# Lamotrigine (Lamactil)



## luke1979 (Aug 20, 2004)

well.. my last post about this dissapeared, so ill just re-write it and see how it goes.
anyways.. my doc has prescribed me Lamotrigine (Lamactil) to try in combination with mirtazapine which i have been on for 2 months.
ive read a few good things about lamactil from the dp research unit and kings college in london.
just thought id throw up a post and see if anyone else has anything to add, have u tried it? how did it go? any side effects, etc.?
anyway, hope your all going ok
cheers
Luke.


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## Living in a fog (Aug 12, 2004)

The last time I posted here was in may 2002 the reason was that I started to feel better and became very busy with my life. Yes, I have been on lamictal started out at 25mgs and quickly went up to 100-125mgs in about 2-3 weeks. I think i went as high as 200mgs but felt something in the 100-125 range worked fine. I was also on celexa 20 mgs and 1.0mg-1.5mgs of klonopin. It did not get rid of my DR(i don't have DP but DR instead). It just made me care less about it. You are probably wondering why I am back its because i started to slip back into a hole again. If you want to know the side effects I can tell you what I experienced but I am not sure if it came from the celexa or the lamictal. Nausea, constantly grinding my teeth, sexual dysfunction, diarrhea and gas. Most of the symptoms went away except for the sexual dysfunction but thats why they make viagra. I just started lamictal 100mgs and celexa 20mgs today as I would like to get out of the hole that i managed to slide into. I didn't want to start out slowly on the lamictal since I did not get a rash the first time so why not start at the dose that felt comfortable to me. I am also taking 2mgs of klonopin but I hope to get it back to 1.0- 1.5mgs as in my previous experiment. I take it luke that ur about 25 yrs old by your screen name. i have 22 years on you therefore you may not experience the sexual dysfunction as you are so much younger and your testosterone levels are probably a lot higher then mine. I have never stopped the klonopin since I am dependent/addicted to it. I will keep you posted on how I feel in the upcoming days/weeks.


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## luke1979 (Aug 20, 2004)

that sounds promising, most of those side effects look like side effects from the anti-d.
as for sexual problems.. i dunno if i care all that much, im single and my libido is pretty non existant anyway.
i hope you get some good results again this time round.
cheers 
Luke.


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## luke1979 (Aug 20, 2004)

well.. havnt got many replies.. maybe thats a good thing?
anyway, i just picked up the new tablets.. ill start them tonite, my initial dose will be 50mg and slowly increase from there.
well i got my fingers very firmly crossed, and ill keep you all informed as to how things go.
cheers
Luke.


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## Guest (Oct 13, 2004)

I SWEAR I don't own stock in the Lamictal company -- I always seem to be touting it. But, once again, the following cocktail has given me nearly complete relief. Lamictal (lamotrogine) 300 mg; Zoloft (sertraline) 25 mg; Tofranil (imipramine) 10 mg; Klonopin (clonazepam) 4 mg. All taken at bed time in one giant gulp of chemicals. From my own experience and what I've read, it's especially important to combine the Lamictal with an SSRI.

Lamictal gave me a headache and made me a bit wired for the first few days. My vision was also a bit blurry. All went away quickly; I'm not aware of any side effects now.

And, yet again, the Lamictal + ssri + tricyclic + Klonopin is the same structure, with different doses, that Dreamer describes.

Marjorie


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## Dreamer (Aug 9, 2004)

LOL marjorie,



> I SWEAR I don't own stock in the Lamictal company -- I always seem to be touting it. But, once again, the following cocktail has given me nearly complete relief. Lamictal (lamotrogine) 300 mg; Zoloft (sertraline) 25 mg; Tofranil (imipramine) 10 mg; Klonopin (clonazepam) 4 mg. All taken at bed time in one giant gulp of chemicals. From my own experience and what I've read, it's especially important to combine the Lamictal with an SSRI.


