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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Girlnterrupted78 on January 22, 2010, at 19:10:16
My combo of Parnate 80mg + Adderal 15mgs was working first great, then some of it pooped out and turned into just ok-blah.
When it went to ok-blah, my doctor tried adding a number of things that only made things worse.
Nortriptyline: Made me sleep and feel sleepy all the time. I don't know if it's because he raised the dose too fast (I was horribly depressed at that point because I had been off Parnate for 2 days in a row.. )
Lamictal: Pretty similar to nortrip. My mood became more apathetic, less energetic, and I sleep day and night.
I get the feeling that both of these meds just undid the good effects I had on Parnate-Adderall, rather than augment them.
I'm having suicidal ideation 24/7 because in this current situation I can't go out and get another job that I need desperately. I'm behind in all my bills, especially rent, and I might even lose it all. So I just sleep, cry and think about killing myself. I just spend my time researching methods and trying to figure out the fastest and least painful, and I just start crying whenever I think of how my family will be hurt by this, but at the same time I can't stay here any longer, I just want out of this mess. I promised to myself that before going homeless, I'd kill myself.
So I stopped the Lamictal yesterday
Is it normal for Lamictal to do this? To make you tired, apathetic, and very sleepy? And to worsen social anxiety? I'm not more anxious per se, but the fact that I'm less motivated makes me afraid of people's rejection, because people will be less likely to hire me if I come with that kind of attitude, and I'm also very upset after having lost that great attitude I initially had on Parnate+Adderall.
If anyone has had bad experiences with Lamictal or Nortriptyline, I'd like to hear what your experiences were.
Thanks.
Posted by Phillipa on January 22, 2010, at 20:35:45
In reply to Lamictal is ruining my life, posted by Girlnterrupted78 on January 22, 2010, at 19:10:16
Should I add a trigger to your post as you mention suicide and researching methods but then you sound more positive and looking for answers. Are you actively suicidal with a plan? Love Phillipa ps please let me know
Posted by Girlnterrupted78 on January 22, 2010, at 20:43:18
In reply to Re: Lamictal is ruining my life » Girlnterrupted78, posted by Phillipa on January 22, 2010, at 20:35:45
What do you mean by a "trigger"? I don't understand..
> Should I add a trigger to your post as you mention suicide and researching methods but then you sound more positive and looking for answers. Are you actively suicidal with a plan? Love Phillipa ps please let me know
Posted by gman22 on January 22, 2010, at 20:46:07
In reply to Lamictal is ruining my life, posted by Girlnterrupted78 on January 22, 2010, at 19:10:16
I am currently taking nortriptyline 50mg pm since Jan 1. So far so good, no side effects other than faster heartbeat and dry mouth. Feeling significantly better, more positive and more energy
Posted by Maxime on January 22, 2010, at 20:53:45
In reply to Lamictal is ruining my life, posted by Girlnterrupted78 on January 22, 2010, at 19:10:16
Lamictal made me depressed and suicidal so I had to stop it.
If you are doing through a lot of stress re. money and job (I'm in the same position) there is really little a med can do to help you in that area. Your life circumstances are really sh*tty right now so it's no surprise that you feel like crap.
Posted by Phillipa on January 22, 2010, at 21:52:16
In reply to Re: Lamictal is ruining my life » Girlnterrupted78, posted by Phillipa on January 22, 2010, at 20:35:45
Means adding to subject line word trigger as some get upset when hearing about these things. So far what's written is true life circumstances no pill will change. Love Phillipa
Posted by emmanuel98 on January 23, 2010, at 0:53:58
In reply to Lamictal is ruining my life, posted by Girlnterrupted78 on January 22, 2010, at 19:10:16
Lamictal had no impact on me, positive or negative. Maybe it isn't the lamictal, but just the depression itself you're feeling. Are you off parnate and adderall then? Just taking lamictal?
Posted by gibbons482 on January 23, 2010, at 9:08:39
In reply to Re: Lamictal is ruining my life, posted by emmanuel98 on January 23, 2010, at 0:53:58
> Lamictal had no impact on me, positive or negative. Maybe it isn't the lamictal, but just the depression itself you're feeling. Are you off parnate and adderall then? Just taking lamictal?
