Posted by ronaldo on November 5, 2006, at 7:38:38
In reply to Lamictal, when will it ever work?, posted by tensor on November 5, 2006, at 6:15:00
> My fifth week with Lamictal, one week at 100mg. The only time i noticed any improvement was the two days after raising the dose from 50mg to 100mg(a week ago). Since that, no improvement at all. Currently it's like before i started Lamictal, no effect but no side effects either. My sex life is improved, but can't really enjoy that thanks to my depression, i have no energy.
> I'm wondering, since i got a little transient response going from 50 to 100mg, is this indicating that i need a higher dose? Is there any point to stay at 100mg, does it need more time etc.
> Currently i do not work, and haven't done so for appr. two months. I have feelings of guilt, my employer is wondering why i never recover. Last time i was away ill i did not work for seven months, which was a nightmare. My employer wonder if that's going to happen again.. sigh.
> I'm gonna call my pdoc tomorrow and i'm wondering if i should call for a higher dosage, 150 or 200mg. What do you think?
>
> /MattiasFound this for you Matt. Hope it helps...
"9. How is treatment with lamotrigine initiated?
In people not taking carbamazepine or valproate, lamotrigine is usually initially prescribed at an initial dose of 12.5 or 25 mg a day and the dose increased by 12.5 or 25 mg every week or two.
In people taking valproate the initial dose of lamotrigine is often 12.5 mg/day and the drug is increased by 12.5 mg every ten days or two weeks.
In people taking carbamazepine somewhat larger initial doses and more rapid increases in dose are possible".
"11. What is the usual final dose of lamotrigine?
When used as an antidepressant or as a mood-stabilizing agent the final dose of lamotrigine is most often between 100 and 200 mg/day. Some people require doses as high as 600 mg/day to achieve a good antidepressant effect. Such doses should be avoided in patients taking valproate because of the pharmacokinetic effect of valproate that increases plasma levels of lamotrigine, and the accompanying increased risk of serious dermatological side effects".
Website: http://www.psycom.net/depression.central.lamotrigine.html
Above website will tell you most of what you want to know.
I think you have to be careful if you are taking other anti-convulsants. They can affect the blood levels.
You also have to start off very gently due to the danger of developing a rash. One rash, SJS, is particularly nasty, fatalities have been reported.
It is very NB that you increase the dose slowly. It seems you have been at 100 mg for only one week. Maybe you could increase it to 125 mg for a fortnight and then increase to 150 mg. They say that the slower you increase the better your chances of avoiding the rash. Some of the rashes are not dangerous, but SJS is.
"12. How long does it take for lamotrigine to 'kick-in?'
While some people notice the antimanic and antidepressant effects early in treatment, others have to take a therapeutic amount of lamotrigine for up to a month before being aware of a significant amount of improvement".
Seems like you should give it another month, say at 150, Matt. If that doesn't work you could take it to 175 mg or 200 mg remembering to increase the dose slowly.
SJS = Stevens-Johnson syndrome
see http://www.medterms.com/script/main/art.asp?articlekey=14086
....Alan
poster:ronaldo
thread:700519
URL: http://www.dr-bob.org/babble/20061104/msgs/700533.html