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Re: Lamictal: Ron Hill, Ritch 'Q' and 'A' » fluffy

Posted by Ron Hill on June 15, 2003, at 15:54:40

In reply to Re: Lamictal: Ron Hill, Ritch 'Q' and 'A', posted by fluffy on June 12, 2003, at 10:58:14

Katy Fluff,

> If I augement, would a pinch of Lithium do the trick? I know there are *many* meds to try. I just don't want to slip again.

After rereading my initial response to this post of yours, I feel I should have shown a little more enthusiasm regarding your idea of adding some lithium to your current Lamictal.

For some time I've thought that this might make a good combination for many bipolar patients, particularly those patients who struggle significantly with bipolar depression. Lithium would provide the bulk of the moodstabilization and Lamictal would provide the antidepressant contribution.

This might be worth a trial after the conclusion of your study. On the other hand, Colin Wallace added some Lithobid to his Lamictal/Prozac combo a few days ago and, the last I heard, it's not working out very well. Perhaps you've seen Colin's post on this subject in a thread further down on the PB page. There was a time when I wished I could try a Lithobid/Lamictal combination because, although Lithobid does a real good job controlling my hypomania, it does little or nothing for my atypical depression. So I wanted to add Lamictal to treat my depression. However, Lamictal give me a nasty rash over a significant portion of my body. Now, however, it is a moot point since I have my depression problem (and my irritability problem) solved using nutritional supplements.

It is my opinion, however, that you will need more than just a pinch of lithium. If I were you, initially I’d shoot for a blood level of about 0.4 mEq/l and increase, if needed to fully control your hypomania, to 0.6 mEq/l. But all of this is just my opinion.

Dr. Charles Bowden is a leading expert in bipolar disorder. He recently gave a presentation regarding Maintenance Treatment of Bipolar Disorders at the University of Chicago. Dr. Bob has it on Grand Rounds. I think it is worth your time to watch it, so here is the link:

http://psychiatry.uchicago.edu/grounds/030303/

-- Ron


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