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Lamictal Sexual And Other Side Effects?


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#1 StrungOutOnLife

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Posted 24 February 2008 - 07:16 AM

Effect of lamotrigine on sexual function in patients with epilepsy.

Hypersexuality in two patients with epilepsy treated with lamotrigine.

Differential effects of antiepileptic drugs on sexual function and hormones in men with epilepsy.

Improved sexual function in three men taking lamotrigine for epilepsy.

ETA: Full text of that last one available from Medscape.
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#2 daikomeo

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Posted 24 February 2008 - 07:22 AM

Sorry to kinda laugh about this. I've not had the "pleasure" of having this at all. Lamictal is such a roller coaster of med tweaking for me my mind is not on sex. I'll have to go back and read some of the links specifically. It just seems like a side effect I've not dealt with. We, my pdoc and I, know that Lamictal tends to deter and mess up my "girly" hormones.

Wish I could "enjoy" that please. LOL
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#3 dymphna

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Posted 24 February 2008 - 09:52 AM

Well... seeing as Lamictal knocks down my seizures by pushing me hypomanic -- I'd have to agree with this concept.

(I know, I know, this probably isn't what's really happening, but I have noticed a correlation between an increase in zoominess and a decrease in seizure activity, and Lamictal increases my zoominess)


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#4 Blackbird

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Posted 25 February 2008 - 04:50 AM

Coincidentally enough, I was reading those articles just yesterday.

Since reaching stability, I've noticed a definite difference in that regard. Didn't really think it would be the Lamictal, but there you go. Weird, but I'm not complaining. :mad:
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#5 StrungOutOnLife

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Posted 17 March 2008 - 06:51 PM

What the hell?
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#6 lostanddelirious

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Posted 17 March 2008 - 08:33 PM

oddly enough i tend to agree.

well the fact that i was on depakote all through my teen years and college years...i had no libido.
now that i am on lamictal it is off and on. for example, i got so horny on the train the other day. some random guy i would NEVER be attracted to in a million years was standing in front of me and i actually fantasized about me having sex with him!
i have never thought that way EVER! but it comes and goes.
all i know is that depakote SUCKED when it came to libido.
i wonder if i was on just lamictal (without keppra) if i would be a sex machine! hahaha!
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#7 anywho

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Posted 18 March 2008 - 05:49 AM

yeah, um, I have to agree with the book excerpt. Things in that department came to a screaching halt when I started lamictal.
I thought it was just me and never found any evidence of it having that side effect. I suspected it was lamictal and my pdoc said she didn't think so.
Dammit!
Thanks for the info, atleast the mystery is solved...
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#8 StrungOutOnLife

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Posted 20 March 2008 - 07:59 AM

yeah, um, I have to agree with the book excerpt. Things in that department came to a screaching halt when I started lamictal.
I thought it was just me and never found any evidence of it having that side effect. I suspected it was lamictal and my pdoc said she didn't think so.
Dammit!
Thanks for the info, atleast the mystery is solved...

You're welcome.
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#9 lostanddelirious

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Posted 20 March 2008 - 04:20 PM

do u think its different depending on the gender?
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#10 dymphna

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Posted 20 March 2008 - 04:58 PM

do u think its different depending on the gender?


Anything is possible.

I know that, with dopamine agonists, guys will get a sexual pick me up, and gals will usually get fucked (and not in a good way). Different drugs, but, yeah...


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#11 Jerod Poore

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Posted 22 March 2008 - 08:13 AM

Improved sexual function in three men taking lamotrigine for epilepsy.

ETA: Full text of that last one available from Medscape.


That one has always been on the page about sexual side effects.
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#12 Jerod Poore

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Posted 22 March 2008 - 09:03 AM

What the hell?


By "what the hell?" I take it you are wondering what they mean by serotonergic effects of lamotrigine?

There was some bogus study measuring body temperature and a case report, but once you bring in the kids with Lennox-Gastaut or some other form of intractable epilepsy, then you can do whatever you want! Hell, they're just as good as pediatric tards when it comes to being human rats.

Plasma and urinary serotonin and 5-HIAA in children treated with lamotrigine for intractable epilepsy.

A bunch of rat studies came after the above.
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#13 StrungOutOnLife

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Posted 23 March 2008 - 09:46 AM

What the hell?


By "what the hell?" I take it you are wondering what they mean by serotonergic effects of lamotrigine?