Again, think you mentioned this before, I have had sucess, but not "nearly complete relief" with virtually an identical combo which was "constructed" over the years.

Me: Lamictal 200mg, Klonopin 6mg, Nortriptyline 50mg, Celexa 40mg

My depression has been worse recently, but I'd chalk that up to chronic negative life experiences recently, isolation, and the chronicity of the DP. Who knows? I've alwas been depressed.

Looking for a new psychiatrist to replaced the great guy I left in L.A.

His goal was to bring me down to just Lamictal, but I would say, Lamictal and Celexa. I've tried a few times to up the Lamictal, and I can barely stay awake. I'm thinking I might try to slowly lower the Klonopin a couple mg/up the Celexa (for the depression?), and maybe be able to up the Lamictal.

I have "better quality of life", but I wouldn't say "nearly normal" by a mile.

I say, a combo might be the best w/Lamictal.

Best,
D


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## Dreamer (Aug 9, 2004)

No side effects at all up to 200mg. Also, as I always forget to say, it takes TIME for Lamictal to reach the proper level in your blood. I was ready to give up on it... my doctor begged me to give it more time. I noticed subtle differences after getting to 200mg and being on it about 4-6 weeks. If the psychiatrist hadn't begged me to give it a further try, I would have never gotten the benefit.

One needs a good shrink. Damned hard to find. Still shopping for a replacement.


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## Guest (Oct 13, 2004)

Dreamer,

Can't speak for anyone else, but my fling with Lamictal monotherapy was a complete disaster. I don't act overtly strange, so no one, including me, realized I was so confused that I kept putting appointments into the wrong week of my calendar, and other things that are very unlike very unditzy me. One dose of Zoloft cleared my head, and since then I've stuck with it, along with going back to the Tofranil and Klonopin and, of course, continuing the Lamictal.

Marjorie


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## luke1979 (Aug 20, 2004)

well it's been about 12 hours or so since my first dose.. no side effects yet and nothing negative to say.. on the same note, nothing positive to say, but then again.. far too early to tell.
but yeah.. so far so good i spose
cheers
Luke.


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## Living in a fog (Aug 12, 2004)

Well its been 4 weeks since I have been on lamictal 100mgs and Klonopin 2mgs. I have to say that it is working I still have DR but I am less apprehensive about it . I stopped taking the 20mgs of celexa 2 weeks ago since the side effects did not go away( in the past most side effects went away after about a week). I added 12mgs of ephedra to give me extra energy in place of the dreaded SSRI-celexa. I never thought much of SSRI's for my DR though it may have helped with my depression. I feel I am doing better because I am taking my first real vacation(11/21-11/29) in about 6 years. I will be going up to Manitoba, Canada (I live in NY) to do some hunting in the canadian bush. I realize there may be people here that don't agree with this activity but it was something that I enjoyed before I had DR. 5-6 weeks ago I could barely leave my house now I will be traveling 2000 miles by plane then 2 hours by truck to a base camp and finally drive app. 2-3hrs on a off road vehicle(ATV or snowmobile) to get to my final destination. I will be in NY until 11/21 therefore any questions or comments feel free to ask otherwise I will give an update in app. 4 weeks.


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## Guest (Nov 8, 2004)

wow, all these drugs scare me! i was always willing to take drugs for my anxiety/depression, but i wonder sometimes if you can be on TOO many drugs. i also wonder if being on anti-deps for nearly 11 years has caused my DP. i think my shrink told me that only 46% of people who take anti-deps have success with them. now, that could be due to getting the wrong dosage, not taking them correctly, or not getting the right one, but sometimes, i have to wonder about people taking so many medications. however, if it works, hey, i am not knocking it. my body doesn't handle medications well, so i am going the route of therapy, exercise and reading as much info as i can about DP. i am only on 10 mg lexapro and .5 klonopin, but that's only as needed, which is rare.

i guess my question is: do any of you on meds hope to be med-free or do you expect to be on meds for a long time/rest of your life?


