# Started Lamictal



## brian3

So yesterday I had my appointment with Dr. Daphne Simeon in NYC. We decided to start me on Lamictal, since nothing else has helped me thus far (I've tried and failed with Cymbalta, Concerta, Zoloft, Seroquel, Abilify, and Wellbutrin). I'm also on 150mg of Trazodone for sleep, which seems to work well.

Anyway, this was my first appointment with her and we decided it would be best to try this first, since there has been some positive research studies in using it to treat DPD. We plan on adding an SSRI (Viibryd) to it if I don't respond at all.

I'm on my second day of 25 mg, and it's going to take a while to build up the dose. You can only titrate up 25 mg every two weeks, because of the potential rash side effect. So far haven't noticed anything, but I was told I'll have to get up to at least 100 mg before there's any chance of a response...so that should take about 8 weeks. She also told me I can go as high as 300 mg. So, it will definitely take a while to get the dose up, but I'm hoping it's worth it and I notice some improvement. I'll keep you guys posted.

Also, if you are currently on this or have taken it in the past please let me know what your experiences have been like. Thanks


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## opie37060

I've have been taking lamictal for about a year now. The highest dose i got to was 300mg but had to lower it because it was giving me pain and cramps in my legs. But i usually take around 200mg daily and for me I don't think I can even tell if it helps. I want to think it helps but honestly don't know. If that makes any sense.


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## insaticiable

Hey, I've been on Lamictal for 3 years now. I take it mostly due to its mood stabilization effects since I have Borderline Personality Disorder. It helps a lot in that regards, but I don't know how much it helps with DP/DR since I was taking it already a year prior to developing the dissociative symptoms. It does take a long time to build up to therapeutic doses, but I guess I lucked out on that regards because when I was hospitalized in 2009 and put on it, the doctor raised my dose from 25 mg to 350 mg within a WEEK. Crazy, but thank God I didn't develop any adverse side effects or anything like that. Good luck to you!


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## insaticiable

tim111 said:


> Hey! I also started with a Lamictal & SSRI(Paxil) combination about 2 weeks ago. I have to tell that I feel very tired but also I think that DR is little bit better (about 20%) than before.
> 
> Do you think it's really important to raise dosage on Lamictal only by 25 mg every 2 weeks? What you you think about raising it every week? It seems just too much for me to take it 8 MONTHS to get to potential 400 mg... To how much can one even go? I think I read in some book max dosage is 800mgs?


Max dose is 400 mg, but it is dangerous to get to THAT high of a dose. Highest I ever went was 350 mg.


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## brian3

So I haven't noticed anything yet, but I'm still on 25 mg. I'll update once I get to 50. Can anyone else post their lamictal experiences?



opie37060 said:


> Hey! I also started with a Lamictal & SSRI(Paxil) combination about 2 weeks ago. I have to tell that I feel very tired but also I think that DR is little bit better (about 20%) than before.
> 
> Do you think it's really important to raise dosage on Lamictal only by 25 mg every 2 weeks? What you you think about raising it every week? It seems just too much for me to take it 8 MONTHS to get to potential 400 mg... To how much can one even go? I think I read in some book max dosage is 800mgs?


I think you should do what you were told in terms of raising the dosage, just to be safe. You probably wouldn't develop any adverse side effects, but I wouldn't risk it because that rash can be life threatening.


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## brian3

Went up to 50mg today. 25 in the morning and 25 at night. No difference in DP symptoms as of right now. I'll update again once I get to 75mg.


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## brian3

Just wanted to update you all on my progress. Went up to 75 mg today, and will continue to ramp up the dose by 25 mg once per week. Haven't noticed much of a difference in my symptoms yet, but I may feel slight improvement. It's hard to tell...I'll check in again here next week when I reach 100 mg (supposedly the lowest dose that can alleviate the symptoms).


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## Rozzer

Thanks for the update both of you. Tim111, if you don't mind, what visual symptoms do you have? I have loads of visual symptoms myself, but I'm not sure if they are related to my DP.


