Pdoc appointment results

My appointment was changed to today instead of Friday. I was really anxious going and had a break down in the waiting room, but the staff was really nice and calmed me down.

This is the first time meeting my pdoc and she seems like a genuinely kind, understanding woman. I felt comfortable opening up to her and after describing my symptoms, she prescribed me 300 mg of Lithium and 25 mg of Lamictal. She said it does indeed seem like bipolar II, but wants to observe me more before making an official diagnosis to rule out the possibility of Borderline. No matter which it is, she said the treatment would be the same.

I already took my first dosages of both Lithium and Lamictal. What side effects should I expect from these? She told me that Lamictal doesn't usually have side effects and that Lithium only starts having negative side effects at higher dosages, which I'm not on.

I get weird side effects from all meds. So this isn't common at all, but I got blurred vision from lamictal, to the point that I couldn't continue taking it because I couldn't see my computer or read.

Lithium has a lot of side effects but I'm not sure they would appear at such a low dose. You will probably find yourself very thirsty though. Make sure you're drinking a lot of water. Try not to drink juice or soda because you'll end up gaining weight from all the empty calories.

Good luck! I hope your lamictal titration goes well. Did she say why she started two mood stabilizers at once?

Hi Pastel Kitten: I can't really say too much about the side effects of these two med's. I've never been on Lithium. I did take Lamictal. I developed the Lamictal rash about 6 weeks after starting it. They took me off immediately. I don't know how common this is. But it happened with me. So I just thought I would mention it...

Thanks. I'll be sure to drink water. That's something I need to do more of in general She told me Lamictal usually takes a few months to fully kick in, so she prescribed Lithium to help me start feeling better quicker in the meantime (I'm rapid cycling), and that depending on how I feel later, I may not need to continue the Lithium.

She did warn me of a possible rash, but said it's not actually a very common side effect - that she's only seen very few cases of actual Lamictal rash. Even so, I'll be sure to be checking for one.

Lithium makes me really thirsty and I know that at some point when I was titrating up I had GI symptoms (diarrhea, sorry!). The GI symptoms didn't last for long. I also had a short period where I was sweaty. I'm on 1500mg now and I haven't had any other symptoms from lithium.

Lithium gave me very bad, constant diarrhea but mentally it helped. I had to stop taking it because I got toxicity from it though. Lamictal made me manic so that med is a big no for me. If anything I'd say your meds might make you a bit tired but that should pass. And yes drink a lot of water on lithium. If you do end up having side effects that are bothersome them contact your new pdoc. It's not uncommon for BP patients to be on a few different cocktails before finding the right one so don't get discouraged. Good luck!

Dx: BP2, PTSD, bulimia/anorexia
Risperdal 4mg
Trileptal 300mgs
Buspar 45mgs
Ativan 1mg PRN
Vyvance 70mgs PRN

I've been on Lamictal since June and I had very few side effects other than it makes me sleepy. I had a very bad reaction with Lithium. I know it's rare, but I suffered from extreme sedation, derealization, uncoordination, bad headache, and tremors. It was traumatic. Don't let it scare you, though. I am very sensitive to meds and my reaction isn't common.

Thanks for the encouragement everyone. How long does it take for Lithium to work, generally? I'm assuming I won't feel a difference until at least a few weeks from now.

I haven't taken Lithium. I can't remember too much about side effects starting Lamictal, so I must not have really had any. I do remember it stabilized me at like a mild depression. Also, after taking it for 3 years it started to make me feel tired and "out of it" a lot.

Kitten,
I'm glad you got your appointment done.
I'm a little nervous about you starting 2 meds, in case you have side effects you won't know which one is causing it.
I tried Lamictal, had nightmares, insomnia, then got the rash after 4 weeks. Stopped.
Started Lithium. I'm on 600 mg now, titrating up. So far, I like it.
My moods are more stable.
I have some side effects but they are manageable.
Thirsty, a little foggy brained, but I'm calmer & happier.

Good luck with the meds. I hope they work for you. I was very frustrated when Lamictal didn't work but you just have to be patient until you find the right ones or combos.
Hugs to you friend

Aw this is good news, I'm so glad you got to see your doc and liked her. I've never had Lithium, but I LOVE Lamictal. It has improved my mood significantly.

Thanks Mary Yeah I was thinking something similar..that I wouldn't know which med is causing the unwanted side effects if I do have any. How bad was the rash you got? Does it mean you absolutely have to stop Lamictal or can the rash possibly disappear after a while?

The rash was minimal. Tiny Pin size red bumps all over my torso & back. I had splotchy red areas on my legs. No discomfort it itching.
My doc just told me to stop immediately. It took 3 days to clear up. Then I had a few withdrawal symptoms. A panic attack at work, which sucked major. Though, I was only on it a few weeks. I was only up to 75 mg.
I did not like the side effects from it all. It did not agree with me. But everyone is different. Most people love it.

Lithium has been by far much more agreeable. I really like it. And I've read others who had a horrible time. So you just never know until you try.

I pray you get lucky & have a good outcome. Those 2 seem to be the best to start with.

