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Lamotrigine trial update: Some progress and a new med


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So, it's been a couple months and I'm at my target dose of 200mg lamotrigine daily. Still on 2mg clonazepam daily, but will be starting a taper off of it within the next month or so. No signs of addiction or dependence so I'm not too worried about tapering off it. 

 

I'm pretty much the same as I was when I posted the first report. However, the double images/ghosting has improved quite a bit and now seems to come in waves rather than being constant. There are days where it's the same as it was before treatment, and the there are days where it's almost not noticeable unless I purposefully look for it. Another thing of note, it seems to now only occur with brightly colored/reflective objects that are being hit with intense light OR with lights that emit at a high intensity. Also, it sort of follows a cosine like trend where it's at its worse in the morning and night, but not so bad midday (this is perhaps a function simply of eye adjustment, i.e., the eyes adjust to light after being in darkness for an extended period and the eyes adjusting to darkness after being exposed to light for an extended period of time). Ghosting/double vision with text on a computer screen is almost nonexistent now, it comes and goes but for the most part, it isn't present. However, all other archetypal symptoms are still present at their normal intensities.

 

I plan on going the full recommended 12 months to see how this turns out. The improvements make me hopeful. 

 

Another thing of note, I will be starting a course of haloperidol soon due to an increase in psychotic symptoms (pdoc is starting to get worried and wants to get this under control ASAP before I end up in the looney bin). My target dose will be 5mg once daily, starting at 2mg once daily. He recommended it since it primarily affects only the dopamine receptors, specifically the D2 receptors and HPPD seems to be primarily linked with the serotonin receptors, as we all know by now the 5-HT2A receptors in particular, which most modern APs have an affinity for along with the dopamine receptors. In his words, he said it would either have a positive effect for HPPD or be completely benign. In Lerner's clinical literature review, dopamine antagonists (i.e. typical antipsychotics) seem to be either helpful or benign with regards to HPPD. So, I'm hoping it helps or is benign and doesn't worsen HPPD. The only thing that surprises me is that no one has really tried it yet with HPPD, except for a few people here on the forums. I think this is because most HPPD'ers are told not to even approach APs regardless of their generation (typical/atypical), but this seems to stem mostly from experiences with only one AP, risperidone and not others.

 

We'll see how this plays out. If there is anyone else that has tried haloperidol with HPPD, it would be much appreciated if you could give an anecdotal report of your experience, was it a success, complete failure, so-so results, etc. If it works, great. If it doesn't, well, I'll just keep on keeping on and move on to something else (likely clonidine, levetiracetam, perphenazine and a few others, definitely not levodopa though since I have an underlying psychotic condition).

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I was on Lamotrigine for three weeks and once I upped the dosage to 50 mgs I noticed a significant increase in my symptoms. I've felt a million times better since getting off it but I think the important thing to keep in mind with medication is it's all different and affects people in different ways. My HPPD isn't nearly as severe as others and I have a natural sensitivity to substance so I'm just not sure pills are right for me. But I do know Lamotrigine does have a good success rate with this. Good luck!

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