View Full Version : Lamictal for Depression (MDD)


known_guy
02-15-13, 10:22 PM
Experiences, anyone?

It might be of interest to note that Bipolar-NOS was ruled out for me... I also happen to be tapering off Zoloft (150mg to 100mg to 75mg, etc.) which I find a little confusing. I've heard of Lamictal being prescribed for those who have the more "treatment-resistant" kind of depression, but I thought it generally is used as an add-on/adjunct medication? Not like monotherapy. Though the Zoloft I've been taking for 1.5 years and really haven't found much benefit. I guess if anything it helped with my dermatillomania, but not my depression...

starry
02-15-13, 11:16 PM
Copied this from crazymeds.us ;)

"Lamictal (lamotrigine) works, and works well, for two difficult-to-treat conditions: bipolar 2 featuring severe, near-constant depression that is usually misdiagnosed as a variant of unipolar depression, and Lennox-Gastaut syndrome. You may have to drastically alter your lifestyle and that of your entire family (e.g. no more perfume or scented cleaning products) to keep taking it without being covered in a scary-looking, but otherwise benign rash, but that sucks so much less than treatment-resistant bipolar 2 or watching your kid with Lennox-Gastaut hit the floor for the twentieth time today.
In spite of the climate of fear that permeates everything having to do with Lamictal (lamotrigine) due to The Rash, and loud complaints about killer headaches and full-body muscle aches, Lamictal actually has one of the lowest side effect profiles around. It’s not as low as Keppra’s but it is almost as low as Neurontin’s, with the added advantage of actually doing something for bipolar disorder and forms of epilepsy that are usually way too severe for Neurontin to handle. It may be the pickiest of all AEDs, but has been an absolute lifesaver for thousands of people."

starry
02-15-13, 11:28 PM
So I guess if you can deal with the rash and some of the other side effects, it sounds to be a promising medication in the treatment of a near-constant, persistent depression. There is a lot of info in the forums there added by those who are on it and if you like I can PM you the link to it. I think that we're not allowed to post links here/ certain links. I'm still confused about what is allowed and what not, even after reading the FAQ's ....so I'd be happy to PM it to you if you want it.

sarahsweets
02-16-13, 05:29 AM
i think it would be really helpful. Its used as a mood stabilizer for me. I can only speak from the BPII perspective but I would think it would help with MDD too.

Raye
02-16-13, 06:24 AM
I'm the anti D resistant kind and take Lamictal for MDD.

It works very well for me.

425runner
02-16-13, 10:13 PM
Does it slow you down or anything?

Raye
02-17-13, 04:16 PM
For me, it does not slow me down.

known_guy
02-18-13, 10:38 PM
If anything, I felt a little more hyper (not happy) during my first couple weeks on it. Not that it was an unwelcome feeling, given how my mood was before, but it subsided and I now can't tell what effects I experience now. I was told I should start noticing a change when I hit the 100mg-200mg dose range.

known_guy
03-03-13, 10:24 PM
Shoot, so I am maxed (?) out at my targeted 200mg daily dose, but I think I encounter the following problems as a result: 1) my creativity feels impaired, and 2) the frequency of "careless errors" in a variety of contexts has noticeably increased significantly. Does this sort of stuff subside? Or should I consider lowering my dose back to, say, 100mg?

Raye
03-03-13, 10:31 PM
I'm not saying you are one to go AMA, but if you feel you need to lower your dose then you should talk with your dr. You can't go straight from 200mg to 100mg. It's dangerous and you have to slowly lower the dose.

That's what I was told by my pdoc.

Good luck.

sarahsweets
03-04-13, 06:04 AM
When you say maxed out what do you mean? I take 100mg 5 x a day(5 times a day due to digestion issues) and that works for me. I had to slowly build up to that and be very mindful of the side effects.


Shoot, so I am maxed (?) out at my targeted 200mg daily dose, but I think I encounter the following problems as a result: 1) my creativity feels impaired, and 2) the frequency of "careless errors" in a variety of contexts has noticeably increased significantly. Does this sort of stuff subside? Or should I consider lowering my dose back to, say, 100mg?

known_guy
03-04-13, 11:59 PM
When you say maxed out what do you mean? I take 100mg 5 x a day(5 times a day due to digestion issues) and that works for me. I had to slowly build up to that and be very mindful of the side effects.

