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Discontinuing / Stopping / Coming off Lamictal


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#61 sorrel

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Posted 02 July 2008 - 07:22 AM

Detox is not the appropriate word. As for how long it takes to clear from your system, it varies. From the Lamictal page:

Taking Lamictal (lamotrigine) once a day with no other medications produced a range of half-lives from 14 to 103 hours with an average of 32.8 hours. Taking it twice a day produced a range 12 to 62 hours with an average of 25.4 hours. The aggregate half-life given for Lamictal is 26 hours.


Are you sure your depression is worse than your dryness effects? It sounds like you're conflicted about that. And as jook said, your cognitive abilities will also be affected by the depression.
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#62 Jerod Poore

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Posted 02 July 2008 - 10:24 AM

Ive been on lamictal for over a year now. I began with the usual 200 mg. But reduced it to 25 mg because of the side effects (dehydration, headaches, ect). I have just begun a new job that requires me to be able to remember things. So Im trying to quit the lamictal. This is proving to be pretty hard. My ecxema and acne are out of control and my ability to concentrate has not returned.


As jook mentioned, which sucks less? When it comes down to it, bad headaches, dehydration, cognitive effects and actual eczema just might suck enough to consider another medication, especially when you're going to do something as stupid as...

I wont take it for about four days, and then I break down and take it for three. The depression really takes over. Doc doesnt seem to concerned.


Yeah, if your doctor isn't concerned that you do something as idiotic as stopping and starting Lamictal of all things you need a new doctor as well as a new medication.

Any words of wisom? If I go cold turkey, how long till Im back to myself?


As for getting back to yourself, that all depends.

1) Do you consider yourself to be hypomanic most of the time? Or depressed? Because four days is about right for the Lamictal to be completely gone.

2) Is it normal behavior to do something like stopping and starting potent a potent and unpredictable medication like Lamictal?

In which case you need to find a newer version of yourself as well as a new doctor. It sucks when you find yourself and you're an idiot, but that's how life is with bipolar disorder.
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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

#63 Rayjean

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Posted 03 July 2008 - 02:11 PM

Even though it sounds like you are stopping & starting a low dose of 25 mg., I would still be worried about having a seizure. Lamictal affects the brain so it's not safe to play around with stopping & starting anticonvulsants; if you have a seizure then life gets more complicated....you could suffer a broken bone, lose your driver's license or go into status epilepticus and die.
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#64 Jerod Poore

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Posted 04 July 2008 - 11:01 AM

Even though it sounds like you are stopping & starting a low dose of 25 mg., I would still be worried about having a seizure. Lamictal affects the brain so it's not safe to play around with stopping & starting anticonvulsants; if you have a seizure then life gets more complicated....you could suffer a broken bone, lose your driver's license or go into status epilepticus and die.


As much as we get on everyone's case about seizures if one carelessly and abruptly stops taking anticonvulsants, the chance of having an extremely violent seizure in this instance is slim. Possible, just highly unlikely. Status, especially the long-lasting fatal version of status would be almost impossible.

Still, a good reminder that repeatedly stopping and restarting an anticonvulsant does make one more susceptible to having a seizure.
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#65 notfred

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Posted 04 July 2008 - 04:42 PM

I wont take it for about four days, and then I break down and take it for three.

Any words of wisom?


Stop doing that.

Seems like you go back on the lamictal because it works. Dehydration and headaches are manageable.
Lamictal triggered migraines, for me, and I learned how to stop that from happening. Acne is very treatable, too. Trust me,
acne reappeared in my 30's (not med related) and is here to stay. I treat it and never have a breakout.

nf

Edited by notfred, 04 July 2008 - 04:45 PM.

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I am in full remission (296.36) from Depression. Insomnia, ADHD-PI, Epilepsy, and the Pseudoparkinsonian tremor are well controlled.

 

Psyc Meds: Forfivo XL 450 mg (Wellbutrin XL), Abilify 15 mg, (Aripiprazole), Eszopiclone 6 mg (Lunesta), Vyvance 70 mg, (dextroamphetamine) Levetiracetam 2,000 mg (Keppra), Propranolol ER 60 mg (Inderal)
PRN: Lorazepam 1-4 mg (Ativan), Alprazolam 1-2 mg (Xanax), Dextroamphetamine 10-40 mg (Dexedrine), Propranolol 20-40 mg (Inderal)

Supps: Multi-vitamin/mineral, Vitamin D-3 2,000 IU, Fish oil 7.2 g

Dx: Depression, Insomnia, ADHD-PI, Epilepsy, Dyspraxia, Tremor

I also take allergy and diabetes + it's complications meds.

