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Finally got a script for Lamictal. Here's hoping.


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Yeah, saw the psych today and got the all-hallowed script. I'm tentatively hopeful.

 

Just a few things I'd like some insight on, if anyone can help. As far as doing a fair trial, what should I omit from my current supplement regime? It seems harmless to stick with my fish oil, multivitamin, B-complex, vitamin D3, and creatine. I've been taking ~4g of magnesium BID (morning and night), and given that the intention of that isn't purely dietary it seems logical to cut it out whilst figuring out if Lamictal suits. I'm fresh out of NAC which is probably timely as having something else affecting glutamate could potentially skew the results. If it looks like Lamictal's gonna be a long-term thing I'll probably add it back though as the "glutamate management" of NAC sounds as though it's likely to be somewhat synergistic with Lamictal's glutamate inhibition, from what I've read - there are certainly a lot of people on Lamictal who also supplement NAC on their psych's advice.

 

I received some damiana, passiflora and skullcap by mail today and couldn't help myself - I'm vaping a mixture of damiana and passiflora right now, haha. I wasn't expecting anything this noticeable! A definite, slight warmth in my head and an overall "chilled out" feeling, with little-to-none of the distractability/poor articulation/trippiness of weed. Pretty pleasant. Is it advisable that I otherwise abstain from them while trialling Lamictal? Tapering up to even the minimum effective dose is going to take a month and it'd be nice to be able to chill out between now and then a bit, but if those wiser than me think it's not a risk worth taking I'll endure!

 

He was really cool and semi-fudged the script so that I'm not technically taking it off-label and so can get the government-subsidised discount on it. Additionally he prescribed me 50mg despite recommending I start off at 25mg for further bang-for-my-buck, haha. Thing is, the bloody pharmacist didn't ask me if I wanted regular pills or chewable ones, and it was only after I cracked the packet open that I realised I'd wound up with the latter, which are impossible to split in half without them crumbling everywhere. I'm tempted to be cheeky and just start at 50, and if the dreaded rash begins to show I'll move back to 25. There are a bunch of reports online of people starting at 50 with no or little issue and my general impatience is making the idea very tempting. Recommendations?

 

Finally, just a couple things I want to know in the event that I do wind up taking this for an extended period. If its effects are mild at best and I want to give keppra a shot, would it be better to taper fully off lamictal then try keppra on its own or would it be okay to start keppra whilst on lamictal? I know it's a cross-that-bridge-when-you-come-to-it situation but I can't help but speculate!

 

Also, in response to the buzz surrounding procholinergics that coluracetam and Odisa's enthusiasm has generated, I tried choline/ALCAR/inositol a couple of times last week and the effect was definitely positive, if subtle. Is there any reason I wouldn't be able to add these on top of Lamictal down the track that anyone's aware of? How about coluracetam?

 

I'll look into this stuff myself tomorrow but figured it was worth dipping into the collective consciousness, haha. Thanks for any responses and I hope all is well!

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If you start at 25mg and go up 25mg each week the possibility of side effects will be lower. Reports suggest it may take months for lamotrigine to work and so you'll have to be patient anyway! If you haven't started yet then you can probably replace it quite easily if you take it back.

 

I would personally not try too many things at once. Aside from limited data of interactions, if you try too much at once it may be difficult to tell what is doing what. Your basic vitamins and supplements would be fine I'm sure.

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I've been more interested in doing productive things recently i.e. art, cooking, etc. but it's nothing significant and I've only taken the Lamictal for two days so I'm doubtful it's  got anything to do with it. Then again, my ability to perceive slight changes in perception is utterly fucked and there certainly are a fair few cases like yours where changes have become evident very quickly, so perhaps, perhaps.

 

Was there any particular reason you quit/decided to switch to Keppra, Merkan?

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Hmmmmmm, it's subtle to the point of likely just being wishful thinking/placebo but I might be feeling the tiniest bit better. I've decided to split the 50mg tablets and take roughly half in the morning and half in the night because it seems like this slight improvement in mood fades after a short while + the only major side effect to worry about with tapering up too quickly is the rash which is suuuuuuuuper rare and far more common in women/kids under 16. All is fine so far, and I've got enough to go up a little faster than 25mg/fortnight.

