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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by colin wallace on October 19, 2002, at 9:30:16
More Lamictal! The breakthrough irritability/negativity I was experiencing at 25mg has subsided with a move up to 50mg.This seems to be the very first med. I am able to tolerate at anywhere near a therapeutic dose.
So far, so good......luvvit.
Posted by ROO on October 19, 2002, at 10:19:48
In reply to Answer to Lamictal Irritability..., posted by colin wallace on October 19, 2002, at 9:30:16
My lamictal irritability lessened with time....
It was bad when I first started the drug...I remember
standing and waiting in grocery lines feeling like
I would go postal....but with time, I calmed down.
Lamictal was an excellent mood stabilizer....but I couldn't
sleep on the stuff to save my life and gained a bunch of weight
on it, so I gave it up, otherwise....loved it.
Posted by polarbear206 on October 20, 2002, at 10:54:59
In reply to Answer to Lamictal Irritability..., posted by colin wallace on October 19, 2002, at 9:30:16
> More Lamictal! The breakthrough irritability/negativity I was experiencing at 25mg has subsided with a move up to 50mg.This seems to be the very first med. I am able to tolerate at anywhere near a therapeutic dose.
> So far, so good......luvvit.
Good for you!!! I love this drug too! Glad you were patient. I have stressed to many on the board it will take time to really get a good therapeutic response. Some just give up to soon.Laura.
Posted by Ellen S. on October 20, 2002, at 21:11:32
In reply to Re: Answer to Lamictal Irritability..., posted by ROO on October 19, 2002, at 10:19:48
> Lamictal.... I couldn't
> sleep on the stuff to save my life and gained a bunch of weight
> on it, so I gave it up.My teenage son has been taking Lamictal (400 mg daily), in addition to Eskalith, Celexa, and Geodon. He doesn't think the Lamictal ever had any positive effect, and we also didn't notice that it helped him any. However, he thinks that it caused irritability and insomnia, so he secretly stopped taking it a few days ago. He says he is feeling better without it.
I am concerned about the possible consequences of suddenly quitting any medication, particularly after being on such a large dose. Setting aside (for the moment) the question of whether he needs this drug, I'm concerned about the possibility of rebound/withdrawal effects. Is there a "Lamictal discontinuation syndrome" for people who were taking this medication for depression or bipolar?? I know that people taking this med for convulsions can suffer from convulsions if they stop it abruptly, but that's not an issue here.
Posted by catmint on October 20, 2002, at 22:47:23
In reply to Adverse effects from abruptly quitting Lamictal?, posted by Ellen S. on October 20, 2002, at 21:11:32
I had to stop Lamictal due to a rash. It had wonderful antidepressent effects and since I stopped (about 8 days) I have been moderately depressed. It might cause a similar reaction in your son.
Whatever his symptoms of depression are, pay close attention. It is likely that he could have some mood changes. Keep communication going with your son for the next week or so.
Hope that helps.
Amy
Posted by Ellen S. on October 20, 2002, at 23:03:55
In reply to Re: Adverse effects from abruptly quitting Lamictal? » Ellen S., posted by catmint on October 20, 2002, at 22:47:23
Posted by SLS on October 21, 2002, at 0:22:42
In reply to Answer to Lamictal Irritability..., posted by colin wallace on October 19, 2002, at 9:30:16
> More Lamictal! The breakthrough irritability/negativity I was experiencing at 25mg has subsided with a move up to 50mg.This seems to be the very first med. I am able to tolerate at anywhere near a therapeutic dose.
> So far, so good......luvvit.
Just a quickie...
The average effective dosage of Lamictal for affective (mood) disorders seems to be 200mg. I need 300mg. Some people on PB need 400mg.Good luck.
- Scott
Posted by SLS on October 21, 2002, at 0:38:20
In reply to Adverse effects from abruptly quitting Lamictal?, posted by Ellen S. on October 20, 2002, at 21:11:32
Hi Ellen.
> My teenage son has been taking Lamictal (400 mg daily), in addition to Eskalith, Celexa, and Geodon.
What is he being treated for?
> He doesn't think the Lamictal ever had any positive effect, and we also didn't notice that it helped him any. However, he thinks that it caused irritability and insomnia, so he secretly stopped taking it a few days ago. He says he is feeling better without it.
Whether or not he responded to Lamictal, it seems that many people experience a TEMPORARY antidepressant effect from LOWERING the dosage.