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## tori (Oct 15, 2004)

Hi Luke

I've been taking lamictal for four weeks. I started on 25mg and i have to increase the dosage every 2 weeks by 25mg until i reach the target dosage of around 200mg. I am also taking Citalopram 40mg. I have been managing to cope a lot better with my dp since taking lamictal but it hasnt dissapeared.. I have heard that most people notice their symptoms reducing around 125mg. Don't expect miricals with the Lamictal but apparently it reduces or gets rid of the symptoms completley for 40% of dp patients who take it. Lets hope everyone here is in that 40%. My depression has become a lot worse..but..i am not sure if this is because of lamictal or due to the fact that my anti-d's were cut from 60mg to 40mg when i started lmctl. Good Luck Luke.


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## bat (Aug 18, 2004)

i'm hoping to be med free. need to give it a couple of months to make sure i'm levelled out before tapering


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## Guest (Nov 8, 2004)

living,I'm glad the drugs are working for you again.it's great you can now leave the house and have a holiday.


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## luke1979 (Aug 20, 2004)

well.. it's been 4 weeks since i started lamictal, 2 weeks on 50mg and 2 weeks on 100mg, im gonna move upto 150 tonite, stay on that for 2 weeks, then 200mg for 2 weeks and prolly finish up at 250mg, of course if it starts to like help me a lot ill stop at whatever dose that happens.
how do i think it's going... hmm well it's certainly not made anything worse, but i dont think at this stage it is really doing much.
ive made a few changes to my life, which maybe helping me, or maybe the lamictal made those changes possible.. hard to tell really.
bassically im back working and enjoying it. work gives me enough distraction to sorta allow me to concerntrate on other things, rather than my whole mental state. im not sure weather it's just the work helping me, or if the lamictal is sorta giving me the right state of mind to get out there and get things done.
hmm this post is a bitt all over the shop hey.. ahwell i hope you can understand it.
bassically.. at this stage, no major breakthroughs with the lamictal, but i do think my situation is improving.
my advice would be to give it a go, ive had none side effects at all, and it may be benificial for you.
as far as my thoughts on being on meds, hmm at this stage im only taking 3 meds, mirtazipine (45mg), lamictal (100mg) and diazepam (when needed, about 5mg, once a week).
it doesnt worry me too much being on meds, id prefer not to be, but if they are helping me live my life, im ok with it.
i dont look at being on meds to be a long term solution, i see them as being something to help me get over a problem, much like you would take meds if you were sick with something else.
but if i have to stay on meds for a long time (years).. so be it, like i said, id rather not be on meds, but for the moment i need something to help me and hopefully this mix of meds will help.
cheers
Luke.


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## Guest (Nov 14, 2004)

WEll - after heavy research and coaching my psychiatrist, I'm slowly getting on the Lamictal train. I'm hyper-sensitive to drugs so I just started taking it at 12.5 mg per day - in 2 days I go up to 25 mg for 4 more days and then up to 25mg. twice daily. I guess I'll go up to the recommended dose if I can (150-250 mg range you all recommend).

One of the things that scares me is that I've been diagnosed with mild sleep apnea resulting from a childhood accident to my nose. I fear that the lamictal and/or the Xanax XR might induce more sleep apnea. I know benzos repress respiration to an extent. Has anyone else had problems with medication/breathing/sleep apnea. Just curios to know if anyone knows of any research being done or experience.

I'll keep everyone posted on my Lamictal progress (I've had un-relenting DP for 18 years!!!) so if it can help me, it means there is hope for others..


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## indigo (Sep 26, 2004)

Luke - keep going with it, my DP dissapeared at around 250mg, that was in combo with Anafranil .... and I dont get any side effects from the lamotragine only from the anafranil..


