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C10H12N20
26-06-2005, 03:14
Has anybody been prescirbed or know anything about Lamictal (Lamotrigine) used for depression? It is usually used as an anticonvulsant, but at much lower doses has antidepressive qualities. From what i am gathering is it works right away, differently from SSRIs that usually take time to kick in. All I've been able to find is that it agonizes 5HT3 and Sigma-opiod receptors and this link:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12197456&dopt=Abstract

Any info would be appreciated.

BilZ0r
26-06-2005, 05:51
I'm pretty sure lamotrigines biggest effect is on sodium channels...

That study looks pretty poor, I can't believe retrospective, non-controlled trials are even published in regards to antidepressants... But then again, that doesn't mean it DOESN'T work, just that I wouldn't put much faith in that study.

This (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12716240&query_hl=16) is a better trial, though they should have used an active placebo, because if you take 100mg of lamotrigine, you fucking know it.

C10H12N20
26-06-2005, 07:02
Bilzor,

Thanks for the info.

Yes the primary (anticonvulsant) effects are achieved through sodium channels. I can see how tickling 5HT3 can be antidepressive, but what about sigmas?

What should you feel if you take 100mg of lamotogrine? The anti-depressive quantity prescribed is 2mg so it's hard to tell. I kinda thought lamotrigine doesnt really feel like anything just like Valproic Acid.

BilZ0r
27-06-2005, 12:23
I can't see how 5-HT3 are going to be antidepressive... *shrug* I don't know anything about sigmas, and I'm not sure if anyone else does that much either.

Nearly all anticonvlusants make you feel sleepy, or at least dozy.

fishman
29-06-2005, 08:10
I am currently taking 125mg/day of Lamictal, prescribed as a "mood-stabilizer" to reduce the [slightly] manic-episode-inducing side effects of 75mg/day Zoloft. I started both of them simultaneously so it is hard to say whether or not the Lamictal is augmenting the antidepressant effects of the Zoloft, but overall Lamictal seems like a fairly gentle drug with very little side effects compared to most psychiatric pharmaceuticals I've been on in the past. And if anything, the daily 1mg to 2mg clonazepam causes me to be more drowsy than the Lamictal does. I guess I would recommend giving it a try if anyone out there thinks it might help; in my opinion, it probably won't hurt much... just some anecdotal input.

C6H6
30-06-2005, 02:16
Mirtazapine is also a 5-HT3 antagonist, and this activity is thought to contribute to its antidepressant activity. I never bothered to investigate why.

Philoscybin
30-06-2005, 04:25
I took 200mg/day for about 5 months for depression and anxiety. At first it helped illiminate some of the hysteria and erratic thinking I'd experience but lost its effectiveness w/in a month.

fishman
11-07-2005, 08:16
Anyone else here currently on Lamictal, or have been on it in the past? What did you think of it? Just curious...

bowdenta
12-07-2005, 00:28
i was on it cuz i had a seizure. i was prescribed 200mg/day (100 at night, 100 in the morning). it took me 4 weeks to build up to it. i felt like it made slightly more lethargic, but no major effects. i didn't like taking it on an empty stomach in the morning

i stopped taking it because i was positive the seizure was a result of xanax withdrawls

101
12-08-2005, 16:34
I just started a starter pack of it last night, 25mg for 2 weeks, 50mg for 2 weeks, then 100mg for a week.

I can't tell any difference today, maybe a little more relaxed, didn't sleep very well with it last night.

shercakes
13-08-2005, 15:58
I started takimg it 4 weeks ago, i'm up to 50mg, go to 100mg on monday, I feel great now, not ever depressed, but i cannot sleep at night at all unless I take a benzo, but even with little sleep I feel okay. so far I think this shit is great. I was itching alot, but some claritin takes care of that. (it can cause rashes, potentially life threatening one called stevens-johnson syndrome)
I was bipolar, mostly depressed with hypomanic episodes, and now i feel normal all the time, better than when i took ssri's or wellbutrin. I also have panic attacks, and i don't know if it helps with that, because I think whenever i've had that lately, it was most likely xanax withdrawal.

101
13-08-2005, 21:36
Originally posted by shercakes
I started takimg it 4 weeks ago, i'm up to 50mg, go to 100mg on monday, I feel great now, not ever depressed, but i cannot sleep at night at all unless I take a benzo, but even with little sleep I feel okay. so far I think this shit is great. I was itching alot, but some claritin takes care of that. (it can cause rashes, potentially life threatening one called stevens-johnson syndrome)
I was bipolar, mostly depressed with hypomanic episodes, and now i feel normal all the time, better than when i took ssri's or wellbutrin. I also have panic attacks, and i don't know if it helps with that, because I think whenever i've had that lately, it was most likely xanax withdrawal.