All doses are a daily total.


#66 In_Remission_Cooper1977

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Posted 22 July 2008 - 11:43 AM

Hello...
I've been taking Lamictal (in conjunction with Adderall) for about 2 years and it has changed my life!! No more reactions to everything and its given me the ability to actually THINK before I react about if that situation is a battle I want to pick or not...and really evened me out. I love it.

Questions: I WAS taking 200 mg twice a day. Then I just stopped taking the 2nd dose about 2 months ago (no reason really...just stopped)
Well, just recently, I've started to get REAL depressed and want to sleep all day long. Granted my dad got sick so that could be the trigger...but has anyone had this happen when/if they titrated down? I either think it took 2 months to get outta my system and now I am feeling the effects of depression OR could it have stopped working since I had a family crisis?
And, since I titrated down, I feel that entire body muscle ache...all the time and can't sleep without waking up every few hours

I am just hoping someone has titrated down and can tell me if this is a "normal" reaction...and if they ended up titrating up again and had the side effects stop...
Thank you so much!!!!

#67 VAL

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Posted 22 July 2008 - 03:35 PM

Well, I had the muscle pain while titrating down and increased depression but both happened rapidly. I was hoping to get off of it entirely because of the cognitive effects but discovered that I really couldn't, in fact since then it has been increased. I did titrate back up and bizarrely, the muscle pain stopped. I only had the pain while going down which I thought very odd.
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#68 Jerod Poore

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Posted 23 July 2008 - 03:04 PM

It's common with any anticonvulsant. Changing the dosage either up or down can give you side effects you've never had before, or cause side effects you once had and stopped having to return. Side effects tend to go away when one is at the correct dosage one should be at, regardless of what that dosage is.
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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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#69 notfred

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Posted 23 July 2008 - 03:25 PM

I WAS taking 200 mg twice a day. Then I just stopped taking the 2nd dose about 2 months ago (no reason really...just stopped)
Well, just recently, I've started to get REAL depressed and want to sleep all day long.



Well..... seems you have your answer. QED. Unless you have a good reason stop messing with your meds, especially during times of stress. Sam if the work; leave them alone.


Patient: "doc it hurts when I lower my lamictal dose and I get depressed, too"

Doc: " Don't do that"

nf

Edited by notfred, 23 July 2008 - 03:26 PM.

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I am in full remission (296.36) from Depression. Insomnia, ADHD-PI, Epilepsy, and the Pseudoparkinsonian tremor are well controlled.

 

Psyc Meds: Forfivo XL 450 mg (Wellbutrin XL), Abilify 15 mg, (Aripiprazole), Eszopiclone 6 mg (Lunesta), Vyvance 70 mg, (dextroamphetamine) Levetiracetam 2,000 mg (Keppra), Propranolol ER 60 mg (Inderal)
PRN: Lorazepam 1-4 mg (Ativan), Alprazolam 1-2 mg (Xanax), Dextroamphetamine 10-40 mg (Dexedrine), Propranolol 20-40 mg (Inderal)

Supps: Multi-vitamin/mineral, Vitamin D-3 2,000 IU, Fish oil 7.2 g

Dx: Depression, Insomnia, ADHD-PI, Epilepsy, Dyspraxia, Tremor

I also take allergy and diabetes + it's complications meds.

All doses are a daily total.


#70 In_Remission_John

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Posted 26 July 2008 - 08:43 PM

I took Lamictal for about 10 or 12 weeks and was up to 150mg for bipolar depression when a rash broke out on my upper body. It was a strange, itchy red patch on my upper body that also burned a little bit. I called my doctor when I noticed it, and he said stop taking the Lamictal immediately, and I did. He told me to keep an eye on the rash and call him immediately if it got worse.

