# Why isn't everyone trying LAMICTAL+SSRI?



## qbsbrown (Aug 18, 2004)

Granted it was a small scale test, still, a 50 percent recovery rate from it. Just curious to why it isn't a bigger subject here, or more people aren't trying it.


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## Guest (Mar 24, 2005)

Yea i have no idea


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## university girl (Aug 11, 2004)

if i can convince my psyc, i'd like to try...... problem is, she thinks i'm in the early stages of psychosis....wait, maybe it was a rare for of schizo. i don't think she knows. but i know. i have dp. too bad she can't see it for what it is.


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## rob (Aug 22, 2004)

i thought the dp unit in london reported that 40% of trialists reported some improvement in their symptoms some to the point of cure - but not sure if that's much better than a placebo - get the impression they might be moving the focus of their reserarch away from drug therapies

rob


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## gimpy34 (Aug 10, 2004)

I think there is an article in the DP research section which talks about those trials. A first trial did have something like a 50% success rate but in a second trial, none of the patients reported improvement.

The trial was based on the ability of ketamine to induce disassociation and depersonalization when given to non-DPed patients. And lamictal could counteract some of the effects of ketamine. To suggest that as the cure is kind of dumb because obviously a lot of other drugs can cause DP.

I have tried Lamictal and it didn't really do anything. I never took it with an SSRI but they aggravate my depression, panic disorder, and DP anyway. The brain is a pretty complex creature and to suggest that low serotonin is the lone culprit behind anxiety and DP is foolish.


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## dakotajo (Aug 10, 2004)

Gimpy,

I disagree with you. I think serotonin is the lone culprit behind depression, anxiety, panic and dp. How this condition occurs is the big mystery. The fact that ssris worsen your panic is a good sign they will probably benefit you. Boosting low serotonin levels will cause anxiety, agitation until the receptors have a chance to downregulate which can take many weeks or months. I believe anybody who has dp also has extremely low serotonin levels. Its a product of people that didnt seek treatment early enough. Ill bet most here will admit they had mild anxiety,depression before this "condition" came about. Most people here will benefit from an ssri, but they must be willing to tolerate a worsening of their symptoms for quite a while. The best way is to start with an extremely low dose and very slowly painfully inch their way up over a period of months till they hit the therapuetic dose.

Joe


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## jft (Jan 10, 2005)

Hey jo. So then the question is begging to be asked " why is not everyone taking a ssri"? I think most everyone has at one time or another. Granted that yes many do not make it to therapeutic dose and drop out, but it seems if most people would benefit from and ssri then the research folks would be going full guns on this. Correct me if I am wrong but I do not see that they are going full guns on ssri's. I know they have done wonders for you, and that is great. But it seems most here cannot match your experience. Or most of those on other websites for that matter. At least that is what I gather.

I would try them again if given good reason to do so. I am one that for years has tried most every one that came out hoping this would be the ticket. And yes I did bail out on some of them due to side effects but not due to increase of dp or anxiety. But I was on full trials of one TCA and two ssri's (prozac and celexa) though and I literally had no results whatsoever. It was the shrink who had me stop use becasue he saw no benefit in continuance.

I am not at all argueing your thoughts on this, for I am quite ignorant of this all. But I only speak as to what I see. Help me out if I am wrong.
jft


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## gimpy34 (Aug 10, 2004)

Joe, 
I'm not meaning to be abrasive but you have no idea what you're talking about. And really neither do I nor does anybody. The brain is so complex that the ability to think we can completely understand it is laughable. I have taken two different SSRIs, both for several months, and they worsened my DP, panic disorder, anxiety, and depression. Enough said.

We know serotonin, norepinephrine, dopamine, GABA, glutamate all play roles in depression and anxiety. But so do crap like acetylcholine, histamine, and brain hormones. Some people consider certain minerals like zinc to be their own neurotransmitters. The brain is a tricky machine.


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## Guest (Mar 25, 2005)

qbsbrown said:


> a 50 percent recovery rate


There's your answer.

I have such a _rate _ on math tests and it's really nothing to get excited about.


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## Guest (Mar 25, 2005)

50 percent sounds great to me


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## Dreamer (Aug 9, 2004)

I have a much improved quality of life and an lessening of my chronic 24/7 DP/DR on the following:

Klonopin 6mg/day
Celexa 40mg/day
Nortriptyline 50mg/day
Lamictal 200mg/day

This combo was arrived at over a period of about 5 years with a psychopharmacologist.