It sounds like you got the same starter pack as me. I was put on it along with 300mg seroquel at night after having really bad insomnia witch ended in psychosis. I still can only sleep about 5 hours at night but at least its enough not to start thinking the cops are out to get me.

shercakes
14-08-2005, 06:26
yeah, i got the starter pack too, my doctor told me the lamictal would put me to sleep.(i take it at night) he was full of crap obviously.

kittyinthedark
14-08-2005, 10:15
I haven't noticed any side effects with Lamictal (100 mg daily, I'm actually not on it right now but may be back on in the near future) but it does definitely have a positive effect on mood stabilization for me. I take Wellbutrin primarily, but add Lamictal for sometimes months at a time to temper some of the ups and downs - I'm diagnosed as mixed state bipolar, and sometimes my symptoms can "break through" the bupropion. The Lamictal has seemed to make a measurable effect on stabilizing my mood swings, but sometimes it is not quite strong enough.

I'd say overall that it's a very mild drug. I haven't had any noticeable negative effects with it - definitely far more gentle than many other meds out there, although as such, probably a bit less effective, especially on its own. I also have very unusual chemistry, though, so I might be the wrong person to ask... :)

Dr. Beat
15-08-2005, 16:24
i just read a 18 page document by one of the top bi-polar psychiatrists in australia, and he emphasized about 20 times in the document that SODIUM-VALPROATE is the best, cheapest, and most effective drug for bi-polar disorder, and said that SSRI's are totally shit for bi-polar disorder and most GP's should be shot for prescribing so many SSRI's to masked bi-polar people who only present the depressive side of their illness to their GP, and hide their manic side from their GP.

In his opinion, SSRI's are massive over prescribed, and Sodium Valproate is massivly under prescribed for mental illness.

shercakes
26-08-2005, 08:54
i've been on lamictal for 6 weeks now, up to my max dose of 100mg, i felt a noticable difference once i finally got up to 100mg, i sleep better now, my anxiety/panic is mostly gone(have to take some xanax everyday, but that is because i'm addicted to it, don't NEED it like bforte). i still experience mood swings, but they are less pronouced. no side effects. i like this stuff. p.s., i could have taken valproate, but it causes weight gain and tiredness, which i didn't want.
note to women-seemed almost ineffective during pms however

CuriousCub
27-08-2005, 14:14
i took lamictal for mood stabilization due to PTSDisorder, and noticed it slowed me down --i was at loss for words and action most of the time. I couldn't tell if this was good or bad, so i stopped taking it. i took the lowest dose, which i forget is, for 3 months. I didn't like feeling less intelligent and my personality seemed weaker, which is how i felt on it. I felt i lost my wit and my strength and i was more comfortable feeling depressed. Weird effects, i don't think it helps with my condition which is hard to medicate to begin with.

illuminati boy
02-09-2005, 02:28
Your docs are certainly doing some 'interesting' off-label Rx ing. As far as one knows, in the US anyway, it is only indicated for seizure disorders and management of Bipolar disorder. One does remember seeing the actual stats from the 3-arm study that got Lamictal its Bipolar indication. It was a study with Lithium, Lamictal, & Placebo. Needless to say Lamictal was better vs. Placebo, but it was like pulling teeth to get the actual data... because the study did a better job of showing the efficacy of Li in the management of Bipolar (no surprise there). But, if one remembers correctly, the data did seem to indicate an interesting trend (don't think it was significant though). Lithium appeared to do a better job of treating Bipolar when the individual presented as Manic and Lamictal seemed to do better when the person presented as Depressed. One is not sure though that this would translated into Lamictal helps Depression, as if anything it might only translate into Lamictal helps Depression in persons with Bipolar. Still, docs in the past have often augmented treatment of Severe Depression with Li, so there might be something to that sodium ion bit after all...

As far as if you are taking it... well the biggest concern is a VERY severe rash (it can be potentially life-threatening), though this is apparently quite rare. People do experience other mild rashes, but this appears to occur less since the 'Starter Packs' were introduced. It can take up to 5-weeks to titrate to your dosing. Anecdotatly it appears not to have anywhere near the weight gain of Depakote (which can be REALLY pronounced) and does not seem to affect cognition as much as some other agents might (Topamax etc.). Let your doc know if you see any rash whatsoever. Also let your doc know if you are taking any other meds, are a smoker, etc. as these can play a role in how the drugs you take actually act.

