[A Hobbit]

I've been on Seroquel (50 mg) for a couple months to help me sleep while waiting to see a Psych NP.

I finally got in today - after one reschedule. I was supposed to see a lady, but ended up with a fella. I don't like talking to men about anything of substance, so when I got there and found out the change I instantly became anxious. Thankfully, he was really nice, gentle type of guy.

Anyway, after about an hour and a half he told me that Lamictal had my name written all over it. I asked about Lithium, and he said, "That's good. But I think this is better. Let's try Lamictal."

So I'm - what's it called, titrating? (that doesn't sound right) - starting at 25 mg for two weeks, then to 50 mg until my next visit in a month. I'm also staying on the Seroquel.

I've read all kinds of success stories regarding Lamictal, and am hoping to add myself to that list.

QUESTION: Should i expect to feel anything from the starting dose? I'm in a play that is opening soon, and I don't want to ruin it. Please tell me not to worry

[Wild Coyote]

I have slowly been increasing my Lamictal for about 3 months. I have found basically zero side-effects at lower dosages. I'd started to feel a bit sleepy at 300mg and went back down to 250mg.

Everyone is different and may have a very different experience with any med.

Docs and patients seem to like Lamictal for its efficacy and it's relatively low side-effect profile, in general.

Treatment with Lithium is more complicated, including blood tests (lithium levels) and the ongoing potential for lithium toxicity. Many are happier with management via Lamictal, if it works well for them.

I am sure you have been advised to keep an eye out for, and to report, any rash. The Lamictal- induced SJS rash is unique and is potentially very serious. A very small percentage of people experience this rash.

Please do report any rash in order to be safe.

I hope Lamictal works well for you!


WC

WC made a lot of good points.

I'll write the standard and say that what's great for one is not always great for another in terms of mood stabilization and side effects, but having visited bipolar forums for literally 12+ years and having taken both Lithium for several years at doses of 900 to 1200 mg and Lamictal at doses from 100 mg to 300 mg I'll say that Lamictal tends to be a friendlier medication than Lithium for most. Lamictal tends to also be a bit more geared towards depression relief for many compared to Lithium. The question is, what do you need most of? Depression relief, mania relief, or a proper balance? Or other?

My personal experiences with Lithium and Lamictal are this:

Lithium was never my ideal medication. It never did any full job. Though for many it is more of an antimanic, for me it helped more with depression, though never sufficiently. While it is a wonder drug for many (it really can be), for me it equaled 10 side effects total over the course I took it. The only notorious Lithium side effect I didn't experience was weight gain. I was rather slim on Lithium.

Lamictal, for me, has had a proper place in my cocktail in moderation. It is not capable of taming my bipolar 1 mania at all, but it is helpful at curbing and extinguishing much of my depression, with the help of my Seroquel XR. At one point it was a hero ending 1 year of depression that even came back after ECT. However, in my case, 100 mg has always been the max I should take. It can be very activating for me. Some of my worst manias and manias with mixed features resulted from taking too much of it without ample mania preventing medications. Of course for a while at 300 mg with Abilify, I was flying high, but flying too high for me escalates into major danger. But doses of 200 and even much higher are brilliant for many, especially those whose mania is not as likely or easily triggered. It is called a moodstabilizer. For some it is. For me, it's an antidepressant. I don't have any side effects from 100 mg. I did have some mild cognitive impairment at 200 and 300 mg, but it wasn't THAT bad. I did sweat profusely at 300 mg, but I wonder if that was a Lamictal side effect, or hypomania/mania symptom. When I'm hypo/manic, my whole system is on rocket overdrive. Lamictal has always been weight friendly for me.

[Scooter9]

Lamictal was really good for me - I had great results until I had to come off it (I had an allergic reaction to it after being on it for 4 years).

While I was titrating up my mood cycled quite a bit. I went between feeling good and optimistic to feeling depressed. I cycled multiple times a day with some moods lasting just a couple of hours.

Things settled down when I reached 200mg and ultimately I ended up at 300mg.

I did experience rashes as I was titrating but they ended up being benign. My doctors at the time verified that all was good.

Like WC says, everyone's experience is unique.

One thing I would suggest is that you get your liver function checked about every year or two when you are on it. Lamictal can cause liver problems as it did with me. It's a simple blood test.

Best of luck with it!

[~Christina]

I think it helps me altho I have been on it for years, it works more on the depressive end of Bipolar of course little to no help for Manic end.

I’d quit it and see how it goes but having to taper off and back on if need be is just more hassle than I care to go through.

Lamictal is actually a seizure med that was found off label to help Bipolar.

[Moose72]

My brain felt GREAT om lamictal. I could remember things easily, I just felt good! But I had to go off it because I got a purple rash omn my face. Pnurse didnt know if it were related but she took me off even so.

[Guiness187055]

Lamictal at 200mg is a great drug for me. Like others said it acts like a mood stabilizer on the depressive end of the spectrum for me.

[Victoria'smom]

I've been on lamictal for about 8-10 yrs. I take it with a low dose of zyprexa. I recently went back up to 200 mg. I don't think it's enough for my depression but we'll see what pdoc says on the 4th.

[A Hobbit]

Thanks for all your input.

There is a common thread to your responses that gives me comfort: help with Bipolar depression. I think that spend a lot of time in that state. So did the PNP, it seems. But I would qualify that with agitated depression. Though he did say that he wouldn’t rule out BP I vs. BP II, as I’ve always thought better describes my symptoms. I found that... alarming, actually.

I did take lithium — decades ago — but don’t remember anything about it. Though I do think it gave me the shakes (?).

[A Hobbit]

Today has been two weeks since I began taking Lamictal, so I’m doubling my dosage to 50 mg, as prescribed.

