# ssri and lamotrigine combination...



## the big bad i said no!

i have been taking this combination of medication for over 3 months now, starting at a low dose of lamotrigine and building up to 250mg. i set all my hopes on this medication combo as the dp research unit recommends it and it has quite a high success rate, but i dont think its working. but by not working, i mean its not ridding me of my depersonalization and derealization. however it has made me alot more motivated to do things and try and get on with my life i.e going out more, trying to get a job etc. but because of this, im feeling much more frustrated that dp/dr wont go away! i feel its holding me back and motivation alone dosent seem enough, i want and need to actually feel better to be able function correctly with all this new found motivation. i also still get very anxious but seem to be able to supress it alot better, but i wish that would stop too. im thinking of stopping this medication and actually giving up on medication altogether since ive tried so many. if anyone has any advice on what to do it would be much apreciated.


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## the big bad i said no!

oh yeah.... the ssri im on is sertrline and im thinking that maybe its worth changing that first to a different one (maybe prozac) to see if it makes a difference before i think about stopping.


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## the big bad i said no!

spoke to my phychiatrist today and he's told me to come off the lamotrigine and stick with the sertraline antidepressant, but maybe at a higher dose. He has also referred me for a course of obsessional/dp focussed cognitive behavioral therapy which im keen to try as ive never experienced any talk therapys before. I used to believe that medication was the only path to a cure or even just some improvement of symptoms, but after trying so many i now think otherwise. I also realise i need to put some effort in and not just rely on taking a load of pills.


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## university girl

hey there, i'm on 600 mg seroquel, 40 mg paxil and just started lamotrigine at 25 mg. Will update under this section in a new thread.


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## Life Sentence?

I just took my first Lamotrogine today. I'm building up from 25mg to 200mg. It will be in addition to the Zoloft and Klonopin that I have been on for years now. Truthfully, I have little faith anything good will come of it. It has been 18+ years for me with constant, non-stop DPD. But here goes. I will keep you all posted. :|


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## brandon is not taken

Life sentence:

If no good comes from the new med, have you thought about mayby giving things a go med free? I was on klonopin and zoloft, and after getting off both i felt much better and conitnue to feel good. The withdrawal sucks, but it doesnt last forever. It might be worth giving this a try for a few months.


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## spert23

I was on Lamictal, and I got the rash....it sucked. I'm actually thinking about coming off meds, but I am on such a low dose of Seroquel (100 mgs), that if its working (which it is) without side effects (there are none), then what's the point? I'm hate the fact that I am on meds, but if its helping the process, then why the hell not? Really though, it comes down to working as hard as you can to get better. It can happen, I've been mj-induced DP for a year, and I've noticed that my hard work can pay off. After all, its you that controls your thoughts, in the end.


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## Life Sentence?

I was medication free for the first 4 - 5 years of this thing, and it never went away. Since then I have only been medication free for a couple week, before I tried Marplan, and that was hell!

I feel that I have given the no meds. thing more than enough of a chance. Now I just want to try everything I can! I'll either get cured or die trying....


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## Guest

Thanks for the info in this thread guys.


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## Life Sentence?

I have worked my way up to 300mg of Lamictal, and have been on that dose for a little over a month. If there is any improvement, it is fairly minor.

Does ANYONE know how long a Lamictal / Lamotrigine trial period should be? What does the DOP in London recommend? I don't want to give it up until I have given it a sufficiant try.

FYI, I am also on Sertraline and Clonazepam.

Thanks,

Dan


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## Guest

Wowly shite pal "300mg"? are you melting yet? lol. Did you have any rashes pop up at all? I'm on 100mg

I found that when I was taking Clonazepam with Lamotrigine, I felt really good. I might ask to go back onto Clonazepam.


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## Life Sentence?

I haven't really noticed any side effects, good or bad. :?

I'm just not sure how long I should wait until I try something else. :?:

I believe the Depersonalization Research Unit at the Institute of Psychiatry in London, suggested an affective dose of 300mg? I think I'm correct on that part, but I'm not sure how much longer to stay on that before giving up??

Does ANYONE know more about the research trial that was done on Lamotrigine???


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## comfortably numb

I don't know very much at all about treating dp/dr with lamotrigine. All i know is that from what ive read and heard from people on this board as well is that it seems to be the best anti-convulsant for treating dp/dr. I havent heard much good about the other anti-convulsants such as the valproates like divalproex (they all work the same just different names, doses and severity of side effects) or carbamazepine.

