[Nola0250]

Hi all,
I just got diagnosed with bipolar II. Pushing 50 with some major life stressors that probably helped tip me into a hypomanic - maybe really manic or on the verge - episode. I've been working with a therapist since the spring. I thought I had anxiety and an anger management problem, and getting older was just making it harder for me to control it!

While waiting a month for a psychiatry apt to confirm diagnosis, my therapist suggested I try an OTC lithium supplement which really helped a lot. Before I started it I was in an irritable manic situation where the energy coursing through me felt like it was going to set my fingertips sparking. I wasn't delusional, I knew that wasn't going to happen, but the energy was so strong it almost felt like it might.

Anyway I finally saw the psych last week and he put me on lamictal 25mg to start and it has helped a ton already, but I was still waking up at 3am and unable to sleep more so with his permission I moved the dose from am to pm (still on the low dose otc lithium till we see what lamictal does) to see if it would help since I was sleepy during the day. Now I toss and turn for about 3 hours at night, then when I finally sleep I can sleep all night. I think the influence of the lamictal is wearing off by afternoon and then I'm getting amped up. Does this make sense to you guys? I'm reluctant to switch it back to am's because I was so sleepy during the day. But I'm not really sure if that's what's causing this problem or if it's just me being me. Any thoughts?

[Vaporeon]

Everyone's chemistry is different, of course, but I take 200 mg Lamictal in the morning and don't feel groggy during the day. Maybe you're still a bit hypomanic and that's why you're waking up at 3 AM. The common therapeutic dose of Lamictal is 200 mg, I think, but I've heard of doses as high as 400 mg per day. Your body probably needs more time to adjust to the new medication. I'd say if you're not feeling better by the time you're up to 100 mg (if you even need to go that high), talk to your psychiatrist and let him know what's going on. Good luck.

[Nola0250]

Thanks for your input. I know I'm on a super low dose right now and I was surprised it felt like it was doing something after just 3 or 4 days. I felt slowed down on the outside but still fast on the inside, if that makes sense, and then kept getting better. I thought maybe it's not the lamictal, maybe I'm just naturally coming down from being really really hypomanic. My therapist (phd psychologist with lots of experience with bipolar) is convinced it's the lamictal though. If she's right, that's really encouraging and I wonder if I'll feel normal by the time I get to 100mg!

I see so many people on here struggling with getting on meds that work. It seems like it would be damn near miraculous if I get that lucky.

[~Christina]

Lamictal dose of 25mg seldom has an effect on BP as already mentioned..... but i guess it could happen.

Did your Pdoc prescribe any other med or just Lamictal for now? Which is a bit odd as most people with BP need a stronger Mood stabilizer than Lamictal which is actually a seizure medication that is quite commomly used in BP treatment(s)

Lithium is what has been considered for years as the "Gold standard" for Bipolar. Much of that has changed as AP's seem to be the med of choice for almost any symptom Bipolar hands out. I still dont understand why people are tossed on strong AP's ? but then again Lithium can blast your Thyroid to hell and also can cause kidney damage..

Not to be a downer at all but I was diagnosed late ( late age 43) and it took me a few years to finally find something that actually helped me across the board... Meds take time and adjustments .

Lack of sleep is just going to probably make matters worse tbh .. Thats what "usually" flips on the switch to hypo/mania..

What coping skills are you learning ? meds can only do so much.

Have you tried Melatonin? It helps me some..

Have you had a complete physical recently with blood work? Hormones and thyroid imbalances can cause lots of problems too.

When do you see Pdoc again?

Welcome to PC

[Nola0250]

Thanks for replies.

I thought it was unusual if the lamictal at 25mg was actually helping already. but my therapist (phd psychologist with lots of experience with bipolars) thinks it is. I'm on low dose (otc) lithium oratate. Would prefer to get off it because of the history of thyroid disorders in my family so hopfully titrating the lamictal up will help well enough. My mood is pretty brittle right now. I see the psychiatrist late next week and then plan increase to 50mg lamictal.

I think my coping skills are pretty decent. I eat healthy, not drinking (I have a glass of wine occasionally, none recently). Usually exercise well but I have bronchitis right now which means I've missed my exercise classes this week. I've been doing a little yoga at home, best I can do right now. My sleep hygiene is usually good but I'm having a lot more trouble sleeping lately. The coughing makes it hard. And no before you ask - I'm not taking any decongestants because those would totally amp me up!

Last night I took everything that usually helps altogether and it still didn't work - melatonin, benadryl, cbd, along with my otc lithium and my lamictal. I did finally get 5 hours, but not till about 3.5 hours after I took all of that. I've tried ambien in the past, does absolutely nothing for me.

I have a friend who is a family practice doc (only friend I've told yet about my diagnosis) and he thinks I should try a low dose seroquel. Maybe I'' ask the psych about that next week. I don't know if an AP is overkill for me if I'm type II, but maybe not. I'm pretty certain I did have some mild hallucinations back when I was a teenager, so I may be closer to type I than is obvious in a brief psych exam.

[tecomsin]

As has already been said, everyone responds to medication differently.

In my case lamictal had no effect on my sleeping patterns even at much higher doses than 25 mg. The thing about seroquel is that it can be a hard drug to get off of in my experience, but a low dose can also be very effective for inducing sleep.

Some people use trazodone for sleep. I prefer a low dose of pregabalin (lyrica), which also helps with anxiety. I only use it occasionally as otherwise I'd have to take more and more to have the desired effect and then the side effects also become more prominent. On the other hand, I take an antipsychotic every day and will for the foreseeable future.

Every person is different. The best thing you can do at this point is to develop a close working relationship with your care team, which, by the sounds of it, you are already doing. I would definitely bring up experience with hallucinations in the past. People can only diagnose and treat based on the information you give them.

Dealing with bipolar is a long term problem... it's a marathon, not a sprint in most cases.

[Guiness187055]

Everyone is different but 25mg is such a baby dose I am suprised you are feeling anything from it. From what i have heard lamictal really starts working at 200mg. YMMV