[Hashi/bipolar mom]

So, I've been on Lithium for about 2.5 months since I was diagnosed BP. I've had terrible side affects that aren't going away and my pdoc yanked it today. In some ways I'm relieved because I physically don't feel good. So, starting tonight, I wean off the Lithium and she is adding Depakote syrup and slowly upping that. Oh, she also dropped down my Lamictal since I was starting on Depakote as well. So, my new meds will eventually only be Depakote and Lamictal. Any experience with this combo? Any success? Scared!

Eventually:
1000mg Depakote
300mg Lamictal

[Blue_Bird]

I have no experience with Lamictal but am on Depakote and it helps a lot.

Good luck

[Hashi/bipolar mom]

Originally Posted by Blue_Bird

I have no experience with Lamictal but am on Depakote and it helps a lot.

Good luck

What dosage are you on and how long?

[Blue_Bird]

I've been on 750mg a day for probably the last 6 months. (250 3x a day).

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[raspberrytorte]

My pdoc told me lamictal and depakote don't work well together. Just her opinion I guess. She wants to yank me off lamictal and put me on depakote instead (not happening). I've never experienced depakote....but I like lamictal.

[BeyondtheRainbow]

That's surprising that your dr. said they don't work well together. Way back when I was first diagnosed I was in a clinical trial that was supposed to show that the combo of lamictal, depakote and lithium slowed rapid cycling and made rapid cyclers more stable. It was based on research that showed that depakote and lithium were more stabilizing than one alone and I think (maybe I'm mis-remembering) that depakote and lamictal were more stabilizing together. It was so long ago I'm not sure but I had the impression they were a good pair of meds. I don't know aside from the study helped get lamictal approved for bipolar and I met someone in the hospital who'd been in the study too which was neat since she was also the first person I'd ever met in person who was bipolar and not someone I was treating.

It's interesting how different drs get such different ideas about so many things.

[raspberrytorte]

Yeah. I don't know. That's just what she told me, after I adamantly told her I WAS NOT GOING ON DEPAKOTE. Lol.

[BeyondtheRainbow]

I don't blame you. Depakote helped me but it was a tough med, the hardest I've ever been on to handle. I was so glad to get off it. My pdoc suggested a low dose of it a few months ago and I nearly fell off my chair. No thank you unless it is the last drug left and then I suppose.

[Hashi/bipolar mom]

Originally Posted by BeyondtheRainbow

I don't blame you. Depakote helped me but it was a tough med, the hardest I've ever been on to handle. I was so glad to get off it. My pdoc suggested a low dose of it a few months ago and I nearly fell off my chair. No thank you unless it is the last drug left and then I suppose.

What was your experience with it? Lithium has been horrible for me physically. I've been on it just 2.5 months and put on 10 pounds. I can't keep hydrated and I'm swollen all over.

[Hashi/bipolar mom]

Originally Posted by raspberrytorte

My pdoc told me lamictal and depakote don't work well together. Just her opinion I guess. She wants to yank me off lamictal and put me on depakote instead (not happening). I've never experienced depakote....but I like lamictal.

My pdoc added Lithium to my Lamictal and said it's number one for treating bipolar. She said number two is Depakote plus Lamictal. However, she said it gets tricky with dosing because the Depakote doubles the Lamictal in your body. You have to be careful. I'm so over it all!

[raspberrytorte]

I've never been on depakote, but I just have a gut, bad feeling about it.

[BeyondtheRainbow]

Originally Posted by Hashi/bipolar mom

What was your experience with it? Lithium has been horrible for me physically. I've been on it just 2.5 months and put on 10 pounds. I can't keep hydrated and I'm swollen all over.

Depakote was hard for me because my body did not handle it well. I had to be on huge doses to maintain a therapeutic level and even then my level would dip for no good reason. The last year I was on it I was on 3200 mg which is a ton. So it caused weight gain, I was always exhausted, waking up in the mornings was awful which made work awful, and I just felt sluggish all the time although it did keep me from having the most extreme manias/depressions most of the time. Even taking it though I was on disability 3 times in 5 years for various time periods and it didn't work on its' own until I was on Seroquel too. Eventually Seroquel was enough I could come off it.

With lamictal the first time I was on too much. The clinical trial increased the dose for everyone and for me it was too much and so I was sick from the lamictal level. After a year of vomiting pretty much daily I stopped it. A few years later I went back on at a lower dose, still with depakote and ltihium, and loved it. I made it 2 weeks past the point the rash is supposed to not be a problem and got the rash pretty badly. After that lamictal wasn't an option for me.

