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Dr. Bob is Robert Hsiung, MD,
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Posted by delna on February 3, 2004, at 12:09:40
In reply to Coffee and Lamictal agitating combo for bipolars?, posted by lizbeth on December 23, 2003, at 11:17:34
Hi,
I'm rsponding to a prevous post- quite late in the day. However I too have also noticed that with coffee (even 1 cup) and Lamictal I become really aggitated and need quite a few rivotrils and inderals to bring to a normal state of calm. I am also on wellbutrin and suprisingly 300mg+Lamictal 200mg and effexor xr 37.5 keep me at a good level of steadiness. BUT add coffee and i am a total mess- even when i cut the wellbutrin out.
Its wierd- but I too have noticed this pattern.
I dont know the science behind it but my experience has been very clear and it is really awful. I am also Bipolar II
Thnx
> My issue is that lately, no matter how little coffee and/or caffeine I have in the morning, I get very agitated within a short period of time. My psychopharmacologist simplified it as such: unlike stimulants like Adderall, which create dopamine in the system (and are bad news for non-ADD bipolars, IMHO and experience), caffeine simply raises the ceiling on the amount of dopamine that's possibly available. Lamictal's effect on glutamate indirectly raises dopamine and norepinephrine (sp) and perhaps this increased dopamine gets magnified by caffeine?
>
> Yikes. Anyone else had similar reactions? I know one of you (Fluffy?) mentioned it.
Posted by alathea on February 4, 2004, at 0:36:48
In reply to Re: Coffee and Lamictal agitating combo for bipolars? » lizbeth, posted by delna on February 3, 2004, at 12:09:40
I don't understand. I've just read almost all your posts (which is a miracle in itself since wellbutrin makes me rapid cycle, apparently although we only just figured that out, but it explains a lot) anyway--I'm stopping the wellbutrin--BECAUSE--
my pdoc wants me starting on lamictal, but I have MAJOR rage problems (when I'm not morbidly depressed) but from a lot of these posts it sounds like Lamictal is going to be just as bad as Wellbutrin?
I actually had two relatively stable years on tegratol and wellbutrin, but I went off the tegratol because I was worried about my liver and it was screwing up my skin--but I'm afraid everything does that.....oh yeah, and coffee....BAD NEWS!!! As if I'm not already clenching my teeth without any caffiene in my system.
I don't know. I never want to take my meds--until I'm so effing miserable that I go crying to my pdoc willing to take anything he says, for a little while.......
Posted by Dalilah on February 4, 2004, at 11:53:07
In reply to My pdoc is Crazy????? (and coffee too), posted by alathea on February 4, 2004, at 0:36:48
For what it's worth, Wellbutrin made me unbearably rage-ful. Lamictal sometimes made me irritable when I increased the dosage, but it only last for about 3 days. I seem to need Lithium with my Lamictal. There's no doubt Lamictal is the only thing that relieved my depression, when I got to a high dose (300mg for me.)
I never ever ever drink coffee - NO WAY. But it's got nothing to do with Lamictal. I think it has to do with my bipolar, cause it always takes me on a teeth cletching horrible icky not fun "high."
And I'm sure you know, I don't think any of these things work unless you take them regularly.
-Dalilah
> I don't understand. I've just read almost all your posts (which is a miracle in itself since wellbutrin makes me rapid cycle, apparently although we only just figured that out, but it explains a lot) anyway--I'm stopping the wellbutrin--BECAUSE--
>
> my pdoc wants me starting on lamictal, but I have MAJOR rage problems (when I'm not morbidly depressed) but from a lot of these posts it sounds like Lamictal is going to be just as bad as Wellbutrin?
>
> I actually had two relatively stable years on tegratol and wellbutrin, but I went off the tegratol because I was worried about my liver and it was screwing up my skin--but I'm afraid everything does that.....oh yeah, and coffee....BAD NEWS!!! As if I'm not already clenching my teeth without any caffiene in my system.
>
> I don't know. I never want to take my meds--until I'm so effing miserable that I go crying to my pdoc willing to take anything he says, for a little while.......
Posted by alathea on February 5, 2004, at 0:25:15
In reply to Re: My pdoc is Crazy????? (and coffee too), posted by Dalilah on February 4, 2004, at 11:53:07
Dalilah--I am so glad to know that somebody else has that reaction to Wellbutrin, and hopefully Lamictal will be the answer for me too. I just wish there was something a little bit sedating that I could take to deal with the irritability at least during during the transition, but I can't take anything like that because I've been clean and sober for three years and, well....I'd like to keep it that way.