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## qbsbrown (Aug 18, 2004)

I am in the process of beginning the Lamictal + SSRI combo, which i've read about the 40 percent sucess rate. Couple questions.
How do the tricyclics fit in here, aren't these two sufficent enough?
I also have access to klonopin, which i think i will use, seeing as my DR is caused by anxiety.
And for the lamictal, are you guys taking it all in one dose? Or splitting it, day and night? And im assuming most take it at night.
Is it best to take the Lamictal and SSRI at the same time, or does one in the morn and one in the night work better?

Lamictal did get me out of depression during the second week of it, something no SSRI could alieviate. I was sleeping all day, now with lamictal, it's 6-8 hours sleep, and pop right up. Kinda scares me, seeing as i've always been a sleeper in my whole life, but perhaps growing up now.

I'd appreciate any feedback.

Thanks everyone,

Brian


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## luke1979 (Aug 20, 2004)

hiya
dont really know too much about the tricylic a-d's, im only taking mirtazipine, an ssnri (i think) with the lamictal.
currently im taking 150mg, all in one dose at nite, with the mirtazipine 45mg, at the same time. about the only side effect i get, about an hour after i take them, i start to get pretty sleepy, but i find if im busy ill keep myself awake and the tiredness wears off after about an hour and a half.
i dunno if thats the lamictal, or the mirtazipine or both, either way it doesnt worry me.
i also find with the combo i dont have to take it at the exact same time each nite, generally i take it at 8pm, but sometimes, if ive gone out to a party or something, i wont take it till i get home...11pm type thing.
at this stage, im not really feeling any major improvements, but at 150mg, im still bitt below my target dose of 250, so im trying to be patient, im also considering changing the anti'd if at 250 i dont get any results.
so yeah.. im just being patient and letting it work.. if it wants to.
good luck anyway.
Luke


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## Guest (Nov 29, 2004)

Hi,

Just a word to keep us updated on this Lamictal process.

I know many people are on this med, so I am very curious and intrested to know if it affects DP/DR, confusion, obsessions in a good way.

Thanks,

Cynthia xxx


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## Dreamer (Aug 9, 2004)

Dear Luke,
Likewise glad to here of some progress.



luke1979 said:


> hiya
> dont really know too much about the tricylic a-d's, im only taking mirtazipine, an ssnri (i think) with the lamictal.


My psychiatrist added the tricyclic Pamelor (generic nortriptyline) to my combo as he says "it potentiates the Celexa". I don't know what that means exactly other than the combo works better than upping the Celexa dose. So apparently in some (I'm rather treatment resistant) that combo helps more with depression.

I also know of one individual here, Stephen C., who has had tremendous success with Imipramine (also a tricyclic). He hasn't been around in a while as he's happily living his life. But he said it took time, and an effort to move on with his life, but his meds helped immensely. At one time he was incapacited from DP/DR for a year (day hospital).



> currently im taking 150mg, all in one dose at nite, with the mirtazipine 45mg, at the same time. about the only side effect i get, about an hour after i take them, i start to get pretty sleepy, but i find if im busy ill keep myself awake and the tiredness wears off after about an hour and a half.
> i dunno if thats the lamictal, or the mirtazipine or both, either way it doesnt worry me.


I take 200mg of Lamictal at in the a.m. now with 2mg of Klonopin and my Celexa and Nortriptyline and 4mg Klonopin at night. The long half life of my Klonopin allows me to be flexible with it. It's just in my system all the time. I've missed doses or doubled up by accident and feel no different. But once I screwed myself up by being late in reordering my meds (through a mail service) and the DP/DR started coming back... the way it was before I started it.

I have little or no side-effects from most meds though. And I seem to need higher doseages. Why? I have no clue.

*I do believe, per the studies at the IoP that Lamictal ALONE is not as effective as in a combo. It has been successful in bi-polar patients w/DP/DR by itself ... work at UCLA my doctor was doing.*



> i also find with the combo i dont have to take it at the exact same time each nite, generally i take it at 8pm, but sometimes, if ive gone out to a party or something, i wont take it till i get home...11pm type thing.


