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Lamotrigine (Lamictal) for depression

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Bluelighter
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Jul 1, 2004
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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/...ve&db=PubMed&list_uids=12197456&dopt=Abstract

Any info would be appreciated.
 
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 is a better trial, though they should have used an active placebo, because if you take 100mg of lamotrigine, you fucking know it.
 
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.
 
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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.
 
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.
 
Mirtazapine is also a 5-HT3 antagonist, and this activity is thought to contribute to its antidepressant activity. I never bothered to investigate why.
 
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.
 
Anyone else here currently on Lamictal, or have been on it in the past? What did you think of it? Just curious...
 
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
 
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.
 
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.
 
shercakes said:
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.
 
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.
 
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... :)
 
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.
 
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
 
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.
 
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.
 
Dr. Beat said:
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.
 
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.
 
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