus I'm trying to treat Bipolar I depression. BP 1 depression is tough to treat because mood stabilizers are more effective at bringing down Mania. If you are someone that mainly struggles with the deep depression side of BP, you will likely need to add some sort of antidepressant or A/P....It's a catch-22 though because many BP 1 folks do not react well to most antidepressants, and other mood stabilizers or A/P meds just often further flatten mood or bring on weight gain & fatigue. Many people do well on Abilify or Rexulti, didn't really help my depression personally (though I'm not BP), it's worth a shot. I would increase the Lamictal, give it time to work and then ask you pdoc what you can add on. Edited October 18, 2017 by Blahblah 1 Link to comment Share on other sites More sharing options...
alen Posted October 18, 2017 Author Share Posted October 18, 2017 @Blahblah I've been on Abilify (15 mg) for over a month with little to no results...I am going to ask my psychiatrist for Seroquel or Symbyax for the depressive side of things at our next meeting (I didn't respond to Latuda). He mentioned Symbyax last time but is hesitant to prescribe it because of the potential for weight gain. I've also read that Seroquel can be very sedating and I already have fatigue so I'm worried about that, too. Sigh. Link to comment Share on other sites More sharing options...
Iceberg Posted October 19, 2017 Share Posted October 19, 2017 (edited) @alen symbyax might be just as sedating because of the olanzapine it has (ymmv). Have you tried rexulti? I had previously tried abilify with bad results but did ok on rexulti Edited October 19, 2017 by Iceberg Link to comment Share on other sites More sharing options...
alen Posted October 19, 2017 Author Share Posted October 19, 2017 @Iceberg I haven't tried Rexulti, no. Link to comment Share on other sites More sharing options...
Iceberg Posted October 19, 2017 Share Posted October 19, 2017 Just thought it was worth a mention Link to comment Share on other sites More sharing options...
phidippus Posted October 19, 2017 Share Posted October 19, 2017 On 10/17/2017 at 2:06 PM, alen said: @phidippus I'm trying to treat Bipolar I depression. Have you tried an MAOI? Link to comment Share on other sites More sharing options...
alen Posted October 22, 2017 Author Share Posted October 22, 2017 @phidippus No, I haven't. My psychiatrist said prescribing an antidepressant was too risky for me because of the possible switch to mania. Link to comment Share on other sites More sharing options...
browri Posted October 24, 2017 Share Posted October 24, 2017 On 10/18/2017 at 1:23 PM, alen said: @Blahblah I've been on Abilify (15 mg) for over a month with little to no results...I am going to ask my psychiatrist for Seroquel or Symbyax for the depressive side of things at our next meeting (I didn't respond to Latuda). He mentioned Symbyax last time but is hesitant to prescribe it because of the potential for weight gain. I've also read that Seroquel can be very sedating and I already have fatigue so I'm worried about that, too. Sigh. I can't speak to Seroquel. Haven't taken it. But I can speak to the Symbyax combo. I was taking fluoxetine and olanzapine separately because it was cheaper. I found that 40mg of fluoxetine would periodically agitate my thoughts but was robustly effective for my depression. 20mg was fairly effective although it would sometimes feel "pooped out". As for the olanzapine, 5mg was just about right for me. 2.5mg didn't stabilize me enough, but 5mg was just right. As long as I didn't take it too late, it didn't make me feel sedated when I woke up the next morning. Did gain a bit of weight though, and I didn't want to go higher than 5mg because of the metabolic side effects. Olanzapine is a pretty high risk for those. However, if I were in a tight spot I would still consider going up to 7.5mg. Not taking either of them anymore because of side effects. Depakote, Trintellix, and Loxitane keep me pretty well controlled. On 10/18/2017 at 11:18 PM, Iceberg said: @alen symbyax might be just as sedating because of the olanzapine it has (ymmv). Have you tried rexulti? I had previously tried abilify with bad results but did ok on rexulti The nice thing about the fluoxetine/olanzapine combination is that while olanzapine is pretty sedating, fluoxetine is stimulating. So they complement each other fairly well. Additionally, while olanzapine causes weight gain, fluoxetine generally causes weight loss. 1 Link to comment Share on other sites More sharing options...
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