Maxed out as in my psychiatrist said the typical maximum for those who take it for depression is 100mg-200mg.

sarahsweets
03-05-13, 05:47 AM
I just googled max dose for lamictal for bipolare disorder and MDD, and I found several sites that state the standard max was 400mg.

Fuzzy12
03-05-13, 08:01 AM
Yes, I've read too that the maximum dose is supposed to be 400mg. I think, in general, it's supposed to be effective from 100mg onwards.

I've just started taking 50mg. It definitely hasn't helped with depression (for me, and it's still early days I suppose!!) and it only seemed to stabilise my mood in the first week (on 12.5mg, maybe it was a placebo effect :rolleyes:).

Zoloft helped me tons with depression (well, it made me hypomanic) but I kept increasing the dose because the positive effect wore off very quickly every time. I didn't have any withdrawal symptoms when I stopped but maybe that's because I immediately started taking venlafaxine. I thought they are supposed to be more severe with SNRIs rather than SSRIs.

known_guy
03-07-13, 07:38 PM
OK. Now I feel stupid because the only maximum dosing recommendations I see say that the 400mg is for those taking certain other medications in conjunction with Lamictal due to interaction reasons. Any evidence suggesting efficacy for Bipolar Disorder, Depression, whatever, at 400mg (to even 600mg though not so efficacious) from what I see is only anecdotal. Like I stated, I only reiterated what was told by my psychiatrist.

By the way, from the very, very brief information I looked into, the decreasing of dose of Lamictal is suggested as decreasing by 50% at a time, and not shorter of a duration than two weeks unless for rash reasons.

Halfpass4
03-07-13, 07:50 PM
You may have to drastically alter your lifestyle and that of your entire family (e.g. no more perfume or scented cleaning products) to keep taking it without being covered in a scary-looking, but otherwise benign rash, but that sucks so much less than treatment-resistant bipolar 2 or watching your kid with Lennox-Gastaut hit the floor for the twentieth time today

I thought that rash could be serious (thinking Stevens-Johnson syndrome)...

My husband takes it with Wellbutrin for depression, and he's had a really good experience with the combination. Not sure of the dosage he's taking, though...

known_guy
03-16-13, 04:01 PM
Hooray, after a week of horrid suffering at 200mg (I honestly believe it was beginning to cause stupidity as a side-effect) my psychiatrist allowed me to decrease my dose to 100mg for now so I will see how that goes. Oy, careless errors - handwriting errors that consisted of word/letter skipping and reordering, one time I wore sunglasses into a movie theater and wondered aloud to my friend "WTF, why is it so dark in here!?", I haven't a clue as to how I confidently reasoned that since I had started the initial 25mg of Lamictal on January 18th, increasing it to 50mg on the 28th was the right date (I knew I was supposed to wait 2 weeks; how I thought that the 18th-28th summed up to 14 days, mind, a thought which persisted until I was ready to up the dose to 100mg a couple weeks thereafter, is just beyond my comprehension.) ...Oh so very frustrating.

Shabazz
03-19-13, 05:07 PM
Hooray, after a week of horrid suffering at 200mg (I honestly believe it was beginning to cause stupidity as a side-effect) my psychiatrist allowed me to decrease my dose to 100mg for now so I will see how that goes. Oy, careless errors - handwriting errors that consisted of word/letter skipping and reordering, one time I wore sunglasses into a movie theater and wondered aloud to my friend "WTF, why is it so dark in here!?", I haven't a clue as to how I confidently reasoned that since I had started the initial 25mg of Lamictal on January 18th, increasing it to 50mg on the 28th was the right date (I knew I was supposed to wait 2 weeks; how I thought that the 18th-28th summed up to 14 days, mind, a thought which persisted until I was ready to up the dose to 100mg a couple weeks thereafter, is just beyond my comprehension.) ...Oh so very frustrating.

