lamictal question?

Yeah. I have more depression issues.

I am afraid to take the increased dose.
bizi

Re-reading, had some thoughts. The impetus for her wanting to increase the Lamictal was to help with a low level depression, right? You'd adjusted the Geodon dose and were stabilizing. She may not have been happy about it, but she already knows the Geodon adjustment was made. In your posts, there is mention of both stabilizing and of hypo. In either of those cases, the initial reason for her raising the Lamictal (for the depression) is no longer a factor. So here is the question (apologies if I've missed this): Has she changed her strategy to now looking for the Lamictal to keep a lid on hypo?

(My line of reasoning hinges on that question so I want to make sure I'm not missing something and barking up the wrong tree. )

Thank you for responding! Last year and a half ago... she wanted to double my dose of lamictal when I was having some hypomania. (I refused due to my knowledge of the antidepressant qualities, she seemed oblivious to this)
4 months ago, I was the one to suggest increasing my dose for low level depression. She agreed to try it. But since I had been hypo I have been afraid to take it. She doesn't know that I have not been taking it. But now I feel I am coming down slowly from this high and maybe I should take it now so I don't have too great a fall.
Just not sure at this moment.
My mood is unstable right now.
??????
what to do.
bizi

Just to be sure you are aware that Lamictal is not really an anti-depressant drug. It is an anti-epileptic drug. But like a lot of other drugs, it also happens to be good at mood stabilizing and sometimes helps depression too. It just seems to me from your posts that you are stressing the depression aid before the mood stabilizer. IMHO if you are hypo now but starting to come down, it would probably be a good time to try it.

One thing to keep in mind, this is not a drug that you can just stop and start when you want to or change the dose often. You must trickle up and down slowly. if you decide to try it, be sure to start with the starter dose, you should have been given a pack that starts you off. This in not a good drug to be non-compliant with.

Thank you shadow.
I currently take 200mg of the lamictal at nite and have for 10 years at least. The extra 100mg is fairly new. I am afraid it is more activating then sedating My geodon is really my mood stabilizer. I take 80mg of that twice a day.
Since I am bp1, I really need to be careful of activating substances but I guess I really am not too concern about that as I head out the door with a big cup of coffee.

bizi
I think that I am still hypo so will hold off on taking the lamictal.
I just don't want to go over the fence again. I was drinking uncontrollably 2 weeks ago. bizi

its worked relatively well for me for years. but any dose over 200mg a day and I cant sleep.

You take the 200mg at night?
bizi

I think my bipolar is still out of whack, takes a while to stabilize. Think I will wait on the extra lamictal.
Thank you for your support.
bizi

Thanks for your answer, bizi. Sorry for disappearing -- RL got hectic and I didn't get any PC time in. Your answer did help clarify, and it turns out that my line of reasoning doesn't really apply.

How have you been doing? (Has it really been a week already?! Yikes.) If the Lamictal increase is still under consideration, here's a thought-- you could ask her if you could start with an increase of 50 mg (or even 25 mg) to start instead of the full 100. I've been on it for years too, but my dose gets changed from time to time, ranging between 200-400 mg, adjusted in 50 mg increments. 100 is a pretty big jump and that sure can't help your apprehension about it, especially as it's never been changed before(!) Can't see why she'd be averse to such an approach.

It has been proven to be the case for these different patients, maybe, but there is no real difference between the two: both contain lamotrigine.

For lithium, something like that (differences between generics and "innovator brands" and one generic and another) may be of importance, since their is little margin between a therapeutic and a (too) toxic dose.

Any change in dose is almost infinitely more important than which generic you use.

However, you (or your psychiatrist) might confuse lamotrigine and valproate: there is a generic sodium valproate and a patent-protected valproate semisodium. But ironically, the generic one is better than the patent-protected one for epilepsy.

It's all about scaring psychiatrists, this research. Except for meds with a narrow therapeutic range, but individual differentdifferences are very much more important (almost infinitely, again) and so require frequent serum level check-ups.

**** .

I beg to differ. With about everything.

a) Lamictal and lamotrigine are not the same. The content is not the same, the binders are not the same.
Ground beef and beans is not the same as chili con carne.
b) Lithium Carbonate is standarized in two formulas. Lithobid and Eskalith, the name brand. Without going to the OTCs. Oroate, ect. Where they are making the money.
d) The Lithium the dosage is not important. Is the serum blood level expressed in mmol/L from a blood test that counts. Not the brand.
The shrink that confuses lamotrigine wit sodium valproate loses his license.

On what are you on today?. I definetely want some.

I'm confused as to where you're finding that Lamictal and Lamotrigine is not the same...?
Besides it being Generic vs. Brand names

Google. There are articles there to read for a week.

Oh, sorry, I did make a big mistake: "individual different" should be "individual differences".

I am on two generics, so that must've been it.

In my database I don't have that (APA PsycNET). And my psychiatry textbooks. Nor the NIH (pubmed.gov). At least that I can find

Simply google: lamictal and lamotrigine difference.

I did. Not all websites are true. I trust research, not randoms on the internet.

The information is there. Reseach included.
You're going to have to do the heavy lifting. I'm getting off it. At 50mg right now. 0 next week.

No, I think (I also keep to scientific and regulator databases) that the research they use to "prove" a difference in efficacy, is research that always has to be done to prove bioequivalence or bioavailability of any generic drug, comparing between different generics and the original product.

Of course there are differences, but they are only important when switching from one brand to another, for some meds, to make sure that, say, 100 mg of lamotrigine of one brand works the same, mostly as strongly, as 100 mg of another. Some meds might "become" too toxic without changing the actual dose, just the brand.

But for lamotrigine this is not an issue.

I gave lithium as an example, because there switching may have direct negative effects. However, as we both said, measuring serum levels is the way to avoid toxicity, because individual differences matter more than excipients.

Research has also suggested that you can just stop taking lamotrigine now.

But maybe Google says differently.

Anyway, if we at least agree it is about epilepsy, not BP, there is really no need to debate it.

Yes. Epilepsy is precisely where they notice that a 200mg generic is not the same as a 200mg generic.
Even if they fill up the generic to 100% of lamotrigine, which they don't, there will be a variance in the binders.

This horse is dead. RIP.

I take 600 MG of Lamictal (which is 200 MG above the FDA recommendation) along with 6 other meds. My pdoc initially wanted to increase my lamictal to 800 MG, but I refused. While I'm not sure which meds do what and I'm not sure I've gotten much better on any of them, I can say that when I was in my early 20's I got down to only lamictal and was well on only that med. Of course I got so much better that I quit my meds and had several years pass before needing meds again.

sorry I would not be comfortable taking that much lamictal.
bizi