[pocketsevens]

I started seeing a new physician's assistant who specializes in psychiatric medications. I told her a bit about my history, which is that I have always have depressive symptoms but once, about 5 years ago, I had a manic episode. Since then I have had no symptoms of mania despite being completely off psychiatric medications for a couple of years.

My issue with her is that I'm seeking treatment for DEPRESSION, not bipolar disorder. I don't believe I am bipolar. She prescribed Lamictal, which I'm fine with since it's supposed to help with depression, but it's not working. I told her I think it's making me nauseous and more tired but she seemed so determined to keep me on it. I told her I'll stay on the dose I'm on, which is 50 mg, but I'm not going to titrate any higher right now. The depression and weakness is too overwhelming and I have a lot to lose right now. I said I need something that's going to work quickly, more immediate help.

So her course of treatment was to add Latuda, another mood stablizer, in addition to Lamictal. I confronted her and asked why she refuses to prescribe a traditional depression medication and she says it's because they haven't worked for me in the past. Which I did say. But why can't we try one in combination with the mood stabilizer?

I just don't understand how two mood stabilizers are going to help me with depression. My mood does not fluctuate, I am CONSISTENTLY depressed, and I'm afraid mood stabilizers will flatten me out even more.

I don't even know what to say. It's so hard to find a doctor I trust. Does anyone know about mood stabilizers for the treatment of depression? Anyone have any thoughts about how Lamictal and Latuda could work together to combat depression?

One thing I noticed about lamictal that you might consider. I had the most physical side effects: tiredness, achiness, headaches, nausea, etc. at the lowest dosages. Once I titrated up and beyond 100 mg, ALL of the side effects went away strangely enough. And lamictal generally isn't considered at therapeutic effect until about 200 mg.

[SingDanceRunLife]

Lamictal and Latuda are both supposed to be good for depression. Latuda isn't even FDA approved for mania.

Not only that, but I think she's being cautious since you do have bipolar I (based on the DSM -- you could have had a manic episode 25 years ago and never one again but if you also suffered MDD, you get the BP I Dx).

I myself have bipolar, but am mostly on the depressed end of the spectrum, and while yes, I do need a traditional antidepressant, mood stabilizers help keep me from getting too depressed, or from getting manic.

[seoultous]

Can you seek out a second opinion? That's what I would do if I felt I wasn't getting any input regarding my medication. Luckily I have a great psychiatrist who gives me real choice in the course of my treatment.

[gina_re]

One manic or hypomanic episode can be diagnosed as bipolar disorder. You can't say it won't happen again even ten years from now. Bipolar 2 tends to swing more on the depressive side, however, and people seek out help for those symptoms more often than not. Like myself.

[Moogieotter]

I enjoy both Lamictal and Latuda. Good Luck in your struggle.

moogs

[Babiesandbarbells]

I'm in the same exact situation except I am also prescribed Prozac for pmdd (depression). But I don't understand the two mood stabilizers either

[AncientMelody]

Latuda is indicated for treating depressive symptoms in bipolar disorder. In fact for most it works more on that end than the manic side of things.

[Kathryn01]

Medications can be frustrating because 1) it sometimes takes a while to find the right combination and 2) in my experience, a lot of anti depressants take about 4 to 6 weeks before they kick in. It's an unpleasant process, so I really feel for what you're having to go through right now.

If it's possible, find a new doctor. If the next one doesn't work for you, keep looking. It's SO important to feel like you can trust the person writing prescriptions that have such a huge impact on your life. For about a year, I made the mistake of letting my GP handle my medication, and it was a constant battle because I told her I was having awful side effects, and she would tell me it couldn't be the medication for XYZ reasons. There were other problems, but ultimately I went looking for another doctor.

I eventually found a psychiatrist who listens to everything I say. If I feel like my medication isn't working or the side effects are too unpleasant, he'll suggest several different options. Most importantly though, he NEVER disregards what I tell him. And I trust him to make sound decisions about my needs.

I hope you can find someone who is a better fit, and I wish you all the best.