Bipolar Disorder- carbamazepine and latuda

Hi there,

I'm a 43 year old male and I was recently diagnosed with bipolar 2. I'm come to grips with the diagnosis, it is what it is, right?

My challenge is the meds that I'm taking, particularly carbamazepine I believe. It has a done a number on my brain. I was previously diagnosed with ADD and dextroamphetamine was prescribed for that. It was helping me throughout the day, but now it only works for a one-two hour period and then I am back to this extreme brain fog. I can seemingly only do one thing at a time, multi tasking is a thing of the past. My memory is shot, and in order for me to take any sort of direction it needs to be written down for me.

I'm extremely depressed by this, and when I get depressed by other things, I can't use any sort of logic to work it out, because my ability to call up things in my head are gone. Frankly it's very depressing, and not the clinical type of depression I've been used to. This is 100 percent situational.

Does anybody have any advice on how to get through this? I've been taking carbamazepine for 2 months, latuda for 1.5 months. I read that I'm not even supposed to be taking these two together, but my doc said it was ok. Anyway I'm at a loss. Any help you can give is great.

300 mg carbamazepine
60 mg latuda
20 mg dextroamphetamine

Don't use together

carbamazepine (bulk) + Latuda oral Never use this combination of drugs because of high risk for dangerous interaction
carbamazepine (bulk) decreases levels of Latuda oral by altering drug metabolism
Additional Information: Do not use together.

Hi thenewexperience. I can't know how long (or even if) you will experience the brain fog you mentioned. I can't know which medication (if the medications) is causing it. I have never taken Latuda to be able to share my experiences with that, and even if I had, your experience could be different. I have taken 1200 to 1400 mg of Tegretol XR for the last almost 9 years. My personal experience follows.

When I first started Tegretol XR, I did experience some issues. Honestly, I forget exactly what all of them were, with the exception of some blurry and double vision I experienced intermittently. I will say that as I grew used to the medication, the uncomfortable side effects went away, including the vision issues. Now I have negligible side effects from Tegretol XR. Maybe a touch of clumsiness, but I guess that's all. It's no big deal for me. I am extremely fond of Tegretol XR (carbamazepine ER) because it got rid of some horrible musical hallucinations I experienced, as well as some other issues. I think it has been helpful for preventing mania and keeping my moods level, but I do need Seroquel XR to do the full job.

If your psychiatrist and pharmacist say that taking Tegretol (carbamazepine) with Latuda is OK, then I'd trust that it is likely OK. Tegretol does have a number of drug interactions, but doctors should know which are dangerous, and which can be worked with. For example, my Tegretol XR does have a drug interaction with my Seroquel XR, but the interaction is that it decreases the effectiveness of my Seroquel XR. In my case, that means that I likely need a bit more Seroquel XR than I might have needed if I took Seroquel XR with a medication that didn't have that particular interaction with it, and was equally as effective as Tegretol XR. But I also know that Tegretol (carbamazepine) can decrease the effectiveness of many forms of hormonal birth control. That can definitely be problematic, and is a reason why I (as a woman) chose a copper IUD. Another option is for a man I'd ever sleep with to wear a condom or have a vasectomy.

Carbamazepine ER and Seroquel XR are a great combination for me. I'm grateful for them. Please only take direction about medication usage from your doctor(s). No one on a forum should be telling another member not to take medications properly prescribed to them. Perhaps suggestions to confirm with their prescribing doctor, or get second opinions (such as from a pharmacist), but not telling a member what to do. It is always strongly recommended to let all of your doctors (from gp to psychiatrist to any other doctors) know ALL of the medications and supplements you take.

Thank you for the thoughtful reply, I really appreciate it. I see my doc on Thursday and I'm hoping he will supply some additional information for me.

I'm not able to work right now with this brain fog, and it doesn't do much for my self esteem. Thankfully I have family to help out right now as I deal with this.

I took Tegretol once, for a very short period of time because it caused a skin rash that would not go away with antihistamines. I only took 100 mg. It created a magnificent effect of no thoughts in me - complete and wonderful stillness. I cannot meditate, but believe it is the effect meditators are after. This was against the backdrop of a hypomanic episode with racing thoughts.

I am wondering out loud if your Tegretol dose is too much for you personally and whether titrating down a bit would resolve these issues. If it is such a potent drug that a tiny dose could bring down racing thoughts to a meditative stillness, a bigger dose can produce brain fog.

Of course we are all different, but still, I am always for trying to work with the dosages before giving up on a med.

Hello newexperience: I'm not able to offer anything with regard to your medications concerns. But I noticed this is your first post here on PC. So I simply wanted to welcome you to Psych Central.

Here are links to 3 articles, from Psych Central's archives, that discuss medications for bipolar disorder plus 2 articles on the subject of bipolar 2:

Medications for Mania & Bipolar Disorder

More Information on Medications for Mania and Bipolar Disorder

Bipolar Disorder Medication Spotlight: Tegretol (Carbamazepine)

What Bipolar II Disorder Really Looks & Feels Like

Bipolar II: Anger, Angst & Understanding

I hope you find PC to be of benefit.

Hello and welcome to Psych Central! I take Tegretol for bipolar AND for facial nerve pain. And, yes, I have some brain fog--memory issues, really. It's distressing, but I'm 64, so it might be caused some by age. I am still able to think well, overall. For example, I'm writing a book and do well on some word games here. I just need to write things down more and repeat things over and over to keep them in my memory.

All that said, I have been over seven years without a bipolar episode, longer than with any other mood stabilizer.

So, I've accepted this memory issue. I can certainly understand your frustration, though.

I've never taken Latuda. But I take Cymbalta, which might be similar.

Good to have you here. Again, welcome.

This issue can be fixed taking a higher latuda dose than if you weren't taking carbamazepine. Usually doctors know it.

Crazy, inside and aside

"Outwardly: dumbly, I shamble about, a thing that could never have been known as human, a
thing whose shape is so alien a travesty that humanity becomes more obscene for the vague resemblance."
I have no mouth and I must scream -Harlan Ellison-

Thank you so much for the reply. It's interesting, I slept 12 (yes 12 hours last night and I feel like my brain is working OK today. Do I need to sleep this long every night? ha

Any way, I see the doc tomorrow, and I have a list of questions for him, and I will not leave until I get them answered

Glad you posted!! I stumbled upon this looking for someone else on Tegretol and a stimulant.

I’ve been on Adderall daily for 3-4 years, started Tegretol last September and Adderall stopped working. Now am trying Dexedrine—same problem. Doesn’t help with the focus like pre-Tegretol plus I do have a crash now with some mood drop/anxiety. And I kinda need to do some work at some point

Also, I hope your doctor cleared up how Latuda levels can be reduced on Tegretol. I happen to be on Latuda as well. It’s been great for me and I’ve had no problems, curious if you’re still on the combo?

Best wishes!

Glad to hear you are being proactive concerning your mental health. I always question my doctor's decisions to see just why it is they think certain combinations work in respect to my symptoms.

Sorry for the late reply! So things for a bit got worse for me, and then better once I was prescribed lexapro. Now, my new doc thinks I should go off the tegretol and stick to latuda and lexapro. She says I can go cold turkey off the tegretol cause it's such a low dose. Her thinking is it was giving me all the side effects, but none of the benefits. How are things going for you?