# lamotrigine and sertraline



## wael (Sep 5, 2008)

In a couple of weeks my graduate semester begins. I started lamotrigine (also using clonazepam) 3 days ago, 25 mg a day, but my psy wants to build it up to 200 mg in 2 weeks! I read some literature about lamotrigine and usually people use 6 to 8 weeks to go to 200mg, due possible rash side effect.
The problem is that i want to try lamotrogine, but the practice shows that it is more reliable with a ssri. Sertraline was for me a pretty good drug, although i had some ejaculation problems. Combining sertraline and lamotrigine could have some interaction affects which i havent heard from when combined with other ssri's.
So what should i do? Can you feel the effects of lamotrigine already after 2 to 3 weeks (50/75mg)? Or should i stop lamotrigine, go for sertraline with clonazepam( Feels more reliable) or go for another ssri now with the lamotrigine and clonazepam.
I probably know the answer already, but i dont know much about sertraline with lamotrigine. Anyone has experience? Any input?


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## Absentis (Jul 10, 2007)

I experience relief from derealization by taking 50 mg of lamotrigine a day. The titration guidelines (like the one your psychiatrist is following) have been created based on research for other disorders. So my advice is to not follow the strict guidelines, and to slowly titrate upwards by 25 mg a week. This is what I did, and I found relief with very few side-effects. I hope it helps you as much as it helps me.


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## wael (Sep 5, 2008)

mm i really like lamotrigine so far. First week on 25 and first days on 50 was a bit confusing, but not really annoying. then, a couple of days later i noticed that i had more energy at evenings/night, i was brighter when i went up in the morning, my eyeside improved and sexual functioning increased (more libido,more intense orgasm). I was really surprised, because i prepared myself that it would at least take a month and a higher dose to feel some effects. But now im 3 days on 75 mg, i feel like im more foggy and have less energy, perhaps due the titration? Or going to fast ( from 25 to 75 in 13 days)
I have no significant side effects, except for some insomnia. Well i keep pushing, i can always back to 50 mg a day. Tomorrow i have appointment with my psych and evaluate. I will update for those who are interested.


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## Absentis (Jul 10, 2007)

I for one am certainly interested in hearing your progress. I had a similar experience when I increased my dose from 50 to 75 mgs, so I went back down to 50 mgs and things got better. It also depends when you take the medication, as some people find it "activing" in that it gives them energy, while others find it "fatiguing" which is self explanatory. Changing when you take it from morning to night, or spreading it out all day (like 25 in the morning and 25 at night) can change the experience of the med.

In any case, be sure to report back!


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## Claymore (Jun 13, 2009)

wael said:


> I will update for those who are interested.


YESSSS PLEAZZZZE update us on how INTENSE your orgasms are!!!!!. :lol:


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## wael (Sep 5, 2008)

Back to 50 mg. My psy told me that is probably around my effective range. But im not sure, maybe im just placeboing it. I notice that its activating, so its probably the best to take it in the morning. Now im taking it around dinner, and in the evenings i feel better and quite energetic. But because i used to take it before bed time, i was more bright when i woke up. Now slightly more foggy when i in the morning. Just have to figure it out. Perhaps 25 in the morning, 25 in the evening
Absentis :How do you switch from evening to the morning and which way works the best for you.


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## Sleepwalker (Dec 4, 2008)

wael said:


> In a couple of weeks my graduate semester begins. I started lamotrigine (also using clonazepam) 3 days ago, 25 mg a day, but my psy wants to build it up to 200 mg in 2 weeks! I read some literature about lamotrigine and usually people use 6 to 8 weeks to go to 200mg, due possible rash side effect.
> The problem is that i want to try lamotrogine, but the practice shows that it is more reliable with a ssri. Sertraline was for me a pretty good drug, although i had some ejaculation problems. Combining sertraline and lamotrigine could have some interaction affects which i havent heard from when combined with other ssri's.
> So what should i do? Can you feel the effects of lamotrigine already after 2 to 3 weeks (50/75mg)? Or should i stop lamotrigine, go for sertraline with clonazepam( Feels more reliable) or go for another ssri now with the lamotrigine and clonazepam.
> I probably know the answer already, but i dont know much about sertraline with lamotrigine. Anyone has experience? Any input?


