![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by gardenergirl on October 30, 2005, at 21:28:20
Lately I'm feeling a bit mentally dull. It seems like I just don't have as much cognitive energy to go around, and I have to sort of "ration" it. Could this be related to Lamictal? I'm at 100 mg now, and 45 mg Nardil. I don't feel depressed, per se, but I do feel sort of less verbal, both in writing/posting, and talking. Of course, some might find that to be a blessing. ;)
Any thoughts?
gg
Posted by Bobby on October 30, 2005, at 22:01:27
In reply to Mental dullness, Lamictal?, posted by gardenergirl on October 30, 2005, at 21:28:20
Been there---am there.
I feel as if there is a battle ship anchor tied to me. Of course, I don't suppose the Zyprexa and Serax help. Good luck in your search for mental freedom---it is out there---right?
Posted by SLS on October 31, 2005, at 2:05:54
In reply to Mental dullness, Lamictal?, posted by gardenergirl on October 30, 2005, at 21:28:20
Hi GG.
Yes, in my experience, Lamictal, especially when combined with Nardil, can produce a mental dullness and numbness to one's surroundings. 100mg is a rather low, but therapeutic dosage of Lamictal. Still, you might be susceptible. I am surprised you didn't complain about memory problems.
So, the question is, what do you do in this situation. I guess that depends on:
1. Are you bipolar?
2. How well do you do on Nardil alone?
3. How high a dosage of Nardil have you tried?
4. Will you retain a positive effect if you reduce the dosage of Lamictal?
5. Which other mood stabilizers have you tried?
6. What will you be for Halloween?
- Scott* The last question is the most important, as it reveals the functional balance between the amygdala and the dorsolateral prefrontal cortex. Boo!
-------------------------------------
> Lately I'm feeling a bit mentally dull. It seems like I just don't have as much cognitive energy to go around, and I have to sort of "ration" it. Could this be related to Lamictal? I'm at 100 mg now, and 45 mg Nardil. I don't feel depressed, per se, but I do feel sort of less verbal, both in writing/posting, and talking. Of course, some might find that to be a blessing. ;)
>
> Any thoughts?
>
> gg
Posted by gardenergirl on October 31, 2005, at 7:41:30
In reply to Re: Mental dullness, Lamictal? » gardenergirl, posted by SLS on October 31, 2005, at 2:05:54
> Hi GG.
>
> Yes, in my experience, Lamictal, especially when combined with Nardil, can produce a mental dullness and numbness to one's surroundings.Is this sort of like an apathy?
>100mg is a rather low, but therapeutic dosage of Lamictal. Still, you might be susceptible. I am surprised you didn't complain about memory problems.
Well, I have been mis-placing things lately. And I have had a bit of forgetfulness, but nothing more than being overstressed causes.
>
> So, the question is, what do you do in this situation. I guess that depends on:
>
> 1. Are you bipolar?Nope. In fact, my pdoc went out of her way to reassure me that I was not when she recommended I try this. Wonder what my face must have looked like to lead her to do that.
>
> 2. How well do you do on Nardil alone?Not bad, actually, but I was trying to lower it to avoid the peripheral edema and urinary retention I get at higher doses. In fact, I'd love to get off of it totally at some point.
>
> 3. How high a dosage of Nardil have you tried?75 mg is the highest I tried, and at that dose I had significant akathisia and insomnia, prompting a between visits call to my pdoc. Absolutely hated that feeling. 67.5 mg is okay, but then the edema is a factor.
>
> 4. Will you retain a positive effect if you reduce the dosage of Lamictal?Hard to say. I've been on higher doses of Nardil and only 50mg of Lamictal before. That was okay. Lower Nardil by itself leads me to go back to the excessive sleeping which is a hallmark of my own experience of atypical depression.
>
> 5. Which other mood stabilizers have you tried?Topomax, which made me more depressed.
>
> 6. What will you be for Halloween?Hmmm, a doorbell responder? A wife who's mourning the loss of celebrating an important anniversary because her husband is a turnip? A dissertation-avoider?
