Posted by SLS on April 10, 2002, at 13:08:42
In reply to Re: Going off Lamictal. Sigh.....(((SLS))), posted by petters on April 10, 2002, at 3:12:35
Hi Anders.
> Why are you going off Lamictal? I thougt that you had mucth benifit from it.
I will continue with Lamictal at 300mg or higher. It does help when I combine it with antidepressants.
> Are you going to have a trial on Litium?
I think that I will try lithium, but at lower dosages. More than 600mg makes me feel worse. Dr. Husseini Manji and others have demonstrated that low dosages have neuroprotective and neurotrophic effects.
Neuroprotective = prevent further deterioration of hippocampus and prefrontal cortex.
Neurotrophic = restore and promote brain tissue in hippocampus, prefrontal cortex, and cerebral cortex.
> On of my problem: I got tearfullnes from Effexor. This often happen when talking of painfull things ( not about me) I am not clinical depressed. I didn´t have this symptom on ssri, despit my depression was worser then. Strang, but when I am depressed I am not experienced this thearfullnes. I am quite sure that Effexor is the culprit.
>
> I was adding Nefazodon 600 mg for two month ago. After 3-5 days I expected hypertemia ( hypomania? Now has the effect wean off AGAIN. I dont´t understand this damed poop out that occure, when tried new medications.
>
> My current medication:
>
> T. Effexor 300 mg
> T. Serzone 600 mg
> T. Lamictal 100mg
> T. Litium ( 0,5 mmol/l)
I’m sorry to hear that you still haven’t found complete remission yet. I was so hopeful for you when you last wrote of the improvement you were experiencing. These illnesses can be demons of deception and disappointment.Sometimes, tearfulness can be a good sign. I think that as a severe and mind-numbing depression begins to lift, the reemergence of mental activity and emotions can allow for tearful reactions to things that previously had no impact. I know that when I have experienced this, I cry while watching movies, seeing children play, and walking on the beach immersed in deep and profound thought – none of these being depressing. On the other hand, I think this same tearfulness occurs more often when one is moving in the opposite direction, while descends through the early stages of depression. Perhaps you are caught somewhere in the middle. My emotional experiences when remembering painful or tragic moments or aspects of my life become amplified and more intense during these “transitional” states.
I am sure that you know that your Lamictal dosage is at the lowest part of therapeutic range. 200mg seems to be the average optimal dosage, with 300mg being necessary occasionally. Also, you might want to try bringing up your lithium blood-level to 0.6 – 0.8. I am curious, what is your current lithium *dosage*? I wish I knew what to do for you. Some of the things that I am considering me are Nardil, S-AMe, modafinil, and low-dosage lithium (300-600mg).
Obviously, I have been feeling a little better these past few days. Unfortunately, things are beginning to deteriorate again. Reducing my dosage of nortriptyline from 100mg to 75mg produced a sort of temporary rebound improvement that is now fading. I am having trouble deciding whether to switch to imipramine 300mg or continue to hope that my system will somehow respond again to nortriptyline. When I am responding to it, I like better the way nortriptyline feels than imipramine. However, imipramine produces a more stable improvement. Also:
1. I need 300mg of imipramine to see an improvement.
2. Imipramine makes me feel numb to my surroundings; nortriptyline makes me feel more connected.
3. At 300mg, imipramine causes disturbances in my memory and cognition (anticholinergic).
4. When I add Nardil, the side-effects resulting from its synergy with imipramine will be worse than with nortriptyline. Last time I tried adding Nardil to imipramine, I could not walk without fainting because of hypotension, and I could not initiate urination.This is why I have been so stubborn and not discontinue nortriptyline. Unfortunately, I don’t think there is a therapeutic window for me. I hate therapeutic windows. They never seem to open up for me.
I will continue to pray for you. I think you are getting close.
- Scott
poster:SLS
thread:102494
URL: http://www.dr-bob.org/babble/20020408/msgs/102640.html