Well, I decided to go the ER instead. I didn't want to take any chances on SJS. Unfortunately I got an ER doc that had never heard of SJS!! (Can you believe that? I was wondering how in the fuck this guy got an MD but I didn't say that) He said he thought the rash was an outbreak of shingles, so he gave me some anti-virals, and I started taking those. I didn't think it was shingles; in fact, the ER doc struck me as an idiot, so I went to see my primary care physician the next day. My primary care physician knew about SJS and said he didn't think the rash I had was it, but he ordered blood work to confirm his hypothesis. He added that he didn't think it was shingles. He said he thought it was some kind of fungus I picked up in the gym and gave me a special cream to use on the rash. Later that day, my blood work came back normal -- he said there was no evidence suggesting SJS based on the bloodwork results.

That made me feel a little better, but I still wasn't satisfied, so I went to see a dermatologist (sp?) two days later. She was familiar with SJS, asked a lot of questions about how long I was on Lamictal and how much I had been taking, and concluded it wasn't SJS. She said she agreed with my primary care doctor that it wasn't shingles, and she suggested I keep using the anti-fungal cream.

So I kept using the cream and finally, a few days later, I was able to get in and see my psychiatrist. I told him two reliable doctors, one an internist who ran bloodwork, the other a dermatologist who specializes in skin disorders, said it wasn't SJS. By this point, the rash had begun to fade. He said it didn't matter, that he wasn't taking any chances, and that he would never use Lamictal on me again and that I should throw out whatever I had left.

The problem for me is that I was getting GREAT results on the Lamictal, and now I can't take it. Trust me, I've tried just about everything over the years for depression, and my depression has been impervious to everything but Lamictal. Trust me when I say NOTHING has worked. But with Lamictal, I noticed a distinct lift after only two weeks when I was only taking 25 mg, and once I got up to 100 I felt better than I've felt in years.

I don't suppose there is anything out there that does what Lamictal does, but without the rash, is there?

#71 Jerod Poore

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Posted 27 July 2008 - 11:21 AM

So I kept using the cream and finally, a few days later, I was able to get in and see my psychiatrist. I told him two reliable doctors, one an internist who ran bloodwork, the other a dermatologist who specializes in skin disorders, said it wasn't SJS. By this point, the rash had begun to fade. He said it didn't matter, that he wasn't taking any chances, and that he would never use Lamictal on me again and that I should throw out whatever I had left.


In all fairness to your psychiatrist there are other rashes that can be problems. As you stopped taking Lamictal it's difficult to tell what really caused the rash to clear up.

The problem for me is that I was getting GREAT results on the Lamictal, and now I can't take it. Trust me, I've tried just about everything over the years for depression, and my depression has been impervious to everything but Lamictal. Trust me when I say NOTHING has worked. But with Lamictal, I noticed a distinct lift after only two weeks when I was only taking 25 mg, and once I got up to 100 I felt better than I've felt in years.

I don't suppose there is anything out there that does what Lamictal does, but without the rash, is there?


There's nothing out there that does anything close to what Lamictal does. Most anticonvulsants are utterly unique in the way they work. Only a few are close to interchangeable because they are just slight variations on the chemical formulae. E.g. Tegretol and Trileptal.

All is not lost. There have been two studies that show with very slow titration going up in 5mg increments it is unlikely the rash will reappear.

Lamotrigine-induced rash--worth a rechallenge.

A total of 688 patients (350 as monotherapy, and 338 as add-on therapy) with either idiopathic generalized epilepsy or focal epilepsy were treated with LTG [lamotrigine]. The patients with LTG-induced rash were rechallenged to LTG. The dosage schedule was: 5 mg every day or every second day for 14 days, increased by 5 mg every 14th day to 25 mg a day. After achieving the daily dosage of 25 mg/day, the up-titration was completed following the current guidelines.

RESULTS: A total of 52 patients developed a rash. The LTG-induced rash occurred in 6%, where 12 (1.8%) developed a rash shown to be coincidentally associated with the initiation of LTG therapy. In their cases LTG was continued with success without intermission. Nineteen (38%) of the initial cohort were rechallenged with LTG, with a success rate of 84%. CONCLUSION: This study is the first one to provide a successful recipe verified in time for the rechallenge with LTG after the initial drug-induced rash.



Dermatology precautions and slower titration yield low incidence of lamotrigine treatment-emergent rash.

We assessed rash incidence in 100 patients with DSM-IV bipolar disorder instructed, for their first 3 months taking lamotrigine, to avoid other new medicines and new foods, cosmetics, conditioners, deodorants, detergents, and fabric softeners, as well as sunburn and exposure to poison ivy/oak. Lamotrigine was not started within 2 weeks of a rash, viral syndrome, or vaccination. In addition, lamotrigine was titrated more slowly than in the prescribing information.

