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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 35 to 59 of 64. Go back in thread:
Posted by SLS on February 22, 2009, at 21:18:24
In reply to Re: Lamictal optimal dosage, posted by mickapoo on February 22, 2009, at 20:46:04
> Not trying to doubt you,
You should. I often doubt myself.
> just wondering about your comment that:
>
> >200mg is the "sweet spot" for this drug when >treating depression.
>
> Is this from personal experience or from doing research? Would this apply for mood stabilization or just depression?
200mg was found to be the average effective dosage from very early in the history of investigations into using Lamictal for bipolar depression. By comparison, a range of 300-500mg has been used for epilepsy.Lamictal is often ineffective as an anti-manic agent. However, it can help penetrate a rapid cycling bipolar disorder, especially when combined with lithium.
For me, personally, I have found no further *stable* improvement from increasing the dosage of Lamictal beyond 200mg. However, my cognition and memory are very much impaired at the higher dosages, especially when I combine them with Nardil or Parnate.
For many, Lamictal feels pretty good each time they increase the dosage, but then watch the improvement fade away. People can even feel an improvement while taking as little as low as 50mg. But once you get to 500mg and are dissatisfied, what do you do? Lamictal does not usually make for a good antidepressant by itself. Now you add Nardil, which seems to amplify the cognitive side effects of Lamictal. How do you know how low to go with the Lamictal? I simply brought the dosage down to the maximum that would allow the cognitive side effects to disappear. For me, this just happens to be 200mg.
- Scott
***********************************************************************1: Pharmacoepidemiol Drug Saf. 2009 Feb;18(2):132-9.Click here to read Links
Trends and changes in the clinical use of lamotrigine.
Reimers A.Department of Clinical Pharmacology, St. Olavs University Hospital, Trondheim, Norway. arne.reimers@legemidler.no
PURPOSE: To investigate long-term trends and changes in the pattern of use of lamotrigine (LTG). METHODS: Retrospective survey of a large, routine therapeutic drug monitoring database. RESULTS: Twelve thousand one hundred and seven samples from 4123 subjects were analysed from October 1999 to May 2007. Within this period, the mean daily dose rose from 183 to 253 mg, whereas the median dose remained unchanged at 200 mg. Females became the majority of LTG users, and they had a higher proportion of psychiatric diagnoses than male patients. The mean patient age increased from 34 to 41 years. The proportion of samples from psychiatric patients became larger than that of neurologic patients. A total of 130 different diagnoses were stated, most of them psychiatric off-label. The mean serum concentration was 3.8 mg/L and it remained quite stable during the whole observation period. Neurologic patients had a higher mean serum concentration than psychiatric patients. 30% of the neurologic and 41% of the psychiatric patients had serum concentrations below the reference range. Sixty-eight per cent of the patients used additional drugs. Females used a higher number of additional medications than males. The 10 most frequent co-medications consisted of seven psychotropic drugs, two anticonvulsants, and thyroxine. CONCLUSIONS: Significant changes in the pattern of use of LTG have taken place during the observation period and some significant trends could be identified.
Posted by dcruik518 on February 23, 2009, at 17:46:53
In reply to Nardil cognitive side effects- zero memory, posted by n_wolfie on February 19, 2009, at 23:23:37
In my experience the MAOI's actually have an extremely positive effect on my cognitive abilities. I find I'm much more fluent with words, for instance, and my writing comes much more easily and is better. I was also wittier on Nardil. I loved it. I just can't afford the weight gain. Are you saying you're losing weight because of the Lamictal. You're actually still on a really low dose of Nardil. The optimal dose for me was 90 mg. It works better the more you take, for most people, up to a point. Still, it could be interacting with the high dose lamictal in some way. Good luck. If nardil doesn't work for you, you could alway try Parnate. It's a bit more stimulating and doesn't affect GABA the way Nardil does.
> I've been on Lamicatal 500 mg for a few mos. It was working wonderfully, then it stopped, I became depressed again, so my doctor started me on Nardil, which had worked in the past with the Lamictal, so well in fact that we discontinued the Nardil. I'm into my second week of 30 mg Nardil, and my mood has improved somewhat, but my cognition/memory is at an all time low. I can't keep a thought in my head long enough to even express it. I can't find my way around the subway, I put money back in my wallet instead of paying the restaurant check, forget to lock my apt, I try to read and I can't understand what I'm reading. It's not sooo bad in the morning, but gets worse as the day goes on, by 2pm I'm exhausted and my brain completely shuts down. I have atypical depression, so this pattern is typical, but I don't remember my memory ever being this nonexistent. It's very, very scary. My doctor told me to reduce my Lamictal to 400mg, as I've lost a lot of weight, and my blood levels have increased, so it may be due to that. Or is this a temporary Nardil side effect? Sorry if this is soo confusing, it's hard just keeping my thoughts clear enough to write this.