Clonazepam seems to work better for dp/dr judging by what people say here and that is a anti-convulsant as well and is used alot for certain types of epilepsy. But clonazepam is a benzodiazepine and has many different properties then lamotrigine or other traditional anti-convulsants.

Im on lamotrigine for bipolar disorder and i must say the stuff works great. It has helped stabilize my moods much better then any other medication ive been on. It has greatly reduced the symptoms of my bipolar and has pretty much put some of them into remission completly. Im only on 125mg's a day yet but i could have been up to 200mg's a day now except for some insurance bullshit. But i will raise my dose to 200mg's a day soon to get my bipolar under control as best i can.

It works much better for me then other so called mood stabilizers such as divalproex and carbamazepine which really did nothing at all. These are not really mood stabilizers at all they are anti-manic agents and do very little for the depression side of bipolar maybe thats why they didnt work very well for me. They can make the depression side of bipolar worse actually. Lamotrigine and lithium are the only 2 true mood stabilizers. I havent tried lithium it's more for classic bipolar 1.

200mg's a day is the usual dose for bipolar but you can go as high as 400mg's a day. You pretty much stay at the dose that best works for you even if it's less then 200mg's a day.

300mg's is a fairly high dose but not that uncommon. I get no side effects from it at all really except insomnia which is a small price to pay for all the benefits i get from it. I havent had any rashes or anything like that which is great.

I have no idea if lamotrigine has had any effect on my dp/dr and brain fog because the clonazepam im on has totally put it into remission for the past 2 years. I was treated with clonazepam and diagnosed with anxiety, panic disorder and the dp/dr that goes along with that long before i was put on lamotrigine or even knew i was bipolar.

When it comes to drugs like these there are no absolute correct doses. 300mg's is just a guideline less or more may work for you.


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## Life Sentence?

Thanks for the information.

You had mentioned that Clonazepam put your DP / DR into remission! Thats great! Unfortunately for people like me, Clonazepam has only helped to a much smaller degree.

I'm very curious what else you were on two years ago when this happened, and at what dose did the Clonazepam put your DP / DR into remission?

Also wondering how long you had DP/DR before the remission and was it constant or did it come and go?


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## comfortably numb

Well i had dp/dr and brain fog all my life up until about 2 years ago when it totally went into remission and stayed there as well. It was pretty constant all my life but it waxed and waned in severity. Sometimes it went away completely for a few days or so but this was only because of recreational drugs i took such as magic mushrooms and weed.

When i went on clonazepam i was already taking amitriptyline for depression (i didnt know i had bipolar at the time) and codeine for some chronic pain that i have.

It only took about 1mg of clonazepam to pretty much abolish my dp/dr and brain fog. It took a little less then a week for it to go away after starting on clonazepam. The anxiety and panic attacks stopped within a day but the dp/dr and brain fog gradually lifted over the course of little less then a week. It was like looking at the world through new eyes and it actually took some getting used to not having dp/dr and brain fog.

I had to gradually up my dose to 6mg's a day to completly control my anxiety and panic attacks. Well the anxiety and panic attacks went away after i went on 2mg's a day but i needed to up my dose to 6mg's a day to help take care of some chronic pain i have and it also helped my bipolar.

Ive been on 6mg's a day for about a year and a half and it still works as good as it ever did. The never ending tolerance thing that some doctors believe in is horse shit anyway.


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## Life Sentence?

Lamotrigine Trial -

Unfortunately, I do not have better news to report. Lamotrigine was not my magic bullet. I still remain on 150mg, because it does seem to have lifted my spirits a bit...but I am not sure why? I've found that my sense of humor has been a little more prominant, and I real slightly more care free? Strange, but far from any cure. Seriously considering Provigil as the next step....

Dan


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## coffeecup

to be honest dan.. your still on a low dose.. in terms of lifting the DP/DR .. ive heard of one guy needing 600mg to lift the DR!

my advice is.. if you dont have any (or minor) side effects ramp it up as much as you can, lamotrigine hasnt been listed (as far as i know) to case dp/dr in anyone

you might get a nasty headache while increacing dose tho! but compared to some other meds out there.. thats nothing...


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## Life Sentence?

