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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by bipolarspectrum on May 24, 2005, at 17:27:50
Hi,
I have found that lamictal makes me agitated and irritable... I am a soft bipolar.. I'm wondering if anyone has used topamax with lamictal.. I was thinking that mabye topamax could act as an antimanic agent and keep the lamcital agitation at bay???.. any thoughts?
bps
Posted by JahL on May 24, 2005, at 18:12:16
In reply to TOPAMAX and LAMICTAL together????, posted by bipolarspectrum on May 24, 2005, at 17:27:50
Hi.
I've taken Lamictal for a few years now and whilst it helps a lot, I do notice the agitation (I get RLS).
I recently added Topamax, purely to try and improve efficacy, but couldn't last long on it. Like a significant proprtion of people who take it, I suffered from the dreaded cognitive dulling, as well as dry mouth, hypotension etc. I came straight off it when I read that 30% of patients on the higher dose (main trial) experienced 'vision disturbances'. The 'acute glaucoma' warning terrified me. [the chances of it actually happening are lottery numbers but I am particularly paranoid about losing my sight. Don't let me put you off tho']. After a month it hadn't helped anyway; it's not fabled for its AD properties.
Because the agitation isn't mania per se, I wonder if an anti manic agent would help in this instance.
However, as you know, (soft) Bipolar is a strange beast and responses seem to vary widely.
There are a few drugs that are said to help with Akathesia, kind of similar, though their names escape me (even tho' I tried them!). Scott will know.
Good luck.
Jah.
> I have found that lamictal makes me agitated and irritable... I am a soft bipolar.. I'm wondering if anyone has used topamax with lamictal.. I was thinking that mabye topamax could act as an antimanic agent and keep the lamcital agitation at bay???.. any thoughts?
> bps
Posted by JahL on May 24, 2005, at 19:17:51
In reply to Re: TOPAMAX and LAMICTAL together????, posted by JahL on May 24, 2005, at 18:12:16
> Because the agitation isn't mania per se, I wonder if an anti manic agent would help in this instance.
Having said that, extreme irritability etc could be indicative of a mixed state.
Does the Lamictal actually help in terms of depression?
J.
Posted by SLS on May 24, 2005, at 19:32:59
In reply to TOPAMAX and LAMICTAL together????, posted by bipolarspectrum on May 24, 2005, at 17:27:50
> Hi,
> I have found that lamictal makes me agitated and irritable... I am a soft bipolar.. I'm wondering if anyone has used topamax with lamictal.. I was thinking that mabye topamax could act as an antimanic agent and keep the lamcital agitation at bay???.. any thoughts?
> bps
Is Lamictal actually doing anything positive for you that pursuades you to continue with it? How much are you taking and for how long?Lamictal is not a good drug to treat mania, and has actually been know to precipitate it. It does treat the depressive phase of bipolar disorder and seems to also help prevent rapid-cyclicity. It is a great drug to combine with lithium when treating bipolar I.
Can you perhaps better describe the negative effects you experience with Lamictal?
- Scott
Posted by bipolarspectrum on May 24, 2005, at 19:37:21
In reply to Re: TOPAMAX and LAMICTAL together????, posted by JahL on May 24, 2005, at 19:17:51
Hey J,
The lamictal doesnt really help with the depression.. its weird, it gives me energy, but the anxious, agitated kind.. I'm currently taking lamictal with zyprexa... even with the zyprexa, im still anxious... thanx for the post btw
bps
Posted by JahL on May 25, 2005, at 12:25:23
In reply to Re: TOPAMAX and LAMICTAL together????, posted by bipolarspectrum on May 24, 2005, at 19:37:21
Hi there.
If you're soft Bipolar I guess you main problem is depression. Am I right?
As Scott says, Lamictal isn't a great anti-manic med, and if it isn't ameliorating your depression, one might question why you continue to take it (one to discuss with your pdoc before changing any meds of course).
I suppose the 'energy' could be regarded as 'hypomanic' in nature, whilst the agitation + irritability could be interpreted as a kind of dyshoria.
Hypomania + dysphoria = mixed state. It could be that Lamictal is inducing a mild mixed state. Certainly, at as low a dose as 25mg, Lamictal precipitated around 3 weeks of hypomania in me.