I always take my meds religiously when I take them, but every few years I get some kind of "wild hair" and want to go off them or switch things around. Here's hopin' the Lamictal works. Thanks for your response!
Posted by delna on February 5, 2004, at 1:25:16
In reply to Re: My pdoc is Crazy????? (and coffee too), posted by alathea on February 5, 2004, at 0:25:15
Hi
I too cycle quite rapidly but only in phases. In general my lows mean i have no energy whatsoever and i cannot even get out of bed and am very suicidal. That where the wellbutrin is essential as well as small dose effexor
I also get thoes awful highs, which you describe, then crash to depression.
What I have found is that Lamactil, at even 300mg makes me really aggitated but 200mg is fine. My doc had asked me to up my dose from my usual 200mg -since he wanted NO symptoms of depression at all. At 200mg the anger and aggression is in control and i feel pretty stable.
So for me the dose is really critical. higher than 200mg and I become worse and actually start cycling alot.
At 200mg, wellbutrin 150mg is great as it keeps me awake. I cant tolerate the 300mg wellbutrin I am prescribed as this makes me jittery.so in my experience with both lamactil and wellbutrin , the dosage is so critical. For me lamactil has been amazing as I was so aggresive and impulsive before.
But my doctor and I have to keep playing with doses to find a balance- which is really destabalising. But worth it.
D
Posted by Dalilah on February 5, 2004, at 12:27:12
In reply to Re: My pdoc is Crazy????? (and coffee too), posted by alathea on February 5, 2004, at 0:25:15
Hi Alathea -
I too am clean and sober (6 years.) I take 50mg of seroquel in the evening to sleep. It may help me with daily aggitation as well. It is non narcotic, not a benzodiazapine (sp?) I find it very difficult in the "program" to talk about all of these issues. Most people don't really understand depression or bi-polar and are all to willing to judge the taking of meds/drugs. Here in L.A. there are large factions of AA that believe if you take any meds at all for depression, you are no longer sober. You can imagine how angry this makes me.And Delna,
I agree dosage is important for everyone. For me 300mg Lam is necessary. It's just different for everyone, as are which meds each person can tolerate. I suppose we all have different chemical make-ups, which is why this disease is so hard to treat.-Dalilah
> Dalilah--I am so glad to know that somebody else has that reaction to Wellbutrin, and hopefully Lamictal will be the answer for me too. I just wish there was something a little bit sedating that I could take to deal with the irritability at least during during the transition, but I can't take anything like that because I've been clean and sober for three years and, well....I'd like to keep it that way.
>
> I always take my meds religiously when I take them, but every few years I get some kind of "wild hair" and want to go off them or switch things around. Here's hopin' the Lamictal works. Thanks for your response!
Posted by Jolene Q. Houghton on February 7, 2004, at 4:34:07
In reply to Lamictal side effects, posted by seamus o'noolan on June 30, 2003, at 17:37:40
Has anyone noticed sleeplessness as being a side effect of lamictal? I'm only on 25 miligrams at the moment, but I've noticed it for the past month.
Posted by fluffy on February 7, 2004, at 13:45:26
In reply to Re: Lamictal side effects, posted by Jolene Q. Houghton on February 7, 2004, at 4:34:07
Hi Jolene--
I definitely had insomnia on Lamictal. Esp. at the higher doses. It's a pretty common side effect. Then again, sleeplessness goes along with mania and depression!
But I found Lamictal to be activating, and at times it made me feel agitated (esp. when I titrated up on the dose). Run it by your doctor next time you see him/her if it is disrupting your sleep too much.
Best of luck with the Lamictal. It's a good drug.
Posted by ramsea on February 9, 2004, at 4:51:49
In reply to Re: My pdoc is Crazy????? (and coffee too), posted by Dalilah on February 5, 2004, at 12:27:12
I have experienced this from AA in the UK. It ruined my career and reputation---their lack of acceptance of bipolar and its treatment, and my wellnesss as a result. I am now quite anti-AA. Their attitude hurt me badly, nealy killed me and now has cost me a lot in terms of counseling jobs in my small region. Over some 20 years my social suport was mostly 12-step, so having lost that center of my life I have no friends, zero. It's been hell. I am recovering from a very destructive breakdown, but matters would have gone more smoothly had the AA members who called me their good friend actually stood by me during hospitalization and convalescence. I have to reinvent myself.