There was some bogus study measuring body temperature and a case report, but once you bring in the kids with Lennox-Gastaut or some other form of intractable epilepsy, then you can do whatever you want! Hell, they're just as good as pediatric tards when it comes to being human rats.

Plasma and urinary serotonin and 5-HIAA in children treated with lamotrigine for intractable epilepsy.

A bunch of rat studies came after the above.

Oh, I meant the part about people saying that it made them not horny. I mean, it really says something that this board isn't covered with posts concerning this drug and hyposexuality. These things should pop up more often, given that message boards skew so heavily towards the miserable and alienated.

ETA: And then there's the fact that lamotrigine-induced hyposexuality hasn't made it into a MEDLINE-indexed journal.
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#14 Jerod Poore

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Posted 23 March 2008 - 09:59 AM

Oh, I meant the part about people saying that it made them not horny. I mean, it really says something that this board isn't covered with posts concerning this drug and hyposexuality. These things should pop up more often, given that message boards skew so heavily towards the miserable and alienated.

ETA: And then there's the fact that lamotrigine-induced hyposexuality hasn't made it into a MEDLINE-indexed journal.


In all the incarnations of the forums, plus various other sites where Lamictal is discussed, loss of libido has been blamed on Lamictal.

From all I could tell I'd put the actual blame on Lamictal in the single digit, excluding the quashing of manic hypersexuality which became a perception of hyposexuality. All in line with PI sheet norms, so nothing to go into MEDLINE.
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#15 In_Remission_dendrobium

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Posted 19 August 2008 - 07:24 PM

after i started lamictal my sex drive went through the roof.
i used to have a fairly strong drive; but after years of ignoring my bp, not taking meds, not seeing a therapist, it had dropped to pretty much nothing. where it's at now with the lamictal is unprecedented for me. i am a very very lucky girl.

but all the studies you linked to involved men with epilepsy, of which i am neither. so is this just a freak occurrence? are there any bp people who have had this same positive side effect? i'm also on ativan - but i know that's not causing it.

#16 Jerod Poore

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Posted 20 August 2008 - 08:19 AM

but all the studies you linked to involved men with epilepsy, of which i am neither.


1) Because Lamictal is still primarily used as an anti-epileptic drug, in spite of all the money being in bipolar. Plus it's use as an anti-epileptic is older, so there are more data.

2) It's just easier to get that sort of data from men.

so is this just a freak occurrence? are there any bp people who have had this same positive side effect?


From previous incarnations of this forum it's not a freak occurrence. If you look at the first study posted, you'll find it's relatively large and includes both genders:

Effect of lamotrigine on sexual function in patients with epilepsy.

Still that has most men being hornier and most women enjoying sex more, but not necessarily wanting more sex. That is the typical pattern. Obviously there are women in the group who were pretty horny thanks to Lamictal.

The only incidents of full-on hypersexuality reported involve men. Women are probably just reluctant to report it because of additional stigma.
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#17 mooon

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Posted 13 October 2008 - 09:02 AM

It's my first time on this site and forum so first, thanks for a great site :mad:

When I started taking Lamotrigine I was real happy to read about the "no sexual side effects" of this drug, unfortunately it first caused complete anorgasmia (a lot like ecstasy) which disappeared after a few months. I didn't mind at the time because I was filling so good, The best I felt in years. It didnít happen the second and third time I took it (yes, I stopped taking the drug twice in 18 months). Still sex isn't the same. It's not the reason I stopped taking it and it's a small price to pay.
Did this happen to anyone else?
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#18 reggie

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Posted 13 November 2008 - 04:42 PM

I'm pretty sure the Lamictal reduces my sex drive - I noticed it decrease when I ramped up from 50mg to 75mg when nothing else medwise was changing and I subsequently felt pretty stable. It seems even further down now I've recently gone upto 100mg (though that could be because the ramp up has made me feel more depressed not less!?).

In line with what's been said already, my psychiatrist has pointed out that it's not on the PIs but that doesn't mean it's not the case for me (and even a significant number of others as the PI sheets seem to me to understate the likelihood of side effects).

Of course it could be the Mirtazapine as well or instead, however, that is an AD I've been told by GPs/pdoc that is specifically prescribed as it is not suppposed to affect sexual drive/function and one I wanted to go on after bad experiences of this type on SNRIs - I'm surprised that's not on the sexual side effects info page but maybe that hasn't been shown in practice.