Posted by n_wolfie on February 23, 2009, at 19:42:23
In reply to Re: Nardil cognitive side effects- zero memory » n_wolfie, posted by dcruik518 on February 23, 2009, at 17:46:53
Hi, thanks for your post! Yes, I lost weight from the Lamictal, and from stress. Lamictal seems to control my carb cravings, which used to be a problem on the Nardil. I was on 75 mg of Nardil a few years ago, and yes, I was wittier, fluent with words, but my memory still wasn't as great as it was when I was on the Lamictal alone. My doctor added the Lamictal as a mood stabilizer, since I'm soft bipolar 2, and it's really worked well for that. When I first took the Nardil, it exhausted me, which improved over time, but I'd still nap around 5 almost every day. I started exercising, cardio about 45 minutes 4 times a week, and it made a huge, huge difference in my energy levels. The exercise also seemed to curb my carb cravings. I also just read about Nardil induced hypoglycemia (even though I'm only on 2), and I tend not to eat for long periods sometimes, and I'm thinking that could be contributing to the complete exhaustion. I've read that eating lots of protein helps, but I'm a vegetarian because I love animals, so eating meat to increase my protein intake is going to be difficult. I've tried Parnate before, and I was literally passing out all over the place,and extremely sensitive to cold. High level Nardil made me hypotensive at first but that subsided over time. Also, the last time I took Nardil it made me much more tired at first, which subsided over time, but not completely. You may want to try adding some Lamictal to the Nardil if you had weight problems, it has really helped control my carb cravings. Yes, I'm having issues right now, but that could be early side effects, or from a high dose of Lamictal. I definitely don't want to go off the lamictal, that's why were reducing it slowly. Supposedly it potentiates the effect of the Nardil, so you may not have to take as much Nardil, which could help with the weight gain. So, from experience, I think you may want to think about adding some Lamictal to the Nardil and exercising. When I was on the Nardil alone, before I started exercising, I weighed 132, after exercising I was down to 117, and now on the 400 Lamictal and 30 Nardil I'm about 107-110. The Nardil initially increased my carb cravings with the increased dosage, but only for a few days. I don't think the exercise per se made me lose that much weight (since diet is more important) but it really curbed my carb cravings, made a big difference emotionally, and did wonders for my energy levels. I should take my own advice.
> In my experience the MAOI's actually have an extremely positive effect on my cognitive abilities. I find I'm much more fluent with words, for instance, and my writing comes much more easily and is better. I was also wittier on Nardil. I loved it. I just can't afford the weight gain. Are you saying you're losing weight because of the Lamictal. You're actually still on a really low dose of Nardil. The optimal dose for me was 90 mg. It works better the more you take, for most people, up to a point. Still, it could be interacting with the high dose lamictal in some way. Good luck. If nardil doesn't work for you, you could alway try Parnate. It's a bit more stimulating and doesn't affect GABA the way Nardil does.
>
>
>
>
>
> > I've been on Lamicatal 500 mg for a few mos. It was working wonderfully, then it stopped, I became depressed again, so my doctor started me on Nardil, which had worked in the past with the Lamictal, so well in fact that we discontinued the Nardil. I'm into my second week of 30 mg Nardil, and my mood has improved somewhat, but my cognition/memory is at an all time low. I can't keep a thought in my head long enough to even express it. I can't find my way around the subway, I put money back in my wallet instead of paying the restaurant check, forget to lock my apt, I try to read and I can't understand what I'm reading. It's not sooo bad in the morning, but gets worse as the day goes on, by 2pm I'm exhausted and my brain completely shuts down. I have atypical depression, so this pattern is typical, but I don't remember my memory ever being this nonexistent. It's very, very scary. My doctor told me to reduce my Lamictal to 400mg, as I've lost a lot of weight, and my blood levels have increased, so it may be due to that. Or is this a temporary Nardil side effect? Sorry if this is soo confusing, it's hard just keeping my thoughts clear enough to write this. Sorry if this is so long and disjointed, let me know if you have any specific questions.
>
>
Posted by n_wolfie on February 23, 2009, at 19:54:39
In reply to Re: Nardil cognitive side effects- zero memory » n_wolfie, posted by dcruik518 on February 23, 2009, at 17:46:53
And now I'm noticing that the reduction of the Lamictal has negatively affected my mood, and my writing doesn't come as easily isn't as fluent. The main reason I reduced it was because it completely destroyed my memory. I don't know, I'm so confused. I guess I just have to wait and see. Maybe the Lamictal mood dip is temporary.
> In my experience the MAOI's actually have an extremely positive effect on my cognitive abilities. I find I'm much more fluent with words, for instance, and my writing comes much more easily and is better. I was also wittier on Nardil. I loved it. I just can't afford the weight gain. Are you saying you're losing weight because of the Lamictal. You're actually still on a really low dose of Nardil. The optimal dose for me was 90 mg. It works better the more you take, for most people, up to a point. Still, it could be interacting with the high dose lamictal in some way. Good luck. If nardil doesn't work for you, you could alway try Parnate. It's a bit more stimulating and doesn't affect GABA the way Nardil does.
>
>
>
>
>
> > I've been on Lamicatal 500 mg for a few mos. It was working wonderfully, then it stopped, I became depressed again, so my doctor started me on Nardil, which had worked in the past with the Lamictal, so well in fact that we discontinued the Nardil. I'm into my second week of 30 mg Nardil, and my mood has improved somewhat, but my cognition/memory is at an all time low. I can't keep a thought in my head long enough to even express it. I can't find my way around the subway, I put money back in my wallet instead of paying the restaurant check, forget to lock my apt, I try to read and I can't understand what I'm reading. It's not sooo bad in the morning, but gets worse as the day goes on, by 2pm I'm exhausted and my brain completely shuts down. I have atypical depression, so this pattern is typical, but I don't remember my memory ever being this nonexistent. It's very, very scary. My doctor told me to reduce my Lamictal to 400mg, as I've lost a lot of weight, and my blood levels have increased, so it may be due to that. Or is this a temporary Nardil side effect? Sorry if this is soo confusing, it's hard just keeping my thoughts clear enough to write this.
>
>
Posted by SLS on February 23, 2009, at 20:00:21
In reply to Re: Nardil cognitive side effects- zero memory, posted by n_wolfie on February 23, 2009, at 19:54:39
> And now I'm noticing that the reduction of the Lamictal has negatively affected my mood, and my writing doesn't come as easily isn't as fluent. The main reason I reduced it was because it completely destroyed my memory. I don't know, I'm so confused. I guess I just have to wait and see. Maybe the Lamictal mood dip is temporary.