I was origianally up to 300mg, for many months. I dropped the dosage because it was having no effect on my DPD. I believe that I had read that 300mg was the potential effective dose, but I could very well be wrong. Do you happen to recall where mentions of a higher dose being effective are posted? I would love to hear the spacifics of a successful trial on Lamotrigine! I believe that I have enough to ramp things up to 600mg for a week or so, but who knows if that's enough time?

Dan


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## Life Sentence?

If anyone is interested.... I had spent several months on 300mg of lamotrigine, with no lifting of DPD. I am currnently back down to 150mg. In my case, I would have to say that lamotrigine is not the answer.

Dan


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## Guest

Keep in mind that everyone's mind is totally different. So what might not help one "will" help another... If you're on Lamotrigine and it's doing nothing for you, please try it along side an SSRI like Fluoxetine because it does work for me. "but" i'm also on Clonazepam so that will also make a big diffence for me. I'll be coming off Clonazepam very soon so i'll be able to tell whether I need it or not.


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## stoemmekluut

Having been on Venlafaxine and Lamotrigine (+ Clonazepam) myself, I feel like reviving this thread ;-)

I believe these medicines did work for me to a great extent: I was on Venlafaxine already and Lamotrigine made a difference very quickly. For months (a year maybe) I felt close to remission thanks to this cocktail. So good that I wanted to and did get off the SNRI, with some difficulty but it worked.

Now I'm on 200mg Lamotrigine and also take minute amounts of Clonazepam and Alprazolam. And I was wondering what effect it actually still had, if any, on the DPDR. Quitting smokes and relapsing, I noticed, changed the metabolisation of Lamotrigine greatly inducing terrible side effects (bio-availability increases when you quit and makes you go mad). But is it still doing something for the DP?

Unfortunately, I don't fully trust my current psychiatrist; I feel he's too much of a take-no-chance kind of guy and that's why he wants to put me on antidepressant again. He was very concerned about the break-up with my fiancee, asked me about suicidal thoughts, etc. Granted, my DP returned strongly a few weeks after but that doesn't have to imply that the solution is to put me on SSRI or SNRI again, does it? What if the Lamotrigine didn't have any effect anymore wrt to DPDR, to start with?

So far, I noticed that too high a dose of Lamotrigine makes me anxious and agitated while too low a dose lets me exhausted and depressed. At least, that is what I learnt from the abrupt variations induced by nicotine.

I've become very wary of changing treatments and would be interested in the insights of the (numerous, it seems) people here who are or have been on Lamotrigine.

Cheers!


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## psychiatrysucks

MrMister said:


> lamotrigine hasnt been listed (as far as i know) to case dp/dr in anyone
> 
> you might get a nasty headache while increacing dose tho! but compared to some other meds out there.. thats nothing...


Lamotrigine was a disaster for me. I had severe headaches while tapering up combined with horrendous all day anxiety. That is when my dp first started. After the Lamictal trial to treat my mood instability. Now I have dp chronic and have had it for a year. Im not saying not to try Lamictal, but I am saying that it does have side-effects for some people and not to play around with too much medication (which I did). In addition, Dr. Simeon says Lamictal does not treat Dp or is very unlikely to do so. Hate to break all the excitement.


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## psychiatrysucks

stoemmekluut said:


> So far, I noticed that too high a dose of Lamotrigine makes me anxious and agitated while too low a dose lets me exhausted and depressed. At least, that is what I learnt from the abrupt variations induced by nicotine.


I thought i was the only one. THis medicine triggered dp for me. Either that or it did a great job of speeding up its progression.


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## coffeecup

"That is when my dp first started. After the Lamictal trial to treat my mood instability. Now I have dp chronic and have had it for a year. Im not saying not to try Lamictal, but I am saying that it does have side-effects for some people and not to play around with too much medication (which I did)."

i know where your coming from.. i was initally diagnosed with schizophrenia as i didnt feel "real" after that 6 years of varying antipsychotics (some actually made me psychotic!) thing is if you have an underlying disorder (for me depression) it will effect the way the meds work on your DP (for example with me it more DR) i was just trying to say in the post if its straight DP/DR it may benefit.. one drug ive found that has made my DR worse is reboxetine.. and thats a drug for depression :/

bloody marvelous


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## Guest

"A" works for 1 where as 1 for "B" doesn't work, although 2 for "C" does work although it does have issues... but 2 for "D" and "A" are excellent... but then again 4 & 5 are even better on X.


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## university girl

lamo did nuttin for me.


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