I also notice (and I think that this is like the Klonopin) that taking the Lamictal at different times in the day (by accident) makes no difference. It also builds to a steady level in the bloodstream. Long "half-life" perhaps. If one were taking this for seizures, I think a very strict schedule would be in order.



> at this stage, im not really feeling any major improvements, but at 150mg, im still bitt below my target dose of 250, so im trying to be patient, im also considering changing the anti'd if at 250 i dont get any results.
> so yeah.. im just being patient and letting it work.. if it wants to.
> good luck anyway.
> Luke


For me, and as others have said, the change is VERY subtle. It takes a while for this to build up in the blood. I truly recommend giving it a real chance. My doctor explained, if you've just started 150mg, it won't reach that level in your blood for a while, hence the need for patience.

Again, the effect is very subtle, yet profound. For me it took away "fear" of the DP/DR. Put it more in the back of my mind. Has helped me "distract myself" even though my DP/DR is chronic. No cure here, but improvement in the quality of my life. And that is very important.

Stick with it. Give it time. I could kick myself in the past when I'd stop at a certain level of a med. I'll never know if I went high enough or for a long enough period of time.

If your liver function is AOK (I get yearly liver function tests... no problems) and you have no serious side effects. Give Lamictal time. And I firmly believe for DP/DR it needs to be in combo w/an SSRI.

Take Care,
D


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## Living in a fog (Aug 12, 2004)

Well I am back from vacation I actually felt pretty good therefore I went away for about a month. I am presently on lamictal 150 mgs and 2mgs klonopin. I have been on the lamictal since around 10/9. I started at 100mgs but in the last 2-3 weeks upped it to 150mgs. I do feel better there are times when I believe my DR is gone- it may be wishful thinking or that I am preoccupied with something that I do not notice it. Its weird its not like the DR has gone away completely but its like it does not bother me as much. I want to see how I do on 150mgs and may up it to 200mgs when I see my doc on 1/15. I will keep everyone updated on my progress.


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## Guest (Dec 28, 2004)

iT'S great, very great to hear this.

Cynthia xxx


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## Guest (Dec 29, 2004)

Just wonder about Lamictal.... can it goes with all SSRI? And if you don't have any epilepsy, is it dommaging for the brain, or it's just do... nothing? Many people here take it, and it seems to do almost nothing.... I just wonder.

I haved read the blue book of pharmacists (big one), and I didn't found those answers.... I don't know if it goes with, per example, Luvox. I wonder if M.D. knows about that.

That would be my next step if I don't feel better.

Cyn xx


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## Living in a fog (Aug 12, 2004)

Just to keep anyone who is interested on my lamictal treatment. Started 10/9 100mgs around 12/05 I upped it to 150mgs then app 1/05 I went to 200mgs. I have noticed a slow but steady improvement in my condition. I will say one thing 3 days after I went to 200mgs I noticed a greater change. I knew that it takes time for it to build up in my system and what I was feeling was the 150 mg dose not the 200mgs dose therefore I decided to drop back down to 150mgs. I remember from my past experience with this med that 150mgs seemed to be allright. I will stay at this dose and maybe go up if I feel that I have leveled out. I am also taking 2mgs of klonopin-1mg p.m., 1mg a.m. and 50mgs of benadryl to sleep at night. I am improving as people have noticed a change in my behavior. I have been at this point before and if this is as good as it gets I can accept it but hopefully it will dissipate with more time.


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## Guest (Jan 21, 2005)

Hi,

Maybe then I could try Lamictal VERY slowly, like 12,5 mg a day for now...

I hate to let go this med because of 1-success with DP (even if my psychiatrist look at me like it makes no sense) 2- Another kind of med so another chance to target the good thing 3- No side effects for those who take it here 4-No addiction like other meds.

And.. when I took it I didn't had the headache of the day (that I used to have since many months). It's bizarre.