Posted by n_wolfie on February 23, 2009, at 20:00:23
In reply to Re: Lamictal optimal dosage » mickapoo, posted by SLS on February 22, 2009, at 21:18:24
Scott, I'm more confused than ever. My mood has dipped from the Lamictal reduction, and my word retrieval writing skills are much worse. When I was on the 500 of Lamictal, my mood was actually pretty good, and I could write, my word retrieval was great (I thought it wasn't, but when I actually wrote I discovered it was), and now my mood has dipped, and I'm having trouble writing, and my memory is still bad. All around I feel worse. Do I just need to wait it out? I just added 2 more posts on this, but they're pretty disjointed, my writing is suffering from the Lamictal reduction.
> > Not trying to doubt you,
>
> You should. I often doubt myself.
>
> > just wondering about your comment that:
> >
> > >200mg is the "sweet spot" for this drug when >treating depression.
> >
> > Is this from personal experience or from doing research? Would this apply for mood stabilization or just depression?
>
>
> 200mg was found to be the average effective dosage from very early in the history of investigations into using Lamictal for bipolar depression. By comparison, a range of 300-500mg has been used for epilepsy.
>
> Lamictal is often ineffective as an anti-manic agent. However, it can help penetrate a rapid cycling bipolar disorder, especially when combined with lithium.
>
> For me, personally, I have found no further *stable* improvement from increasing the dosage of Lamictal beyond 200mg. However, my cognition and memory are very much impaired at the higher dosages, especially when I combine them with Nardil or Parnate.
>
> For many, Lamictal feels pretty good each time they increase the dosage, but then watch the improvement fade away. People can even feel an improvement while taking as little as low as 50mg. But once you get to 500mg and are dissatisfied, what do you do? Lamictal does not usually make for a good antidepressant by itself. Now you add Nardil, which seems to amplify the cognitive side effects of Lamictal. How do you know how low to go with the Lamictal? I simply brought the dosage down to the maximum that would allow the cognitive side effects to disappear. For me, this just happens to be 200mg.
>
>
> - Scott
>
>
> ***********************************************************************
>
>
>
> 1: Pharmacoepidemiol Drug Saf. 2009 Feb;18(2):132-9.Click here to read Links
> Trends and changes in the clinical use of lamotrigine.
> Reimers A.
>
> Department of Clinical Pharmacology, St. Olavs University Hospital, Trondheim, Norway. arne.reimers@legemidler.no
>
> PURPOSE: To investigate long-term trends and changes in the pattern of use of lamotrigine (LTG). METHODS: Retrospective survey of a large, routine therapeutic drug monitoring database. RESULTS: Twelve thousand one hundred and seven samples from 4123 subjects were analysed from October 1999 to May 2007. Within this period, the mean daily dose rose from 183 to 253 mg, whereas the median dose remained unchanged at 200 mg. Females became the majority of LTG users, and they had a higher proportion of psychiatric diagnoses than male patients. The mean patient age increased from 34 to 41 years. The proportion of samples from psychiatric patients became larger than that of neurologic patients. A total of 130 different diagnoses were stated, most of them psychiatric off-label. The mean serum concentration was 3.8 mg/L and it remained quite stable during the whole observation period. Neurologic patients had a higher mean serum concentration than psychiatric patients. 30% of the neurologic and 41% of the psychiatric patients had serum concentrations below the reference range. Sixty-eight per cent of the patients used additional drugs. Females used a higher number of additional medications than males. The 10 most frequent co-medications consisted of seven psychotropic drugs, two anticonvulsants, and thyroxine. CONCLUSIONS: Significant changes in the pattern of use of LTG have taken place during the observation period and some significant trends could be identified.
Posted by SLS on February 23, 2009, at 20:30:36
In reply to Re: Lamictal optimal dosage, posted by n_wolfie on February 23, 2009, at 20:00:23
Try not to worry. You are going to need patience on this one. You have quite a way to go to reduce your dosage of Lamictal down to 200mg.
You must expect that during these dosage-reduction induced depressive dips, you are going to manifest all of the symptoms of your depression, including depressive cognitive impairments. So now you got two things working against you: depressive cognitive impairments plus high dosage Lamictal cognitive side effects. Give yourself one or two days for your system to stabilize. You should find that your mood stabilizes and your head clears a little - but not a lot. You're still taking a lot of Lamictal.
How much did you decrease the dosage of Lamictal by?
- Scott
Posted by n_wolfie on February 23, 2009, at 20:57:49
In reply to Re: Lamictal optimal dosage » n_wolfie, posted by SLS on February 23, 2009, at 20:30:36
only by 100, my doctor doesn't want to change too much too quickly until the nardil has time to take full effect, and the Lamictal had worked better than any med I had ever taken, I processed things at the speed of light. My memory is bad right now, but I might remember the Nardil impairing it a year ago before it kicked in. Thing I don't understand is the the increased dosage of lamictal always improved my mental clarity in the past. Is there a window where it improves memory and after that point it hampers it? It's so hard because the Nardil takes 4 weeks, so I have to wait four weeks for every 15 mg increase. My doctor doesn't want to up it too fast because on 75 last time it made me too hyper, increased my mood reactivity, so we're trying to keep the dosage at the minimum level necessary. This is driving me nuts, it's taking me forever to even put a sentence together, they're long and awkward, and I have to think for 30 seconds about how to spell a word, and I typically write at the speed of light and am a spelling whiz. Even when I've been depressed I've still been able to write fluently, which is odd. This is what is scaring me the most. I've never had writing problems. Could this just be a temporary lamictal withdrawal symptom? Wait, this just happened today, with the writing problems. i ran out of trazadone last night and took 2 benadryl to fall asleep, could that have something to do with it? I've done that before and it's given me a horrible hangover, but I can't remember how long the hangover lasted.
> Try not to worry. You are going to need patience on this one. You have quite a way to go to reduce your dosage of Lamictal down to 200mg.