This side effect pisses me off and doesn't help with confidence in getting back into dating or a relationship again - I can deal with it if it's going to be a temporary medication regime (psychiatrist thinks another year or two but who knows?) but I'm not sure if I can stay on this combo 'forever' if these effects continue...Sometimes I worry I'll be rewired permanently :mad:
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#19 Rayjean

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Posted 13 November 2008 - 08:06 PM

I haven't had the sexual problem on Lamictal...once it got up to the level that it helped with depression, then the lack of sexual interest with depression went away. But, it wouldn't surprise me if it's related to Lamictal as it seeems every type of side effect can occur with these meds!
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#20 Jerod Poore

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Posted 14 November 2008 - 11:56 AM

In line with what's been said already, my psychiatrist has pointed out that it's not on the PIs but that doesn't mean it's not the case for me (and even a significant number of others as the PI sheets seem to me to understate the likelihood of side effects).


For all their faults at least the US PI sheets are complete. They may use weasel wording, but if a side effect is reported, it usually goes in there. The US PI sheet has libido decrease, impotence and anorgasmia listed.

Of course it could be the Mirtazapine as well or instead, however, that is an AD I've been told by GPs/pdoc that is specifically prescribed as it is not suppposed to affect sexual drive/function and one I wanted to go on after bad experiences of this type on SNRIs - I'm surprised that's not on the sexual side effects info page but maybe that hasn't been shown in practice.


Once again, the full US PI sheet for Remeron (mirtazapine) has libido decreased and impotence. Granted they aren't popular, but still possible.

I don't have it listed because I wasn't familiar with Remeron being prescribed to avoid sexual issues. Probably because the increased appetite, weight gain and need for sleep are so common that someone's normal sex drive would be overwhelmed by being too hungry and/or tired to think about other matters.
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#21 Bipolar Bear

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Posted 17 November 2008 - 12:12 AM

I'm on Lamictal. I don't know if it's the lack of SSRIs, the switch to Lamictal or a combo of both, but I'm good in that department.
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#22 reggie

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Posted 17 November 2008 - 06:18 AM

In line with what's been said already, my psychiatrist has pointed out that it's not on the PIs but that doesn't mean it's not the case for me (and even a significant number of others as the PI sheets seem to me to understate the likelihood of side effects).


For all their faults at least the US PI sheets are complete. They may use weasel wording, but if a side effect is reported, it usually goes in there. The US PI sheet has libido decrease, impotence and anorgasmia listed.

Of course it could be the Mirtazapine as well or instead, however, that is an AD I've been told by GPs/pdoc that is specifically prescribed as it is not suppposed to affect sexual drive/function and one I wanted to go on after bad experiences of this type on SNRIs - I'm surprised that's not on the sexual side effects info page but maybe that hasn't been shown in practice.


Once again, the full US PI sheet for Remeron (mirtazapine) has libido decreased and impotence. Granted they aren't popular, but still possible.

I don't have it listed because I wasn't familiar with Remeron being prescribed to avoid sexual issues. Probably because the increased appetite, weight gain and need for sleep are so common that someone's normal sex drive would be overwhelmed by being too hungry and/or tired to think about other matters.


Just had a look at the US full PIs on the site (BTW I couldn't see reduced libido for mirtazapine only increased) .They're so much more comprehensive - why is this? Doesn't seem right that the UK ones for docs as well as patients aren't the same. So is it possible the pdoc isn't aware of these side effects?

Anyway, overall this side effect is less pronounced than on the Cymbalta or Citalopram so I think it's best just to get on with it...
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Current Meds: Lamotrigine 200mg, Mirtazapine 45mg (second time around for this combo) + Venlafaxine 112.5mg

 

Previous Meds: Citalopram (first one tried, didn't do much), Cymbalta (helped but bad side effects and withdrawing was hard work), Seroquel (low dose as short term crisis med), Propranolol (when resisting going back on the crazy meds). Lithium

 

Supplements: Fish oil, Vitamin D/light box for most of year

 

Other stuff I do to help:  Exercising, Trying to be social, Cognitive therapy, Yoga, Music, Volunteering on projects when I can.


#23 Jerod Poore

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Posted 17 November 2008 - 11:11 AM

Just had a look at the US full PIs on the site (BTW I couldn't see reduced libido for mirtazapine only increased) .


