[Moreta]

Which one would you choose?

I'm on 400 mg of lamictal, and it's really messing with my cognitive functions, but I'm more stable now than I have been in more than a year. It's really messing with my memory too, and I'm having word finding issues. I feel so dumb at times. Like last week I had a phone interview and could barely get out what I wanted to say, and forgot over half the stuff I did at my last job.

I just don't know how much more of this I can take.

[venusss]

Impaired cognitive function would send my moods off the whack............ I value my intelligence greatly and like to come off so to other people.

So no way one should sacrifize that. I mean...... our cognitive function is what makes us human, it is hard to do much when that is impaired.

Sorry to hear about your struggles.

[SunReach]

I would try to find a different kind of balance. And if that wasn't possible, I'd prefer to be less stable and more functional...Because then I could have a better go at keeping myself stable as well.
But it also depends on how badly mood instability affects your cognitive functions.

All in all...I think you should definitely talk to your pdoc about this. You shouldn't have to put up with a side effect that has such an impact on your life.
There must be an alternative, be it a lower dose, or a different drug..

[Beebizzy]

Moreta, I completely understand. I'm on 300mg of Lamictal. At the end of last year I felt totally stupid. I couldn't string a thought or a sentence together, couldn't find my words and couldn't remember anything. It got bad in work - I messed up two major things and generally looked like an idiot in front of my colleagues.

How long have you been at the dose of 400mg?

I've been on 300mg since November or so, and I have to say that I feel things are a bit better now. I say that tentatively because I'm not completely sure - I still have memory issues and finding words issues, but I think overall it's better.

But stable and feeing well otherwise, definitely.

Maybe it's something to do with side-effects at a certain dose, and it passes when you get used to that dose...?

Have you had any other med changes that might have an influence?

I fully understand the frustration of this - I wish I had the solution...

[SunReach]

p.s. I realise how what I said sounds paradoxical, but I mean better cognitive function helps stability at the points where drugs fail. So it shouldn't necessarily be a choice of the one or the other.

[Beebizzy]

Oh and yes, as SunReach says, do tell your pdoc. I told mine and he was rather surprised - he didn't seem to be expecting it as a result of Lamictal, but I've read lots of people on here with the same issues. Anyway, he was going to do some research into it and get back to me. But he didn't and meanwhile I think things are slightly better. Maybe your pdoc would have an idea about all this. Let us know

[Moreta]

I've been on 400 mg since mid November. I was on 400 mg last year for a most of the year, but after not being able to take the cognitive function impairments, I finally got my pdoc's ok to go down to 100 mg, which was more tolerable. This happened around August. Then in September, I went into a depressive episode, and it got so bad I was considering ECT, in November. So, my pdoc ramped up the Lamictal again, since it had worked in the past, and it was ok for a while, but now my cognitive functions are shot again. I'm so ready to just go off Lamictal, but I know that wouldn't be a good idea, b/c I'm a rapid cycler and I don't want to go through that again.

[Resident Bipolar]

I'd go for mood stability to be honest. I remember looking forward to taking my medications at one time just so I can have some peace from complete emotional despair.

As said by others...speak to your pdoc/healthcare provider about this. You may still be stabilized with a lower dose or even a change of medication.

RB

[Rosie23]

I have been like that ever since I started taking this generic lamictal.
I was typing this really long document at work and my boss brought me another project to do first. I closed out of the other document and didn't save it. And I had no memory of even closing out of the document. I have never, ever not saved something.
I have a one cup coffee maker. I made coffee and forgot the cup.
Yup, I feel mostly stupid right now. And the generic is making me super agitated and cranky so every time I do something stupid I have to keep from boiling over.

Not going to say this is why everyone feels this way, but for me it is this version of my meds and it is the opposite of help.

[Trippin2.0]

I would NEVER give up my intelligence/cognitive function. It would flip me off, and then mood stability would be out the window anyway I had severe memory problems and trouble finding words when I was on lithium. I could no longer construct intelligable sentences, and it ticked me off that my English was at the same level as a 13y.o

I'd like to echo that you need to alert your pdoc, and tell him it's unacceptable. You shouldn't have to choose between the 2.

[AniManiac]

Originally Posted by Moreta

I've been on 400 mg since mid November. I was on 400 mg last year for a most of the year, but after not being able to take the cognitive function impairments, I finally got my pdoc's ok to go down to 100 mg, which was more tolerable. This happened around August. Then in September, I went into a depressive episode, and it got so bad I was considering ECT, in November. So, my pdoc ramped up the Lamictal again, since it had worked in the past, and it was ok for a while, but now my cognitive functions are shot again. I'm so ready to just go off Lamictal, but I know that wouldn't be a good idea, b/c I'm a rapid cycler and I don't want to go through that again.

Do you take an antidepressant as well, or just the Lamictal? I can't do it on Lamictal alone, but combined with an antidepressant things are going pretty well now. If you're not taking a combo, maybe that would let you lower the Lamictal dose? But yeah, ask the pdoc...

[venusss]

What SR says makes actually perfect sense........... without decent cognitive abilities........ there is no mood stability. If your interaction with the world is affected, it will retrospectivelly affect your mood and make it less possible for you to think through/get yourself bad episodes.

[AniManiac]

Wow, tough question... It's like asking would you rather be blind or deaf? Neither!

