Dealing with low-grade depression. Any suggestions?

I currently take 200mg Lamictal and 80mg Latuda as my main psych combo.

The problem is that I've been dealing with low-grade depression almost the whole time I've been on this combo. I'd label it dysthymia, if that's appropriate. I'm still able to function, go to work, etc., but it seems life has no joy. Every couple weeks I will get a day or two of deeper depression, where I'd rather stay in bed than do anything else. On these days I force myself to go into work, but I don't get much done. In the evenings I'll stare at my phone rather than play games with my kids or whatever. It takes a tremendous amount of mental energy to do anything other than be a vegetable. At one point we went up to 300mg Lamictal. This had the effect of lifting the depression some and eliminated the periodic deeper depressions. Unfortunately the increased Lamictal began to give me blurry/double vision, and we had to go back down to 200.

At my most recent psychiatrist visit, my doc started talking about other med possibilities. He listed a whole bunch of different ones, and kind of put them on the back burner as options to look at.

Does anyone here have any similar experiences? I don't want to increase the Latuda, simply because there is very little clinical support for doses above 80mg showing any benefit in bipolar depression. I'm looking for any similar experience you may have had, and possibly any different cocktails that seem to have made a difference.

Recently we tried adding Wellbutrin to the existing combo with disastrous results. I began having insomnia, worsening depression, extreme anxiety, and suicidal thoughts. I tried to tough it out for three weeks, but eventually had to give it up.

I know we can't prescribe for each other, but I guess I'm looking to hear if anyone else has had this low-grade depression with some breakthrough, and what you've done about it. I'm open to other mood stabilizers, APs, and/or antidepressants. Either in conjunction with my current combo or as a partial or total replacement. I'm really open at this point, and am looking to take all suggestions under advisement.

Thanks for reading, and I'd love to hear anyone's cocktail and/or experiences that allow them to live life to the fullest.

I've had a little help for severe depression with Adderall.
Do you have room to increase your Vyvanse?

I am sorry you have been going through this.
I hope it resolves soon.


WC

Lamictal stabilized me in mild-mod depression. Ended up swapping it for Trileptal due to some other issues. Trileptal has been much better for my depression.

Wellbutrin XL gave me that same problem, but SR was completely different. It gave me the energy to get off the couch and do shiit.

Thanks for saying this. Trileptal was one med my doc brought up.

Thanks for the insight. During my WB trial we tried both XL and SR. Same effects.

Thanks for caring. I'm actually at the max daily dose of Vyvanse. I take 40mg AM and 30mg at noon. 70mg is the FDA recommended max. In the past I've been on 70mg 2x/day, but this doc won't go there.

Abilify? It didn't work for me, as it was basically a sugar pill even when I maxed out the dose, but some people have had luck with it. In fact, I actually stopped it cold turkey because I thought it wasn't doing anything. Even stopping it cold turkey didn't do anything! That was proof it never worked.

Latuda didn't help eliminate my depression either.

Seroquel helps, but it makes me emotionally flat, so I don't like it. But you could try that if you're really desperate? It may not necessarily make you emotionally flat. Also, I almost vomited my brains out when i went off it cold turkey. Severe nausea.

I'm at the point where I want to boost my lexapro dose, but my pdoc isn't giving in! I'm pretty sure I need an AD boost. But lexapro is nice at higher doses. My pdoc won't give it to me anymore since he claims it made me manic. I mean, he gave it to me without a mood stabilizer or AP, so of course it made me manic! But we've never tried it after that because he's lame. Whatever. Douchebag. I like Lexapro.

I was on Wellbuterin and Prozac for a while but the Wellbuterin kicked my anxiety into high gear. Now I just take the Prozac for AD. I take Lamictal and just started Latuda.

Ritalin has helped with my depression. I'm sorry you're having a tough time. Hope you can work it out.

I'm sorry to hear that. I saw someone else mention Trileptal, that helped me as well. Good luck.

Here's a thought... for the 300 Lamictal, did you try it in divided doses (am/pm)? I had visual trouble at 400 (everyone's different), and dividing the doses into am and pm instantly solved it. It might be worth a try since it was otherwise helping your depression.

Rexulti, although pricey, lifted my depression in four days. Another thing that helped was getting off Klonopin. Just something to think about.

Thanks for the thought. I did try dividing the Lamictal 150 AM/PM, but unfortunately the PM dose gave me sleep disruption so eventually I went back to all 300 in the AM. There's a chance if I stuck it out I might have gotten over the sleep hurdle, but eventually I was too tired to care and needed to sleep somehow.

There's a second vote for Trileptal. I'm definitely going to talk to my doc about it.

I'm not worried about the cost, so Rexulti is an option (I take Latuda, and they don't get much more expensive than that). What do you think was causing your depression? Did you switch from another AP?

I think my depression was just chemical. I have no idea why Rexulti lifted it.
If you are taking Klonopin once a day or more prn, think about stopping it and see how you feel. I was put on buspar instead for the anxiety.
I took Latuda for a while and got no results, either good or bad.

Do you take Lamictal, by any chance?

Thank you to everyone who has weighed in on this thread. Does anyone else have any thoughts on my situation and/or experiences that could be relevant? I'm trying to gather as much information as possible before I have a conversation with my doctor, and all your experiences are truly valuable to me.

Regarding the Klonopin usage, I know for a fact that Klonopin is a depressant for me. However, the symptoms I've been having present themselves even when I've not taken Klonopin for days or even weeks on end. When I do take it, I know that it'll relieve breakthrough anxiety, and I also know that I'll spend a few hours depressed afterward. Thank you for the reminder and note of caution.

Thanks again everyone, I hope you have a stellar day.

Yes, I do take Lamictal and Wellbutrin, as well as Buspar and Rexulti.

I was popping Klonopin here and there (.5's) for anxiety or upset. It took me a while to clear it out of my system but it really worked. I had no trouble getting off, but I found that mentally I always wanted to reach for it at the slightest upset. Now I save it for big things like a plane flight or the dentist or some major health scare, etc. I always heard bad things about Klonopin because it is addictive, but never knew it could also depress some people.

Lamictal is great for my depression also zyprexa actually works well for my depression too.

I was on Lamictal for over a year. I took 300mg. Then a little later increased to 400mg. It worked then I guess I got immune to it. This past winter I started Zoloft. But only 20mg because I have to be careful of mania. I've had a antidepressant send me into mania.

Depression is not a sign of weakness nor something that can be redressed with a simple attitude adjustment. People who suffer from it cannot simply “snap out of it”. It afflicts women more than men, possibly due to hormonal factors that are more present in females. There are various treatments for depression including Electroconvulsive Therapy (ECT), psychotherapy and anti-depressant medications.