Same for me. Lamictal did nothing for me. It was like taking a sugar pill. It was a big disappointment after the slow titration.
Posted by bleauberry on January 23, 2010, at 11:51:32
In reply to Lamictal is ruining my life, posted by Girlnterrupted78 on January 22, 2010, at 19:10:16
Lamictal seems like magic for some people, but is absolutely horrible for others. For example, a quick trip to suicidal lethargy for me would be to ingest lamictal. Poison for me.
We kind of have to listen to what our bodies are telling us. Whatever a piece of literature says, whatever a clinical study says, how good a med worked for someone else, whatever our doctor says...none of these things matter one whit. All that matters is what the drug does to you. In your case, your body is saying lamictal is bad, and your body is saying parnate is on the right track but by itself not capable of fixing whatever is wrong.
There is no doubt you have plenty of neurotransmitters. A deficiency of any of them, while on Parnate, I seriously doubt it.
But what could be happening is the feedback loops are preventing the neurotransmitters from being used. In other words, there are plenty of them in storage, but on the receiving end the umpire is saying, "we have genetic instructions to not fill this bus, so back off." If that were correct, then meds to look at in order to interrupt the feedback loops and get some flow going would be Buspar, Pindolol, Abilify, Risperdal, Zyprexa. Basically, put a blindfold on the umpire so all those neurotransmitters can flow again.
A crude way to look at it, without any proof, but then, there isn't any proof of anything in psychiatry.
Posted by Girlnterrupted78 on January 26, 2010, at 21:13:03
In reply to Lamictal is ruining my life, posted by Girlnterrupted78 on January 22, 2010, at 19:10:16
So I could not deal with Lamictal and I told my doctor it was ruining my life. I was very grateful that he allowed me to go off it without asking me to "give it at least 6 weeks.." which would have probably left me homeless, or caused some major damage to my life.
Within 2-3 days that I went off it, I'm starting to feel alive again.. what a BiiiiiiiiG difference. I don't sleep all day anymore, I don't feel heavy, lethargic and unable to accomplish anything, and I'm not having those endless suicidal thoughts.. at least for now...
God, I was ready to die.. Strangely enough, I had similar reactions to Abilify, and to an extent to Nortriptyline.
It seems like the only meds that fight my depression effectively are stimulant medications (Parnate & Adderall..) Even Nardil turned me into a zombie and slowly began to ruin my life as well.. I didn't realize it was doing it because it went very slowly...but now that I look back, I see how poorly I was doing on it, and how long I stayed on it due to its great reputation as the "gold standard" for depression + social anxiety.. I wanted to give it as much time as possible to work.. and of course, after a FULL YEAR of waiting, raising the dose, etc.. I had to go off it.
So given this (short) story of success vs failure, and the type of medications that have caused each, does anyone know if there is any med out there that I could add to my combo, that will improve my response and possibly bring me back to my initial response to Parnate?
(For those who might not have read about my initial response to Parnate--it was outstanding and gave me a level of self-confidence and happiness I can only dream of now. I'm not in the pit of misery, insecurity and depression right now, but I'm definitely far from that initial response. Back then I was feeling so "normal" that I could not believe it. Just like one of those normal people you see laughing and enjoying life and social interactions, and that you could never understand... Sadly, it didn't last..)
Within 2-3 weeks of that initial response, the effectiveness of the combo diminished from an 80% to about a 40-50%..
Even though not back to full blown depression, some symptoms began to return when the med partially "pooped out".. the great confidence was replaced by a sense of slight discomfort.. not bad enough to make me as socially anxious as my natural state, but bad enough to not allow me to enjoy several social situations that I was able to enjoy during the initial response I had to Parnate.
So now that I know all these meds (Lamictal, Abilify, Nortriptyline)strangely enough make me sleep an untold amount of hours, make me lethargic and apathetic, and worsen my depression to a point of engaging in suicidal ideation..what could be added to my current combo that will not do the same, and that will potentially kickstart the antidepressant effects I initially had?