Klonopin in 1987 was the first drug to significantly decrease my symptoms. But has never been a cure. I have never gone off of it.

Later Celexa and Nortrip helped with my chronic depression and GAD.

Lamcital is VERY subtle -- I've heard this from some others who've had some success with it. It added another punch to the power of the Klonopin. It is very difficult to describe, and you have to be on the right dose long enough to see if it works. It makes me "less afraid" of the DP/DR.

I really don't have existential thoughts much at all, not like I did as a young girl and in my 20s. My DP/DR is in essense a perceptual shift that is unbearable. My anxiety causes intrusive negative thoughts. I also have some borderline characteristics, and the Lamictal has helped level out my moods.

I take this combo as it has improved my quality of life that I do not want to change it. This is only MY experience, no one else's.

The doctor who gave me this combo has had success with it in those who have DP/DR with another major mental illness. His success at the time was with bipolar individuals with chronic DP/DR. Lamictal completely eliminated their DP/DR while stabilizing their mood. He is doing an ongoing study on this.

We are all so different.
And no, we don't understand how these meds work.
For me it is a quality of life choice.
Hey, I'm still here. I still have DP/DR 24/7, even in my dreams. I couldn't tolerate the DP/DR at the intensity it was in my 20s and considered taking my life by age 30. Well, I'm still here.

Why? Meds, time, psychotherapy, group therapy and trying to live my life as best as I can.
I hate to be on meds. BUt my DP/DR existed since childhood. It didn't come from an Rx or Rec drug.


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## Dreamer (Aug 9, 2004)

P.S. I agree 100% with Gimpy, for whatever it's worth.
Peace,
D


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## dakotajo (Aug 10, 2004)

Good for you.


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## gimpy34 (Aug 10, 2004)

Has anyone who has tried Lamictal know if it has helped with the visuals and depth perception part of DR? I think I got up to 200 mg in about 2 months and stayed there for another month before quitting it. After 2 months, Dreamer, I think I noticed what you are talking about how it subtlely made you think less about the DP/DR. But, it never did anything for the visual part of DP/DR which royally pisses me off.

If it weren't for that damned rash, more people here could get up to the therapeutic dose faster and live to tell about their Lamictal experience before they wither and die of old age.


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## dalailama15 (Aug 13, 2004)

I have core DP experience 23.998/7 for 30 years ? not a lot of anxiety for 25 or so, and ?depression? seems to me subsumed in detachment. No overt DR (as I understand it) in that I have no visual disturbances above the ever-present (when I choose to notice) flatness, or alien-ness, or detachment or disconnectedness of/from sensory input.

I?ve been on a therapeutic dose of lamictal for about 9 months now, 3 or 4 of which in combination with Wellbutrin (substantial forgetfulness) and now 3 or 4 or so with an SSRI (prozak).

Results: no improvement at all in DP stuff. Perhaps some lightening of mood on the surface ? that is, perhaps my interface with the world is a little smoother, my speech a little more glib, but this is both good and bad: good when I joke around a little with the girl at the grocery store or at the coffee shop; bad in that, after a day of work with more complex interactions, I am a little less sure that I have not been a little odd, quirky, or inappropriate.

I have also been sleeping a _lot_ and have noticed a real decrease in any kind of motivation, which was never very high in the first place.

In addition, it seems to me that my sleep is less deep, my dreams more verbal.

Also, I seem to have nonsense verbalizations going on in my mind with much more frequency than I remember--e.g. the moment I wake up I 
will be reciting something like some stupid lyric, and throughout the day I find myself repeating, in my mind, some words or numbers or whatever that I have just thought or encountered -- a stop sign, a highway number, or whatever.

I have given this combo a fair shake, have given SSRIs a fair trial, and can conclude that they are of no use to me and can be done with them. I am weaning off now, and am not sure what to expect. It is possible that I will feel better, and equally possible that I will crash, fulfilling the prognosis of Dr. MHP (metal health professional), made within the first ten minutes of our first appointment, that I will have to take ?something? for the rest of my life, just as if I had diabetes or whatever.

I am now interested (further experiments in psychopharmacology) in a specifically dopamanergic drug (based on some small success with wellbutrin by itself) perhaps the anti-parkenson?s treatment selegiline (deprenyl) .

