Posted by JahL on December 16, 2003, at 22:44:24
In reply to Dilemma- Lamictal/Amisulpride, posted by premed812000 on December 15, 2003, at 14:23:43
Hi there.I originally presented as Dysthymic with Social Anxiety, since age 6 or 7, though now I'm a confirmed sufferer of Soft Bipolar NOS (a diagnosis sometimes dismissed as being 'trendy' and vague, but which I feel can be very useful. Anyway...).
Over 50 meds later and I'm settled on Lamictal + Sulpiride (used interchangeably with Amisulpride in some UK hospitals over here, though their effects can and do differ), as well as Klonopin (1mg) and now Ropinirole (0.5mg tid). This cocktail is nothing like effective but it keeps me -just- out of the hole in the ground.
I was alerted to Lamictal's efficacy when I added 0.25mg of Klonopin to 25mg of Lamictal and emerged hypomanic half an hour later. Not your standard 'kindling' (unlike SSRIs, which also promote brief spells of euthymia/hypomania in me), but it was easily repeatable. I now take *600*mg (I'll explain...) of Lamictal, which primarily helps with cognition and also co-ordination.
Sulpiride (I was led to this by an old and obscure antipsychotic, Promazine) has been a life saver with regards to social phobia. No full remission but a dramatic difference all the same. There still remains that element of paranoia but I can kid people, no problem. The beauty of Amisulpride and Sulpiride is that *if* they work, they tend to do so pretty rapidly. Both Promazine & Sulpiride 'worked' within a day or two for me (it was the same for my bro', who takes the same meds for the same disorder). I don't get any side effects from the low dose (150mg) I take and there are no significant interactions with Lamictal that I know of.
Lamictal took much longer to take effect and IMO you might want to titrate up to btwn 100 & 200mg before deciding to pack it in. The Lamictal has not so much 'pooped-out' on me so much as settled down from the feverish high it originally produced. The reason I'm on so high a dose is that I've been taken off it 3 times (once for ECT) and each time the benefits could only be reinstigated at higher doses. Not sure how common this is, though I have read a few anecdotal reports describing this phenomenon, including on this forum.
Please treat Lamictal with plenty of respect. I once missed a dose and soon developed a rather attractive rash and hugely swollen lymph (I think) glands. Scary stuff.
None of the drugs I take do much for my actual depression, tho' obviously being able to at least function (which I couldn't sans drugs) improves emotional wellbeing somewhat.
Sorry if this is rather long and rambling; currently my brain is well and truly f***** and I'm having trouble taking the proverbial gun outta me gob. Also haven't been here for some while. All these new people...I only recognise SLS (Hi Scott. Hope you're OK).
Nite.
Ta,
Jah*PS. I forgot. I also take low-dose (5 ml daily)Methadone. Helps a little with mood and motivation w/o side effects.
*************************************************
> 1) Has anyone experienced enduring success with lamictal for my symptoms, (primarily dysthymia w/ anxiety), and if so, what dose? (Currently I receive no benefit or side effects but I am aware that lamictal appears to poop out once a benefit is felt)
> 2) Anyone experienced enduring success with amisulpride for my symptoms?
> 3) Do you think I should a) stick it out with lamictal, b) discontinue lamictal and try amisulpride, or c) continue titrating lamictal and add amisulpride (an option I am leaning away from)
>
> In any event, sorry for the length and thanks in advance for your feedback.
>
>
poster:JahL
thread:290089
URL: http://www.dr-bob.org/babble/20031213/msgs/290782.html