Lamotrigine (Lamictal) for BPD - Forums at Psych Central



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Old 03-22-2019, 05:40 PM #1
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Help Lamotrigine (Lamictal) for BPD

Anyone have any experience with this med? My doctor's been trying me on various antidepressants/anti-anxiety meds for 2 years with little effect, but I'm finally seeing a psychiatrist who's addressing my BPD (maybe bipolar) and she started me on lamotrigine. From what she told me and what I've read about it, it's the only med that's shown real effect on BPD, as well as medication-resistant depression. Has anyone taken it? What kind of effects should I expect - like how will I know if it's working?
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Old 03-22-2019, 11:00 PM #2
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Default Re: Lamotrigine (Lamictal) for BPD

i take 200mgs/day along with 20mgs/abilify. im labeled w/ 'severe bipolar i, mixed states, psychotic features.' makes me sound...a whole lot less stable than i actually am. LOL.

anyway...its an anti-seizure drug. not sedating per se, but..for me, it slows things down a bit but also keeps my mood from dipping into the deep, dark pit of psychotic depression (again, makes me sound scary...i can function during those episodes, just...barely...).

doses vary a good bit. 200mgs/daily is standard for Bipolar I. a lot of psych docs use it 1st line in bipolar II, because those people tend to be depression-heavy.

good news: -if- it works for you, it can help a whole lot w/ low dips and even reduce the ups, too. bad news: risks. one must be slowly, slowly dosed up...and now there are case reports coming in of nasty, bizarre, sometimes lethal events...

thankfully, those are rare (or seem to be, at this point). oh, and liver toxicity. its not mega-toxic, but there have been cases of liver damage that just kinda...appeared, it seems.

oh, and...---if--- you and the psych doc decide that you need a neuroleptic/tranquilizer/so-called 'antipsychotic,' some limited data shows good synergy between lamictal and seroquel, also abilify. that's a big deal for -me- because abilify at a full dose is an effective anti-manic, not so much an effective drug for the moody blues. i don't know what the seroquel augmentation is all about, but...it seems to help.

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Old 03-22-2019, 11:13 PM #3
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Default Re: Lamotrigine (Lamictal) for BPD

Yes, she's titrating me up very gradually. Starting at just 25mg for two weeks. She expects to end up at 150-200, so it'll take quite a while to get there.

I'm definitely more on the depressive side, and those deep dark pits are what I'm hoping to avoid. I don't do full manic. From what I've been reading my ups might verge on hypomanic, but for the most part I just feel like I'm happy and functional. I sleep and eat normal amounts, I have energy and motivation to actually accomplish things. I do tend to be pretty impulsive, but mostly within the scope of "normal" behavior. Things like taking a new job or deciding to move, not high risk stuff.
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Old 03-23-2019, 01:06 AM #4
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Default Re: Lamotrigine (Lamictal) for BPD

ok. you're...not as 'manic depressive' as me. i have a friend who takes 200mgs lamictal and a little bit of Rx amphetamine. i think you two have similar 'issues.' works well for her..
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Old 03-23-2019, 01:43 AM #5
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Default Re: Lamotrigine (Lamictal) for BPD

I'm already on percocet for physical issues, so I have a feeling they're not gonna want to do amphetamines. Also Welbutrin and Ambien.
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Old 03-23-2019, 02:40 AM #6
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Default Re: Lamotrigine (Lamictal) for BPD

just throwing it out there. i have another acquaintance....we're close enough to talk pills...she takes seroquel xr pm and adderall xr am. its like a 60s goof ball, just...with 2 copays. covers a lot of bases.

wellbutrin is a lot like Tenuate, a milder stimulant used in weight loss. apparently, tenuate was Trump's Rx of choice from his bariatric MD back in the 80s. true, kinda scary story.

ambien was great for me...until it wasn't. then i was on temazepam, which...when it worked @ 30mgs, was bliss. now, i take tons of antioxidants, etc., and the most 'fun' rx i have is gabapentin. :-(

wellbutrin works nicely for me, too. what form do you take? i was on the 2x daily sr for a long time, 400mgs/daily. new prescriber person wants me on 300mgs/day, once daily xl. fun fact: wellbutrin is 2nd or 3rd line for some people w/ the add/adhd label. and now you know...

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Old 03-23-2019, 02:48 AM #7
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Default Re: Lamotrigine (Lamictal) for BPD

150XL. I've only taken it with the Cymbalta, so it'll be interesting to see how effective it is after I'm off that.

The Ambien is just for sleep. So far it's the only thing that's worked, and it's great. Although yesterday I took my first dose of Lamictal when I got home from therapy and promptly passed out for the rest of the day. I didn't sleep much the night before, but considering I've been totally unable to nap for several months, I decided to switch the Lamictal to PM. Gonna be hitting the sack here shortly, so we'll see if it works.
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Old 03-23-2019, 03:13 AM #8
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Default Re: Lamotrigine (Lamictal) for BPD

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Originally Posted by notmyrealname567 View Post
150XL. I've only taken it with the Cymbalta, so it'll be interesting to see how effective it is after I'm off that.

The Ambien is just for sleep. So far it's the only thing that's worked, and it's great. Although yesterday I took my first dose of Lamictal when I got home from therapy and promptly passed out for the rest of the day. I didn't sleep much the night before, but considering I've been totally unable to nap for several months, I decided to switch the Lamictal to PM. Gonna be hitting the sack here shortly, so we'll see if it works.
hey there. :-) ive had that reaction, too...i guess since im on the 'severe' end, its a lil different...if i up the abilify to counter...the 'manic depressive psychosis' (LOL), i need a nap, stat.

cymbalta scared me. wired, apathetic, cheerful but vacant...i felt like a Stepford Dewd. blah. it is effective, though...and it can help pain syndromes, I think.

if you have most excellent insurance coverage, provigil or nuvigil might be options. Schedule IV, so refills would be a possibility. some people (not me) report fabulous results.

I hope the Lamictal does wonders for you. I also hope the ambien keeps on working. Restoril (temazepam) was a godsend when i was a train wreck of 'issues...'

but its not good, long term. tapering ambien was a breeze; tapering temazpeam...un-fun. decidedly un-fun.

i kinda sorta oddly look forward to the xl. my starting dose is to be 150. maybe this time i'll stay on it, and we can be besties.

ok. i hope things work out well in your world, Rx and otherwise. ever tried trileptal? some people do well with lamictal+ a micro-dose of trileptal. probably safer than a neuroleptic, but anti-seizure drugs carry their own set of risks. I read that D3 and coenzyme Q-10 supplements are a must, along with a good B-complex.

ahhh, the miracle meds. have a good night. :-)
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Old 03-23-2019, 03:31 AM #9
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Default Re: Lamotrigine (Lamictal) for BPD

No, haven't done that one. Last week was my first time with a real psychiatrist; my PCP has been prescribing so far and I don't think she knew anything about borderline. She's the one who put me on Cymbalta and I'm not happy about it (see my thread under Getting Off Meds.) Psych is going to take things one step at a time - want to make sure we know what is or isn't working, never mind which cause side effects. She also said she won't do benzos - I don't think anything else is gonna do much for my anxiety

I don't know for sure that I am bipolar - psychiatrist agreed that it's hard to tell if my emotions are from that, or just part of BPD. Maybe we'll figure out it out as my treatment progresses.
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Old 03-23-2019, 06:15 AM #10
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Default Re: Lamotrigine (Lamictal) for BPD

It is one of the drugs that saved me. I take 500mg a day as part of my cocktail.
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