RESULTS: No patient had serious rash. Benign rash occurred in 5 patients (5%) and resolved uneventfully in 3 patients discontinuing and 2 patients continuing lamotrigine. Two patients with rash were found to be not adherent to dermatology precautions. Therefore, among the remaining patients, only 3/98 (3.1%) had benign rashes. CONCLUSION: The observed rate of benign rash was lower than the 10% incidence in other clinical studies. The design of this study confounds efforts to determine the relative contributions of slower titration versus dermatology precautions to the low rate of rash. Systematic studies are needed to confirm these preliminary findings, which suggest that adhering to dermatology precautions with slower titration may yield a low incidence of rash with lamotrigine.


What? Someone did a study to back up what I had been writing all this time? I wonder how much grant money they got.

The latter study is published in a psychiatry journal, the former in a neurology journal. One way or another your doctor should be able to get to the full text of the latter one.
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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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#72 In_Remission_John

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Posted 02 August 2008 - 10:16 AM

Many thanks for this information. I'll bring it up for sure.

What's my best bet for bipolar depression if he still doesn't want to use it?

#73 Jerod Poore

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Posted 02 August 2008 - 01:01 PM

What's my best bet for bipolar depression if he still doesn't want to use it?


For bipolar 1 with dysphoric mania and Lamictal being the thing that worked great?

Lithium + trial & error with antidepressants with or without gabapentin.

Lamictal is unique in that it is the only anticonvulsant on the US market that, depending on which paper you read:

1) doesn't affect GABA or doesn't affect it that much

2) enhances GABA, but about as much as a moderate dosage as gabapentin does

3) actually inhibits GABA, which is the opposite of what every other anticonvulsant on the planet does


When you talk to your doctor, emphasize what you wrote here.

The problem for me is that I was getting GREAT results on the Lamictal, and now I can't take it. Trust me, I've tried just about everything over the years for depression, and my depression has been impervious to everything but Lamictal. Trust me when I say NOTHING has worked. But with Lamictal, I noticed a distinct lift after only two weeks when I was only taking 25 mg, and once I got up to 100 I felt better than I've felt in years.


These are the words any doctor wants to hear. 'The meds WORK!' I bet he/she changes their mind if you do this. Be pro-active. It's your brain, not theirs. Right?


This is the best course of action. Otherwise it's going to be a lot of rides on the med-go-round.
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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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#74 In_Remission_April

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Posted 05 August 2008 - 08:53 PM

John,

I am curious as to what withdrawal symptoms you are experiencing? I am trying to taper off the medication. I have only been on it for about 12 weeks, but I am up to 200 mg. Please let me know. I would love to taper off fast but I have read about the horrible side effects of doing that.

#75 In_Remission_John

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Posted 06 August 2008 - 05:33 PM

The short answer is that it wasn't a pleasant experience. I had severe headaches and general fogginess for days. I had to take a lot of Xanax. I wouldn't recommend it if you can help it.

Regards,

John,

I am curious as to what withdrawal symptoms you are experiencing? I am trying to taper off the medication. I have only been on it for about 12 weeks, but I am up to 200 mg. Please let me know. I would love to taper off fast but I have read about the horrible side effects of doing that.



#76 Jerod Poore

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Posted 07 August 2008 - 09:50 AM

I had severe headaches and general fogginess for days.


Which are typical symptoms of sudden anticonvulsant withdrawal. Good thing you didn't have any seizures.

I had to take a lot of Xanax.


Which is probably why you didn't have any seizures. Benzos are the best friend of anyone who has to do this. Any benzo. Klonopin (clonazepam) is the best, but anything you already have a prescription for / on hand will do.
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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

#77 daikomeo

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Posted 05 September 2008 - 03:28 PM

What about paranoia, euphoria, and massive anxiety as a decrease in Lamictal? Anyone have these while going down?
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[i]Daikomeo

Bipolar II w/ Mixed Features, PMDD

Lamictal 150 mg, Klonopin 2 mg t.i.d., Neruontin 100 mg t.i.d., 1 mg of Klonopin prn.
Vitamin D 50,000 IU, 800 mg Skelaxin PRN, Lortab 7.5/500 PRN, 25mg promethazine PRN, Isoptin...dosage will change in the next few weeks.