I will now defer to someone with more experience with mixed states, though I can tell you they are a recipe for trouble; very easy to get into a fight when you're so 'hyped-up'! I've only ever experienced a mixed state a couple of times, always med induced, and it was not pleasant.
Does any of that add up?
I won't offer any med advice, ECT has wiped far too much from my memory banks to have real confidence in my thoughts. But I would certainly ask your pdoc if it is wise for you to continue to take Lamictal when it seems to confer few benefits.
Cheers,
J.
> > I have found that lamictal makes me agitated and irritable... I am a soft bipolar.. I'm wondering if anyone has used topamax with lamictal.. I was thinking that mabye topamax could act as an antimanic agent and keep the lamcital agitation at bay???.. any thoughts?
bps> The lamictal doesnt really help with the depression.. its weird, it gives me energy, but the anxious, agitated kind.. I'm currently taking lamictal with zyprexa... even with the zyprexa, im still anxious... thanx for the post btw
> bps
Posted by bipolarspectrum on May 25, 2005, at 18:09:56
In reply to Re: TOPAMAX and LAMICTAL together???? » bipolarspectrum, posted by JahL on May 25, 2005, at 12:25:23
Hey J,
Thanx for the feedback... I'm currrently on 15 mg zyprexa and 67.5 mg lamictal.. I sleep 12 hours a night, then take the lamictal and become very agitated for the next couple hours.. I get into fights with my girlfriend whom i seem to take my agitation out on... I'd love to substitute topamax for lamotrigine in this combination but my pdoc wants to continue to build up the lamictal 15 mg at a time...
bps
ps. as i said on a previous message, a psychopharm pdoc i know just completed a study on ~ 75 bipolars and found that topamax had an antidepressant effect
Posted by tendency on May 25, 2005, at 18:43:39
In reply to Re: TOPAMAX and LAMICTAL together????, posted by bipolarspectrum on May 25, 2005, at 18:09:56
> Hey J,
> Thanx for the feedback... I'm currrently on 15 mg zyprexa and 67.5 mg lamictal.. I sleep 12 hours a night, then take the lamictal and become very agitated for the next couple hours.. I get into fights with my girlfriend whom i seem to take my agitation out on... I'd love to substitute topamax for lamotrigine in this combination but my pdoc wants to continue to build up the lamictal 15 mg at a time...
> bps
> ps. as i said on a previous message, a psychopharm pdoc i know just completed a study on ~ 75 bipolars and found that topamax had an antidepressant effect
>ive been on topamax for about 5 weeks now and ive found it to be working pretty well at controlling my anger and hostility. it's a med that really works on the temporal lobes so if you have issues there do look into it.
it's a tricky med as far as dosing goes; a little too much or too little and you can feel much worse.
for me if i go to 100 my anger is noticeably worsened but greatly improved at 75mg.
tried lamictal (up to 200mgs) for about 8 months and found it did next to nothing for my anger.
good luck
Posted by temoigneur on May 27, 2005, at 0:10:46
In reply to TOPAMAX and LAMICTAL together????, posted by bipolarspectrum on May 24, 2005, at 17:27:50
> Hi,
> I have found that lamictal makes me agitated and irritable... I am a soft bipolar.. I'm wondering if anyone has used topamax with lamictal.. I was thinking that mabye topamax could act as an antimanic agent and keep the lamcital agitation at bay???.. any thoughts?
> bps
Hi BPS I was wondering about the contact info for DBS in Toronto - I'm Canadian, with OCD and major depression - are they still taking clients? Sorry to drop on you out of the blueBen
Posted by bipolarspectrum on May 27, 2005, at 16:02:41
In reply to Re: TOPAMAX and LAMICTAL together????, posted by temoigneur on May 27, 2005, at 0:10:46
> Hi BPS I was wondering about the contact info for DBS in Toronto - I'm Canadian, with OCD and major depression - are they still taking clients? Sorry to drop on you out of the blue
>
> Ben
>
Hi Ben.. I believe they are definately still taking clients... They are in the next-stage of trials... But I don't believe there doing it for OCD, only unipolar depression... If you give me ur email I can tell u as much as I know about the contact info... I feel a little awkward posting all that stuff...
bps
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