Thank you I hope I get lucky too, and don't have to spend a lot of time hunting for the right combo.

I'm glad you got a good first impression of your pdoc. That makes so much difference. I've never been on lithium but I do talke lamictal, and it's been very helpful for me. It does take a while to become effective though. The lamictal rash is really uncommon but I understand it is very dangerous, so if one gets it they should stop using the lamictal immediately and see the doctor. As I said though it's very uncommon. Lamictal really has been a great help to me.

Hello there. I take both meds. Lamictal took a while to work because of titration time. I started taking it for SAD and it saved me. I take 400 MG with no problems since 2013. Lithium is my holy grail. It's the only med that tamed my mania and mixed episodes. I take 900 MG and have been on it since 2012. I did stay thirsty right away. I do have cognitive disfunction. My hands are tied it's the only med that works.

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Yeah, I'm slowly titrating up on Lamictal too. So I haven't been imagining this thirst? It seems like no matter how much water I drink I'm still thirsty. I've been waking up very parched

I don't know about Lithium but I did fine on Lamictal and didn't get a rash on it. I hope this all works out for you.

I had the severe lamictal rash. Here's the lamictal rash info to know: most rashes people get while on lamictal are perfectly safe. However you must let your dr. know immediately if you get one, especially during the titration phase. The rash is pretty uncommon after 6 weeks but I got it at 8 and it can happen at any time, rarely. If you get a rash try to get it looked at by a dermatologist who can tell you if you need to worry. Many times you can re-start it and be absolutely fine. But do not do what I did and think "huh, I have a tiny rash on my cheek", take more lamictal and wake up to find that you have a serious problem.

The rash that is dangerous to less than 1% of people on lamictal. It must be monitored and lamictal stopped but the experts on lamictal feel that most people can actually try it again after the rash with a slower titration, so if you get a rash ask about this. They do it routinely in my hospital; the dr there wanted me to re-try once but my pdoc said no because I'd had 2 bad reactions.

Factors that reduce the chances of trying again are location, whether mucus membranes were involved, severity and whether other bad reactions had occurred on lamictal before (I had taken it before and vomited on a daily basis. I also had it on my face and neck with it on my eyelid, lips, around my nose, on my ear, etc. and due to location wasn't safe to try again.)

The rash is distinct from all other rashes. It's hard to explain but you know it when you get it. Mine looked something like hives crossed with burns and it was horribly itchy but burned terribly if touched. My lips eventually peeled. I didn't shower for 5 days to avoid having water touch my skin because it hurt so much. (That is not to say if you have a rash that doesn't burn you are fine, but if you have a rash that isn't burning you are less likely to have a dangerous situation although it still needs caution).

I was fortunate in that the day the rash got terribly bad I had already scheduled a dr appt. because I had bronchitis too. (It was a great week). So I went to work, the rash kept spreading and my eye was swelling shut, so I left, and later went to the dr. who took one look and called my pdoc. Having someone look at it and say definitively "this is THE RASH" helped a lot since I didn't have to wonder if it was stopped when it might have/had been working.

It wasn't pleasant at all and I wish I'd been able to continue as it was helping me. But it is so rare and yet so scary when they put you on it and warn you about it. So, chances are really good you'll be fine.

I am on lamictal 200 mg and I love this med. The only side effect I had was itchiness when I titrated up. Lithium was not my friend but it may work for you. Everyone is different. Good luck. I am glad to hear you liked your pdoc, that is very important.

I was very thirsty when I was on lithium (900mgs IRRC). It also made me a bit zombie-ish. I had to come off it because I had no energy or motivation and was in my final teaching internship but it did help get me stable when I was on it. My doc was ok with me coming off and being a little hypomanic since it helped with getting stuff done for school and he monitored me closely to make sure it didnt get out of hand.

Wow I'm so sorry you had such a negative experience with lamictal! I can't imagine how scary that must have been. I sure hope I don't experience something similar, but thank you for telling me some of the warning signs. I'll be sure not to ignore even a slight rash.

I never had any terrible problems personally with either lithium or lamictal. The lithium kicked in after about a month. Mostly I dealt with thirst (and the constant trips to the restroom because I was always drinking water) and some hand tremors which improved when we went down a bit on the dosage. Lamictal took forever to hit a therapeutic dose for me; had to go up to 400 mg to get there. Some achiness during titration, but that subsided once I go up above 100 mg.

My husband has had trouble with both lithium and lamictal. He went into severe toxicity with lithium despite careful monitoring, went into kidney failure and had to be put on dialysis in the ICU for a week. Very scary time. Needless to say they won't be putting him on lithium again. (Note: he has complicated medical issues so his toxicity was probably tied up with those problems but we probably will never know for sure.)

With lamictal he had severe memory and cognitive problems when the dose got above 100 mg. Once reduced below 100mg those problems improved.

That's the exact thing that happened to me, my kidneys shut down and I was in the ICU for a week on dialysis and I had seizures. I was on 1800mg though and my levels went to about 4.6, I barely remember being in the hospital I was so messed up, they sent me home with a walker. Crazy experience, it helps some people but when it's too much it's dangerous as hell