 

Though, I took the second half only 2 or so hours back and haven't really seemed to notice what I think I've noticed before, so I don't know. It's really just way too early on to even be thinking about this stuff I guess.

 

Yeah, that's what's been going on.

 

On the off chance Odisa is lurking, have you got any input on whether once/if I reached a therapeutic dose that I'm gonna sustain for a bit and am sure of its effects whether I'll be able to take procholinergics (ALCAR/Choline(+Inositol)/coluracetam as well? What about piracetam or aniracetam?

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Hehe on the off-chance :P Well so far so good mate; nothing bad I read. To be honest I don't know.. I mean I don't see why not. It's a sodium channel blocker, but I don't know too much about Lamotrigine in particular.. I'd say best to ask your doctor. Coluracetam is a different story because nothing is known about its metabolizatin afaik. I wouldn't see any problems with ALCAR/Choline(bitartrate I'm presuming)/Inositol combo though. But I don't have the highest safety standards, if you get my drift :)

I mean of course you should always tell your doctor what you're using according to.. random disclaimers, though I don't always do so. Chances are he's not going to like it if you tell him you've decided to start taking Coluracetam. So perhaps best to just limit your questions to whether procholinergics would be a problem, or just pose it as a "hypothetically" type of question (e.g. "So doc.. what if I were to enhance my HACU.. would that interact with Lamotrigine in a dangerous way?").

That's just my take on it. By no means does this substitute for professional advice... you know the drill. Or you can just say that you're interested in trying out supplements, but have no specific supplements in mind, and ask him whether he could tell you about any possible interactions or supplements to avoid, and why.

Sorry if that's not much use to you.. I really don't know :)

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  • 2 weeks later...

For anyone curious, nothing much seems to be happening so far - I've been on 50mg BID for five days or so and can't note anything really, just the persistence of the usual issues. Not that there's really any cause to have expected much this early on, of course.  I did a spot of reckless drinking over the weekend and I've felt somewhat dazed from that, plus the following day I managed to lose a bag containing a lot of valuables - laptop and accessories, clothes, etc. as well as my supplements and medication, which has put a pretty significant dent in any optimism I had. I've called most of the places it might have wound up were it to have been found by a respectful, responsible person, and it hasn't shown up. Seriously, fuck people. Anyhow, I digress - that caused me to be off the lamotrigine for a couple of days and I'm not sure how much that might impair the course of treatment, but I gather not too severely. So long as side effects don't pop up I suppose I'll likely wind up on 200mg for a while and see how that goes.

 

I suppose one thing possibly worth mentioning is that I have this one odd symptom - a CEV that I noticed when falling asleep wherein a faint white "ring" would appear in my periphery and then shrink inward until it faded, then this would repeat, etc. I didn't really keep tabs on it since it seemed fairly benign and was pretty constant, but since being on Lamictal it hasn't been happening. I'm pretty confident that that's only been the case since I started treatment, but I'm not 100%. At any rate, all other visuals remain constant.

 

Hope you're all well.

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  • 1 month later...

200mg here, about 3 weeks. The closed eye visions are still there. Also i feel very mellow the whole day, i also take klonopin(1mg a day). I must say, it gets a little better now. I am trying to accept it, but its hard. 

 

some doctors say, oh panic disorder, you should try anafranil etc. I am now on lexapro(ssri10mg) i'll stay on it a while. 

 

Yesterday i was at a docter to see how my blood is, for all the meds etc etc. Pfff. Hopefully its ok.. I try not to sleep in the daytime, and when its get evening i feel alot better and want to continue behind my computer ;) I just need a structure, healthy food, vitamin.. etc. Its hard for me too eat i just dont like food anymore!@@

 

Give it time people, listen to you mother/father. Take your time with everything. 

 

Take care everyone,

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  • 1 month later...