Very glad to see you are doing better on 100mg. Has your creativity returned? And is it helping your depression? I'm on 150mg for depression, no bipolar. I wouldn't want to go higher.

Your doc was correct. From every study I've read, going higher than 200mg is not really going to help if the issue is strictly depression. Do you still intend to come off the Zoloft?

known_guy
03-25-13, 10:59 PM
Your doc was correct. From every study I've read, going higher than 200mg is not really going to help if the issue is strictly depression. Do you still intend to come off the Zoloft?

Thanks for your response. Unfortunately I still feel blunted/dulled. In addition I was surprised at how poorly I responded to my medication decrease, mood-wise. But I suppose the whole "stabilization" thing is working to some extent. Perhaps I just need to find the correct balance. Does Lamictal effect your creativity? =\

Shabazz
03-27-13, 12:03 PM
Thanks for your response. Unfortunately I still feel blunted/dulled. In addition I was surprised at how poorly I responded to my medication decrease, mood-wise. But I suppose the whole "stabilization" thing is working to some extent. Perhaps I just need to find the correct balance. Does Lamictal effect your creativity? =\

Hi there. I see you have dropped the Zoloft. I think that may be the reason for your decline in mood. From my understanding, for treating unipolar depression, lamictal is best to use as an augmenting med along with an antidepressant ... rather than just by itself. Maybe you could add another antidepressant other than Zoloft.

I know that in my case, I would still be depressed if I was taking just lamictal without cymbalta. At first, lamictal seemed to stifle my creativity and sharpness, but now I've adjusted to it. I'm back to normal, fortunately ... Maybe you could decrease the lamictal if it's still causing you troubles?

spinifex
03-27-13, 09:32 PM
Hey all.

After a stint on many different ADHD drugs, and me still having problems, we discovered that my depression wasn't being treated. Hence, we're tackling the Treatment Resistant Depression with Lamictal, and the ADHD with 10 MG of generic Concerta. The Lamictal is only at 50 mg (after starting at 25 mg), but you know? I've been taking it for a month now and it's really working for me and my depression. It's like that little voice in my head that tells me that I'm evil is finally silenced for once.

Next week, my doc wants me to ramp up to 75 mg, but should I, if the 50 mg is working so well for me? I'll also put a call into him about it, but has only 50 mg worked for anyone else?

known_guy
03-28-13, 05:46 AM
Hi there. I see you have dropped the Zoloft. I think that may be the reason for your decline in mood. From my understanding, for treating unipolar depression, lamictal is best to use as an augmenting med along with an antidepressant ... rather than just by itself. Maybe you could add another antidepressant other than Zoloft.

I know that in my case, I would still be depressed if I was taking just lamictal without cymbalta. At first, lamictal seemed to stifle my creativity and sharpness, but now I've adjusted to it. I'm back to normal, fortunately ... Maybe you could decrease the lamictal if it's still causing you troubles?

Funny you should mention Cymbalta, that's why my doctor is recommending I consider as a new antidepressant option. I suppose 1 could be better than 3. At least, when it comes to potential side effects.
(At one point I was on 150mg Zoloft, 300mg/450mg Wellbutrin, and 15mg/30mg Remeron - and that seemed necessary to shake me out of my depressive funk. Added one after the other very slowly. Pretty gnarly.)

Fuzzy12
03-28-13, 08:03 AM
Hey all.

After a stint on many different ADHD drugs, and me still having problems, we discovered that my depression wasn't being treated. Hence, we're tackling the Treatment Resistant Depression with Lamictal, and the ADHD with 10 MG of generic Concerta. The Lamictal is only at 50 mg (after starting at 25 mg), but you know? I've been taking it for a month now and it's really working for me and my depression. It's like that little voice in my head that tells me that I'm evil is finally silenced for once.

Next week, my doc wants me to ramp up to 75 mg, but should I, if the 50 mg is working so well for me? I'll also put a call into him about it, but has only 50 mg worked for anyone else?