Body does not tolerate BCPs, ADs, or APs. Don't ask. Nearly all of what you would like to know about this is in: Women's issues: Adj. Dis. NOS.

I guess I live by a motto of life sucks but change is inevitable.
And: Do not underestimate your own ability to learn or undermine your own comprehension level. You might be surprised when you try it.

Never Give Up, but Know When to Surrender!!!!!!!!!

#78 dymphna

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Posted 05 September 2008 - 10:54 PM

What about paranoia, euphoria, and massive anxiety as a decrease in Lamictal? Anyone have these while going down?


Yes.

It's an anti-convulsant, after all. All of the things that a person could see in a person who has seizures can subsequently be brought forth by an anti-convulsant in a person who doesn't have them. Well, except for the gnarled EEG. The EEG remains stable. It is the side effects that go wonky. And that isn't even accounting for a person's original illness simply shining through the lack of medication (no side effects, just crazy).

Remember: brain cooties are a spectrum. BP, Migraine, Epilepsy -- they aren't the same thing, but they exist along a continuum wherein symptoms can interchange. This is why AEDs are used for BP. But sometimes those same AEDs will give nasty, epi-like side effects. Personally, I would hate to be a neurologist and have to pin down diagnoses. It would be like giving a cat a bath.


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#79 Jerod Poore

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Posted 06 September 2008 - 08:18 AM

What about paranoia, euphoria, and massive anxiety as a decrease in Lamictal? Anyone have these while going down?


Let's see, you're BP II with mixed features, you're decreasing the medication to treat it and having symptoms of BP II with mixed features, regardless of your having those specific features previously.

I don't think it's specific to Lamictal.
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#80 daikomeo

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Posted 06 September 2008 - 11:25 AM

Neither do I. These three symptoms of paranoia, euphoria, and anxiety all keep coming in waves. Roughly every 6 hours as best I can tell. Pdoc told me to go back up to my previous decreased dose(137.5 mg Lamictal) to see if it helps. So far I've had two more "attacks". Each feeling very intense. They believe that he Lamictal decrease is the reason that I am having all three of these symptoms at the same time. I don't know whether to call the pdoc back or not. I don't want to end up back at the hospital but like you I don't think this is specific to Lamictal.

If I had to guess I assume that the decrease triggered something else when I first lowered from the original dose of 150 mg to 137.5 mg(very very med sensitive). Then when I went down to the 125 mg whatever this is came on full blown.

Is it time to call the pdoc back?
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[i]Daikomeo

Bipolar II w/ Mixed Features, PMDD

Lamictal 150 mg, Klonopin 2 mg t.i.d., Neruontin 100 mg t.i.d., 1 mg of Klonopin prn.
Vitamin D 50,000 IU, 800 mg Skelaxin PRN, Lortab 7.5/500 PRN, 25mg promethazine PRN, Isoptin...dosage will change in the next few weeks.

Body does not tolerate BCPs, ADs, or APs. Don't ask. Nearly all of what you would like to know about this is in: Women's issues: Adj. Dis. NOS.

I guess I live by a motto of life sucks but change is inevitable.
And: Do not underestimate your own ability to learn or undermine your own comprehension level. You might be surprised when you try it.

Never Give Up, but Know When to Surrender!!!!!!!!!

#81 dymphna

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Posted 06 September 2008 - 01:03 PM

"Whatever this is" is your illness, just like Jerod said.

You misinterpret him when you assume Lamictal isn't playing a role. By decreasing your Lamictal, you are allowing your illness to shine through.

It is coming in "waves" because Lamictal processes through your body over a period of hours. I would almost bet money that it doesn't happen in the few hours immediately following your morning meds. If you are only taking your meds at night, and have decreased the dose, then it would follow that you are having problems throughout the day.

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Yes, my name really is Dymphna.

 

I'm not a doctor, nurse, pharmacist, or therapist.

I can find you an answer and I won't blow smoke up your ass.

 

St. Dymphna is the Patron for brain maladies.

 

I'm the Enforcer.

 

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#82 In_Remission_Donna Marie

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Posted 06 September 2008 - 01:17 PM

Hi, Is there a reason you had to cut your Lamictal dosage? The evening dosage probably calmed the brain activity down so you were able to have a deeper night's sleep. The depression (im sorry your dad isn't well) if it feels deeper then that(a bit uncontrolable) I would go back to the dose that worked.