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## Sleepwalker

brian3 said:


> So yesterday I had my appointment with Dr. Daphne Simeon in NYC. We decided to start me on Lamictal, since nothing else has helped me thus far (I've tried and failed with Cymbalta, Concerta, Zoloft, Seroquel, Abilify, and Wellbutrin). I'm also on 150mg of Trazodone for sleep, which seems to work well.
> 
> I'm on my second day of 25 mg, and it's going to take a while to build up the dose. You can only titrate up 25 mg every two weeks, because of the potential rash side effect. So far haven't noticed anything, but I was told I'll have to get up to at least 100 mg before there's any chance of a response...so that should take about 8 weeks. She also told me I can go as high as 300 mg. So, it will definitely take a while to get the dose up, but I'm hoping it's worth it and I notice some improvement. I'll keep you guys posted.
> 
> Also, if you are currently on this or have taken it in the past please let me know what your experiences have been like. Thanks


I've been on it for 7 years, now.
I'm up to 100mg X 2 per day.
200mg dosage seems to be optimal for me. 
It has worked extremely well for me along with (and essential) clonazepam. They work together. Without it I would not be able to live a functional life.
It has drastically reduced my anxiety and intense feelings of DD and fatigue, which I suppose come with anxiety.
It took me several weeks to reach that dosing but caution is natural. One just has to be patient.
If it doesn't help by 350, it probably never will. As I said, when I hit 200mg/day a thick veil began to lift but not completely.
I would say it's definitely worth a try but you have to give it time to work. 
Most people which it has helped reported an optimal dose of 200mg.
A couple of side effects I noticed: speech enunciation deteriorated; remembering people's names got very difficult; I had a odd change in my gait.


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## brian3

Up to 100 mg now, and I'm starting to feel something. Not sure what it is, but I'm feeling improvement. Vision seems a little improved, and the blank mind may be slightly less blank, lol. Ill update once I reach 125 mg on friday.


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## Spectre

brian3 said:


> Up to 100 mg now, and I'm starting to feel something. Not sure what it is, but I'm feeling improvement. Vision seems a little improved, and the blank mind may be slightly less blank, lol. Ill update once I reach 125 mg on friday.


How's the progress with Lamictal coming along?


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## brian3

Spectre said:


> How's the progress with Lamictal coming along?


Haven't noticed much of a difference going from 100 to 125, but I go up to 150 tomorrow. I'll check in again tomorrow


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## brian3

Up to 175mg and feeling a bit better. I'm not sure if it's because I've been keeping so busy, or if the med is actually working. I plan on adding an SSRI (Viibryd) after getting up to the maximum dose of lamictal (300mg). Ill keep posting my progress.


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## aloof

Lamictal is a weird med..lots of possible sides and it takes so long to ramp up and most likely it will do nothing. It got alot of attention by DPD sufferers when it was used in a study, but was shown to give little to no improvement when used alone...the study was small and concluded the benefits(if any) are in conjunction with an SSRI. Sorry but SSRIs do nothing for DPD sufferers in most cases, and in fact may make it worse. Basically if you are suffering from depression, and you have some comorbid depersonalization symptoms, then Lamictal along with an SSRI may help. If you need it for mood stabilization then perhaps it will help some. I use Trileptal for that and its an easier med to take, no weird skin rash sides, no ramp up, and it works. Lamictal did nothing for me btw when I tried it.


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## staples

Lamictal did help balance my mood which was good and this was also matched with an SSRI (Cymbalta I believe). I can't really remember if it did anything for the dissociation though. I'm surprised she didn't try you on Anafranil. That seems to be her med of choice and really the only med I haven't actually tried, yet.


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## brian3

aloof said:


> Lamictal is a weird med..lots of possible sides and it takes so long to ramp up and most likely it will do nothing. It got alot of attention by DPD sufferers when it was used in a study, but was shown to give little to no improvement when used alone...the study was small and concluded the benefits(if any) are in conjunction with an SSRI. Sorry but SSRIs do nothing for DPD sufferers in most cases, and in fact may make it worse. Basically if you are suffering from depression, and you have some comorbid depersonalization symptoms, then Lamictal along with an SSRI may help. If you need it for mood stabilization then perhaps it will help some. I use Trileptal for that and its an easier med to take, no weird skin rash sides, no ramp up, and it works. Lamictal did nothing for me btw when I tried it.


