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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by jaime on April 21, 2002, at 0:26:14
I am currently on Lamictal 50 mg (gradually going up 25 mg each week to 100 mg - I'm at the end of week 2). Is this a drug that you gradually feel better on during the dosage increase, or is it a matter of waiting until you get up to a certain dose that kicks in and you *know* it is for you? I feel like I'm sinking lower instead of feeling better since starting it.
I'm also on Wellbutrin 350 mg and Klonopin 1 mg. Before Lamictal, I was on lithium to augment Wellbutrin. I was having memory problems on lithium and that's why I switched to Lamictal. So far, I have had no cognitive impairment on Lamictal, but I feel like I am slipping back into a bad depression.
Thanks in advance for any input.
Posted by Ponder on April 21, 2002, at 10:50:02
In reply to Sinking on Lamictal dosage increase, posted by jaime on April 21, 2002, at 0:26:14
When I was initiating treatment on Lamictal, I recall having a good response with each dosage increase that would last a couple of days, then wear off. That evened out when I reached 150 mg/day. Lamictal has been a godsend to me.
Posted by jaime on April 23, 2002, at 11:31:40
In reply to Re: Sinking on Lamictal dosage increase, posted by Ponder on April 21, 2002, at 10:50:02
> When I was initiating treatment on Lamictal, I recall having a good response with each dosage increase that would last a couple of days, then wear off. That evened out when I reached 150 mg/day. Lamictal has been a godsend to me.
Thanks Ponder. Seems like Lamictal has been a *godsend* for many other posters as well. I guess it's just hard to wait (especially with Lamictal due to the slowwww dosage increase), at the same time sinking back into a worse depression. After trying so many other meds with no success, and not knowing if this one will work either. But I'm going to stick it out. My temporary solution (after talking with my pdoc): Add Li low dose back on until I reach *therapuetic* level of Lamictal. Hopefully that will provide some stability. But I'm not sure how we will determine what the *therapeutic* level is. My pdoc said *you will just know.* Hummm.
Posted by Ponder on April 23, 2002, at 14:02:40
In reply to Re: Sinking on Lamictal dosage increase » Ponder, posted by jaime on April 23, 2002, at 11:31:40
> Thanks Ponder. Seems like Lamictal has been a *godsend* for many other posters as well. I guess it's just hard to wait (especially with Lamictal due to the slowwww dosage increase), at the same time sinking back into a worse depression. After trying so many other meds with no success, and not knowing if this one will work either. But I'm going to stick it out. My temporary solution (after talking with my pdoc): Add Li low dose back on until I reach *therapuetic* level of Lamictal. Hopefully that will provide some stability. But I'm not sure how we will determine what the *therapeutic* level is. My pdoc said *you will just know.* Hummm.Oh, those pdocs! Shooting from the hip and in the dark. ;-) I'm sure you've seen from the posts on this board how variable the "therapeutic" dosages are from one person to another. 150 is clearly the best for me. When I reached it, I wanted to go higher just to see if there was any further benefit. Nope. 125 is no good, 175 is no good. 150 is great. I sure hope Lamictal will do its magic for you.
Posted by Cecilia on April 24, 2002, at 1:02:42
In reply to Re: Sinking on Lamictal dosage increase, posted by Ponder on April 23, 2002, at 14:02:40
Ponder, how long did you stay on each dose before increasing? It scares me that there might be a therapeutic window that I might pass without realizing it. It`s taken me 4 months already to get up to 156.25 mg., I`ve been increasing by 6.25 mg every 4 to 6 days. If it takes the 400 mg. suggested by Dr. Goldberg, that means maybe another 6 months before I know whether it works. Not that I have any real expectation that it will, nothing else has, and there`s nothing else new on the market to try. But I kind of worry about what taking an anti-seizure med when you don`t have seizures does to your brain. Cecilia
Posted by Ponder on April 24, 2002, at 11:54:18
In reply to Re: Lamictal dose increase-Ponder, posted by Cecilia on April 24, 2002, at 1:02:42
Cecilia, I don't think my dosage increases were as small as yours and my doc allowed larger increases as we progressed. The reasoning there is that increasing from 25 mg to 50 mg is a 100% increase, whereas 50 to 75 is only a 50 % increase etc. But, obviously, your doctor has reasons for wanting to take yours extra-slow. I don't have the clearest of recollections regarding my titration schedule. Increasing as slowly as you are, it is unlikely that you will miss your "window." But, I can see it's taking a lot of patience on your part, when, understandably, you'd like to have some symptom relief yesterday already!