>
> You must expect that during these dosage-reduction induced depressive dips, you are going to manifest all of the symptoms of your depression, including depressive cognitive impairments. So now you got two things working against you: depressive cognitive impairments plus high dosage Lamictal cognitive side effects. Give yourself one or two days for your system to stabilize. You should find that your mood stabilizes and your head clears a little - but not a lot. You're still taking a lot of Lamictal.
>
> How much did you decrease the dosage of Lamictal by?
>
>
> - Scott
Posted by SLS on February 23, 2009, at 21:15:09
In reply to Re: Lamictal optimal dosage, posted by n_wolfie on February 23, 2009, at 20:57:49
Reducing the Lamictal by 100mg is a big jump. I would expect that you would experience a transient rebound depressive dip as a result. There is nothing happening to you that hasn't happened to me with these two drugs.
What was the first dosage of Lamictal that produced an improvement?
What dosage of Lamictal produced the most improvement, and how long did the improvement last for?
How much improvement did you experience from increasing the dosage of Lamictal from 400mg to 500mg? How long did it last for?
- Scott
Posted by n_wolfie on February 23, 2009, at 21:24:36
In reply to Re: Lamictal optimal dosage » n_wolfie, posted by SLS on February 23, 2009, at 21:15:09
I started taking it in March, slowly increased it to 300, it kicked in in earnest in early june. it worked well for several mos, but I did have a few "temper tantrums" ie mood reactivity, so we upped it to 400 that lasted about a month. Then went through extreme stress upped it to 500. I can't remember right now exactly when i upped it but I know that each time i did the results were great, but didn't last as long. I don't know, maybe I was at 200 in early june when it worked well? My memory is really failing me right now. I'd like to up it to 600, and I think if I did it would make a difference, but my doctor won't let me. This is very frustrating, I'm having trouble just writing this post. it's odd, even when my short term memory has been nonexistent over the last few days i've never had writing or word retrieval issues. Even the depression didn't create these symptoms, so I don't know what is causing this writing problem, it's scaring me. If it's the reduction of the lamictal then I'll have to up it again and that might completely destroy my short term memory. It's a tiny better today, but only marginally so.
> Reducing the Lamictal by 100mg is a big jump. I would expect that you would experience a transient rebound depressive dip as a result. There is nothing happening to you that hasn't happened to me with these two drugs.
>
> What was the first dosage of Lamictal that produced an improvement?
>
> What dosage of Lamictal produced the most improvement, and how long did the improvement last for?
>
> How much improvement did you experience from increasing the dosage of Lamictal from 400mg to 500mg? How long did it last for?
>
>
> - Scott
>
>
Posted by n_wolfie on February 23, 2009, at 21:25:36
In reply to Re: Lamictal optimal dosage » n_wolfie, posted by SLS on February 23, 2009, at 21:15:09
wait so what exactly are you taking? yes, I guess it's a big jump, since the 100 mg jump has produced pretty drastic improvements in the past.
> Reducing the Lamictal by 100mg is a big jump. I would expect that you would experience a transient rebound depressive dip as a result. There is nothing happening to you that hasn't happened to me with these two drugs.
>
> What was the first dosage of Lamictal that produced an improvement?
>
> What dosage of Lamictal produced the most improvement, and how long did the improvement last for?
>
> How much improvement did you experience from increasing the dosage of Lamictal from 400mg to 500mg? How long did it last for?
>
>
> - Scott
>
>
Posted by n_wolfie on February 23, 2009, at 21:27:13
In reply to Re: Lamictal optimal dosage » n_wolfie, posted by SLS on February 23, 2009, at 21:15:09
the depression is definitely coming back. I can't take pleasure in anything- I can barely get off my couch. I don't even want to eat. I didn't feel this way a few days ago. My mood was good, it was just my short term memory that had disappeared.
Posted by SLS on February 23, 2009, at 21:40:52
In reply to Re: Lamictal optimal dosage, posted by n_wolfie on February 23, 2009, at 21:27:13
> the depression is definitely coming back. I can't take pleasure in anything- I can barely get off my couch. I don't even want to eat. I didn't feel this way a few days ago. My mood was good, it was just my short term memory that had disappeared.
Trust me. Don't panic and go reaching for that Lamictal bottle!
You will feel better VERY shortly.
You answered all of your own questions by answering mine.
Yes, with Lamictal monotherapy, one is always chasing the antidepressant response. Many people get a nice kick between 50-100mg. Then it disappears. Next, 150mg. Then, 200mg. Then, 300mg. Etc. Your experience with Lamictal is classic. The higher you go, the worse the memory impairments become. 450mg really screwed me up. I couldn't remember how to drive from one place to another. I would forget familiar roads and get lost.
Perhaps you can reduce Lamictal by 50mg every 3-5 days. You will eventually find the right dosage to be between 150-250mg. That's my best guess, anyway.
- Scott
Posted by n_wolfie on February 24, 2009, at 15:52:47
In reply to Re: Lamictal optimal dosage » n_wolfie, posted by SLS on February 23, 2009, at 20:30:36
Hi Scott, my memory has improved vastly. It's not great, and I have some lingering depression, but it's not nearly as bad as it's been for the last 3 days, when I couldn't even leave the house, it was very scary, even though my mood was better for the first two days off of it, except yesterday. My writing still isn't as great/creative as it was on the Lamictal, (writing was only bad yesterday.) I guess it's a trade off between my memory, my creativity, and my mood, but now neither are that great. I'm hoping the nardil takes care of the lingering depression, but I'm 2 weeks in, and I'm not feeling much yet.
> Try not to worry. You are going to need patience on this one. You have quite a way to go to reduce your dosage of Lamictal down to 200mg.