All ideas or suggestions are welcome and appreciated.
Posted by Phillipa on January 26, 2010, at 23:48:57
In reply to UPDATE: Off Lamictal now, posted by Girlnterrupted78 on January 26, 2010, at 21:13:03
Well I'm sure glad your're feeling better. Hasn't it been said here that the initial feeling can't or isn't captivated again? I"m not sure as haven't been on parnate. Love Phillipa
Posted by julie1977 on January 28, 2010, at 16:24:28
In reply to Re: UPDATE: Off Lamictal now » Girlnterrupted78, posted by Phillipa on January 26, 2010, at 23:48:57
I had a similar great response to nardil + olanzapine, and it lasted for over a year. Lately i've been wobbling though, i'm afraid its pooping out.
Posted by Tony P on January 30, 2010, at 19:00:15
In reply to UPDATE: Off Lamictal now, posted by Girlnterrupted78 on January 26, 2010, at 21:13:03
I have had good results with Modafinil (Provigil, Alertec) as a stimulant in combination with SSRI's & SNRI's. It has the added benfit of not causing insomnia.
My experience with Lamictal is mixed. First time I was on it, it worked reasonably well as both AD & mood-stabilizer (350 mg/day) - but I was also living a good lifestyle in a supportive/safe community. More recently, I tried it again and had a negative reaction similar to you & others -- blah's combined with severe anxiety attacks. As far as its AD effect goes, it's pretty mild compared to others, but my pdoc at the time said he had found doses much higher than the MFRD of 200 mg/day, up to 600 mg/day, effective with some patients.
Posted by tonyz on February 6, 2010, at 12:10:50
In reply to Re: UPDATE: Off Lamictal now » Girlnterrupted78, posted by Tony P on January 30, 2010, at 19:00:15
My depression has always been the result of or accompanied with high anxiety and severe insomnia. So for me Nortriptyline is a reasonable choice. As mentioned by others everyone reacts somewhat differently to drugs. I am not sure about the Parnate adderal combination, and by the that I mean I don't know much about those medications other than adderal is stimulating. Nortriptyline can be sedating.
I only took lamictal very briefly and I can't really comment on my experiences with it one way or the other.
But, getting back to Notriptyline here are some characteristics: it has been around a long time so a lot is known about it. Generally people prefer SSRIs as opposed to tricyclics of which Nortiptyline is a tricyclic. (I can't handle SSRIs they are too stimulating for me, but my situation is probably a lot different than yours) It works on multiple neurotransmitters serotonin and norepinephrine. This drug is known to raise heart rate slightly and must be ramped up to a therapeutic dosage slowly. There is a blood level test that can be done to determine if you are in the correct range for it to have a therapeutic effect. You should ask your doctor when he thinks you should have the blood level taken. Some of the side effects can be troubling: dry mouth, constipation, increase in occular pressure, dizziness on rapid rising from a seated position, etc. Miralax works great for managing the constipation. Miralax is available by prescription or otc. It has helped to alleviate depression for me. I have read that high fiber can interfere with Notrtiptyline absorption so it would probably be best to time your dosages a sufficient time after eating. I take the full dosage at night, but again insomnia is a big issue for me and this may be helping. A doctor I was seeing suggested that there tends to be less poop out with the older drugs than the SSRIs, but I am not sure. I have never been on it for a very long time, but I am rethinking my choices now along with other medications.
Besides the poop out effect you have described, your doctor must have some reason for switching to these meds. Maybe he sensed you had too much anxiety and needed something more calming. I don't know. I know a lot of people are suffering now with life situations and job issues, etc. You are not alone and it is hard to assess how much that is affecting your life and your depression. Try as best you can to keep your chin up and have a plan for each day. You also may be concerned because you normally come across as a very high energy person and you feel that quality is important for the job interview(s). It may be a false perception on your part that you have lost that.
Anyway best of luck, hope some of this helps. I'm sure others will chime in and add comments.
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