Regarding the effect on the brain of anti-seizure medications, I'd be curious to know your diagnosis, symptoms, meds history, etc. Although most of us on this board have conflicting feelings about having to take meds, there is no question that serious depression, bipolar, etc. has ongoing detrimental effects on brain functioning. So the risk-benefit ratio is always the thing to consider.
> Ponder, how long did you stay on each dose before increasing? It scares me that there might be a therapeutic window that I might pass without realizing it. It`s taken me 4 months already to get up to 156.25 mg., I`ve been increasing by 6.25 mg every 4 to 6 days. If it takes the 400 mg. suggested by Dr. Goldberg, that means maybe another 6 months before I know whether it works. Not that I have any real expectation that it will, nothing else has, and there`s nothing else new on the market to try. But I kind of worry about what taking an anti-seizure med when you don`t have seizures does to your brain. Cecilia
Posted by Cecilia on April 24, 2002, at 21:50:14
In reply to Re: Lamictal dose increase-Ponder » Cecilia, posted by Ponder on April 24, 2002, at 11:54:18
Actually my doctor didn`t say I needed to increase so slowly, I`m just doing it that way because I`ve had so many problems with side effects with drugs. I have chronic depression, anxiety, social phobia.
I take trazodone, celexa and clonazepam, I`m not sure any of them really do anything but they don`t have any bad side effects and I`m afraid to go off them, I had horrible anxiety attacks when I went off celexa even though I never felt it was doing anything for me when I was on it, and the trazodone and clonazepam were added during a period of severe situational anxiety, which improved somewhat after I was on them but I don`t know if it was the drugs or just time, I just know I don`t want to go through that again. For me, depression is constant but anxiety varies depending on life circumstances. I guess I have a hard time understanding how depression can ever be cured because it`s about the past, all the losses and regrets and humiliations that can`t be changed. Anxiety is about the future and most of that can`t be changed either, no matter what, we`re all going to get old and probably get some horrible disease and die. I obsess about cancer a lot, not so much the dying, but the waiting to die, living in fear of the fear. Sorry for this cheerful post, I don`t know what I`d if I DID find a med that woks, like a dog chasing a car, what would he do with it if he caught it?
Cecilia
Posted by Bela on August 21, 2003, at 12:31:34
In reply to Re: Sinking on Lamictal dosage increase » Ponder, posted by jaime on April 23, 2002, at 11:31:40
I hope I am following the correct procedure for starting a new thread. This subject may have been addressed before, in which case, I apologize, but I can't find it. My drug history: I am currently taking 200 mg. of Lamictal per day (100 morning and night) and have only exhibited radical mood shifts since I started taking SSRIs a few years ago. Before that, the only psych problem I had was insomnia.I am now on my 4th SSRI; all of them poop out after a few months of use--at least for me.The Lamictal was added this past January 2003 to stabilize daily mood swings and hopefully help maintain the efficacy of the SSRIs. It doesn't. I want to get off all of them but very, very slowly because I think the drugs are creating much of the problem.
Questions: does anyone have any thoughts or experiences on Lamictal dose reduction, withdrawal and relapse, its effect on SSRIs, etc? Does anyone else suspect that these drugs actually have exacerbated their problems? If you can shed ANY light on this rather frustrating matter, I would be greatly appreciative.
Bela
This is the end of the thread.
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