Mental Health Lamotrigine inducing (hypo)mania

crOOk

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I've been on it for three weeks now, currently at 75mg, increasing to 100mg today. Was in a major depressive episode before that with daily suicidal thoughts, disturbed biofunctions, lots of pain, irritability, severe anhedonia, hopelessness, the whole package. It had been building up for a year, lithium along with ssri/nri/snri/quetiapine failed to stop progression.

So at 50 along with 300mg bupropion it seemed to be an awesome antidepressant, no side effects whatsoever (!) which is a huge bonus after having been on lithium for some time. The pills also taste like blackcurrant which is a plus!

Now, after raising the dosage to 100mg, I'm going close to batshit within a week. I get out of bed and without even thinking about caffeine I turn up the music and immediately want to dance, am smoking tons of cigarettes (had gradually stopped smoking to maybe 2 cigarettes per week), need 5 orgasms per day minimum but still can't sleep for shit, my tics are really prominent again, I'm behaving compulsively, lack appetite, impulse control etc.

I thought it's noteworthy for those with bipolar disorder who are looking for a "phase prophylactic" (lol!). Anyway, this is so much better than depression, so I'm totally gonna ride this for a few days before lowering dosage or getting on a neuroleptic!

EDIT: I'm mostly abstaining from drugs except for 30mg (lol) cannabis per day and a cup of tea in the morning. I did however do some ketamine in the last week, partly to pull myself out of depression, but ended up using a k hole dosage instead. So it might also be due to that, but I've never experienced a switch from ketamine before. Probably the combination. You'd still think a switch would be less likely while on a anticonvulsant like this...


To those who have had more than one manic episode, do you think it's a bad idea to "ride on this wave" for a few days?
This is probably going to get cleared up in a couple of days, because my next psychiatrist appointment is on Monday, he has been specialized in bipolar 1 and schizophrenia for decades. My next psychotherapist appointment is tomorrow morning. My last transition from hypomania to full-blown mania took many months and was aided by massive substance abuse, but I'm not sure if this could go down a lot faster since I'm climbing up so rapidly in the past days. I'm not too worried (I am after all hypomanic lol), but I'm not sure if I should be.
 
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Please get on your neroleptic. This could turn very bad very fast.
Thank you for your advice. It's very hard to follow though. I felt fantastic this morning. Didn't need 2-5 hours to "wake up", but was ready to leave the house 30 minutes after opening my eyes. This is the first time I've felt good in over a year. I can appreciate music again. I'm not really sure if this is hypomania, since I used to have this energy all the time during my youth. I'll see what my therapist thinks about this, gonna head over there in 20 minutes.

Yesterday was my daughter's 5th birthday so I had to socialize a lot. It didn't seem like I was spinning out of control at all, e.g. I usually get pressured speech very early on before full-blown mania, so usually my hypomania is accompanied by a constant "feeling bad" about my behaviour and the things I say. This felt very balanced. If this could be a half way stable state I'm actually optimistic I can finish studying. I'm really just worried I'll stop sleeping/eating and become too compulsive.

Are you bipolar? Is it normal to start treating hypomania this early on? It always seems my psychiatrists tolerated a lot more dysthymia than hypomania. I can see how the prospect of mania is very threatening to anyone familiar with it and it surely has been much more destructive for me, but with my depression I am in a constant downward spiral, I feel so fucking worthless, like I am doomed to fail at pretty much everything in life, e.g. I won't ever fulfill my financial obligations towards my daughter without resorting to criminal behaviour.

EDIT: My therapist didn't seem to think it's necessary as of now. She did see me in the morning though, things are a little different at night. Still, the psychiatrist is hopefully gonna say the same thing. A little hypomania is okay I guess. Still thanks for the advice, 'better safe than sorry' is one way to go about this.

God if I can keep this up I have my fucking life back!!! I'm afraid this is just the ketamine though and I'll wake up feeling like that same old pile of shit in a couple of days. I actually planned on stashing some racemic ketamine (well I kinda already did) for the next year or two, so I could IV 35mg once or twice a week, but unfortunately I have very little impulse control when drawing ketamine solution from a 10ml vial. :/
 
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