> I am concerned about the possible consequences of suddenly quitting any medication, particularly after being on such a large dose. Setting aside (for the moment) the question of whether he needs this drug, I'm concerned about the possibility of rebound/withdrawal effects. Is there a "Lamictal discontinuation syndrome" for people who were taking this medication for depression or bipolar?? I know that people taking this med for convulsions can suffer from convulsions if they stop it abruptly, but that's not an issue here.Whether or not someone has a seizure disorder, abruptly discontinuing any anticonvulsant by anyone can potentially produce seizures. However, I don't know the propensity of Lamictal to do this. My guess is that it is quite a bit lower than the old mainstream anticonvulsants (phenobarbital, phenytoin, valproate, carbamazepine, etc.) Anxiety and heart-palpitations might be among the withdrawal symptoms. Just another guess.
Sorry I couldn't be more helpful.
- Scott
Posted by kaweah on October 21, 2002, at 15:09:35
In reply to Answer to Lamictal Irritability..., posted by colin wallace on October 19, 2002, at 9:30:16
Colin,
Glad to hear that your slow titration is paying off. How long did you take to go from 25 to 50 mg? And how were the side effects during the increase? Other than side effects how is Lamictal helping with your depression, etc?
I've been using Dr. Phelps advice and taking 12.5mg, twice a day and it seems to help. First dose at breakfast and second dose at lunch. I still feel wired but not maniac. I take 200mg of Neurontin at bedtime to deal with the insomnia.Good luck.
kaweah
Posted by colin wallace on October 21, 2002, at 17:31:17
In reply to Re: Answer to Lamictal Irritability..., posted by kaweah on October 21, 2002, at 15:09:35
> Colin,
> Glad to hear that your slow titration is paying off. How long did you take to go from 25 to 50 mg? And how were the side effects during the increase? Other than side effects how is Lamictal helping with your depression, etc?
> I've been using Dr. Phelps advice and taking 12.5mg, twice a day and it seems to help. First dose at breakfast and second dose at lunch. I still feel wired but not maniac. I take 200mg of Neurontin at bedtime to deal with the insomnia.
>
> Good luck.
>
> kaweahHi there,
It was quite strange actually, considering my sensitivity and painstaking titration;it took me around two months to reach 25mg and get comfortable with that dose.After a short while, I suddenly felt some breakthrough symptoms (erratic mood/irritability and dire gloom).This was not caused by the Lamictal itself, rather by my underlying condition trying its luck again.
I added a further 12.5mg and these symptoms literally disappeared within a few hours.This would probably have been enough to keep things in check, but a few days later I tried my hand at 50mg (easier to manage than pill-splitting.)
My erstwhile frazzled brain responded appreciatively, with few of the side-effects I'd experienced during my initial super-slow titration.I've been at 50mg (divided doses) for almost a week, and aside from a slight and occasional slurred sentence (which only I can notice), I feel good : energized, motivated ,even-tempered and clear-headed.I'm even coping with foul weather, which usually renders me helpless and despairing with depression- seems to shut my brain down somwhow.
I think that once you reach a certain point of tolerance with Lamictal, further increases are far less bothersome.50mg seems to suit me quite well.
Gonna try out some Neurontin too, and hopefully reduce my 4mg diazepam.Will start at 200mg, same as you.
Keep plugging away (same to everyone else on this thread).Col.
Posted by Ellen S. on October 21, 2002, at 18:15:26
In reply to Re: Adverse effects from abruptly quitting Lamictal? » Ellen S., posted by SLS on October 21, 2002, at 0:38:20
> Hi Ellen.
>
> > My teenage son has been taking Lamictal (400 mg daily), in addition to Eskalith, Celexa, and Geodon.
>
> What is he being treated for?Good question to ask [sigh....].
His current psychiatrist is treating him for bipolar disorder (apparently "mixed-state"), although we (and other professionals who have had more direct contact with him than this psychiatrist has) have serious doubts about that diagnosis. His issues definitely include anxiety and depression, seasoned with a strong pinch of oppositional behavior (but never conduct disorder). "School avoidance" (apparently due to a mixture of social anxiety and anxiety about academic performance) is an enduring behavioral theme. There have been several episodes in which he was desperately ill (with psychosomatic ailments at younger ages and with depression more recently) during the school term and got miraculously better for a weekend, holiday, or vacation period.