Remake a life. At 47, no easy task. I also have to keep looking the other way as most of the former friends don't want to say hello--which is fine. But it is all so awkward. I do hope to move away from here someday. There are a few rehab centers around here, so in a small town that makes the whole situation a little, excuse the word, tight.
Posted by Dalilah on February 9, 2004, at 12:48:58
In reply to Re: My pdoc is Crazy????? (and coffee too) » Dalilah, posted by ramsea on February 9, 2004, at 4:51:49
I am sad and angry to hear your story. I too am pretty anti AA after receiving much support for 5 years in. I've heard numerous stories of people directed NOT to take their meds, that the 12 steps would relieve there depression, and then these people ended up committing suicide, something that may very well have been avoided with meds.
They have a few (very few) dual-diagnosis meeting here in La La Land, but probably not in remote areas of the globe. I am very leary of these meetings and have only attended one I liked. A friend is dragging me to a new one on Wed night. Wish me luck. The other problem is it's an hour drive from here (more in traffic.) OUCH. This kind of thing only leads to more depression for me.
There are also those who take meds but won't tell anyone cause of the shame etc, which I fear only perpetuates the stigma of the mentally ill. But that's another situation entirely.
-Dalilah
> I have experienced this from AA in the UK. It ruined my career and reputation---their lack of acceptance of bipolar and its treatment, and my wellnesss as a result. I am now quite anti-AA. Their attitude hurt me badly, nealy killed me and now has cost me a lot in terms of counseling jobs in my small region. Over some 20 years my social suport was mostly 12-step, so having lost that center of my life I have no friends, zero. It's been hell. I am recovering from a very destructive breakdown, but matters would have gone more smoothly had the AA members who called me their good friend actually stood by me during hospitalization and convalescence. I have to reinvent myself.
>
> Remake a life. At 47, no easy task. I also have to keep looking the other way as most of the former friends don't want to say hello--which is fine. But it is all so awkward. I do hope to move away from here someday. There are a few rehab centers around here, so in a small town that makes the whole situation a little, excuse the word, tight.
Posted by Parisss on February 10, 2004, at 14:12:48
In reply to AA and meds, posted by Dalilah on February 9, 2004, at 12:48:58
So how did your Wed meeting go?
Posted by zero on February 10, 2004, at 17:55:36
In reply to Re: My pdoc is Crazy????? (and coffee too) » Dalilah, posted by ramsea on February 9, 2004, at 4:51:49
Posted by silmarilone on February 11, 2004, at 2:05:21
In reply to AA and meds, posted by Dalilah on February 9, 2004, at 12:48:58
You're going to a dual dx meeting in los angeles? where? i'm in the pasadena area, and would like to find one
death_in_venice_mann@yahoo.com
Posted by Dr. Bob on February 11, 2004, at 8:05:09
In reply to AA and meds, posted by Dalilah on February 9, 2004, at 12:48:58
> I am sad and angry to hear your story. I too am pretty anti AA after receiving much support for 5 years in...
I'd like follow-ups regarding AA to be redirected to Psycho-Babble Substance Use. Here's a link:
http://www.dr-bob.org/babble/subs/20040130/msgs/311972.html
Thanks,
Bob
Posted by alathea on February 16, 2004, at 19:13:32
In reply to Re: Lamictal side effects - URGENT, posted by Houston on September 24, 2003, at 16:50:58
I would be curious about this too. But, did you stop just recently on the wellbutrin? Cause coming off that can cause weight gain I think. i'm on so much crap now I really have no interest in eating. But that never lasts.
I couldn't tell if it was going on Lamictal or comoing off the Wellbutrin that was making me hungry--but now I started back on tegratol and am taking Lamazapam (sp?) and I really have no desire whatsoever to eat.Good luck!
