Starting Lamotrigine - Adding To The Growing Med Cocktail - Thoughts?

[NovemberStar]

I've been on Venlafaxine (300mgs currently) the past couple of years. It helped. A year ago my depression and PTSD became worse, so I was prescribed Mirtazapine. Currently on 22.5mg night. That helped the depression! I'm also on Quetiapine (25mg tablets, 3-5 a day for anxiety. Worked fairly well for a while but recently my depression came back - very unevenly. My mood changes so much - Tuesday I saw my Pdoc, I was feeling really good, positive, started to feel my old self again (first time in 3.5 years).

But the next day, my mood plummeted - very severely. I had two days feeling so incredibly depressed and very suicidal. I cannot recall feeling THAT close to 'doing it'. I think I ended up having ongoing flashbacks - the flashbacks are of a time I felt the same severe depression and suicidaliity - I still do not know the incident that caused me to feel that way; all I know was I was about 9 years old and I really really wanted to die. I started having flashbacks triggered by the severe mood drop; it was like a feedback loop - flashbacks into depression / feeling suicidal into more flashbacks because the severe mood low was EXACTLY how I felt all those years ago.

My pdoc has now suggested I start lamotrigine (sp?). I've read ok things about it - I'm hoping it will even out my mood and I've read some people get less symptoms of 're-experiencing'.

At this point I feel I have nothing to lose. But I'd be interested in how others found it.

 

[Maggiemay]

*Hugs* started it a while ago, but am not at a therapeutic dose yet... Positive that it helps re-experiencing -- I came on quetiapine to go on it & seen a marked rise in flashbacks *sigh* I know it's got a lot to do with life events too tho... Xxx

 

[Bekah]

I've been on 200 mg of Lamotrigine for about a year now. It's been very helpful for me, but I haven't been mixing it with anything but some anti-anxiety meds for a while, so keep in mind that it could react strangely with your other medications. In my experience it really helps to keep things 'stable.' If you have an emotional crash, you can still tell it's happening, but Lamotrigine helps take the edge off and keep it manageable.

The side effects aren't too bad, though again, everyone's body chemistry is different. Depending on how high your dosage is you might have some problems with minor twitches and jerks in your limbs that you can't control. They're not obvious enough to be noticed in public, but it can feel wierd and unsettling, especially when you're trying to sleep. Your hands are also likely to get pretty shaky pretty much all the time. I've heard insomnia can also be an issue, but because that was an issue for me before I started this medication I'm not a good judge. But personally, I like it better than the anti-depressants I've tried.

 

[jcat]

Body chemistry yeop yeop yeop. I'm getting off lamotrigine. Been on it for 10 years and it did wonders .In my case though if I missed a dose within 2 hours I was almost having a panic attack. I do hope your not going to reactions with your other meds.

 

[jcat]

Did want to add something here. I decide to go all out and all in with therapy. A full year with an appointment with my shrink every week and going to group therapy one day a week as well. That's why I'm stopping the lamotrigine. My shrink and I totally agree that we should try no medication for awhile and are pretty confident about me not needing it.
If you're chemically imbalanced however you may consider finding a shrink with a PhD in neurochemistry who will be a vampire with blood work. That's quite a cocktail you're on and it has to be doing some harm to your internal organs.

 

[jcat]

It was that shrink that nailed it down and got me off my cocktail and onto lamotrigine alone. With the occasional xanex for anxiety but I rarely needed it and in a .5mg dose. Heck.....sometimes I even broke the xanex in half. If the lamotrigine isn't getting the effect you need you may want to look into abilify.
That's if you have good insurance and your doc can show that other drugs just aren't working. They don't like the $1200 a month price tag and generics won't be out until April of next year

 

[NovemberStar]

Thanks everyone. I'm aware everybody's body reacts differently. I might get all the side effects or I might not get any. I'm pretty lucky with most things I have tried - the exception being Risperidol - that was truly awful!!!