Libido decreased was listed at the top of page 22, although it was less than 1% and the same as placebo during the clinical trials. Like any of the infrequent-to-rare side effects that's in the same statistical range as postmarketing (i.e. once a drug is approved and is being prescribed), in that it could be the med or it could be something else. So it happened during the clinical trials, but who knows?

They're so much more comprehensive - why is this?


America: land of the frivolous lawsuit. Stupid people will sue companies for not warning them against their own stupidity, and that generates painfully obvious warning labels.

Doesn't seem right that the UK ones for docs as well as patients aren't the same.


In the US anyone getting a bottle of pills can get any one of:

  • The full PI sheet
  • An advanced patient information leaflet (similar to the UK version)
  • A basic PIL (be a good boy/girl and take your meds, side effects will be those mentioned in the ads)
  • The HMO's / pharmacy's own version (which can be anywhere from receipt-sized to somewhere from basic to advanced PIL)
  • Nothing at all

So is it possible the pdoc isn't aware of these side effects?


I presume you haven't read any of the hundreds of posts where I've bitched about doctors not looking up something in the PDR? That's the big book that weighs several pounds and collects thousands of PI sheets into one volume.
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Current meds: lamotrigine 300mg, topiramate 325mg, buspirone 60mg, protriptyline 60mg, EPA 600mg, methylphenidate 5-10mg, lorazepam 1mg PRN
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#24 MissM

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Posted 17 November 2008 - 11:37 AM

I actually do have more interest in sex since starting the Lamictal.
Sadly my hubby has his own issues so I am SOL.
Thank God for the double A.
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BiPos Take heart~
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I have never ever met anyone as creative, and fun as a (properly medicated)BiPo.

#25 bourne

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Posted 18 November 2008 - 03:50 PM

America: land of the frivolous lawsuit. Stupid people will sue companies for not warning them against their own stupidity, and that generates painfully obvious warning labels.


I apologize if this is a digression from the main topic, but...

The stupid legal system uses those warning labels to excuse painfully obvious misuse.

A close friend of mine lost her husband in a car accident. They were pulled over on the highway with a flat tire and someone who'd been driving on Ambien (sleep pill) wove around them to the right and slammed into their car from the right (e.g., the shoulder side), catching her husband between the two cars.

The driver had picked up the Ambien prescription 30 minutes earlier. The prescription was for one pill, but there were 3-1/2 pills missing from the bottle.

There are 20 minutes of 911 calls from other drivers describing his car weaving from lane to lane on the highway, flashing his lights, and at one point knocking down a highway sign.

The judge found the driver not guilty because at the time Ambien did not come with a warning about driving. They added that warning 6 months after the accident. (It was a judge trial, not a jury trial).

Lawyer who took sleeping pill cleared of vehicle homicide

I would think that, as you say, it is painfully obvious that sleeping pills should not be taken before driving and that the lack of a warning should not excuse one from making logical decisions. But in this case, the stupid person - literally - got away with murder because of the lack of a painfully obvious warning label.

Again, please forgive the digression. But I have never stopped being angry about this and wanted to point out that the lack of warning labels can also remove responsibility for horrible, horrible things.

Edited by bourne, 19 November 2008 - 11:25 AM.

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BP II, rapid to ultraradian cycling

#26 nina

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Posted 19 November 2008 - 12:06 AM

Bourne - that is truly horrific.

On this point I like the system here in Sweden. We used to have a warning triangle on meds that could make you non-suitable for driving, but that had the same downside as other forms of warning labels - people would swear off responsibility if their pill didn't come with the triangle. So it has been replaced on just about all meds with a text that goes something like this:

"During treatment with Substance X, the ability to focus and react may be diminished. Therefore, you need to know how the treatment affects you before you engage in activities that require sharp attention (such as driving a vehicle or precision work).

You are fully responsible yourself to judge whether or not you can drive motor vehicles or perform work that requires attention. One of the factors that can affect this abilify is the use of medical drugs due to their effects and/or side effects."


But then we also don't sue each other a whole lot.
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#27 Deep Sea Philosopher

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Posted 19 November 2008 - 07:57 PM

I'm really sorry to hear about your friend, Bourne. Words really can't explain that kind of a loss.