Lamictal was added to his "cocktail" several months ago to combat what the doctor interpreted to be a cycle of treatment-resistant bipolar depression. We think this episode of depression was triggered by despair that he was failing several courses because he had missed many classes, was behind in the make-up work, and was being given "zeroes" for work not completed. At the time, he was denying that his behavior and worries were a major contributor to his symptoms, and he liked having a doctor tell him that his symptoms were due to a biological illness (BPD) and could be resolved by medication. He did get better while he was taking Lamictal, but only after a plan was worked out that would allow him to salvage the school year. He also finally started to agree with his therapist about the role of his feelings and behaviors in causing other problems, and he is now *working* at recovery instead of waiting for meds to do everything. He thinks he has benefited from the other meds, but not Lamictal. Therefore, he told the psychiatrist that he wanted to stop the Lamictal because he thought it was hurting more than helping, but the doctor told him "No -- maybe later, but not yet."
> > He doesn't think the Lamictal ever had any positive effect, and we also didn't notice that it helped him any. However, he thinks that it caused irritability and insomnia, so he secretly stopped taking it a few days ago. He says he is feeling better without it.
>
> Whether or not he responded to Lamictal, it seems that many people experience a TEMPORARY antidepressant effect from LOWERING the dosage.
>Interesting.... My son says he has not experienced depression in several months. His feeling "better" without the Lamictal means it's been easier to get to sleep at night, which is a good thing. Difficulties getting to sleep at night and then waking up the next morning have been interfering with his goal of successfully leading a normal life. The pdoc thinks these are symptoms of depression (meaning a need for increased medication), but we think they are medication side effects.
>
> > I am concerned about the possible consequences of suddenly quitting...
>
> Whether or not someone has a seizure disorder, abruptly discontinuing any anticonvulsant by anyone can potentially produce seizures. However, I don't know the propensity of Lamictal to do this. My guess is that it is quite a bit lower than the old mainstream anticonvulsants (phenobarbital, phenytoin, valproate, carbamazepine, etc.) Anxiety and heart-palpitations might be among the withdrawal symptoms. Just another guess.
>
> Sorry I couldn't be more helpful.Thanks for sharing what you DO know, Scott. I guess I'm going to hope for the best at this point... It's been long enough (6 days) since he quit that his body probably has cleared most of the Lamictal, so it's probably too late to try to taper off....
-- Ellen
Posted by polarbear206 on October 21, 2002, at 19:27:06
In reply to Adverse effects from abruptly quitting Lamictal?, posted by Ellen S. on October 20, 2002, at 21:11:32
> > Lamictal.... I couldn't
> > sleep on the stuff to save my life and gained a bunch of weight
> > on it, so I gave it up.
>
> My teenage son has been taking Lamictal (400 mg daily), in addition to Eskalith, Celexa, and Geodon. He doesn't think the Lamictal ever had any positive effect, and we also didn't notice that it helped him any. However, he thinks that it caused irritability and insomnia, so he secretly stopped taking it a few days ago. He says he is feeling better without it.
>
> I am concerned about the possible consequences of suddenly quitting any medication, particularly after being on such a large dose. Setting aside (for the moment) the question of whether he needs this drug, I'm concerned about the possibility of rebound/withdrawal effects. Is there a "Lamictal discontinuation syndrome" for people who were taking this medication for depression or bipolar?? I know that people taking this med for convulsions can suffer from convulsions if they stop it abruptly, but that's not an issue here.Ellen,
Can you tell what doses of the other meds he is on? Perhaps the Lamictal is not able to work right due to the doses of his other meds. High doses of antidepressants can exacerbate mood cycling with bipoolar disorders. Since Lamictal has antidepressant properties in addition to mood stabilizing, he may be on too much of the others. 4 meds may be too much?
Laura
Posted by Ellen S. on October 21, 2002, at 20:49:30
In reply to Re: Adverse effects from abruptly quitting Lamictal?, posted by polarbear206 on October 21, 2002, at 19:27:06
> Ellen,
>
> Can you tell what doses of the other meds he is on? Perhaps the Lamictal is not able to work right due to the doses of his other meds. High doses of antidepressants can exacerbate mood cycling with bipoolar disorders. Since Lamictal has antidepressant properties in addition to mood stabilizing, he may be on too much of the others. 4 meds may be too much?
>
> LauraHis doses of Celexa and lithium are in the typical range for therapeutic doses, and the Geodon is a low dose for an antipsychotic effect.
There's no doubt in my mind that he's been taking too many meds. And there are doubts about the BPD diagnosis (see my previous post)... Thus, my main concern right now is not over the fact that he quit Lamictal, but *how* he quit it.
Ellen
This is the end of the thread.
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