Last but not least... none of this was meant to diagnose, cause, treat, or cure anything that might be misconstrued as a disease by the FDA.

maybetinymaybesad
12-09-2005, 05:17
Originally posted by Dr. Beat
i just read a 18 page document by one of the top bi-polar psychiatrists in australia, and he emphasized about 20 times in the document that SODIUM-VALPROATE is the best, cheapest, and most effective drug for bi-polar disorder, and said that SSRI's are totally shit for bi-polar disorder and most GP's should be shot for prescribing so many SSRI's to masked bi-polar people who only present the depressive side of their illness to their GP, and hide their manic side from their GP.

In his opinion, SSRI's are massive over prescribed, and Sodium Valproate is massivly under prescribed for mental illness.

sodium valproate (known as depakote in the US) is probably relatively cheap but i don't know about the best or most effective drug for treating bipolar disorder. that is going to totally depend on the person. certianly it should be tried, and an argument can be made that it should be the first tried if i really is the cheapest (i don't know whether it is or not.) he's right that prescribing SSRIs to people with bipolar can be detrimental, but if someone is hiding his/her manic side, there isn't much a doctor can do besides prescribe to the symptoms described. the fact that psychiatry must rely so much on self survey is one of its biggest problems.

i have wondered frequently though why, especially in the case of behaviorally challenged children in which the symptoms of many disorders overlap (ADD and bipolar for instance), doctors don't start out by prescribing a mood stabilizer before a stimulant/antidepressant? i don't think a mood stabilizer would have detrimental effects on ADD or anxiety, and if it didn't work, it could be stopped. but if you start with a stimulant, a bipolar child can really be thrown for a loop. maybe this is what your doctor was saying.

NotTonight
12-09-2005, 23:10
I've been taking Latmctal (100mg 2x daily) for almost three years for bipolar/acute depression. For a while I took it along with several other drugs, but am currently taking only Lamictal and have had no serious depression or mania in a very long time with no noticeable side effects. It is the most effective drug I have tried for depression with the fewest side effects. I think it is a wonderful medication. The only downside is that it is rather expensive. I have tried depakote and found it to be much less effective. The reason there are so many drugs for treating these disorders is that they have to be considered on a case by case basis. What works for me might not work as well for somebody else. You just have to keep trying until you find the best drug for you.

C10H12N20
12-09-2005, 23:43
Has anyone heard of this drug being prescribed in 2mg doses for depression along with Depakote for bipolar?

NotTonight
13-09-2005, 23:10
I don't think they even make it in 2mg doses. A typical dosage is 200mg daily for bipolar and can even be higher than that. Its possible that I'm wrong but I can't imagine that 2mg could possibly have any effect, even if combined with Depakote

C10H12N20
14-09-2005, 01:03
My doc actually gave me 2mg chewable Lamictal samples with Cherry flavour :)

streetsurfer
06-06-2006, 12:15
Bump!


Has anyone got anything to add? I am thinking of ditching the valproate for this one as I am almost exclusively in a depressed affective state and my mania is more agitation (god damn it).

Valproate seems to have not only the effect of making you gain weight but also makes your belly distended.....for me anyway. I have had to up the dose 5 fold since I started taking it and while it helps...... somehow I feel more unstable

rashandreflex
06-06-2006, 19:41
i take 100 mg of lamictal a day, and i agree with the above posters that it is really a mild drug in terms of noticeable side effects. obviously, the most important thing to watch for is the development of a rash...most of the rashes are non-fatal allergic reactions, but a few of them are the potentially fatal SJS. you should titrate slooowly.

lamictal has been a better drug for me than depakote (sodium valproate) ever was, but it's really difficult to recommend a drug based on anecdotal evidence bc your mileage may vary. you mentioned agitation...if you are having agitation even on depakote, lamictal alone might not be the answer bc its strength really isn't in tempering agitation...are you taking anthing else?

so far on this board i have heard that lamictal affects sodium channels, that it is a glutamate inhibitor, a 5HT3 agonist, and a sigma opioid agonist. i can see how 5HT3 agonization and maybe sigma opioid agonization would affect mood, but does anyone have any theories on how glutamate antagonization or sodium channel action would affect mood?

streetsurfer
07-06-2006, 07:12
Well drugs like ketamine are antagonists of glutimate at the nmda receptors, maybe reducing the amount of glutimate in the brain reduces erratic firing of neurons and over stimulation, which would manifist as worry, anxiety, stress... thereby reducing depression....maybe?