Every medication that I take/have, including all of the STIMULANTS that I still have, have a warning on the bottle that says in some form or another that it might impair my ability to drive. They are covering their ass from any possible lawsuit that might occur.
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#28 reggie

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Posted 21 November 2008 - 01:21 PM

Bourne, that is really awful, I'm really sorry to hear that.

It would seem that something like the Swedish label is the way forward on that front?

As for the PIs (mirtazapine specific and general 'rants'), my poor attention Jerod, thanks for that. My doc did consult his book in sessions when I've brought this up, but maybe it's not *that* book... it seems crazy that all pdocs wouldn't use them and double check everything in them but then why should that surprise me?
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Current Meds: Lamotrigine 200mg, Mirtazapine 45mg (second time around for this combo) + Venlafaxine 112.5mg

 

Previous Meds: Citalopram (first one tried, didn't do much), Cymbalta (helped but bad side effects and withdrawing was hard work), Seroquel (low dose as short term crisis med), Propranolol (when resisting going back on the crazy meds). Lithium

 

Supplements: Fish oil, Vitamin D/light box for most of year

 

Other stuff I do to help:  Exercising, Trying to be social, Cognitive therapy, Yoga, Music, Volunteering on projects when I can.


#29 TemperaMental

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Posted 04 December 2008 - 04:22 AM

Old thread, I know, but I wanted to add my experience here.

This is definitely happening to me! I have a really low sex drive normally, unless I'm wildly manic, in which case sex is more like a power trip than a pleasure thing anyway. Hypomania tends to make me feel sensual, rather than sexual.

But now I'm, shall we say, suffused with a warm glow ... It started when I hit 50mg, and now I'm on 100mg I'm actually finding it difficult to sit down. Or walk. And I don't have anybody to 'share' this feeling with at the moment :mad: . Next week I'm supposed to go to 200 - I dread to think what could happen..

I don't feel hypomanic in any other way - I'm not physically restless, there's no racing thoughts or pressure of speech, and my sleep's pretty average. The only other thing I've noticed is heightened sensory stimulation in other modalities - colours are brighter, sounds louder, scents more pungent.

I'm female, by the way, 29 years old. As well as the lamotrigine, I also take lithium and olanzapine.

I guess my question is, does this side-effect, which is both pleasant and problematic, wear off? This drug seems to be working out pretty well for me otherwise, although it's still early days.
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#30 Jerod Poore

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Posted 04 December 2008 - 10:18 AM

I don't feel hypomanic in any other way - I'm not physically restless, there's no racing thoughts or pressure of speech, and my sleep's pretty average. The only other thing I've noticed is heightened sensory stimulation in other modalities - colours are brighter, sounds louder, scents more pungent.


Those are physical symptoms of mania / hypomania. Lots of people have physical mood symptoms, e.g. real or perceived changes in body temperature and increased or decreased reflexes.

I guess my question is, does this side-effect, which is both pleasant and problematic, wear off? This drug seems to be working out pretty well for me otherwise, although it's still early days.


It's not a side effect per se. Lamictal has triggered a form of hypomania with only physical symptoms. At dosages below 125-175mg (on average) it acts as an antidepressant. It's an odd presentation, but with the olanzapine doing what all antipsychotics do, which is only masking mental symptoms and not doing anything to address the cause, it's easy enough to explain.

You can expect the "warm glow" and heightened senses to go away at or above 200mg of lamotrigine. That's when its antimanic effects kick in. You may need a higher dosage and/or an adjustment to your lithium if you haven't had a blood serum level done recently.

More olanzapine probably wouldn't make a difference, although it could tone down the sensory stuff.
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Jerod Poore - Owner, Founder and Chief Citizen Medical Expert of crazymeds.us
Keep up with Crazymeds and my slow descent into irreparable madness boring life via your preferred social media:

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I am not a doctor, nor do I play one on TV. No doctor, nurse, pharmacist or lawyer was harmed in the creation of this post. No warranty is expressed or implied. Not valid with any other offer. Void where prohibited.

Current meds: lamotrigine 300mg, topiramate 325mg, buspirone 60mg, protriptyline 60mg, EPA 600mg, methylphenidate 5-10mg, lorazepam 1mg PRN
Past meds (likely incomplete): Abilify, clonazepam, desipramine, diazepam, Gabitril, lithium, Neurontin, Paxil, prochlorperazine, Provigil, Prozac, Risperdal, Seroquel, Serzone, Strattera, Trileptal, Zyprexa


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