I have been taking lamotrigine since 2004--100mg X 2, morning and evening. I love it! It ressurected me from a death-like state.

I started off at 25mg and increased gradually every week. I am glad I didn't follow my every daily feeling to decide if it was working.

With or without a med one can feel different everyday because of the fluctuating nature of this syndrome and also the body's needing time to adjust to any new med.

I patiently stuck with it week by week until-behold! I felt consistently better at 100mg X 2 and I waited until I knew it wasn't any placebo effect.
For most of those I know that have been helped by lamotrigine, the dosage has been 100mg X 2.

Maybe your effective dose may be lower, but my advice to you, with any med, unless it makes you feel dreadful is (1) to be patient and wait for a real response over several days.
Also, note well that (2) lamotrigine is short-acting and I would definitely recommend splitting the dose.
I hope this helps and good 'luck', man.

p.s. lamotrigine has intrinsic antidepressant properties. 
I use it with clonazepam to control excess anxiety during the day but I do still need an antidepressant. 
I'm saving to buy escitalopram (Lexapro) as the others just don't cut it for me.


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## wael (Sep 5, 2008)

Thanks for the info and experiences, sleepwalker.
Due to tensions about doubts of functioning good enought for a pretty intensive time, makes me more self monitoring. Its stress. Will i have a functional baseline, in order to perform. Will the meds kick in before the colleges? That kind of doubts.
The past half year was pretty relaxed.
Its always a trial and error with meds, so it was perhaps not smart to try this right now. 
And its so true, what you say about the natural fluctuation, one day/evening/morning is better/worse, and that that should'nt be the way to evaluate a med
But i will stick to 50mg a while, and then go up if the time is right.

Q: At what dose did you split?


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## Sleepwalker (Dec 4, 2008)

I take 100mg in the morning and 100mg in the late evening=200mg/day :shock:


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## Absentis (Jul 10, 2007)

wael said:


> Absentis :How do you switch from evening to the morning and which way works the best for you.


I take 50 mg each night, along with 0.5 or 1 mg of clonazepam. I found lamotrigine to be activating the first day I took it (I didn't sleep that night, and I can't think of any other reason why I wasn't tired until the next night) but then I started to take it along with clonazepam, and that most likely gets rid of any side-effects as I'm asleep with the help of a benzo when the meds enter my system.

If you want to switch from night to morning, it is easiest if you have 25 mg pills. (Aside: The pharmacy I get my meds from dispenses most of my meds in the smallest available quantity. For instance, I'm prescribed 1 mg of clonazepam a day, and they've always dispensed two 0.5 mg pills.) So one night take half your dose, and then the other half the next morning. Then take half your regular dose at night.

If you want to switch completely, I'd recommend waiting a full day before taking the meds in the morning. For instance, if you take your meds Thursday night, then wait until Saturday morning to take your full amount. I think it causes less harm to have the amount of drug in your system to go lower than normal, rather than higher. If you're not sure, ask a pharmacist. Heck, you should probably ignore what I say and talk to a pharmacist anyway. They don't charge money for people to talk to them, even if you didn't get your meds prescribed at that pharmacy. You can just grab a phone book, pick a pharmacy out of the yellow pages, and ask them a question.


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## kcjddd03 (Nov 21, 2009)

i am curious when you say you experience relief by using this med combo. what do you mean by relief? can you feel yourself to be somewhat connected back to reality? just curious....


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## Absentis (Jul 10, 2007)

By relief I mean that I experience less derealization and depersonalization, and thus feel more connected to reality.

BTW, you could have sent me a PM since a private message is more likely to get my attention than a months-old thread. Just a thought.


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