I'm not a big Halloween fan. Although I do have a great Star Trek Next Generation uniform top. Or a musketeer outfit. But it works better with the other two ladies who have the matching outfits.
>
>Thanks for your thoughtful reply,
gg
Posted by gardenergirl on October 31, 2005, at 7:42:29
In reply to Re: Mental dullness, Lamictal? » gardenergirl, posted by Bobby on October 30, 2005, at 22:01:27
> Been there---am there.
> I feel as if there is a battle ship anchor tied to me. Of course, I don't suppose the Zyprexa and Serax help. Good luck in your search for mental freedom---it is out there---right?I sure hope so. I hate feeling apathetic and dull. Good luck to you, too.
gg
Posted by SLS on October 31, 2005, at 8:08:52
In reply to Re: Mental dullness, Lamictal? » SLS, posted by gardenergirl on October 31, 2005, at 7:41:30
> > Yes, in my experience, Lamictal, especially when combined with Nardil, can produce a mental dullness and numbness to one's surroundings.
> Is this sort of like an apathy?Not really. Sort of. I guess. I don't know. It doesn't take away from my motivation to initiate activities, but it does perhaps make me more apt to not act on things.
What would happen if you were to treat the edema with a diuretic? If Nardil yields the best antidepressant effect for you, then I think you may have no better choice than to aggressively treat the side effects, including the insomnia. Adding Klonopin might be helpful. I have difficulty believing that you are experiencing true akathisia. I think this word has been overused here. Can you explain what exactly happens at the higher dosages of Nardil? Anxiety? Irritability? Insomnia? Racing thoughts? Restlessness?
- Scott
> >100mg is a rather low, but therapeutic dosage of Lamictal. Still, you might be susceptible. I am surprised you didn't complain about memory problems.
>
> Well, I have been mis-placing things lately. And I have had a bit of forgetfulness, but nothing more than being overstressed causes.
> >
> > So, the question is, what do you do in this situation. I guess that depends on:
> >
> > 1. Are you bipolar?
>
> Nope. In fact, my pdoc went out of her way to reassure me that I was not when she recommended I try this. Wonder what my face must have looked like to lead her to do that.
> >
> > 2. How well do you do on Nardil alone?
>
> Not bad, actually, but I was trying to lower it to avoid the peripheral edema and urinary retention I get at higher doses. In fact, I'd love to get off of it totally at some point.
> >
> > 3. How high a dosage of Nardil have you tried?
>
> 75 mg is the highest I tried, and at that dose I had significant akathisia and insomnia, prompting a between visits call to my pdoc. Absolutely hated that feeling. 67.5 mg is okay, but then the edema is a factor.
> >
> > 4. Will you retain a positive effect if you reduce the dosage of Lamictal?
>
> Hard to say. I've been on higher doses of Nardil and only 50mg of Lamictal before. That was okay. Lower Nardil by itself leads me to go back to the excessive sleeping which is a hallmark of my own experience of atypical depression.
> >
> > 5. Which other mood stabilizers have you tried?
>
> Topomax, which made me more depressed.
> >
> > 6. What will you be for Halloween?
>
> Hmmm, a doorbell responder? A wife who's mourning the loss of celebrating an important anniversary because her husband is a turnip? A dissertation-avoider?
>
> I'm not a big Halloween fan. Although I do have a great Star Trek Next Generation uniform top. Or a musketeer outfit. But it works better with the other two ladies who have the matching outfits.
> >
> >
>
> Thanks for your thoughtful reply,
>
> gg
Posted by gardenergirl on October 31, 2005, at 14:31:56
In reply to Re: Mental dullness, Lamictal? » gardenergirl, posted by SLS on October 31, 2005, at 8:08:52
>
> > Is this sort of like an apathy?
>
> Not really. Sort of. I guess. I don't know. It doesn't take away from my motivation to initiate activities, but it does perhaps make me more apt to not act on things.That's pretty much almost exactly how I feel. It's hard to describe, isn't it?