>
> You must expect that during these dosage-reduction induced depressive dips, you are going to manifest all of the symptoms of your depression, including depressive cognitive impairments. So now you got two things working against you: depressive cognitive impairments plus high dosage Lamictal cognitive side effects. Give yourself one or two days for your system to stabilize. You should find that your mood stabilizes and your head clears a little - but not a lot. You're still taking a lot of Lamictal.
>
> How much did you decrease the dosage of Lamictal by?
>
>
> - Scott
Posted by n_wolfie on February 24, 2009, at 15:57:55
In reply to Re: Lamictal optimal dosage » n_wolfie, posted by SLS on February 23, 2009, at 21:15:09
But I still slept all day, and memory still pretty bad, am thinking these are depression symptoms? Is it possible that the Lamictal is not doing anything at all anymore, and I'll have to up the Nardil to my previous levels? Well, maybe the Lamictal will control the mood swings.
> Reducing the Lamictal by 100mg is a big jump. I would expect that you would experience a transient rebound depressive dip as a result. There is nothing happening to you that hasn't happened to me with these two drugs.
>
> What was the first dosage of Lamictal that produced an improvement?
>
> What dosage of Lamictal produced the most improvement, and how long did the improvement last for?
>
> How much improvement did you experience from increasing the dosage of Lamictal from 400mg to 500mg? How long did it last for?
>
>
> - Scott
>
>
Posted by n_wolfie on February 25, 2009, at 12:00:37
In reply to Re: Lamictal optimal dosage » n_wolfie, posted by SLS on February 23, 2009, at 21:40:52
Scott, I am feeling a tiny less spacy, but it's still pretty bad. Now I'm also completely and totally exhausted, I have to nap about an hour after I wake in the morning. Is that a Nardil side effect or the Lamictal withdrawal? I'm as dysfunctional as I was when I was severely depressed because I can't stay awake.
> > the depression is definitely coming back. I can't take pleasure in anything- I can barely get off my couch. I don't even want to eat. I didn't feel this way a few days ago. My mood was good, it was just my short term memory that had disappeared.
>
> Trust me. Don't panic and go reaching for that Lamictal bottle!
>
> You will feel better VERY shortly.
>
> You answered all of your own questions by answering mine.
>
> Yes, with Lamictal monotherapy, one is always chasing the antidepressant response. Many people get a nice kick between 50-100mg. Then it disappears. Next, 150mg. Then, 200mg. Then, 300mg. Etc. Your experience with Lamictal is classic. The higher you go, the worse the memory impairments become. 450mg really screwed me up. I couldn't remember how to drive from one place to another. I would forget familiar roads and get lost.
>
> Perhaps you can reduce Lamictal by 50mg every 3-5 days. You will eventually find the right dosage to be between 150-250mg. That's my best guess, anyway.
>
>
> - Scott
Posted by dcruik518 on February 25, 2009, at 18:50:03
In reply to Re: Lamictal optimal dosage, posted by n_wolfie on February 25, 2009, at 12:00:37
I'd guess that you need to get your Nardil up to 75 or 90mg to get a therapeutic response. When it works, it works a little bit like stimulant, so it shouldn't make you sleepy; that's an early side effect that always goes away in my experience. The nardil should also help with your cognitive function in general, making you more alert but less anxious.
I agree with Scott that lowering the lamictal makes the most sense but you should do it very gradually. Another thing to remember is that your subjective sense of your memory abilitiy is not always accurate. It would be much better if you could find some way to test yourself objectively on a regular basis. I use a program called Brain Builder for this on occasion. Good luck.
Posted by n_wolfie on February 26, 2009, at 0:57:02
In reply to Re: Lamictal optimal dosage, posted by dcruik518 on February 25, 2009, at 18:50:03
It's so confusing, I don't know if I'm dumb from the depression because of the reduced lamictal, I reduced it by 100 about last thursday, and now I feel more depressed. Or I don't know if I'm dumb from Nardil side effects. I went from 15mg to 30 mg around Feb 6th, and nothing has happened except dry mouth and exhaustion. You're right, I'm so spaced that I can't imagine ever feeling dumber, but it's possible that it was worse a few days ago. I'll try the brain builder. My dr. wants me to keep a mood log, but I keep forgetting to do it.
> I'd guess that you need to get your Nardil up to 75 or 90mg to get a therapeutic response. When it works, it works a little bit like stimulant, so it shouldn't make you sleepy; that's an early side effect that always goes away in my experience. The nardil should also help with your cognitive function in general, making you more alert but less anxious.
>
> I agree with Scott that lowering the lamictal makes the most sense but you should do it very gradually. Another thing to remember is that your subjective sense of your memory abilitiy is not always accurate. It would be much better if you could find some way to test yourself objectively on a regular basis. I use a program called Brain Builder for this on occasion. Good luck.
Posted by dcruik518 on February 27, 2009, at 12:12:13
In reply to Re: Lamictal optimal dosage, posted by n_wolfie on February 26, 2009, at 0:57:02
The Nardil is not making you dumb. Read below.
Department of Psychobiology, University of Valencia, Blasco Ibáñez, 21, E-46010 Valencia, Spain. santiago.monleon@uv.es <santiago.monleon@uv.es>
This is a selective review of the literature concerning the effects of antidepressant drugs on animal memory, which was performed with the aid of the PubMed database. Monoamine oxidase inhibitors tend to either have no effect on memory or result in its improvement. Studies with cyclic antidepressants have reported no effect or, more often, memory impairments. Pre-training administration of selective serotonin reuptake inhibitors (SSRIs) has been shown to have either no effect on memory or undermine it (with some isolated exceptions, in which improvements have been recorded), while post-training administration of SSRIs has been demonstrated to improve memory or have no effect. A small group formed by the remaining antidepressants has been shown to improve memory, with the exception of trazodone, which impairs memory. These findings are discussed in the light of knowledge regarding the actions of antidepressants on several neurotransmission systems. The possibility that the effects of antidepressants on memory are the core of the therapeutic effects of these drugs is also considered.