Posted by sczacovi on February 20, 2004, at 8:56:53
In reply to Re: Barb, Re: Lamictal side effects » Dalilah, posted by Barbara Cat on August 3, 2003, at 13:52:10
I have a 12 year old son who was diagnosed with epilepsy when he was 8 years old. He was put on depakote and his seizures stopped, but he started getting very aggressive and mean. He would hurt his 3 year old brother on purpose, didn't seem to know the consequence of his actions and got hyper. The doctor then diagnosed him with adhd and put him on all different types of meds with the depakote. He was on concerta (made him more hyper), paxil (made him sleepy and more depressed) and risperdal (which totally put him in a severe depression) and straterra (which did nothing). I had enough. I told the doctor that I thought that the depakote was the whole problem and the other meds where just making it worse. I said we should clean out his system and get him off all meds to see if his behavior changes. He was clean and did o.k. but now he was not on any seizure medication and he was having a lot more seizure activity. I finally went to a new doctor at Children's Memorial and she put him on lamictal. Over time he got better, but he still had that anger thing and he would easily be brought to tears. Before he was diagnosed with seizures, it seemed he didn't know how to act socially. He was very immature for his age and he would breakdown and cry if things didn't go his way. For instance, if we were playing a board game and he lost, he would cry horribly. He doesn't know how to make friends and he's never been asked over to anyone's house. So, before all the meds he cried a lot, didn't like attention, lacked self-esteem and self confidence and was very disorganized. He was never aggressive. He started talking about suicide so we went to a neuropsychologist that said he was bipolar. He is now on lamictal, zyprexia and adderall. We had to decrease his adderall to 10mg because 20mg made him worse. The doctor said that's probably because he is not adhd. When you give someone meds for something that he doesn't have, it tends to make them worse. So now he are going to individual therapy, family therapy and seeing a psychiatrist. My husband and I are so frustrated. I'm doing all kinds of research and there are probably about 1,000 mood disorders he could fit. Now I'm thinking that before he went on any meds for anything, he was never aggressive, just wishy-washy crying, that maybe the meds are making him seem bipolar? It's like now he is aggressive/depressed where before meds he wasn't. Can these meds give you symptoms of other disorders? We put him through a lot of psychological testing and we will get the results next month. Hopefully they can pinpoint what the ++++ is wrong and we can get him healty again.
Posted by Toph on February 20, 2004, at 10:06:21
In reply to Re: Barb, Re: Lamictal side effects, posted by sczacovi on February 20, 2004, at 8:56:53
Sczac,
Maybe a little out of left field, but have you thought of getting a dog for your son? If you choose the right breed they can be the most loving and accepting animals of an owner with mood swings. Your son can gain self worth from being adored by his pet. If you have a dog park in your county it might be an area for socialization for the pet and your son. My children have grown and are finding their way in this world, but my Portuguese Water Dog (non-shedding), Gus, will be with me till death do us part. (Thankfully, my wife loves me too).
Toph
Posted by sczacovi on February 20, 2004, at 10:21:38
In reply to Re: Barb, Re: Lamictal side effects » sczacovi, posted by Toph on February 20, 2004, at 10:06:21
> Sczac,
>
> Maybe a little out of left field, but have you thought of getting a dog for your son? If you choose the right breed they can be the most loving and accepting animals of an owner with mood swings. Your son can gain self worth from being adored by his pet. If you have a dog park in your county it might be an area for socialization for the pet and your son. My children have grown and are finding their way in this world, but my Portuguese Water Dog (non-shedding), Gus, will be with me till death do us part. (Thankfully, my wife loves me too).
>
> TophThank you for your response. We actually have 2 dogs and 3 cats. What's really neat is that our chocolate lab sleeps with my son. Before that our husky/shepherd mix dog also sleep with my son. They say dogs can sense something and maybe they sense his needs or epilepsy. I don't know. We have trails behind our property and we go and take the dogs for walks and let them run free. I try to get my son out as much as possible, but he would rather play video games 24/7. We have restriction on the games so he doesn't get his way. I also tried camps, baseball, football, etc. He can't seem to hold on to any social activity. For example, if he doesn't get a hit whenever he goes up to bat, he gets angry and cries. He's like a sore loser but he isn't. It's weird. We never push for our children to be the best. We always say have fun and try and the word "perfect" is not in our family vocabulary. It seems we have tried a lot of things without success. Thanks again for your suggestion.
Posted by Toph on February 20, 2004, at 10:53:06
In reply to Re: Barb, Re: Lamictal side effects, posted by sczacovi on February 20, 2004, at 10:21:38
I hope the tunnel vision into the TV doesn't contribute to the seizure disorder. Sometimes all you can do is love them and let them find their own way. Most of us have struggled with self-image issues related to our mental illness. Maybe spending more time with other epileptics will help him eperience normal interaction with peers.
Posted by jackwade on February 20, 2004, at 16:03:30
In reply to Re: Lamictal side effects » HenryO, posted by Jack Smith on July 1, 2003, at 12:52:36
Does anyone know anything about Lamictal and if it increases your heart rate. I have been on it for a month or so and my blood pressure is way up.
Posted by Emme on February 21, 2004, at 9:44:04
In reply to Re: Lamictal side effects, posted by jackwade on February 20, 2004, at 16:03:30
> Does anyone know anything about Lamictal and if it increases your heart rate. I have been on it for a month or so and my blood pressure is way up.