I cant agree with everything you said. A more recent double-blind study was conducted with lamictal. 74 DPD patients were in the study, 36 recieved lamictal and 38 recieved placebo. 26 of 36 DPD patients responded to the medication at 300mg, while only 6 of 38 responded to placebo.

http://www.psychopharmacologyupdate.com/sample-articles/lamotrigine-outperforms-placebo-study-of-difficult-to-treat-depersonalization.aspx

Staples, she suggested Anafranil but was actually very open to my suggestions, and we decided on lamictal.


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## staples

Thanks for the link, but I wonder what improvement was seen by most? I hope it does work for you. I didn't come near 300mg, so maybe that could have also been an issue.


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## brian3

staples said:


> Thanks for the link, but I wonder what improvement was seen by most? I hope it does work for you. I didn't come near 300mg, so maybe that could have also been an issue.


Not quite sure of the actual improvements that were noted, but response was defined as a 50% reduction in the patient's score on the cambridge depersonalization scale. 50% is a pretty big improvement, so hopefully this med will help me. Other studies have shown that lamictal+ssri can help dpd, which is why I also want to add an ssri in the future.

Im on 200mg right now and I plan on going up to 300mg.


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## aloof

brian3 said:


> I cant agree with everything you said. A more recent double-blind study was conducted with lamictal. 74 DPD patients were in the study, 36 recieved lamictal and 38 recieved placebo. 26 of 36 DPD patients responded to the medication at 300mg, while only 6 of 38 responded to placebo.
> 
> http://www.psychopharmacologyupdate.com/sample-articles/lamotrigine-outperforms-placebo-study-of-difficult-to-treat-depersonalization.aspx
> 
> Staples, she suggested Anafranil but was actually very open to my suggestions, and we decided on lamictal.


Ok, I looked at that study. WOW. Incompetent. All you need to read is this-

Patients received no antidepressant or anticonvulsant medications for 2 months prior to the study. *During the study, they were allowed to take up to 4 mg/day of clonazepam* for insomnia, as well as 7-day courses of treatment with hydroxyzine for rash...

Are you kidding me? 4 mg of Clonazapam, when it is probably the one med that gives the most relief from DPD? That study is useless as far as determining the effectiveness of Lamictal. Any improvement in symptoms is just as likely the result of the clonazapam as the Lamictal. And why even use Clonazepam for insomnia??? Its not normally used for that and there is only about 100 other meds/supplements they could have used. Poorly done study. Ive been on both btw, Lamictal was a dud, Clonazapam at less than 1 mg per day has greatly improved the quality of my life.

Good luck, hope it works for you. But that study is highly suspect.


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## staples

aloof said:


> Ok, I looked at that study. WOW. Incompetent. All you need to read is this-
> 
> Patients received no antidepressant or anticonvulsant medications for 2 months prior to the study. *During the study, they were allowed to take up to 4 mg/day of clonazepam* for insomnia, as well as 7-day courses of treatment with hydroxyzine for rash...
> 
> Are you kidding me? 4 mg of Clonazapam, when it is probably the one med that gives the most relief from DPD? That study is useless as far as determining the effectiveness of Lamictal. Any improvement in symptoms is just as likely the result of the clonazapam as the Lamictal. And why even use Clonazepam for insomnia??? Its not normally used for that and there is only about 100 other meds/supplements they could have used. Poorly done study. Ive been on both btw, Lamictal was a dud, Clonazapam at less than 1 mg per day has greatly improved the quality of my life.
> 
> Good luck, hope it works for you. But that study is highly suspect.


I skimmed through this article, but should have paid more attention. You're right about the Klonopin and the 4mg. I could see a lot more benefit from the Klonopin then the Lamictal. At least if we're talking standalone medications.