#83 In_Remission_Donna Marie

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Posted 06 September 2008 - 01:19 PM

Oh sorry- I am also on 100mg of Lamictal

#84 Rayjean

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Posted 06 September 2008 - 02:45 PM

My guess is like someone else said, your illness is shining thru as you decrease the lamictal.

Some time ago, both my spouse & I misjudged the way my mood was turning....we thought I was going "Up" because of all the anxiety. Decided to cut back the lamictal as we thought I was really hypomanic & anxiety got worse & depression starting coming on. Went back to an increased dose of Lamictal and all is fine.
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#85 daikomeo

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Posted 07 September 2008 - 09:16 AM

I gotcha. I am beginning to feel better with the slight increase. I am pretty sure we will have to go back to my original dose of 150 mg. Last year I was at 200 mg and it turned out that it was causing a humongous number of "pregnancy" symptoms w/o being pregnant. At that point my husband's vasectomy had not reversed it self. Now, we learned in April, that his vasectomy reversed itself. When the symptoms spiked again just as intense this time we thought we were pg but found out that we are not. So the blame "switched" to the lamictal. This was the reason to attempt the decrease. So since the symptoms BPII outweigh the pg like symptoms I am pretty sure I'm going to have to suck it up and deal with them. The BPII is not something I want to get out of control. I hate hospitals.

So, this is why for the decrease and why I'm going to have to suck it up on the other symptoms. I would rather feel sane with pg like symptoms than end up in the hospital to decrease the pg like symptoms via lamictal decrease.

Thanks for all your feedback. I appreciate the insight.
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[i]Daikomeo

Bipolar II w/ Mixed Features, PMDD

Lamictal 150 mg, Klonopin 2 mg t.i.d., Neruontin 100 mg t.i.d., 1 mg of Klonopin prn.
Vitamin D 50,000 IU, 800 mg Skelaxin PRN, Lortab 7.5/500 PRN, 25mg promethazine PRN, Isoptin...dosage will change in the next few weeks.

Body does not tolerate BCPs, ADs, or APs. Don't ask. Nearly all of what you would like to know about this is in: Women's issues: Adj. Dis. NOS.

I guess I live by a motto of life sucks but change is inevitable.
And: Do not underestimate your own ability to learn or undermine your own comprehension level. You might be surprised when you try it.

Never Give Up, but Know When to Surrender!!!!!!!!!

#86 Jerod Poore

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Posted 07 September 2008 - 10:31 AM

It is coming in "waves" because Lamictal processes through your body over a period of hours. I would almost bet money that it doesn't happen in the few hours immediately following your morning meds. If you are only taking your meds at night, and have decreased the dose, then it would follow that you are having problems throughout the day.


I like that hypothesis, given Lamictal's wildly variable half-life. It's possible that the waves are also a presentation of ultradian cycling, but Occam's Razor favors the former over the latter.
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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

#87 daikomeo

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Posted 07 September 2008 - 10:34 AM

It is coming in "waves" because Lamictal processes through your body over a period of hours. I would almost bet money that it doesn't happen in the few hours immediately following your morning meds. If you are only taking your meds at night, and have decreased the dose, then it would follow that you are having problems throughout the day.


I like that hypothesis, given Lamictal's wildly variable half-life. It's possible that the waves are also a presentation of ultradian cycling, but Occam's Razor favors the former over the latter.



Quite the opposite. I take it in the morning and hit at least three "waves" during the day. And now I am noticing racing thoughts with more intense anxiety. this sucks....
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[i]Daikomeo

Bipolar II w/ Mixed Features, PMDD

Lamictal 150 mg, Klonopin 2 mg t.i.d., Neruontin 100 mg t.i.d., 1 mg of Klonopin prn.
Vitamin D 50,000 IU, 800 mg Skelaxin PRN, Lortab 7.5/500 PRN, 25mg promethazine PRN, Isoptin...dosage will change in the next few weeks.

Body does not tolerate BCPs, ADs, or APs. Don't ask. Nearly all of what you would like to know about this is in: Women's issues: Adj. Dis. NOS.

I guess I live by a motto of life sucks but change is inevitable.
And: Do not underestimate your own ability to learn or undermine your own comprehension level. You might be surprised when you try it.

Never Give Up, but Know When to Surrender!!!!!!!!!