I figure I have to take Paxil because it was less worse for me, for DP, than all others (except heacahes)I know I should have tried Anafranil more than days, but because of my dad's heart attack ad many heart problems in my family and serious side effects, I am very afraid to worsen my physical condition.

So. I'll push my doc to go back on Lamictal WITH an AD.

C


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## David (Nov 23, 2004)

Just came across this post. I've already posted on several occasions on Lamictal. I was already on Prozac and started last November on Lamictal, increasing by 50mg every two weeks. I'm now up to 375mg and two weeks away from my final dose of 400mg. This is through the DP research unit in London.

I've had no side effects at all and only positive stories. I keep a brief note of my symptoms in my diary and so far I have gone 13 days without any symptoms!

Regarding various posts about Lamictal on its own or with an SSRI such as Prozac or an SSRI on its own, Lamictal works better with an SSRI. An SSRI on its own DOES NOT improve DP symptoms. Research abstracts below.

David

Lamotrigine as sole agent was not found to be effective in a previous double-blind randomised crossover trial although open trials were encouraging. We carried out an open label trial of lamotrigine in patients with DPD seen in a specialist clinic. The majority were also receiving other medications, mostly selective serotonin re-uptake inhibitors. 32 patients agreed to participate and had complete follow-up data. 16 (50%) showed a significant improvement (mean 40%) in their depersonalisation symptoms, as rated by standard and novel scales, assessed 16.6 months after commencing treatment. Concomitant symptoms of depression also showed improvement but this did not account for the specific effect on DPD. There were no serious adverse effects. The results of this trial suggest that a significant number of patients suffering from DPD may respond to lamotrigine, particularly when combined with antidepressant medication.

Anecdotal reports suggest that serotonin reuptake inhibitors may improve depersonalisation disorder. Objective: To investigate the efficacy of fluoxetine in the treatment of depersonalisation disorder. Methods: Fifty-four people who met DSM-IV criteria for depersonalisation disorder were recruited through newspaper advertisements, and 50 were randomised to a 10-week, double-blind trial of fluoxetine 10-60 mg/day or placebo. Primary outcome measures were the Dissociative Experiences Scale-Depersonalisation Factor, the Depersonalization Severity Scale and the Clinical Global Impression-Improvement (CGI-I) scale. Results: Intention-to-treat analysis revealed that fluoxetine (mean dosage 48 mg/day) was not superior to placebo except for a clinically minimal but statistically significantly greater improvement in CGI-I score in the fluoxetine group prior to covarying for anxiety and depression (2.9 v. 3.6). Depersonalisation was significantly more likely to improve if comorbid anxiety disorder improved. Conclusions: Fluoxetine was not efficacious in treating depersonalisation disorder, despite the commonly reported clinical use of serotonin reuptake inhibitors for this condition.


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## Guest (Jan 25, 2005)

Hi

When you say 13 days w/o no symptoms, do you talk about symptoms of dp and dr?

I can't take Prozac since I am VERY nervous and anxious but for now I am on Paxil.

Thanks!

C zzz


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## David (Nov 23, 2004)

I never really know/understand the difference between the two


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## Guest (Jan 25, 2005)

Hi David

What I mean is what do you mean 13 days w/o symptoms? Do you feel w/o symptoms of dp or dr (whatever, our illness)? Which symptoms?

Thanks!

C xxx


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## David (Nov 23, 2004)

Yeah, I mean - apart from the occasional odd sensation - that I have not felt any of what I call DP symptoms eg feeling disconnected from people and the environment around me, not knowing where my voice is coming from etc

David


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## luke1979 (Aug 20, 2004)

375mg.. sounds like a pretty high dose, but if it's working, thats brilliant.
ive got a fairly conservative docter, im on 200mg, and i cant see him increasing that dose.. ive allways had problems with this docter and medication, im sorta keeping my eye out for a new doc as we speak.


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