>
> What would happen if you were to treat the edema with a diuretic?I've taken Lasix at times. It's okay, but sometimes I feel a bit icky on it. Hard to describe...maybe I get dehyrdated? And it's not all that effective, but I take a low dose.
>If Nardil yields the best antidepressant effect for you, then I think you may have no better choice than to aggressively treat the side effects, including the insomnia.
I take Ambien periodically. I didn't have that before, when I was at 75 mg Nardil. My pdoc gave me Gabitril to try to help at the time, but it did nothing.
>Adding Klonopin might be helpful. I have difficulty believing that you are experiencing true akathisia. I think this word has been overused here. Can you explain what exactly happens at the higher dosages of Nardil? Anxiety? Irritability? Insomnia? Racing thoughts? Restlessness?
Restlessness. I feel like I'm going to jump out of my skin. I can't lie still when I try to lie down. I have to get up and move. It's not quite jitteriness, like I used to get when I took some kind of adrenaline-based med for childhood asthma. It's just a need to move. It's horrible. No racing thoughts. Some anxiety that I won't get to settle down and sleep or relax, but that's related to the physical feeling more than anything else. No irritability. The insomnia is somewhat related, but also occurs without the restlessness.
gg
Posted by SLS on October 31, 2005, at 14:47:44
In reply to Re: Mental dullness, Lamictal? » SLS, posted by gardenergirl on October 31, 2005, at 14:31:56
> >Adding Klonopin might be helpful. I have difficulty believing that you are experiencing true akathisia. I think this word has been overused here. Can you explain what exactly happens at the higher dosages of Nardil? Anxiety? Irritability? Insomnia? Racing thoughts? Restlessness?
> Restlessness. I feel like I'm going to jump out of my skin. I can't lie still when I try to lie down. I have to get up and move. It's not quite jitteriness, like I used to get when I took some kind of adrenaline-based med for childhood asthma. It's just a need to move. It's horrible. No racing thoughts. Some anxiety that I won't get to settle down and sleep or relax, but that's related to the physical feeling more than anything else. No irritability. The insomnia is somewhat related, but also occurs without the restlessness.
That sure sounds like akathisia to me.:-(
Have you tried Parnate?
- Scott
Posted by gardenergirl on October 31, 2005, at 18:28:45
In reply to Re: Mental dullness, Lamictal?, posted by SLS on October 31, 2005, at 14:47:44
I haven't tried Parnate. I forgot to bring it up last visit. We talked about it before, but at the time, it wasn't a good time to make a change like that. Maybe once I've gotten past the big school hurdle? Or maybe it will take Parnate to get past that hurdle.
So confusing.
gg
Posted by theo on November 1, 2005, at 21:48:19
In reply to Mental dullness, Lamictal?, posted by gardenergirl on October 30, 2005, at 21:28:20
> Lately I'm feeling a bit mentally dull. It seems like I just don't have as much cognitive energy to go around, and I have to sort of "ration" it. Could this be related to Lamictal? I'm at 100 mg now, and 45 mg Nardil. I don't feel depressed, per se, but I do feel sort of less verbal, both in writing/posting, and talking. Of course, some might find that to be a blessing. ;)
>
> Any thoughts?
>
> ggLamictal did the same thing to me. I felt positive effects at low doses, but unfortunately they wore off and you have to keep increasing the dose to get AD response. The more you increase the dose, the more side effects.
When I hit 150mg I was emotionless and couldn't remeber what I did 5 minutes ago. I wish Lamictal had more staying power at lower doses, but it just doesn't.
Posted by fuchsia on November 3, 2005, at 20:26:19
In reply to Mental dullness, Lamictal?, posted by gardenergirl on October 30, 2005, at 21:28:20
I'm on 150mgs and I feel very dull but I think I was duller before, when depressed, so I won't blame the lamictal yet.
I don't have obvious memory loss but I could be forgetting things (bigger chunks of things) without realizing it. I guess you can't know until you encounter something you've forgotten.
I definitely can _not_ remember my dreams and I always used to. Maybe that's related to memory loss or maybe it's via a different mechanism. I'm curious about that.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.