I don't want to believe it's been almost four months, fuck. I think I can safely say that I've given this a decent trial, at least. Reached 200mg to no avail, currently on 150mg, and calling it quits.

 

Anhedonia and lethargy increased (didn't think that could be possible, ha): I had been maintaining a blog, occasionally creating and posting digital art, and interacting with my friends pretty frequently. I was still feeling really down, sedentary, felt utterly incapable of pursuing a job/education, etc. but was doing ok. I've since abandoned that blog, lost motivation and faith in doing artsy stuff, and have withdrawn completely from interaction with my friends - just somewhat abruptly stopped talking to them, responding to them, etc. due to feeling far more worthless, burdensome, self-loathing, all that good stuff. I've moved back into to my mum's dysfunctional household because I can't stand the stressful environment of my dad's - feels like I'm the insufferable freak in the attic - and I've stopped communicating with him as well. Nowhere I can be is ideal for me but I just feel incapable of coping with all the stress, judgement, pressure and loneliness of my dad's household like I had been doing. Sigh. It's incredibly frustrating that one of the main reasons my psych was so intent on Lamictal was its mood-stabilising effects and all it's done is make that stuff worse. Hopefully now he'll appreciate that my poor mood is very much a result of facing cognitive impairment, DP/DR and visual anomalies all day and focus exclusively on treating those issues than on attempting to make me more tolerant of them. 
 
Cognition decreased - aphasia is particularly prominent and unpleasant - spend a lot more time wondering if a sentence makes sense, how to use certain words correctly, generally struggle to get things out, etc. etc. Find myself trying to say something then just desperately fumbling for the right words, often finding none at all. Embarrassing. What would've taken post-HPPD pre-Lamictal me 5 minutes to convey relatively eloquently takes 10 or 15 minutes and comes out far more awkwardly. I look over the things I write and could almost weep - before this whole HPPD ordeal writing was my greatest strength and I'd received numerous accolades for it; now I find myself envious of people I would once have smugly looked down upon. Initially I thought I could well have been imagining Lamictal's impairment of it, but a 50mg dosage increase caused all of those issues to worsen, so I'm pretty confident Lamictal's to blame. It's odd because I'm on a pretty low dose - 50mg TID - and as far as I know these issues don't tend to pop up until much larger dosages and are often considered negligible/tolerable. Perhaps Supplementing with folic acid as is often recommended hasn't helped any, unfortunately. Who knows, perhaps some other problem's sprung up simultaneously, but that seems unlikely, hah. I find it hard not to fret about such possibilities though - the house I'm staying in has a slight mould problem and my mind keeps bringing up things I've heard about mould exposure damaging the CNS, etc. etc. 
 
And nothing positive to balance it all out. Sigh. Last word from my psych was a dosage adjustment and my next appointment is in bloody February, and there's no fucking way I'm going that long just to hear "okay, well, let's take you off it", or God forbid, "maybe you just need to try more for another few months". I've taken myself down to 100mg and am gonna call the centre he works at once they reopen in the new year so I can have somebody there be aware of the negative side-effects I've been suffering and monitor my tapering. Can't help but think that if I walked in there in February and announced that I'd taken myself off it due to the higher dosage exacerbating my negative side effects he'd just chastise me and try to put me back on it...
 
Anyhow, this is where the Lamictal saga ends for me. One thing down, a million more to go. Hopefully I'll be off it in time for my NSI-189 trial! Really looking forward to it.
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  • 2 weeks later...

There's an article about treatment with lamictal, the patient was on it for a year.

 

"During a year-long trial of lamotrigine, with a maximum dose of 200 mg, the patient experienced significant relief from her symptoms, some of which disappeared completely."

 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3736944/

 

I didn't read the details of side effects in the trial, the patient had a lot of other things going on too - depression, no surprise.

Good luck, whatever you decide to do!

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Yeah, I'm familiar with that study. A sample size of 1 doesn't doesn't really give me much faith in it. Also, presumably at the 4 month point she'd seen at least gradual remission of symptoms, rather than none at all... Pretty damn confident I'm just not a lamictal responder, unfortunately.

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