To Cam

I recently explained my use of Lamictal. I just wanted to know if it is safe to use as a mood stablizer along with other antipressants. I sometimes get frustrated taking so many meds. I take Paxil, Nortryptlene, Lamictal, Trazadone,Klonopin and wonder if it will ever stop. Taking more and more meds that is. How much can the body take before it becomes toxic?

Rainbow - I see drug files like this all the time. I'll bet that you get a partial effect from each of the drugs, but still do not enter remission. Sometimes the problem for the physician to decide which of the drugs, if any, are working, or working the best. So, instead the doc just keeps adding meds, without stopping the meds that are giving partial relief.

Looking at your drug profile, it does look like there was a sequential adding of meds over time. Each of the drugs are thought to have different mechanisms of action. Paxil is a SRI; nortriptyline is mainly an NRI; and Lamictal possibly works by disrupting the phosphoinosital pathway. (Quite frankly, I don't think that these MOA are the major causes of depression, but are technically side effects.

I am also assuming that you are using the Klonopin for anxiety and the trazodone as a sleeping pill.

I do not believe that you are taking a toxic combination, but I cannot say that for sure, as I do not know your history, dosages of the dugs, etc. The meds of today are much safer than we had even 15 years ago. In most classes of drugs the "therapeutic window" (the difference between minimal effective dose and minimal toxic dose) has grown steadily larger.

You could ask your doc if he/she eventually plans on stopping any of the meds. And if so, which meds would he/she consider stopping first.

I hope that the above helps somewhat, - Cam



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