Also, the new miracle weight-loss, smoking-cessation drug (in trials now and yet to be approved) rimonabant, is of real interest, because it works directly on the endocannabinoid system, blocking the receptors that marijuana targets. For many reasons, it seems to me that the cannabinoid system may be at the core of this whole DP mess.


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## Dreamer (Aug 9, 2004)

Sorry to hear about all the negative Lamictal stories, and Dalailama, your frustration with many med trials.

I have to say, I have a suspicion in my case, that Lamictal has been working ENOUGH (not a cure) because I have something of a "mood dysregulation" problem -- not bipolar, but something akin to it -- which is associated with my Borderline tendencies.

Sadly, Lamictal is not THE drug for DP/DR. To be honest, I think the only med that is closest to a good first try is Klonopin -- especially for those with intense anxiety. But I know there is a hue and cry over benzos.

I can only say again, I was on Xanax, Ativan, and Valium, waaaay back. They were all like sugar pills for me, literally. They didn't even help my anxiety that much.

I'll only say again, each and every one of us here is an individual case, and should be taken as such. We DO have DP/DR in common, but I hear of so many variations and accompanying symptoms we aren't all exactly the same here.

Also, Gimpy, I don't have say, "static" in my vision or the distortions described by many here that sound like "trip" images -- light trails etc. but I do have that damned 2-D, dimmed, effect -- the DR. The Lamictal really hasn't touched it at all.

I will say, in group therapy now, DBT or CBT, working on "ignoring it" or rather "pushing the fear of it" further from my mind is the most effective, but I HATE going outdoors during the day, especially beautiful sunny days. And continue to wear transition lenses, and Rx sunglasses that are very dark.

Each one of us has different experiences here, most notably:

1. Some have only DR or DP (which I can't quite fathom)
2. Some have both DP/DR (which I have)
3. Some have this as a chronic condition
4. Some have this as coming in cycles
5. The intensity of the experience can vary from severe/incapacitating to "bearable" or less intense
6. Some dream in DP
7. Some find relief in dreams (experience reality)
8. And some have disruption of sleep/dreams while others do not

THere are more differences, but this is also the reason I believe some respond well to one drug, while others to another, while others have no response whatsoever.

It is up to each individual to decide if he/she needs/wants to experiment with meds -- and it is a tedious process, or not. We are indeed living guinae pigs in this mess.

Very frustrating to say the least.

Best,
D


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## revdoc (Jan 2, 2005)

rereamer - The effect of Lamictal with me has been more than subtle. It's definitely made me feel more at ease, less anxious and less dull in the head. Unfortunately at 175mg my sleep went to pot - I kept on waking up after about five hours and unable to get back to sleep. I'm going to try raising it more slowly and see what happens.
I do suggest that people give this a try. It won't solve anything but it might make life more bearable. Klonopin didn't work for me - it's horses for courses (is that just a British expression?).


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## Guest (Mar 29, 2005)

I'm not taking an SSRI simply because no matter how many times I've tried I cannot tolerate them.My anxiety and dp goes through the roof,it's beyond terror.
I hate this because I actually think I might benefit from taking them,I get a lot of depression,mostly reactive in my opinion still,it's persistent and CBT only gets me so far.

I'd also like to try Lamactil.I'm way too concerned about having an allergic reaction,a rash called Stevens Johnson Syndrome.

I realise this rash is rare but I'm prone to nasty allergic skin reactions from different antibiotics and had to go to hospital a few weeks ago due to a rash.
It's triggered a histamine sensitivity and I'm still itching.

Somebody I know who used Lamactil and did find it helpful for dp put on a lot of weight in a short time and hence became very depressed due to it.
She's still struggling to lose the weight and would rather manage her dp by taking a benzo than be fat.

I think if you can tolerate these drugs,it's worth giving them a go.

Cheers Shelly


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## Guest (Mar 29, 2005)

I tried Lamictal 2 weeks, first week I was feeling nauseated, and weirdo, and when I upgraded to 25 mg, I was sick as hell all night. I throwed up many times and couldn't take care of my son the day after. Very sick. So, lucky are the people who tolerate it, but unfortunately, I think maybe it's not all the people who can tolerate it  I talked to th Dp unit at London about that, and he said that then it's not the right med for me.

Maybe that's why there is only 50 % success rate?


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