I haven’t gotten any notorious rash. Not that I know of, at least. I assume it would be pretty obvious, yes?

Regardless. I’m wondering — if you are on this medication — how did you know that it was working? Did you feel anything, or did you just become aware of some effect?

[xRavenx]

Lamictal helped me a lot with depression without inducing mania. SSRIs were hell for me. I was so psychotic, so I am thankful for Lamictal. I still get breakthrough mania and depression, but I am on an antipsychotic medication to control that. It usually helps where my episodes are not as long-lasting, compared to before I was on it. (I am struggling with some mania right now, but that issue does not really involve the Lamictal, but more so because my antipsychotic dose is not high enough).

I really have nothing but good things to say about Lamictal. The taper definitely takes time (I'm on 400 mg, which is pretty high). I do not get side effects from it at all, which is wonderful. Please be careful though when it comes to any skin irritation or rashes. There is a very small chance of Steven-Johnson's syndrome when you first start it, but if you are fine after a period of time while on it, it's usually smooth-sailing. A good pdoc will make sure the taper is not too fast, so that way your body is able to tolerate it. Everyone is different, but I really hope it works for you!

[~Christina]

Originally Posted by A Hobbit

Today has been two weeks since I began taking Lamictal, so I’m doubling my dosage to 50 mg, as prescribed.

I haven’t gotten any notorious rash. Not that I know of, at least. I assume it would be pretty obvious, yes?

Regardless. I’m wondering — if you are on this medication — how did you know that it was working? Did you feel anything, or did you just become aware of some effect?

I got to 150 and decided to sit there and it was really helping me , that gave me wiggle room if I needed to go up.

The rash shows up mucus membrane areas like mouth , I took Triliptal for 5 days and my gums started bleeding, was early rash I was fine in a day or so , any mouth soreness or bleeding is a huge sign to DUMP the Med right away. There is a very little chance of the full rash to be honest.

[Lefty Seven]

Lamictal and I are intimate. Nights are spectacular.

[GLMS]

Lamictal was the light at the end of the tunnel, that finally wasn't an oncoming train...

I had only mild side effects with start up and each dose increase, all disappeared within a few days.

Improvement was subtle and gradual at first, but when I hit 100mg my depression, off the charts panic/anxiety, anger and suicidal ideation were so reduced. I'm still having some cycling I think, but they are much milder, easier to work through. For the first time in years I feel fairly steady and my mind is quiet and the near constant irritability I had is gone.

I know some meds poop out for folks after a while, I'm hoping this doesn't happen anytime soon but if it does I have a lot of room for dosage increases.

[liveforsummer]

I started lamictal 14 months ago. Titrated up to 200mg with little side effects. It has stabilized my overall mood. I have just added Zoloft to help with my anxiety.

[hopeless2015]

Lamictal has been good for me. I'm actually starting back on it now...I ran out and messed around and didnt get refill, then thought "I'm fine" without it...yeah right. Anywho, starting back on it...working back up to 200mg 2x a day. That plus 100 mg Seroquel at night seem to be the magic combo for me

[Unrigged64072835]

I did well with Lamictal—too well, actually. I was more manic. IP doc put me on Depakote—what a difference from over happy to depressed and unmotivated.

No problems with a rash though my cognitive abilities took a hit.

[MickeyCheeky]

I hope Lamictal is going well with you, A Hobbit. Let us know how it goes

[wildflowerchild25]

Lamictal is my miracle drug. I had to go up to 100mg to feel it, but my depression disappeared once I got to that dose. I’ve been mostly stable for 8 months now. The only side effect I got was blurry vision which was corrected by a stronger prescription for my glasses.

[~Christina]

I think it helps me, been on it for yearssss.

[Nammu]

I didn't care for it, nothing dramatic it just dulled me too much.

[A Hobbit]

Ugh.

Titration sucks.

50 mg since Tuesday, and of course I feel no positive effects from Lamictal. I know that I shouldn’t; but I’m feeling like dog doo right now.

At what dosage did you begin to feel better?

My next appointment is a couple days after Christmas, and I don’t know what my next increase will be. Will it be another 25 mg, or will I jump to 100?

I spend too much time in a depressed state.

[GLMS]

For me I started to feel better on the 2nd week of 50mg, but everyone is different. My provider bumped me to 100mg after two weeks of 50. I really started feeling better after a week on that dosage.

A Hobbit, I hope you start feeling better soon, depression is such an awful place to be.

[UpDownAround]

Originally Posted by Guiness187055

Lamictal at 200mg is a great drug for me. Like others said it acts like a mood stabilizer on the depressive end of the spectrum for me.

Pretty much the same. I am BP2 and it does such a good job for me that I feel cured and have to keep reminding myself of what has happened in the past when I go off meds. It's almost a blessing in disguise when I get slightly hypomanic because it is a reminder that I am not cured.

[MJLouise]

Im glad you wrote about this. I’m starting lamictal to add as a combo with my 600mg of lithium. The lithium’s working I’m much more stable and feel more capable and balanced but it’s not fully working for my year of depression -similar story to the poster above who’s on a combo. Lithium is fantastic for me but it’s not fully taking care of it. I start on .25 this week of Lamotrigine/lamictal. I’ve been on it be fore -about 6 years ago I was in just Lamotrigine 150 mg and had to go off because of blurry vision so we’re aiming for 100 mg of lamictal. Fingers crossed it works.

I was reading leaving bipolar untreating a living through cycle damages the brain and makes the disease worse. I was depressed for so long I don’t remember normal. I really hope I didn’t permanently hurt my brain 🤔😞 anyway good hearing from someone titrating up at the same time as me !!