PMID: 17761406 [PubMed - indexed for MEDLINE]
Posted by myco on February 27, 2009, at 12:47:42
In reply to Re: Lamictal optimal dosage » n_wolfie, posted by dcruik518 on February 27, 2009, at 12:12:13
My early side effects and those experienced when upping each dose of nardil resulted in memory issues, some cognitive impairment (such as slower ability to articulate words), reading impairment (even worse than before)...but that cleared in a short time and memory, cognition and reading/focus became very good.
myco
> The Nardil is not making you dumb. Read below.
>
> Department of Psychobiology, University of Valencia, Blasco Ibáñez, 21, E-46010 Valencia, Spain. santiago.monleon@uv.es <santiago.monleon@uv.es>
>
> This is a selective review of the literature concerning the effects of antidepressant drugs on animal memory, which was performed with the aid of the PubMed database. Monoamine oxidase inhibitors tend to either have no effect on memory or result in its improvement. Studies with cyclic antidepressants have reported no effect or, more often, memory impairments. Pre-training administration of selective serotonin reuptake inhibitors (SSRIs) has been shown to have either no effect on memory or undermine it (with some isolated exceptions, in which improvements have been recorded), while post-training administration of SSRIs has been demonstrated to improve memory or have no effect. A small group formed by the remaining antidepressants has been shown to improve memory, with the exception of trazodone, which impairs memory. These findings are discussed in the light of knowledge regarding the actions of antidepressants on several neurotransmission systems. The possibility that the effects of antidepressants on memory are the core of the therapeutic effects of these drugs is also considered.
>
> PMID: 17761406 [PubMed - indexed for MEDLINE]
>
>
Posted by n_wolfie on February 27, 2009, at 16:51:59
In reply to Re: Lamictal optimal dosage » n_wolfie, posted by dcruik518 on February 27, 2009, at 12:12:13
Thank you so much!! At least now I can eliminate one variable. Memory is very very slowly improving, (but still not functional) don't know if because of lamictal reduction or nardil helping my depression. The waiting is torture...every time i up the nardil i have to go through another round of side effects. 2 mos so far. And my doc will likely up it again. another mo of side effects. And reducing the Lamictal gives me a miserable week of rebound depression. And I'm so, so tired and unmotivated, but I don't know if that's Nardil or depression either. It's so hard, this is time that I can never get back, that just passes me by while i sit in bed.
> The Nardil is not making you dumb. Read below.
>
> Department of Psychobiology, University of Valencia, Blasco Ibáñez, 21, E-46010 Valencia, Spain. santiago.monleon@uv.es <santiago.monleon@uv.es>
>
> This is a selective review of the literature concerning the effects of antidepressant drugs on animal memory, which was performed with the aid of the PubMed database. Monoamine oxidase inhibitors tend to either have no effect on memory or result in its improvement. Studies with cyclic antidepressants have reported no effect or, more often, memory impairments. Pre-training administration of selective serotonin reuptake inhibitors (SSRIs) has been shown to have either no effect on memory or undermine it (with some isolated exceptions, in which improvements have been recorded), while post-training administration of SSRIs has been demonstrated to improve memory or have no effect. A small group formed by the remaining antidepressants has been shown to improve memory, with the exception of trazodone, which impairs memory. These findings are discussed in the light of knowledge regarding the actions of antidepressants on several neurotransmission systems. The possibility that the effects of antidepressants on memory are the core of the therapeutic effects of these drugs is also considered.
>
> PMID: 17761406 [PubMed - indexed for MEDLINE]
>
>
Posted by detroitpistons on February 28, 2009, at 12:29:52
In reply to Re: Lamictal optimal dosage, posted by n_wolfie on February 27, 2009, at 16:51:59
FYI...On 200mg of Lamictal, my memory was screwed up enough that people at work noticed, and it was embarassing. I went down to 100mg, and the situation improved a lot.
> Thank you so much!! At least now I can eliminate one variable. Memory is very very slowly improving, (but still not functional) don't know if because of lamictal reduction or nardil helping my depression. The waiting is torture...every time i up the nardil i have to go through another round of side effects. 2 mos so far. And my doc will likely up it again. another mo of side effects. And reducing the Lamictal gives me a miserable week of rebound depression. And I'm so, so tired and unmotivated, but I don't know if that's Nardil or depression either. It's so hard, this is time that I can never get back, that just passes me by while i sit in bed.
>
> > The Nardil is not making you dumb. Read below.
> >
> > Department of Psychobiology, University of Valencia, Blasco Ibáñez, 21, E-46010 Valencia, Spain. santiago.monleon@uv.es <santiago.monleon@uv.es>
> >
> > This is a selective review of the literature concerning the effects of antidepressant drugs on animal memory, which was performed with the aid of the PubMed database. Monoamine oxidase inhibitors tend to either have no effect on memory or result in its improvement. Studies with cyclic antidepressants have reported no effect or, more often, memory impairments. Pre-training administration of selective serotonin reuptake inhibitors (SSRIs) has been shown to have either no effect on memory or undermine it (with some isolated exceptions, in which improvements have been recorded), while post-training administration of SSRIs has been demonstrated to improve memory or have no effect. A small group formed by the remaining antidepressants has been shown to improve memory, with the exception of trazodone, which impairs memory. These findings are discussed in the light of knowledge regarding the actions of antidepressants on several neurotransmission systems. The possibility that the effects of antidepressants on memory are the core of the therapeutic effects of these drugs is also considered.
