Posted by PB and J.C. (my dog) on June 16, 2000, at 19:46:45
In reply to Re: Amnesia associated with Lamictal (Lamotrigine)?, posted by SLS on June 16, 2000, at 9:25:45
Scott -
Thanks for the words of wisdom -- as of yesterday,
my pdoc started me on Neurontin as I'm gradually
reducing my Lamictal dosage. I'm Bipolar II, and
had been on a lower dose (250 mg) of Lamictal for
almost 2 years. Towards the end of last year,
we started increasing the dosage and by the time I was up
to 450 mg a day, about six weeks ago,
I started rapid cycling - often ultra cycling
in the same day. So my pdoc and I decided to start
increasing the Lamictal since my Lithium blood
levels were right on target. Looking back, I started having some
amnesia when we hit 350 mg of Lamictal, but didn't
associate it with that med until I was at 450 mg. At
this point, some of the things I managed to accomplish
that I didn't remember until days after were: 1) I
changed my home telephone number to incorporate my
dogs initials and my two letter state abbreviation; 2)made
an appointment to get my hair cut, got it cut, and didn't
realize it until I woke up the next morning and looked
in the mirror (I wear cap a lot when I'm off-kilter, which
I am at the moment); and 3) made telephone calls to
friends across the country and sent faxes to some of
them (I realized this when they either called me back
or I looked at my fax log confirmations!.As to unsteadiness of gait, taking into account my
general "flop" manner, I was always veering from the
straight line I was aiming for - but I had not associated
this with the Lamictal until I read your comment, and
I assume that was in connection to the Lamictal.I've tried Depakote twice in the past six or seven years.
Both times it managed to stabilize my mood into a
zombie like trance from "The Night of the Living Dead."
(I also managed to gain about 40 pounds each time - more
than twice the 15 pounds I gained when I started Remeron.)From the AD standpoint, in addition to the Remeron, I was on
Celexa until I switched to Effexor XR (is there another
version in addition to XR?). When I finally reached
my therapeutic dose of 450 mg, it triggered a hypo manic
phase that lasted for about 3 weeks until my friends and
my pdoc clued in on the "happy" state that had consumed
me. I'm down to 150 mg of the Effexor for the past two weeks with
no cycling.You can also throw into the mix 60 mg of Ritalin a day. I would
NEVER make it to work and be able to concentrate without it! However,
if I'm in a major depressive episode, it doesn't do a thing for me - even
if i take 40 mg at once as she (my pdoc) has given the ok to.No other KNOWN mental illness on either mom or dad's living relations.
Being originally from the South, depression, bipolar disorder or any
mental illness were topics not to be discussed, so there may be some
kin-folk out there, but I don't know about them. But with 6 hospitalizations
over the past 11 years, and another one coming up on Monday to Johns Hopkins,
my parents have become very aware of the efforts I've made with my
pdoc to control my illness, the limitations of medications and the stark
reality that "it" can rear its ugly head at any time - even after three
years of stability in my case. But I thank God that they are so supportive!!And to both of you, Scott and Judy, J.C. sends big wet kisses. By the way Scott, he is
my best advisor when it comes to my major depressive episodes - sleep . . . and eat, a lot.
But it is uncanny how he can sense my moods. He's 14 now, so he is
not an active dog (to say the least). He hasn't gotten on the sofa
in the den where I watch TV (and fiddle on the computer), but when
I'm depressed, he'll come over and put one of his front paws up on the
sofa so I can then lift him up and then he lays as close to me as
possible without actually laying on me!! Talk about great therapy!Thanks for all the input.
Our best
Philip & J.C.
> Hi Guys!
>
>
> Yes. Lamictal can do a number on memory.
>
> I suffered some pretty heavy-duty memory disturbances when I took more than 300mg/day. I would be driving down a road that I've been on all of my life, when it suddenly became unfamiliar to me. I wouldn't know where I was. What's worse, I didn't even remember where I was going.
>
> I can't comment as to what extent these memory disturbances dissipate with time, as I didn't stay at 450mg for very long. I do believe, however, that I experienced some problems when I restarted Lamictal in September and moved to 300mg. They have dissipated completely. When treating bipolar depression, 200mg seems to be the average effective dosage (range 50-300mg). I need 300mg for it to help at all. Judy's suggestion to try lowering the dosage to find the maximum you can tolerate is a good one.
>
> Has your ability to walk a straight-line been affected?
>
> Is Lamictal helping at all?
>
> What is it about your case that requires mood stabilizers to treat it?
>
> Does or did lithium ever help at all?
>
> Have you ever combined Depakote and lithium?
>
> Do any members of your family have bipolar disorder? If so, what drugs are effective for them?
>
> Treating a depressive episode with mood stabilizers alone is often ineffective (with the exceptions of Lamictal and possibly Zyprexa). Antidepressants are often required, but it is encouraged that one also be taking mood stabilizers to help prevent a switch into mania. I'm sure you know all of this already.
>
> The decision you and your doctor reach as to whether or not to continue with Lamictal will depend on many factors regarding your case profile and treatment history. Lamictal is a good mood stabilizer with antidepressant properties that seems to be effective for treating various bipolar presentations, including rapid-cyclicity. Of course, it doesn't work for everyone, nor will it necessarily work by itself. Judy's suggestion regarding using Lamictal in combination with Depakote is a good one. However, when doing so, the dosage of Lamictal must be reduced by half, as Depakote prevents the body from eliminating it as fast.
>
> Another combination that is emerging as potentially effective is Lamictal plus Neurontin. Neurontin may play a role analogous to Depakote by increasing GABA activity, albeit by different mechanisms. The NIMH recently published a study describing its effectiveness, and seems to be pursuing it. These two drugs do not affect each other's levels in the body. I recently tried this combination. Unfortunately, it was inadequate for me.
>
> So, what else is new?
>
> Good luck P.B. et al. Is your dog bipolar? Is he involved in your decision making process? I doubt you can go wrong by listening to him.
>
>
> Hi Judy. :-)
> You may want to look into the Lamictal + Neurontin combination if you are otherwise stuck, especially since you describe a good response to Lamictal + Depakote.
>
>
> - Scott
>
>
> > Has any one out there experienced amnesia while on
> > Lamictal for mood stabilization? As my pdoc has
> > increased my dosage over the past six weeks or so, I've
> > started having some significant memory lapses. I
> > finally read the GlaxoWellcome's package insert for
> > Lamictal, and they list amnesia as a "frequent" side
> > effect.
> >
> > By the way, because my amnesia/memory lapses are occurring with greater frequency, my pdoc is tapering
> > me off the Lamictal - but she said I can't go too fast
> > for risk of a seizure if I abruptly stop the med.
> >
> > Also, any success stories with different mood stabilizers other than lithium, which I currently take.
> >
> > Thanks,
> >
> > PB & J.C.
>
> > Too bad about lamictal, I really liked it, although it worked too well as an AD- pushed me into hypomania. Depakote is great with mania, but it makes me depressed. Neurontin helps with anxiety, but that's about it. Hated tegretol (vomited all the time), but I hear it works well for a lot of people. The best combo has been depakote and lamictal- if you can handle a lower dose of lamictal w/o the amnesia- would your dr. consider it? I'm assuming depression is the problem here, since you probably wouldn't be posting if manic. Take care and Hi to your dog- Judy
poster:PB and J.C. (my dog)
thread:37316
URL: http://www.dr-bob.org/babble/20000610/msgs/37587.html