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Lamictals antidepressant action? What to do?

Posted by JohnX2 on February 7, 2002, at 18:19:10


Ok, more whining..what to do?

First a little background...please lend me your ears.

Diagnosis Bipolar 2

Current Cocktail:

Lamictal 150 mg (should I increase to 300 mg?)
Zyprexa 15 mg
Klonopin 1 mg (In process of tapering)
Topamax 400 mg

Well I've hit 2 mini crashes while tapering Klonopin.
I've been at 1 mg for 6 days now and feel that my
body has adjusted completely to this dose. It seems
as I dose down the Klonopin I get rebound hypomania
and as it settles in I become a bit sluggish ,
a bit empty inside , uninterested, blah...This is
pretty typical when I was taking a good dose of Klonopin
and it was active in my body as the med had good
anti-manic properties. I have replaced it with a
strong dose of Topamax.

Now adding Topamax has been interesing. For starters
I don't have any stimulant tolerance no mo'. I just took
pseudoephedrine and it mopped up today's mini-depression.
But alas, I'm thinking as I get off Klonopin I may
be in this slight "lull" due to the residual anti-manic
properties of Topamax and Zyprexa and Lamictal.

So what to do if I wind up in a funk? I can drop the
Zyprexa dose? I can bump the Lamictal dose?

Bumping the Lamictal dose seems the most interesing?

Now my question is : What is the prevailing wisdom as
to what makes Lamictal an anti-depressant? Before
at 300 mg this weird thing would happen whereby my
emotions would numb out and I would get a bit of a
headache. So a part of me says that Lamictal is doing
something with serotonin? Am I guessing right here?
I think with the Topamax that this may not happen and
I may get more mood stabilization with anti-depressant
effects? In the mean time I can take stimulants
(pseudoephedrine) if I am in desperate mild
depressions (isn't that an interesting outcome).

Any thoughts?

Another approach that my pdoc is hot for is Lithium,
which I have shunned, am I being too stubborn? I've
taken 25 medicines or so and feel quite beat up by
side effects at this point. I have almost none from
my current meds and feel that I can come up with a
cocktail that stays that way, hence my reluctance.

-John


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poster:JohnX2 thread:93227
URL: http://www.dr-bob.org/babble/20020131/msgs/93227.html