BilZ0r
07-06-2006, 09:39
^ Uh, I wouldn't go that far...

streetsurfer
07-06-2006, 12:12
Well if its not that, I am going to go with my second theory...Magic =D

Jamshyd
17-04-2007, 04:02
I'd like to revive this thread because my doctor suggested that I try this medication for my manic-depression (Bipolar II according to him). Seeing that it is a glutamate antagonist and a sodium-channel blocker, I am wondering now if it might be effective for me, since I found that the only thing that worked for my mood was Ketamine and, to an extent, gabapentin?

Also, is anyone aware of Lamotrigine's interactions with recreational drugs?

toxide
18-04-2007, 06:11
Well, as far as nmda antagonists such as ketamine are concerned, lamotrigine blocks the fx of these drugs, not sure why but i guess it dominates the receptors or sumthing. They have dun studies where subjects where givin larg doses of k/pcp and lamictal brought down the high and killed the hallucinogen fx. I think it's close to the way neostigmine which is used to block antichlorgenic overdose by dominating the antichlorogen for the receptors

itsasony
01-05-2007, 07:50
Case for lamotrigine?

I have a family member age about 62 who began psychosis about 3 years ago. A neurologist discovered seizure activity with an EEG test. Patient didn't follow up because Patient's mother had same condition in retirement years and psych meds made her worse until she was mentally gone. Patient saw same neurologist from 3 years ago - a few months ago, again EEG showed seizure. During the elapsed time psychosis increased and family figured out it was clinical and started at psychologist who prescribed lexapro. That caused hallucinations and aggravated psychosis. Another psych dr. prescribed risperdol, then two weeks later abilify. Both had disastrous results. catatonic demeanor or hallucinations and tardive. It took three months for the Patient to recover from two weeks of risperdol and 6 weeks of abilify symptoms mentioned. After 2nd EEG Patient tried Keppra and went angry/belligerent in 3 days and had to stop. At this point, none of the neuorleptic meds have helped, all made conditions worse. Any dopamine boosting substances or supplements increased psychosis as well as moderate to excessive sugar in diet (as we witnessed during monitoring Patient daily.) Daily treadmill exercise helped recovery and builds brain cells too.

While searching the issue of seizures I came across a study that reveals a genetic explanation about seizures by glutamate toxicity that leads to dopamine toxicity and LTP or long term memory loss in the hippocampus all as a result of glutamate toxicity and a microdeletion in a gene. Some of you may have seen our blog http://orthosz.blogspot.com which tracks this Patient's progress. We have been unable to get a Dr. to even try Lamotrigine because they all approach this matter from a treat the symptoms by observation perspective rather than find the underlying cause of the psychosis. We (the family members active in the Patient's progress) want to try Lamotrigine because it appears from our reading it would address all the known and suspect issues involved: seizures, drop attracts, glutamate toxicity in hippocampus and quite possibly the psychosis caused by the increased dopamine of the chain of events. There's more details of the study on our blog.

There's a Dr. Restak who's got an article on "Complex Partial Seizures Present Diagnostic Challenge" here's a link for this http://www.psychiatrictimes.com/p950927.html

Basically, there's a high probability that patients with these psychosis symptoms never get a fair shake at recovery because they are prescribed neuroleptics only to mask the symptoms and return people back to their catatonic socially safe lives (my own opinion and over simplification.) But as I read this article, words jumped out at me as descriptions of the seizure experience were what our Patient has experienced, including the fear. It makes me think we're onto something somewhat of a possible solution.

We're going to try to convince our family Patient to seek a specialist and ask for a trial of Lamotrigine. I wanted to bring this issue to the board here so it may help someone if they have this condition and are not getting treated by doctors correctly. Our Patient was just released by a involuntary psych hospital with a two week prescription for Quetiapine only! After all the seizure evidence (which included childhood seziures)! Quetiapine (Seroquel) a drug that has 50% chance of diabetes and lowers seizure threshold for many people making the seizures happen more often! When I asked them what test they use to determine if a Patient is ready for release the answer was "observation." They look at the patient. 8o Doesn't seem like scientific method for detecting complex partial seizures. 8(

MadMadamEmily
18-10-2009, 03:50
Seroquel is freaking me out, and I am glad I'm off of it. I am taking a low dose of Lamotrigine working my way up to 100 mg a day or more if it is effective. I just wonder about about energy levels. Does it help? Make you sleepy? So far so good, but I am worried about becoming a zombie when I have two babies.