[irishgirl4]

I have been diagnosed since November. Prior to my diagnosis, I was on the Emsam patch. It is an MAOI. I had tried over twenty antidepressants, ECT treatments, many hospitalizations for anorexia and suicide attempts. For the first time ever, the Emsam patch made me feel whole again. I was doing fabulously. Eventually, i became manic (I was flying high-not sleeping-etc.). Then, the crash came. It was really, really, bad. I was suicidal. I couldn't get out of my ditch. I was then given an ultimatum: partial hospitalization or inpatient. I did the partial program. They tried different mood stabilizers, however, Lamictal worked best. I was told that if I get "balanced" on the Lamictal, I could eventually take the Emsam again. I went into my Pdoc's office last week. I told him that I feel balanced, but depressed. I urged him to put me on the Emsam. Instead, he encouraged me to take 400 mg of the Lamictal-that it would help with the depression.

Here's my question: many of you seem to take the stabilizers, but also antidepressants. Isn't that common? Do you think upping the Lamictal seems crazy? Keep in mind that the MAOI class was the only class that worked for my depression.

[missmoonshine]

I have been on venlafaxine since the beginning and am still on it. I believe it has never really helped me. I was put on lamotrigine which has worked wonders I am on 300mgs a day its the only drug I found that has really worked.
Despite some unfortunate blood abnormalities I have chosen to continue on it as it has given me my life back. The good thing with lamotrigine is that it has got very good anti-depressant properties compared to some other mood stabilisers. If I ever need to i ncrease the dose then I would go for it.

[SunnyD]

I was originally on Lithium and antidepressants when I was first dx. I had a crisis with the Lithium and had to discontinue it. Fortunately Lamictal was approved as a mood stabilizer for bipolar people about this time.
I was still on antidepressants but my doctor thought they were destabilizing me and took me off of them. She said that bipolar people sometimes did better without antidepressants.
So I am on a very low dose of Lamictal 150mg which was reduced from 300 mg. I get double vision as a side effect and take it at night. I am stabilized enough to manage my symptoms and have a good quality of life right now.
If you are not experiencing any side effects currently and your pdoc thinks that an increase would help I think you might consider it.

[Tsunamisurfer]

Originally Posted by irishgirl4

I told him that I feel balanced, but depressed. I urged him to put me on the Emsam. Instead, he encouraged me to take 400 mg of the Lamictal-that it would help with the depression.

Here's my question: many of you seem to take the stabilizers, but also antidepressants. Isn't that common? Do you think upping the Lamictal seems crazy? Keep in mind that the MAOI class was the only class that worked for my depression.

Bipolar disorder is characteristically a cyclical condition. The trouble with treating the depression part with antidepressants is that it pushes you in one direction - towards agitation and mania. Your doctor's plan of increasing the lamotrigine aims to avoid the destabilising risks of antidepressants, while improving stability in both directions. Its a complex problem with no simple solutions for most of us.

I'm off ADDs altogether and use stabilisers alone because I cycle so frequently (weekly).

I hope it works for you.

[lotusflames]

i'm quite sensitive to anti-depressants. i've tgried many and ended up worse on them. however, i take one now with lithium and seroquel cos i can't manage the depression without it but i end up changing my anti-d quite often

[wing]

I've been on lamictal and abilify since both came out and have been able to stay off antidepressants altogether.

[sugahorse1]

I'm on Lamictin and Wellbutrin currently. Don't think the Lamictin alone helped me, but adding the AD definitely did.
I am BP2 and only get hypomanic, but my depression is the same as you describe- but no more!

[thinker22]

I'm on both Lamictal and Cymbalta. I was on Cymbalta only (with Geodon and others) and did great for about 5 months. Then I started getting depressed again, so the p-doc added Lamictal. My mood improved gradually such that I was hypomanic for about a week. I'm only on 150mg of it. I had a couple of downer days last week, but now I feel good and stable again. So I need both an anti-d and a depression quelling stabilizer.

If I ever turn manic, the first thing they'll probably remove is Cymbalta.

Originally Posted by irishgirl4

...I went into my Pdoc's office last week. I told him that I feel balanced, but depressed. I urged him to put me on the Emsam. Instead, he encouraged me to take 400 mg of the Lamictal-that it would help with the depression.
Here's my question: many of you seem to take the stabilizers, but also antidepressants. Isn't that common? Do you think upping the Lamictal seems crazy? ...

That is exactly what my psych did too. I was originally on 200 mg, with old P-doc. Moved. New one put me up to 300. Then upped it again to 400 mg, both times with the same objective as your P-doc. Like SunnyD (though mine at a higher dose), I got double vision and another problem (can't remember atm...) with that last increase. Splitting it into am and pm doses totally alleviated that. After a fair while, I told her that that particular increase wasn't making any difference and she let me back down to 300 mg.

Yup, it's quite common for people to be on both mood stabilizers and ADs, but it's certainly not universal. Everyone's different (dosage and effectiveness-wise) and of course it's just fine to be on one thing if thats what's working(!) So, no, I don't think it seems crazy to at least try it.

[owllover99]

I don't know - everybody's different. But something that eventually made you manic - I'd try more lamactial. But see your mania is probably not my mania. I went psychotic for 3 weeks and it still scares me though it happened in 1993. Now I take an antidepressant low dose Cymbalta without any side effects. I feel very lucky. Think about it. And google meds do a real through search on psych meds before you commit. Love, Owl.

[richyy68]

Sometimes I don't think meds are the answer but they do help I have been off mine for years because I can't afford them but I know I need something but nothing I can do so I do without they say I make to much money but after rent and the few basics I can pay there's nothing left

[kathleen slattery]

That's an interesting observation Irishgirl. I take depakote as a mood stabilizer, and abilify which is an anti-depressant; but I take that medicine as it is also an anti-psychotic.( I suffered a psychosis in the past). Furthermore, my psychiatrist isn't anxious about the idea of my trying lamictal for whatever reason. He said that he would not consider treating me with that drug unless I was unwell with as much as 30mg of abilify (I now just take 10mg).
So I guess that everyone is unique, and doctors treat patient's differently based on their histories and success rates with various combinations of drugs. I would try what your dr. suggests for a few weeks; and if it doesn't work, then you will know yourself, as you are the consumer of the drugs.

[irishgirl4]

Thanks for your input everyone. I started taking the 400 mg of Lamictal eight days ago, but I became extremely nauseous. I was actually throwing-up and losing weight-which is bad, because of my history of Anorexia. Anyway, I called my pdoc and asked him what I should do. He sent me an email telling me to take 200mg tonight, and 300mg tomorrow. I am so scared that he is going to try to put me on Lithium. He suggested it last week. That drug scares me because of weight gain. I cannot handle weight gain-my eating disordered mind would go crazy. I tried Depakote (even though I know it makes people gain weight), but it gave me a scary rash. I am so frustrated. Does anyone take another mood stabilizer that doesn't cause weight gain? Thanks.

As I understand it, it sounds like your pdoc is saying to split the Lamictal dose half and half into am/pm? At the higher dosage that is exactly what I did and it worked just fine. (It totally overwhelmed me taking it all at once - double vision etc). Sounds like he just suggested this? Give it a chance. It may well work for you. No need to worry about any concerns you have about lithium till you give this change a chance.