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Originally Posted by bioChE
You mentioned the kindling effect of the SSRI. I was misdiagnosed as MDD for years, and was on most of the SSRIs/SNRIs at one point or another. They helped with the depression, but didn't do a thing for the manic side of things. I don't know whether or not I experienced kindling, but after about a decade of antidepressants I was diagnosed BP.
The BP diagnosis has been both a blessing and a curse. I never wanted the diagnosis or the stigma that goes along with it, but it helps to at least know what's going on and to have a path for treatment. After years of med trials, living in different places and having different doctors, I was finally put on the combination of Depakote, Latuda, and Lamictal. We tried Depakote monotherapy and that quieted the mania, but it didn't do a thing for the depression. When Latuda and Lamictal were added, I pulled out of the depression within days. They're kind of my "savior" meds. Eventually I started to have liver problems and the Depakote was removed, but staying on the Latuda and Lamictal have been enough to keep me stable. I hope it remains that way.
Best of luck on your journey. You're right that the Lamictal titration takes time to reach a therapeutic dose - I hope it does well for you. Thanks for your detailed introduction, it's good to know people's background and experiences leading to the present state of affairs. Like you, I'm "high-functioning" and don't want to lose that edge as time goes on and meds change.
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Thank you so much for your response. Lamictal seems okay so far. I've gone into a rather dark phase though perhaps from being used to 10 mg of Lexapro for a decade and now being on only 5. I can recognize the similarity to the period when I first went off of Nortriptyline. It's hard to say whether any kindling occurred. I slept better and would usually go into alive feeling moods after I had my second meal of the day. I drank coffee around the clock and still do though I've scaled back a bit in the evenings. Sometimes dark thoughts or feelings would be present but they were so easy to ignore by just focusing on something else, and I was often engaged, involved, happy, interested.
I feel half-alive and half-present on half of my ordinary Lexapro dose. I rarely fall asleep when I try to nap. I was taking 0.25 mg of Ativan to sleep for 2-3 weeks and have been off of it for 2 nights in a row so perhaps I'll feel a bit more normal soon.