#88 dymphna

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Posted 07 September 2008 - 12:30 PM

It is coming in "waves" because Lamictal processes through your body over a period of hours. I would almost bet money that it doesn't happen in the few hours immediately following your morning meds. If you are only taking your meds at night, and have decreased the dose, then it would follow that you are having problems throughout the day.


I like that hypothesis, given Lamictal's wildly variable half-life. It's possible that the waves are also a presentation of ultradian cycling, but Occam's Razor favors the former over the latter.



Quite the opposite. I take it in the morning and hit at least three "waves" during the day. And now I am noticing racing thoughts with more intense anxiety. this sucks....


That doesn't compute.

You said:

These three symptoms of paranoia, euphoria, and anxiety all keep coming in waves. Roughly every 6 hours as best I can tell.


If you wake at 5 or 6 AM and take your meds, under the above description, the first "wave" would not occur until 11-12, the second, around 5-6 PM, and the third, 11-midnight. That isn't three waves "during the day".

Perhaps the TID dosing of the Klonopin is kicking you in the head.


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Yes, my name really is Dymphna.

 

I'm not a doctor, nurse, pharmacist, or therapist.

I can find you an answer and I won't blow smoke up your ass.

 

St. Dymphna is the Patron for brain maladies.

 

I'm the Enforcer.

 

eqnmrt.jpg

 


#89 daikomeo

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Posted 07 September 2008 - 05:49 PM

It is coming in "waves" because Lamictal processes through your body over a period of hours. I would almost bet money that it doesn't happen in the few hours immediately following your morning meds. If you are only taking your meds at night, and have decreased the dose, then it would follow that you are having problems throughout the day.


I like that hypothesis, given Lamictal's wildly variable half-life. It's possible that the waves are also a presentation of ultradian cycling, but Occam's Razor favors the former over the latter.



Quite the opposite. I take it in the morning and hit at least three "waves" during the day. And now I am noticing racing thoughts with more intense anxiety. this sucks....


That doesn't compute.

You said:

These three symptoms of paranoia, euphoria, and anxiety all keep coming in waves. Roughly every 6 hours as best I can tell.


If you wake at 5 or 6 AM and take your meds, under the above description, the first "wave" would not occur until 11-12, the second, around 5-6 PM, and the third, 11-midnight. That isn't three waves "during the day".

Perhaps the TID dosing of the Klonopin is kicking you in the head.


Dymphna



Three symptoms occurring at the same time, three different times of the day. I said roughly. I take my meds around 7 am. The first of the "wave" hits around 11 to noon(nearly two hours before my afternoon meds). The second around 4 to 6 pm. Then the next around 10 to 11pm after evening meds. By "during the day" I mean when I'm awake. sorry to confuse you all.
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[i]Daikomeo

Bipolar II w/ Mixed Features, PMDD

Lamictal 150 mg, Klonopin 2 mg t.i.d., Neruontin 100 mg t.i.d., 1 mg of Klonopin prn.
Vitamin D 50,000 IU, 800 mg Skelaxin PRN, Lortab 7.5/500 PRN, 25mg promethazine PRN, Isoptin...dosage will change in the next few weeks.

Body does not tolerate BCPs, ADs, or APs. Don't ask. Nearly all of what you would like to know about this is in: Women's issues: Adj. Dis. NOS.

I guess I live by a motto of life sucks but change is inevitable.
And: Do not underestimate your own ability to learn or undermine your own comprehension level. You might be surprised when you try it.

Never Give Up, but Know When to Surrender!!!!!!!!!

#90 In_Remission_claire08

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Posted 05 October 2008 - 10:13 AM

On advice from my doctor, I am coming off lamictal. Dosage was pretty low compared to most people here: it was being used as a preventative for chronic migraine vertigo. The jury is out on success or not. Had a couple of practically symptome free weeks in the summer, but had begun to have week after week of viral-y feelings, extreme nausea over last month or so. Doctor reckoned it would be worth coming off completely before my next visit to the hospital as I was obviously not feeling well or "cured". Hospital will then assess and suggest next preventative trial. I was on 75mg, did a week at 50mg and am now at 25mg (in the morning). I feel pretty rubbish. Viral-y, on and off dizziness, thick head (not headache), stomach problems, nausea and the sensation of an aching dead weight in my stomach, sense of looking through a gauze. Does anyone have experience of lamictal withdrawal similar to this? I also realises that all these symptoms could be the migraine vertigo jollies reinstating their superiority. :mad:


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