> >
> > PMID: 17761406 [PubMed - indexed for MEDLINE]
> >
> >
>
>
Posted by n_wolfie on February 28, 2009, at 18:35:42
In reply to Re: Lamictal optimal dosage » n_wolfie, posted by detroitpistons on February 28, 2009, at 12:29:52
But now my mood has worsened, my short term memory is bit better, but I cannot retrieve words or write fluently, at all. Which is a HUGE problem. I'm confused, maybe it was the Nardil side effects doing that? I feel like I have to trade between my writing skills and my mood. Even when my memory was so bad that everyone noticed, I could still take pleasure in things and get out of bed, and now I can't. Lowering the lamictal 100 mg to 400 mg has definitely made me more depressed and more sensitive to criticism, weepy etc. I feel like I just can't win with medications. At one point i was on 30 mg of Nardil and 300 of lamictal, and was clear headed and free of depression, and I know now that if i lower the lamictal another 100 i'm going to be even more depressed. Why doesn't the old combo work? I'm seeing my doctor in 2 days, i suspect that he will up the nardil, am I going to go through side effects all over again now that i'm through with them from the 30 mg dosage? Will the Nardil increase help my writing skills/word retrieval?
> FYI...On 200mg of Lamictal, my memory was screwed up enough that people at work noticed, and it was embarassing. I went down to 100mg, and the situation improved a lot.
>
>
>
> > Thank you so much!! At least now I can eliminate one variable. Memory is very very slowly improving, (but still not functional) don't know if because of lamictal reduction or nardil helping my depression. The waiting is torture...every time i up the nardil i have to go through another round of side effects. 2 mos so far. And my doc will likely up it again. another mo of side effects. And reducing the Lamictal gives me a miserable week of rebound depression. And I'm so, so tired and unmotivated, but I don't know if that's Nardil or depression either. It's so hard, this is time that I can never get back, that just passes me by while i sit in bed.
> >
> > > The Nardil is not making you dumb. Read below.
> > >
> > > Department of Psychobiology, University of Valencia, Blasco Ibáñez, 21, E-46010 Valencia, Spain. santiago.monleon@uv.es <santiago.monleon@uv.es>
> > >
> > > This is a selective review of the literature concerning the effects of antidepressant drugs on animal memory, which was performed with the aid of the PubMed database. Monoamine oxidase inhibitors tend to either have no effect on memory or result in its improvement. Studies with cyclic antidepressants have reported no effect or, more often, memory impairments. Pre-training administration of selective serotonin reuptake inhibitors (SSRIs) has been shown to have either no effect on memory or undermine it (with some isolated exceptions, in which improvements have been recorded), while post-training administration of SSRIs has been demonstrated to improve memory or have no effect. A small group formed by the remaining antidepressants has been shown to improve memory, with the exception of trazodone, which impairs memory. These findings are discussed in the light of knowledge regarding the actions of antidepressants on several neurotransmission systems. The possibility that the effects of antidepressants on memory are the core of the therapeutic effects of these drugs is also considered.
> > >
> > > PMID: 17761406 [PubMed - indexed for MEDLINE]
> > >
> > >
> >
> >
>
>
Posted by detroitpistons on February 28, 2009, at 18:48:57
In reply to Re: Lamictal optimal dosage, posted by n_wolfie on February 28, 2009, at 18:35:42
I feel for you. You are in a tough situation. If the Lamictal isn't preventing the depression anymore, but it is still causing you cognitive impairment, then....Well, if I were in your shoes, I would consider making a change, even though you're going to have to go through new side effects all over again. I know it sucks, but right now you're not getting any benefit at all. Of course, you need to rule out if there's anything else causing this to happen. Hopefully, you're doctor will have a good solution when you see him in 2 days.
Scott knows more about this than I do, but it seems like 400 mg of Lamictal is more like an epilepsy dose. I'm pretty sure that I read somewhere that, above 200mg, there was no increased therapeutic benefit for depression. This causes me to question whether the Lamictal is the real culprit here.
> But now my mood has worsened, my short term memory is bit better, but I cannot retrieve words or write fluently, at all. Which is a HUGE problem. I'm confused, maybe it was the Nardil side effects doing that? I feel like I have to trade between my writing skills and my mood. Even when my memory was so bad that everyone noticed, I could still take pleasure in things and get out of bed, and now I can't. Lowering the lamictal 100 mg to 400 mg has definitely made me more depressed and more sensitive to criticism, weepy etc. I feel like I just can't win with medications. At one point i was on 30 mg of Nardil and 300 of lamictal, and was clear headed and free of depression, and I know now that if i lower the lamictal another 100 i'm going to be even more depressed. Why doesn't the old combo work? I'm seeing my doctor in 2 days, i suspect that he will up the nardil, am I going to go through side effects all over again now that i'm through with them from the 30 mg dosage? Will the Nardil increase help my writing skills/word retrieval?
>
> > FYI...On 200mg of Lamictal, my memory was screwed up enough that people at work noticed, and it was embarassing. I went down to 100mg, and the situation improved a lot.
> >
> >
> >
> > > Thank you so much!! At least now I can eliminate one variable. Memory is very very slowly improving, (but still not functional) don't know if because of lamictal reduction or nardil helping my depression. The waiting is torture...every time i up the nardil i have to go through another round of side effects. 2 mos so far. And my doc will likely up it again. another mo of side effects. And reducing the Lamictal gives me a miserable week of rebound depression. And I'm so, so tired and unmotivated, but I don't know if that's Nardil or depression either. It's so hard, this is time that I can never get back, that just passes me by while i sit in bed.
> > >
> > > > The Nardil is not making you dumb. Read below.