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## brian3

aloof said:


> Ok, I looked at that study. WOW. Incompetent. All you need to read is this-
> 
> Patients received no antidepressant or anticonvulsant medications for 2 months prior to the study. *During the study, they were allowed to take up to 4 mg/day of clonazepam* for insomnia, as well as 7-day courses of treatment with hydroxyzine for rash...
> 
> Are you kidding me? 4 mg of Clonazapam, when it is probably the one med that gives the most relief from DPD? That study is useless as far as determining the effectiveness of Lamictal. Any improvement in symptoms is just as likely the result of the clonazapam as the Lamictal. And why even use Clonazepam for insomnia??? Its not normally used for that and there is only about 100 other meds/supplements they could have used. Poorly done study. Ive been on both btw, Lamictal was a dud, Clonazapam at less than 1 mg per day has greatly improved the quality of my life.
> 
> Good luck, hope it works for you. But that study is highly suspect.


Very true, I have heard of clonazepam helping dp on many occassions. I plan on trying that med as well. 4mg is also a pretty large dose.


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## staples

brian3 said:


> Very true, I have heard of clonazepam helping dp on many occassions. I plan on trying that med as well. 4mg is also a pretty large dose.


Yes, extremely large. Most people take anywhere from 0.5mg at night to 0.5mg (4) x daily. Depending on how bad your Anxiety is.


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## aloof

If you are going to try Klonopin(Clonazepam) my advice is to start at 1 tablet per day. They are scored, break it in half, take it twice a day. Each tablet is 0.5 mg. Might not sound like much but its strong stuff. See what that does for you. I've been on it 3 years and I keep my dose to that or less and when I need more on a particular day I take it. It was like a miracle for a while, but you do build a tolerance over time. Still it is better than nothing. I have tried it all(other than antipsychotics which Id never do), and Klonopin is by far the most effective. Neurontin and Trileptal are helpful somewhat, but more as mood stabilizers.


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## brian3

MateodeMateo said:


> Hi all,
> 
> I've read through the recent posts and have a few questions/comments.
> 
> I agree with what someone else wrote regarding the lamotragine study conducted by Nadir A. Aliyev, M.D., Ph.D...it is really hard to ignore that the participants were allowed to take up to 4 mg of clonazapam a day. I'm not saying that lamotragine won't help, but it seems kind of sloppy to me that they would not have controlled for clonazapam. IMHO.​
> Brian3, I'm curious why you decided not to start with Anafranil, and what made you think starting Lamical first and then adding Viibryd might be a better way to go.
> Last, I have suffered from headaches for about the last year since my DPD started, and the Lamictal was really aggravating them, so I stopped a few weeks ago. I've been taking Viibryd at 10 mg/day for 10 days now. I'm not sure where these headaches are coming from as starting or stopping any of these psychiatric meds doesn't seem to make a difference. So I'm going to try and see a neurologist soon and see if he/she can help me get the headaches under control. At that point, I'll reconsider trying Lamictal in conjunction with an SSRI, possibly Viibryd, if I'm still on it.​
> Hope this was helpful in some way. I look forward to reading your updates.​​Matthew​


I decided on the lamictal because i had read a lot of positive posts about it on these forums, and it seems to be the most widely researched drug for dpd. I initially wanted to start taking the Viibryd and the lamictal at the same time, but Dr. Simeon only wanted me to add one medication at a time in order to see what's helping and what's not.


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## brian3

brian3 said:


> I decided on the lamictal because i had read a lot of positive posts about it on these forums, and it seems to be the most widely researched drug for dpd. I initially wanted to start taking the Viibryd and the lamictal at the same time, but Dr. Simeon only wanted me to add one medication at a time in order to see what's helping and what's not.


Just wanted to update my progress. I have another appointment today with Dr. Simeon and plan on starting Clonazepam and Viibryd. Also, I'm on 200 mg of Lamictal now. The other day I took 400 mg because I forgot to take it the prior day, and I felt great. It doesn't do much for the dissociation, but it really seems to clear up my head, and do a lot for the depression/anxiety that comes from having DP.


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## ThreePlateDan

That's great Brian. Helping with anxiety/depression is no small thing. And when the brain is less consumed by those problems, it can remove a barrier to eventually ridding the dissociation problem as well.