The timing of your BP increase matches when you started Lamictal (or when you hit a certain dose?) I haven't read anything about it, and a neurologist freind hasn't seen it in her patients. My pdoc says her other patients haven't complained of that. BUT she believes me when I stay it's a bit stimulating for me and that it might possibly be increasing my heart rate a little. It's been counteracted by other things I take.
I don't think it's driven my BP up. but I don't have a hard time believing it might to it for you. A lot of people find it increases anxiety at first. I had some irregular heartbeats while starting up. Not too often and nothing extreme and my internist wasn't worried. It stopped after a few weeks and I haven't had any of that since.
A benzo might settle your system down. A low dose of a beta blocker might be helpful while you see if your body adjusts to Lamictal. I find atenolol helps with the physical symptoms of anxeity and overstimulation. Atenolol doesn't readily cross the blood brain barrier and would probably be less likely to cause depression than the other beta blockers.
If you and your pdoc can find something that helps with your BP, it might be possible for you to ride it out for a while and see if you adjust to it - unless you deem it best to stop it.
Also, how quickly are you titrating?
Emme
Posted by bruce_w6 on February 24, 2004, at 9:37:33
In reply to Re: Lamictal side effects » jackwade, posted by Emme on February 21, 2004, at 9:44:04
My history...
I tried all the SSRI's didn't work) and have been started on Lamictal. Dr. says bipolar II. Started with 25mg for 2 weeks, 50 mg for 2 weeks and just started 100 mg 3 days ago. Taking Neurontin 400 mg 2 times a day to help with agitation. Just started on fish oil.My question...
The mind racing. Especially when trying to go to sleep (ambiam 10 mg helps to go to sleep. If I wake up at all it is almost impossible to go back to sleep. AD did help with this problem in the past. Will Lamictal eventually help with this?When did you start seeing results with Lamictal (how long did it take)?
Posted by DepNYer on February 24, 2004, at 12:01:25
In reply to Lamictal And Mind Racing, posted by bruce_w6 on February 24, 2004, at 9:37:33
I don't post here often (more lurking to see what i can learn), but, if you are BPII, you should know that Lamictal is a good mood stabilizer, particularly for the depressive aspect, but it can induce hypomania. The racing thoughts may be such a reaction, and I would speak to your Pdoc ASAP about it.
Posted by Viridis on February 24, 2004, at 23:23:46
In reply to Lamictal And Mind Racing, posted by bruce_w6 on February 24, 2004, at 9:37:33
Do you mean that it caused your mind to race, or that this was already happening and Lamictal didn't help?
If it's causing this, you definitely should speak with your pdoc in case it is inducing hypomania. If it's just not helping, it could be that you haven't reached a therapeutic level (which you also should ask your doctor about).
I started taking it about three weeks ago (I'm still at the 50 mg stage) and noticed some minor activation/restlessness at first, but this went away very quickly for me and I haven't noticed any other side effects. It does seem to have a mild mood-lifting/mellowing effect, so I'm hoping that these results will be more pronounced once I move to 100 mg. Overall, I've found it very benign so far, and have had no problems with interaction with other meds (Klonopin and Adderall).
Of course, everyone reacts differently, and if you think it might be destabilizing your mood then you really need to see your pdoc and sort this out. Good luck!
Posted by bruce_w6 on February 25, 2004, at 8:50:51
In reply to Re: Lamictal And Mind Racing » bruce_w6, posted by Viridis on February 24, 2004, at 23:23:46
I have had the mind racing before. Usually when I was taking AD it would go away after awhile. I am hoping the Lamictal will take it away after awhile.
> Do you mean that it caused your mind to race, or that this was already happening and Lamictal didn't help?
>
> If it's causing this, you definitely should speak with your pdoc in case it is inducing hypomania. If it's just not helping, it could be that you haven't reached a therapeutic level (which you also should ask your doctor about).
>
> I started taking it about three weeks ago (I'm still at the 50 mg stage) and noticed some minor activation/restlessness at first, but this went away very quickly for me and I haven't noticed any other side effects. It does seem to have a mild mood-lifting/mellowing effect, so I'm hoping that these results will be more pronounced once I move to 100 mg. Overall, I've found it very benign so far, and have had no problems with interaction with other meds (Klonopin and Adderall).
>
> Of course, everyone reacts differently, and if you think it might be destabilizing your mood then you really need to see your pdoc and sort this out. Good luck!
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