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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by MarkCSF on October 8, 2002, at 1:31:50
Hi,
I started on Lamictal about 10 weeks ago.. I worked my way up to 150mg in about 5 weeks or so with no problems or side effects whatsoever and I was actually feeling decently normal. At least not descending downwards.. I moved up to 200mg at the doctors request, he was trying to get me up to 300mg for some reason. Anyway, after a day or two of 200mg I just felt kind of groggy and super irritable. Everything little thing was getting on my nerves, I was snapping at people, didnt have the same feelings toward people that I had just two days before. Sooo, I promptly dropped back down to 150mg as my girlfriend was moving in 2 weeks and I didnt want to me snappy and mad at her the whole time. Well, things were going great on 150mg for another 4 weeks maybe when just out of nowhere this past Monday I woke up and found myself super depressed once again. Granted, my girlfriend did move but decided to move back (weird, I know) so I know it wasnt due to that. It was just like, one day good, next day suicidal thoughts and crying, etc. Anyone have any thoughts on this? Am I getting tolerant to 150 and need to move up again, hopefully without irritability this time? I went to a brand new pdoc as I just moved to Austin and he told me to stay on the 150mg while we added 300mg of Wellbutrin, so have been only doing this for a few days and still do not feel nearly like I did 2 weeks ago.. thanks for the thoughts and what not..!
-Markm
Posted by jrbecker on October 8, 2002, at 14:03:03
In reply to Lamictal and irrratbility at higher doses, posted by MarkCSF on October 8, 2002, at 1:31:50
I am currently on 175 mg of Lam.
I also felt great with early treatment on lamictal but the effect would wane and I would have to chase the mood effects by increasing the dose. however, I found that every time I bumped up to the next dosage level I got at least two to three days of anxiety and irritability before I get the positive benefits of the drug once again. I also sweated a lot during this period and felt very flushed. I also don't think everybody that takes this drug gets this period of anxiety reaction though (at least they're not reporting it). So know you're not alone on this nd this is a somewhat normal reaction. As anyone that has taken it can attest Lamictal = P-A-T-I-E-N-C-E. But it works for those that can stick it out.
I'm assuming that this anxious period can sometimes take a little longer for other people to adapt as well. And more likely, you are probably reaching your ideal dosage window -- closer to 200mg or 300 mg than your current 150 mg though). Ad it's most likely gonna take even more time to even out and know that dose is your ideal window.
Obviously, you should talk this over with your pdoc first, but my inference is that you try to titrate back up to 200 again, but this time more slowly (do you have the 25 mg pills you can cut in half and just increase by 12.5?).
Oh, and as for the Wellbutrin, it made me terribly irritable. I didn't like it at all. And for you to titrate up to 300 mg so quickly, there's gotta be a lot of irritability associated with this as well. I would talk to your pdoc whether this is a necessary augmentation, especially since you were getting such a good response from lamictal alone.
Stick it out and you'll beat this depressive valley you're in. Good luck.
Posted by MarkCSF on October 8, 2002, at 15:22:02
In reply to Re: Lamictal and irrratbility at higher doses, posted by jrbecker on October 8, 2002, at 14:03:03
> I am currently on 175 mg of Lam.
>
> I also felt great with early treatment on lamictal but the effect would wane and I would have to chase the mood effects by increasing the dose. however, I found that every time I bumped up to the next dosage level I got at least two to three days of anxiety and irritability before I get the positive benefits of the drug once again. I also sweated a lot during this period and felt very flushed. I also don't think everybody that takes this drug gets this period of anxiety reaction though (at least they're not reporting it). So know you're not alone on this nd this is a somewhat normal reaction. As anyone that has taken it can attest Lamictal = P-A-T-I-E-N-C-E. But it works for those that can stick it out.
>
> I'm assuming that this anxious period can sometimes take a little longer for other people to adapt as well. And more likely, you are probably reaching your ideal dosage window -- closer to 200mg or 300 mg than your current 150 mg though). Ad it's most likely gonna take even more time to even out and know that dose is your ideal window.
>
> Obviously, you should talk this over with your pdoc first, but my inference is that you try to titrate back up to 200 again, but this time more slowly (do you have the 25 mg pills you can cut in half and just increase by 12.5?).
>
> Oh, and as for the Wellbutrin, it made me terribly irritable. I didn't like it at all. And for you to titrate up to 300 mg so quickly, there's gotta be a lot of irritability associated with this as well. I would talk to your pdoc whether this is a necessary augmentation, especially since you were getting such a good response from lamictal alone.
>
> Stick it out and you'll beat this depressive valley you're in. Good luck.
>
Thanks so much for the reply..! Since you say you had irritability for a few days after moving up, im a little more confident now in doing so, just give it time. As for the Wellbutrin, I dunno. Actually I started on 150mg/day and will move up to 300 in a week. So far it hasnt made me any worse irratbility wise I would say. So, Ill have to see what transpires over the next few weeks until I see my doc again. We were actually debating which one to augment Lamictal with, Wellbutrin or Serzone, cause I have had good responses to both in the past but they made me hypomanic. So we decided on Wellbutrin. Do you think Serzone would have been a better choice? Yeah, that is a thought, not needing an AD in conjunction with the Lamictal. I'll see how it goes for awhile. Anyways, thanks again..-mark
Posted by jrbecker on October 8, 2002, at 19:00:08
In reply to Re: Lamictal jrbecker, posted by MarkCSF on October 8, 2002, at 15:22:02
I can't be a good judge of which is more effective - serzone or wellbutrin. I have had trials with both and disliked them equally. Wellbutrin was better for focus and increased libido if that's any consolation.
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