I'm currently taking 50mg of lamotrigine and 60mg of duloxetine (cymbalta). I'm not sure if the lamotrigine is doing anything against the depression but even at just 50mg it does help to even out my moods. The therapeutic dose is usually supposed to start at 100mg but everyone is different.

My GP told me last week that she's had some patients who had a very positive result at just 25mg of lamotrigine and so there wasn't a need higher.

Maybe you can try to increase your dose to see if the effect becomes even more positive but if it's working well for you at the current dose, there's no need to go higher. In general, I think, it's good to take the lowest possible dose at which you still get the same effect.

Shabazz
03-28-13, 12:45 PM
(At one point I was on 150mg Zoloft, 300mg/450mg Wellbutrin, and 15mg/30mg Remeron - and that seemed necessary to shake me out of my depressive funk. Added one after the other very slowly. Pretty gnarly.)

Wow, that is an interesting combination. How did you feel while you were on it? Were you very sedated? Remeron made me extremely sleepy & hungry. It was too distracting. It must have helped if you stayed on it.

As for lamictal, its true that some people can see the benefits at even 25mg for depression. From what my doc told me, once you hit a dose that helps, then it doesn't make sense to go higher .... even if it's only 50mg.

known_guy
03-29-13, 12:16 AM
Thanks for the mention of 25mg/50mg of Lamictal. The benefits were more noticeable for me at those initial doses than after continuing with my titration up to 200mg. I am still hanging around 100mg, perhaps I should consider a further decrease to get a better feel for the effect(s).

Thinking back, I think the combination helped my depression way more than I thought it did at the time. Though the trio concoction might have been too brain-stimulatory - it elicited some "hypomanic" symptoms. Not sure whether to call that an effect or a side-effect. Remeron was added mostly to help aid my sleep and appetite so it may've acted as an "antidepressant" via those means. The grogginess tends to dissipate after a few days, then sleep starts to feel natural like it was before any depression nonsense interfered with my life. Hmm. As for the increased appetite, I think other medications taken concurrently (Strattera, stimulants) helped offset the magnitude of that effect.

Darksanity
05-03-13, 07:13 PM
I'm the anti D resistant kind and take Lamictal for MDD.

It works very well for me.
Do you think it would help for impulse control/perseveration/OCD?

Raye
05-04-13, 08:05 AM
Impulse control... for me yes, most of the time. Don't get me wrong, I still have crazy ideas once in a while of just packing up my car and heading south.

then it hits me, hey I can't do that ( at least not yet) I realize that I have no plans once I get there, no money, etc...

Before I was diagnosed and medicated, I made many life altering decisions in a matter of seconds.

as far as OCD... sorry, I don't have any experience with this.

known_guy
05-05-13, 01:24 AM
Trying a second run with an increased dose of 200mg Lamictal to see if the "stupidity" side effects occur again. My belief is that my body adjusted even to the less severe effects upon my decrease to 100mg, so who knows, maybe it's worth a shot. Maybe it will be helpful for 'mood stabilization' or not, might even consider dropping it entirely.

sarahsweets
05-05-13, 05:51 AM
ARe you taking all 200mg at once? For me I take multiple smaller doses morning and night and its been more effective.

Trying a second run with an increased dose of 200mg Lamictal to see if the "stupidity" side effects occur again. My belief is that my body adjusted even to the less severe effects upon my decrease to 100mg, so who knows, maybe it's worth a shot. Maybe it will be helpful for 'mood stabilization' or not, might even consider dropping it entirely.

known_guy
05-07-13, 11:16 PM
Yes, I take 200mg in the morning, all at once. I have considered the possibility of taking 100mg in the AM and another 100mg in the early afternoon. I think when I tried a night dose it exacerbated my insomnia. Thanks for the input, I will think of a way to adjust my dosing schedule, find what works for me. ^^

Parterxred
05-12-13, 06:25 AM
I take 100mg every morning. This dosage works and I'm sticking to it. Steves-Johnson syndrome scares me.

known_guy
05-17-13, 02:33 AM
Decided to drop Lamictal back down to 100mg again - experienced the "stupidity" again so now I definitively know not to go above 100mg (or at the very least, any time soon). Guess I'll just be keeping it here for a while.