I have had struggles with most meds. Lithium was good for me except for a few minor things (thyroid and diabetes insipidus) but I had 3 toxicities and 3 is one more than I was willing to deal with. So I have been off it about 18 months. I just recently discovered that I probably have had psychosis controlled by lithium as my first big episode since lithium was stopped was the first with this much psychosis. I miss lithium though; it was good at slowing rapid cycling for me as well as the psychosis thing.

I hope you find the right thing soon. Trial and error is SO hard and there is nothing to say to make it better. I'm in the middle of it again right now too and I hate it.

[Hashi/bipolar mom]

Originally Posted by BeyondtheRainbow

Depakote was hard for me because my body did not handle it well. I had to be on huge doses to maintain a therapeutic level and even then my level would dip for no good reason. The last year I was on it I was on 3200 mg which is a ton. So it caused weight gain, I was always exhausted, waking up in the mornings was awful which made work awful, and I just felt sluggish all the time although it did keep me from having the most extreme manias/depressions most of the time. Even taking it though I was on disability 3 times in 5 years for various time periods and it didn't work on its' own until I was on Seroquel too. Eventually Seroquel was enough I could come off it.

With lamictal the first time I was on too much. The clinical trial increased the dose for everyone and for me it was too much and so I was sick from the lamictal level. After a year of vomiting pretty much daily I stopped it. A few years later I went back on at a lower dose, still with depakote and ltihium, and loved it. I made it 2 weeks past the point the rash is supposed to not be a problem and got the rash pretty badly. After that lamictal wasn't an option for me.

I have had struggles with most meds. Lithium was good for me except for a few minor things (thyroid and diabetes insipidus) but I had 3 toxicities and 3 is one more than I was willing to deal with. So I have been off it about 18 months. I just recently discovered that I probably have had psychosis controlled by lithium as my first big episode since lithium was stopped was the first with this much psychosis. I miss lithium though; it was good at slowing rapid cycling for me as well as the psychosis thing.

I hope you find the right thing soon. Trial and error is SO hard and there is nothing to say to make it better. I'm in the middle of it again right now too and I hate it.

My biggest worry is the rash since right now I'll be on Lamictal, Depakote, and Lithium all at the same time while everything is being weaned and upped. I've been on 400mg of Lamictal for years without any rash so I'm hoping that I won't get one now that I'm adding Depakote. I hate being scared!

[BeyondtheRainbow]

The rash is so rare. I never say don't worry to someone because I hate being told that but it really shouldn't be a problem. Your body is used to the med and you made it through the danger zone. Plus 1-3% of people get the rash. To put that in perspective when people post about it on here I'm the only one who usually posts about having had it badly. I'm sure others might have had it as I did but there isn't a huge crowd ready to post about what the rash is like. So that's a really good sign considering how many of the people on this site are on lamictal or have been on it. And honestly I'm at higher risk for a lot of things because my body hates medications and I get bad reactions more often than average. Until bipolar I rarely took even tylenol and it turns out that was for a good reason. Meds and I just aren't friends.

The rash is unpleasant to say the least but you more than likely won't have to deal with it. (And even people who get it mostly have it mildly enough to go back on with a slow taper.)

I just hope the depakote helps you. It's a good med when it works right. That happened every so often for me and I'd like it and then it would get weird again. But that's just me and meds.

[Hashi/bipolar mom]

I'm worried about rash and weight gain. I just want to feel good while looking good, is that too much to ask!

[BeyondtheRainbow]

I only gained 8 lbs on Depakote until I had to go on the really high doses (I know for sure because of the clinical trial monitoring it). Lithium was much worse for weight gain for me. After I got to the high doses though I did gain weight but by then I was about to start Seroquel so who knows what caused what?

I wish I could find something that let me stay at a lower weight and feel good. I was there once and my Seroquel dose is heading toward that point again so maybe I'll have a surprise in the next few months.

[Hashi/bipolar mom]

So, night before last was my first night on Depakote. Holy Cow! Up all night long. Thought I was going to have a heart attack. Body felt like it had energy volts going through it. Scared me so bad. I thought it was supposed to make you tired! I called my pdoc and she said to stop taking it until I get down to 300mg of Lithium (one more week), and try again. She thought it might be the combo of all three at their current doses. God, I hate this. Anybody have that reaction?

[CrazyLo]

I am on Lamictal 400mg. I like Lamictal because it has minimal side effects (I virtually have none). It helps the depression part of my disorder. I have never tried depakote even though the pdoc has mentioned it several times because I refuse to take it because of the weight gain component...but that's because I have an eating disorder.

Your reaction to the depakote sounds very similar to my reaction while taking tegretol. My heart was always pounding and I felt wired all the time. It's possible it's your med medication but it's also very possible it's not the right med for you. I have tried so many meds throughout the years...most of them don't work for me because I am hypersensitive to side effects. I hope you can find something that works for you.