> > > >
> > > > Department of Psychobiology, University of Valencia, Blasco Ibáñez, 21, E-46010 Valencia, Spain. santiago.monleon@uv.es <santiago.monleon@uv.es>
> > > >
> > > > This is a selective review of the literature concerning the effects of antidepressant drugs on animal memory, which was performed with the aid of the PubMed database. Monoamine oxidase inhibitors tend to either have no effect on memory or result in its improvement. Studies with cyclic antidepressants have reported no effect or, more often, memory impairments. Pre-training administration of selective serotonin reuptake inhibitors (SSRIs) has been shown to have either no effect on memory or undermine it (with some isolated exceptions, in which improvements have been recorded), while post-training administration of SSRIs has been demonstrated to improve memory or have no effect. A small group formed by the remaining antidepressants has been shown to improve memory, with the exception of trazodone, which impairs memory. These findings are discussed in the light of knowledge regarding the actions of antidepressants on several neurotransmission systems. The possibility that the effects of antidepressants on memory are the core of the therapeutic effects of these drugs is also considered.
> > > >
> > > > PMID: 17761406 [PubMed - indexed for MEDLINE]
> > > >
> > > >
> > >
> > >
> >
> >
>
>
Posted by n_wolfie on February 28, 2009, at 19:13:14
In reply to Re: Lamictal optimal dosage, posted by detroitpistons on February 28, 2009, at 18:48:57
I know how confusing that was,so ask any questions if you need me to clarify., i'm disoriented and can't organize my thoughts (but my short term memory, remembering what i just read, losing keys etc is better, seems like there are two kinds of stupidity i'm dealing with). I'm atypical, so the depression gets worse as the day goes on, so i'm particularly out of it and dumb right now. having trouble getting out of bed. but with the atypical, human contact really helps a lot, talking on the phone, even seeing a movie and people on screen, helps, but it's almost impossible to force myself out of bed to do it, even though i know i have to. i can barely even take a shower. it's so hard, to know that i can make it even slightly better, but the depression prevents me from doing it, so i wind up isolating myself and feeling even worse!! plus i'm self conscious about the depressin and feel like everyone can tell, so i don't want to be around people, even though it helps the depression, so nobody really notices! It's like the illness begets the illness. I'm not sure that even made sense. and if someone came here and wanted to go with me, i could totally go.ok, i'm gig to force myself to take a shower, at the least.
> I feel for you. You are in a tough situation. If the Lamictal isn't preventing the depression anymore, but it is still causing you cognitive impairment, then....Well, if I were in your shoes, I would consider making a change, even though you're going to have to go through new side effects all over again. I know it sucks, but right now you're not getting any benefit at all. Of course, you need to rule out if there's anything else causing this to happen. Hopefully, you're doctor will have a good solution when you see him in 2 days.
>
> Scott knows more about this than I do, but it seems like 400 mg of Lamictal is more like an epilepsy dose. I'm pretty sure that I read somewhere that, above 200mg, there was no increased therapeutic benefit for depression. This causes me to question whether the Lamictal is the real culprit here.
>
>
>
> > But now my mood has worsened, my short term memory is bit better, but I cannot retrieve words or write fluently, at all. Which is a HUGE problem. I'm confused, maybe it was the Nardil side effects doing that? I feel like I have to trade between my writing skills and my mood. Even when my memory was so bad that everyone noticed, I could still take pleasure in things and get out of bed, and now I can't. Lowering the lamictal 100 mg to 400 mg has definitely made me more depressed and more sensitive to criticism, weepy etc. I feel like I just can't win with medications. At one point i was on 30 mg of Nardil and 300 of lamictal, and was clear headed and free of depression, and I know now that if i lower the lamictal another 100 i'm going to be even more depressed. Why doesn't the old combo work? I'm seeing my doctor in 2 days, i suspect that he will up the nardil, am I going to go through side effects all over again now that i'm through with them from the 30 mg dosage? Will the Nardil increase help my writing skills/word retrieval?
> >
> > > FYI...On 200mg of Lamictal, my memory was screwed up enough that people at work noticed, and it was embarassing. I went down to 100mg, and the situation improved a lot.
> > >
> > >
> > >
> > > > Thank you so much!! At least now I can eliminate one variable. Memory is very very slowly improving, (but still not functional) don't know if because of lamictal reduction or nardil helping my depression. The waiting is torture...every time i up the nardil i have to go through another round of side effects. 2 mos so far. And my doc will likely up it again. another mo of side effects. And reducing the Lamictal gives me a miserable week of rebound depression. And I'm so, so tired and unmotivated, but I don't know if that's Nardil or depression either. It's so hard, this is time that I can never get back, that just passes me by while i sit in bed.
> > > >
> > > > > The Nardil is not making you dumb. Read below.
> > > > >
> > > > > Department of Psychobiology, University of Valencia, Blasco Ibáñez, 21, E-46010 Valencia, Spain. santiago.monleon@uv.es <santiago.monleon@uv.es>
> > > > >
> > > > > This is a selective review of the literature concerning the effects of antidepressant drugs on animal memory, which was performed with the aid of the PubMed database. Monoamine oxidase inhibitors tend to either have no effect on memory or result in its improvement. Studies with cyclic antidepressants have reported no effect or, more often, memory impairments. Pre-training administration of selective serotonin reuptake inhibitors (SSRIs) has been shown to have either no effect on memory or undermine it (with some isolated exceptions, in which improvements have been recorded), while post-training administration of SSRIs has been demonstrated to improve memory or have no effect. A small group formed by the remaining antidepressants has been shown to improve memory, with the exception of trazodone, which impairs memory. These findings are discussed in the light of knowledge regarding the actions of antidepressants on several neurotransmission systems. The possibility that the effects of antidepressants on memory are the core of the therapeutic effects of these drugs is also considered.
> > > > >
> > > > > PMID: 17761406 [PubMed - indexed for MEDLINE]
> > > > >
> > > > >
> > > >
> > > >
> > >
> > >
> >
> >
>
>
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Psycho-Babble Medication | Extras | FAQ
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