If it were one or the other, I'd take cognitive function. Like VenusHalley, I really value my intellectual performance and if that's compromised it has a strong negative effect on mood. Whereas stable mood but bad cognitive function would actually be something I can't imagine happening - when my brain doesn't work, it makes me very, very distressed.

I don't know if I'm getting memory side effects from Lamictal because I've always been a bit scatterbrained (ADD, actually). The word-finding thing, which I have problems with when depressed, has been more prominent lately. Mildly irksome but not all that bad - just annoying because the words are on the tip of my brain but it takes a long time to pull them out. I'm guessing it's noticeable right now just because I'm doing a lot of writing but otherwise it probably wouldn't be something I'd pick up on.

[unaluna]

until mood instability takes you "out" more or less against your will. then you sit there, stable mood, but low cognitive function, unable even to solve Wheel of Fortune word puzzles, until you can bring THAT back up AND keep mood stability...

[SunAngel]

The same thing happened to me when I was on Seroquel XR. It made me feel numb and stupid, and I had lost my creativity.

I told my pdoc and she changed my meds. because I felt like I was just existing, had lost my memory, and just felt really, really stupid.

[Moreta]

Do you take an antidepressant as well, or just the Lamictal? I can't do it on Lamictal alone, but combined with an antidepressant things are going pretty well now. If you're not taking a combo, maybe that would let you lower the Lamictal dose? But yeah, ask the pdoc...

I'm not allowed antidepressants. I'm pretty sure my pdoc doesn't believe in giving antidepressants to bipolar patients, due to the possibility of causing mania.

I was just at the pdoc this week, and I was going to ask, but got blindsided by him and my husband determining that I need to be in therapy. I didn't get much say in the matter.

[AniManiac]

Originally Posted by Moreta

I'm not allowed antidepressants. I'm pretty sure my pdoc doesn't believe in giving antidepressants to bipolar patients, due to the possibility of causing mania.

Interesting - it seems like a lot of us around here take a combo of mood stabilizers and antidepressants. Which kind of antidepressant can make a huge difference in whether it causes mania for you. For me, SSRIs always made me flip out, SNRIs didn't seem to do a whole lot but didn't turn me into a lunatic, but NDRIs (Wellbutrin) are the bees knees when it comes to helping with low moods. And then there are the tricyclics and so on.

Anyway, it seems like there are a lot of options that can work without causing mania, depending on the individual - maybe worth trying to bring up again in the future.

And I hear you on being blindsided with therapy; my prescribers won't prescribe if I'm not in therapy. I frankly do not understand this; when I'm properly medicated, I'm way more self-aware, insightful, and well adjusted than the average bear. They did tell me I need better coping skills for when I'm depressed, but I'm really not sure that there's anything more I can do because I figured out an awful lot of that stuff without any help. But whatever. I go along with it because I definitely need meds.

[venusss]

And I hear you on being blindsided with therapy; my prescribers won't prescribe if I'm not in therapy. I frankly do not understand this; when I'm properly medicated, I'm way more self-aware, insightful, and well adjusted than the average bear. They did tell me I need better coping skills for when I'm depressed, but I'm really not sure that there's anything more I can do because I figured out an awful lot of that stuff without any help. But whatever. I go along with it because I definitely need meds.

Imho, it makes perfect sense. Chemistry doesn't work 100%, you still can get pretty bad episode.............. and now you have something to off yourself with at hands. And damage control and learning to recognize our flawed patterns is important...... sure one can do it on their own, but if you seek help in the system, you probably can use some extra help.

[AniManiac]

Originally Posted by VenusHalley

Imho, it makes perfect sense. Chemistry doesn't work 100%, you still can get pretty bad episode.............. and now you have something to off yourself with at hands. And damage control and learning to recognize our flawed patterns is important...... sure one can do it on their own, but if you seek help in the system, you probably can use some extra help.

Yeah, I understand all that. I'm still new at this, but all of my prior experiences with therapy were much more damaging than helpful. So it's kind of logical to see the whole thing as useless, especially since I got by without for a very long time.

I can see that it's a good idea in general, and I know it helps a lot of people. I'm trying to be patient with this, but I am so not patient! My T has already hinted that once meds are stable, I may be fine with much less frequent individual therapy or group therapy instead. I haven't seen any benefit so far after 3 months of therapy, but maybe there's something I haven't noticed. I don't know... I've just never been very good at the "wait and see" game.

I've also never been remotely inclined to OD, even when suicidal, and have always had access to the means to do that. So I don't think that's likely to be an issue for me given prior experience. But you're right that it can always change.

[FuriousGeorge]

I gladly accept some cognitive impairment. It is much better than the delusions, paranoia, hallucinations and general craziness I'd have to put up with otherwise.

[2ofme]

99% of the time Id sacrifice stability for cognitive function - but when Im in a psychotic mixed state Id gladly give up my brain.

[hanners]

I think it would be really difficult for me to choose one or the other. I work in a highly brain-taxing field, so for me losing too much cognitive function would make it very difficult to keep my job. On the other hand, my lack of mood stability has wreaked havoc on my ability to do my job as well. So it's a matter of striking that balance for me, one that gives me enough of each, so that I can continue to function well enough at my job (and in the rest of my life).