Yes, it is a cocktail - it hasn't always been that way. I had PTSD years ago, but came out the other side, and was completely free of it for over a decade - a new trauma re-triggered it and I've been fighting it ever since. At one point I was free of all meds for a few years; an anti-depressant being the only one I was on the rest of the time. I trust my Pdoc that if this new med wasn't compatible with the others, she wouldn't put me on it. When I started Mirtazapine, I had to reduce my venlafaxine because I felt too 'zappy' and gut instinct told me it was too much seratonin (Dr I had at the time was useless -I had to sort out the awful side effects myself!!! :mad:)

The last year especially has been incredibly hard; resulting in a severe anorexia relapse requiring hospitalization for re-feeding at the start of this year. I don't have the 'luxury' of hainvg he option for hospitalization if my mood is severely low. I have approached the emergency psych service in the past (a year ago) when I was actively suicidal and they pretty much told me to go home and offered ZERO support - saying I had an app in 3 weeks time, so just go home. It affected me so much at the time, I can no longer use their service, no matter how suicidal I get. To go through that again - reaching out only to be dismissed and invalidated like that - a repeat of that experience could very well be the thing that triggers me to take my life so I really am better trying to manage it myself!!!

@jcat yes - I am pretty confident i have a chemical imbalance. The major trauma I had 3 and a had years ago was an ongoing trauma that lasted most of 18 months - earthquakes. Pretty intense stuff living on adrenalin for all that time, never knowing if another huge, fatal quake was going to hit in the next 10 seconds. I have had years of therapy - if it were enough (and it was, for years) I definitely would not be on meds. The plan is to reduce the mirtazapine once my mood stabilizes. I also take a benzo (name??) as PRN, half a tablet every couple of weeks on average.

I don't live in the USA so don't have the issue with insurance or costly meds. The bulk of the cost is all paid for by the government ;)

I have picked it up today. I am nervous about starting it cos it is ANOTHER med - but I really really cannot risk my mood dropping as low as it did earlier this week - it was truly unbearable and I'm not sure how much longer I could have 'hung in there'.

 

[jcat]

Ya.....definitely check into the chemistry aspects cuz that can have as much effect as trauma itself.
Must be nice to not have to deal with insurance. Obama care is an utter joke :mad:
I don't know how people really see the USA. Our citizens are awesome!!! Our government? Welp.... Let's just say we don't have a Constitution anymore or much power to do anything unless you're a special interest group or on welfare. Sorry... My little tangent. Things are pretty screwed up here.
The point would be that our working citizens (almost no middle class now) can't afford quality health care. The unemployed on welfare folks get it free. So there are many from the USA on this site suffering from PTSD that can't afford regular therapy and meds and it's very sad.
I'm very fortunate to have an employer that offers insurance. I still have to contribute for mine but they at least pay me well enough that I can afford the coverage. Many folks can't even though the employer offers it. Of course now they have to get it or suffer huge tax penalties. That's Obama care

 

[NovemberStar]

Just want to say I've been on the new med almost a week and I feel pretty good, as my mood varies so extremely it's hard to be sure if the improvement in mood is due to a natural swing or the new med, but so far I haven't noticed any troublesome side effects.

I do worry about how many different meds I'm on and if my brain will ever re-adapt to not having them in the long-term picture.... But I guess it's not helpful to worry about something so far away, and I just need to remind myself that continuing as I was, was at a huge risk due to how suicidal I was feeling.

My pdoc is happy for me to reduce / go off the mirtazapine once I'm stabilised on this new med - so that something to look forward to.

 

[jcat]

Hang in there gal. It takes from 4 to 6 weeks to work it into your system. In pretty sure you'll really notice the stability then. You'll still have good days and bad days but they'll be no better or worse than a " normal " person ( whatever that is lol) does

 

[Lady of Longbourn]

Lamotrigine takes months to really take effect but once it does, it's a pretty rock solid drug. Just be careful not to miss doses.

 

[NovemberStar]

My pdoc got back to me - she doesn't think the thoughts I was having were related to the new med. I waited a few days and re-started it.

It's good to know it might work even in a few weeks. Feel very discouraged starting at such a low dose - I've been told to take 25mg for 2 weeks then increase to 50mg. Then my pdoc gave me a 2 month a rout for 50mg ... That seems a very low dose though.

Hopefully it gives me a kick in motivation and takes away the severe lows. I really feel there is only so much I can do for myself and I really need help with meds to enable me to get to the point where I can do things / feel some motivation.

When I started mirtazapine (while on venlafaxine) it was a very noticeable shift in mood in the first week. I felt motivated, had energy, felt really good.

EDITED TO ADD - I had gone off it as my thoughts were really bad and I felt like,they weren't my own. I thought it was the med as it was the only recent change - but I think now it was just the increase in stress due to my T coming back after her 5 week holiday. Been back on it since the weekend