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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by tubeman on December 19, 2012, at 18:15:09
I've been in crisis for most of the last five years, and taking 300mg of lamictal, which one doc told me was as high as anyone needed to go. I recent lost my mind, too depressed teo eat or drink and what I call dysphoric mania; in my head I kept not just remembering painfull event but reliving them over and over and having them get more painfull every time. It was so intense I couldn't follow a tv show, so confusing I got lost during the short drive to my therapist, just had to turn around and go home. I took some extra lamictal and called my doc to get it ok'ed, we also raised the lutada, which still seems to have no effect on me. I went up to 400mg faster then the doc said because I was at the end of my endurance, on day six I woke up less depressed and almost all the memories gone from my head. Not much as side effects, for a while I would get dizzy when standing up and have to sit back down. I feel hot and sweaty and I'm missing sleep, When I miss sleep I struggle to keep painfull. thoughts out, if we gradually raise the dose I may have more control.One doc years ago said lamictal would be all I need but he was going to pull me of other meds over night and didn't listen well, so I moved on. My last doc knows a lot and would even write scripts for european meds but stated that all my problems were psycholical.
At this point my response to lamactil pretty much nails down my diagnoses I'd say. I've seen at least docs while on this med and not one of them ever considered raising it, it would have saved me a great deal of pain. I have to see my doc (and thank her) tomorrow and I keep rehearsing what to say in our 15 minute session so that has me thinking about this episode more then I want. The awesome thing is you don't get immune to an anticonvulsant like an antidepressant, and I can get off several meds that I only stayed on out of desperation. Now I'm looking forward and I strongly believe that things will continure working long term, I've been on everything but tandesporine, which is in transit from China, it took a lot of work to obtain it and I was ripped off several times but this company sent me another med a while back so I think they're dependable.
Posted by SLS on December 19, 2012, at 19:42:43
In reply to High dose lamictal, posted by tubeman on December 19, 2012, at 18:15:09
I never thought tandospirone would be sold anywhere.
You might want to take a look at vilazodone (Viibryd). It is marketed in the USA as an antidepressant. Like tandospirone, it acts as a 5-HT1a partial agonist, but adds serotonin reuptake inhibition.
You might want to investigate drugs like Zyprexa, Abilify, and Latuda.
- Scott
Posted by MrAnderson on December 20, 2012, at 15:00:07
In reply to High dose lamictal, posted by tubeman on December 19, 2012, at 18:15:09
I'm taking 650 mg of Lamictal right now for depression so you can definitely go higher. You should definitely try magnesium (citrate, taurine). When I started on the magnesium I was able to stop taking the Parnate I was on, I think it affects glutamate transmission to some extent like Lamictal does.
There are other things to try (Riluzole, N-Acetyl-Cysteine) that work somewhat similar to Lamictal. I don't have much experience with those so I can't say for sure.
Posted by alchemy on December 20, 2012, at 22:12:27
In reply to Re: High dose lamictal, posted by MrAnderson on December 20, 2012, at 15:00:07
> I'm taking 650 mg of Lamictal right now for depression so you can definitely go higher. You should definitely try magnesium (citrate, taurine). When I started on the magnesium I was able to stop taking the Parnate I was on, I think it affects glutamate transmission to some extent like Lamictal does.
>
> There are other things to try (Riluzole, N-Acetyl-Cysteine) that work somewhat similar to Lamictal. I don't have much experience with those so I can't say for sure.I have been on 400mg of lamictal for probably a couple years now. I havent noticed any help for my depression, but i think it has helped with my agitation (although it initially made it worse). What made u increase ur dose to that level? Did u find milder anti-dep effects at a lower dose?
Posted by SLS on December 20, 2012, at 22:56:38
In reply to Re: High dose lamictal » MrAnderson, posted by alchemy on December 20, 2012, at 22:12:27
> I have been on 400mg of lamictal for probably a couple years now. I havent noticed any help for my depression, but i think it has helped with my agitation (although it initially made it worse).
Are you satisfied with your treatment?
Does your agitation include anger outbursts and impulsivity? If so, perhaps Trileptal would be a good drug for you.
> What made u increase ur dose to that level? Did u find milder anti-dep effects at a lower dose?
I don't think that there is a therapeutic window for Lamictal when treating depression. Lower dosages won't produce a stable antidepressant response if higher dosages do not. However, the act of lowering the dose often produces a transient improvement. This phenomenon fools people into thinking that they should continue with lower dosages. Of course, some people will profit from lowering the dose if higher dosages produce cognitive impairments, "brain-fog", or sedation.
- Scott
Posted by MrAnderson on December 22, 2012, at 23:40:12
In reply to Re: High dose lamictal » MrAnderson, posted by alchemy on December 20, 2012, at 22:12:27
> > I'm taking 650 mg of Lamictal right now for depression so you can definitely go higher. You should definitely try magnesium (citrate, taurine). When I started on the magnesium I was able to stop taking the Parnate I was on, I think it affects glutamate transmission to some extent like Lamictal does.
> >
> > There are other things to try (Riluzole, N-Acetyl-Cysteine) that work somewhat similar to Lamictal. I don't have much experience with those so I can't say for sure.
>
> I have been on 400mg of lamictal for probably a couple years now. I havent noticed any help for my depression, but i think it has helped with my agitation (although it initially made it worse). What made u increase ur dose to that level? Did u find milder anti-dep effects at a lower dose?
>
>I was on 300 mg for several years, reduced it to 100 mg for another couple years. I did see an antidepressant effect around 300 mg. But earlier this year I was making a lot of changes with my meds and the Lamictal started pooping out, so I've been raising it every week or two since it keeps pooping out now.
I think that if people don't see a difference at 400-500 mg then going above that for bipolar/depression probably won't make too much of a difference. The only reason that I keep raising it is that it initially worked at a lower dose but stopped working.
This is the end of the thread.
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