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## brian3

Dr. Simeon bumped up the lamictal to the maximum dose of 300mg and I feel like I'm nearly rid of depression. I think the DP has improved a bit as well..it is definitely still there but i'm not as consumed by it. This is more so because of the lack of depression..i'm keeping so busy that the DP is still there but more in the background, while it was much more noticeable during the depression. She wants me to continue with the lamictal for four weeks before starting Viibryd.


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## brian3

brian3 said:


> Dr. Simeon bumped up the lamictal to the maximum dose of 300mg and I feel like I'm nearly rid of depression. I think the DP has improved a bit as well..it is definitely still there but i'm not as consumed by it. This is more so because of the lack of depression..i'm keeping so busy that the DP is still there but more in the background, while it was much more noticeable during the depression. She wants me to continue with the lamictal for four weeks before starting Viibryd.


Just wanted to give you guys an update...during my last visit with dr simeon, i told her more of my symptoms (tiredness, brain fog, cognitive impairment) and she actually reccomended a sleep study, stating that a few of her patients with depersonalization ended up having sleep apnea, and she has seen the dp/dr remit once the sleep apnea was treated. I took her reccomendation and requested a sleep study from my GP. Once the results came back, i found out i tested positive for severe sleep apnea. I haven't been treated yet, but dr simeon told me she expected id improve quite a bit once my apnea is treated with CPAP. Ill keep you guys posted.

Also, still on the same meds (lamictal 300mg, trazodone 150mg for sleep) with a new addition (nuvigil 50mg to combat the fatigue and cognitive impairment from sleep apnea).

Nuvigil has also shown promise in treating depersonalization disorder. Im only on 50mg, the lowest possible dose and have only noticed slight improvement in cognition and fatigue, but once the dose is raised i expect to feel even better.


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## Plur

I tried Lamictal briefly, slightly lifted DP, but had a sharp increase in anxiety/restlessness/couldnt sit still. I had to go off it cuz it ramped me up to much...Idk when you wrote this but have you tried it and did it help you? and I asked my doc about it helping for DP and he said the studies are very small and not all that convincing.


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## AussiePheonix

aloof said:


> Ok, I looked at that study. WOW. Incompetent. All you need to read is this-
> 
> Patients received no antidepressant or anticonvulsant medications for 2 months prior to the study. *During the study, they were allowed to take up to 4 mg/day of clonazepam* for insomnia, as well as 7-day courses of treatment with hydroxyzine for rash...
> 
> Are you kidding me? 4 mg of Clonazapam, when it is probably the one med that gives the most relief from DPD? That study is useless as far as determining the effectiveness of Lamictal. Any improvement in symptoms is just as likely the result of the clonazapam as the Lamictal. And why even use Clonazepam for insomnia??? Its not normally used for that and there is only about 100 other meds/supplements they could have used. Poorly done study. Ive been on both btw, Lamictal was a dud, Clonazapam at less than 1 mg per day has greatly improved the quality of my life.
> 
> Good luck, hope it works for you. But that study is highly suspect.


The control group would have been taking this as well so it wouldn't have interferred! If it did you would have seen more in the control group responding!


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## AussiePheonix

I've started titrating up on lamictal (on Prozac as well) .... Any one else care to share their experience with lamictal/lamotrigine.


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## mipmunk40

how are you getting on Aussie, any more news on your recovery. I am on 15 day of prozac, DP still been improving, but not gone. Too soon to say still whether prozac will work until I get to 6-8 weeks of taking it.....


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## AussiePheonix

Yeah too soon to tell for me as well. Have to wait till I get up to at leat 200mg of lamotrigine.


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## mipmunk40

I think the prozac is going wrong for me. I have been fine up until a couple of days ago. DP not gone, but mood definitely improved. I am on day 18, but the past couple of days my anxiety has increased and I have been starting to feel really panicky and bad (not DP wise), I think I will ring my GP tomorrow, as something has gone bad in the past couple of days................


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## Aus29

Did the lamictal help Brian?


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## Max XR

This makes me want to try lamotrigine... Just a bit hesitant, as I'm allergic to sulfa (I get a rash).


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