I have rapid cycling type 2 bipolar and I take 300mg Lamotrigine in split doses (150mg AM & PM). I am prescribed 325mg but have had to reduce it because of constipation. Overall it has been reasonably successful in ironing mood swings however, it has not been the silver bullet I had hoped for.

However, I have tried to decrease the dose further by 25mgs at a time to low of 250mg (to reduce side effects) but find my mood seems to respond adversely, quite rapidly (within 48hrs). I then increase it back with similar effects in the positive direction with similar short term effect.

Is this a placebo or a real effect & any advice?