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Lamictal Brain Fog - How to Reduce?
I told my p-doc I was still depressed and she suggested that we lower Lamictal instead of increasing Wellbutrin (which she said I was maxed out on). I have been a proponent of 'less medication', so I am unsure of what to ask at my upcoming new psychiatrist appointment. Since graduating, I haven't spoken with any t-doc or p-doc in around 8 months.
For the last year or so I was taking 300mg/day Wellbutrin Xr and also 200mg lamictal. I have also taken Buspar for around a year. Around a week ago, I decided to lower my dosage to 150mg. of Lamictal. This is what my psychiatrist had suggested 8 months ago might be capping my happiness. She left town and I had an appointment made with a new guy at a new place this week.
About 10 days ago, noticed before the appt my script would run out. So, I had about 2-3 days where I would not be able to take any Lamictal at all. I decided to break down my 200mg pills into about 190mg,180mg... and then about 6-7 150mg. pills. It took about 5 days to titrate down. I'm on about day 7 off of the normal 200mg dosage.
I have a much clearer mind now. Also, it moves more quickly. It doesn't seem to be sluggish and generates thoughts more readily.
The analogy I thought of was "too much lamictal- wheels slowly churning in mud... less lamictal- wheels spinning on concrete but when it hits the road, it rolls" I am exhibiting some more bipolar traits I hadn't seen so much lately:
Easily teary watching slightly emotional commercials, frustrated more in life (people, cars, technology), trouble wanting to go to sleep.
Will my body get accustomed to the lower dosage?
I previously took Zoloft and I think Prozac early in my diagnosis (3 years ago). I was heavily "upped" due to suicidal thoughts.
I eventually was taken off Prozac, then Zoloft (as it made me hypomanic).
If it is assumed I'll still be edgy on the 150mg of Lamictal- would anyone like to offer what works for them? Please, I really want to know of any other possible combinations or medicines out there.
For the last year or so I was taking 300mg/day Wellbutrin Xr and also 200mg lamictal. I have also taken Buspar for around a year. Around a week ago, I decided to lower my dosage to 150mg. of Lamictal. This is what my psychiatrist had suggested 8 months ago might be capping my happiness. She left town and I had an appointment made with a new guy at a new place this week.
About 10 days ago, noticed before the appt my script would run out. So, I had about 2-3 days where I would not be able to take any Lamictal at all. I decided to break down my 200mg pills into about 190mg,180mg... and then about 6-7 150mg. pills. It took about 5 days to titrate down. I'm on about day 7 off of the normal 200mg dosage.
I have a much clearer mind now. Also, it moves more quickly. It doesn't seem to be sluggish and generates thoughts more readily.
The analogy I thought of was "too much lamictal- wheels slowly churning in mud... less lamictal- wheels spinning on concrete but when it hits the road, it rolls" I am exhibiting some more bipolar traits I hadn't seen so much lately:
Easily teary watching slightly emotional commercials, frustrated more in life (people, cars, technology), trouble wanting to go to sleep.
Will my body get accustomed to the lower dosage?
I previously took Zoloft and I think Prozac early in my diagnosis (3 years ago). I was heavily "upped" due to suicidal thoughts.
I eventually was taken off Prozac, then Zoloft (as it made me hypomanic).
If it is assumed I'll still be edgy on the 150mg of Lamictal- would anyone like to offer what works for them? Please, I really want to know of any other possible combinations or medicines out there.
You don't say what yiur diagnosis is but ADHD can be comotbid with bipolar. If you have bipolar, it makes more sense to me to increase lamotrigine than your antidepressant. Research has shown that antidepressants can cause hypomania in some people with bipolar. I've discontinued effexor and amitriptyline (for migraine) since starting lamotrigine. So off all antidepresdants now. Taking topomax for migraine which is another anticonvulsant used off label for bipolar.
2 Comments
Wow, that's a great answer. Much appreciated!
Wow, that's a great answer. Much appreciated!
So do you mean you are taking have the dosage in the morning and half in the evening? Did that help with your brain fog?
Thank you for your recommendation. We ended up increasing the lamictal to 300mg. After some discussion, he seemed to think I had most of my problems stemming from ADHD. I think I was a bit hypomanic, and that was the true underlying issue. When I get hypo in front of people, I am all over the place. When alone, I can concentrate too much on something- such as a woodworking project or organizing.
We decided to split my dosage in half. He was originally going to take me up to 400mg a day, 300 in the A.M. and 100 in the afternoon. I just said, "Can we just split it in half?"
He agreed. On the ADHD stuff... I was diagnosed with ADD as a child, in part because I wanted to be put on Adderall so that I could use it for studying. I mentioned to him that I didn't like being on ADHD medication because I used to abuse it. His suggestion was Concerta, which I was not enthused about. I have taken Adderall once or twice since stopping my prescriptions 10 years ago. I noticed that on the bipolar meds, I did not go out of control as I used to while taking them. I was actually taking as little as 2.5 mg of the SR and going bonkers all night, not sleeping. It seemed to trigger hypomania very easily. I really don't want to get on more medicine.
The missing gaps in my life are those which made me sober: exercise, fun, family.
I have a lot of voids. Having the weight of them all on my back seems to make me less and less productive. They say I'm doing fine at work in my current temp position. I definitely have the winter blues though. Anyway, the numbing is less intense, which I attribute to splitting the Lamictal up.
Since splitting the 300mg Lamictal dosage, I go to be around one to two hours earlier- sometimes three. I feel more control at the end of the day to not be as wild, though I do feel a bit unproductive and "stuck". I notice I do sleep in more, but somehow feel less depressed when I wake up. I usually dread the day when I wake up. Lately, I am in some sort of emotional rhythm. My morning routine is not too great. I seem to show up 5 minutes late to work every day.
But yeah, thank you for the help. I'm with Mr. New Guy, so I am trying to give this nurse practitioner a chance. I do miss my old psychiatrist though, I wish she hadn't moved away from this town. I trusted her greatly, and we had a great professional relationship.
We decided to split my dosage in half. He was originally going to take me up to 400mg a day, 300 in the A.M. and 100 in the afternoon. I just said, "Can we just split it in half?"
He agreed. On the ADHD stuff... I was diagnosed with ADD as a child, in part because I wanted to be put on Adderall so that I could use it for studying. I mentioned to him that I didn't like being on ADHD medication because I used to abuse it. His suggestion was Concerta, which I was not enthused about. I have taken Adderall once or twice since stopping my prescriptions 10 years ago. I noticed that on the bipolar meds, I did not go out of control as I used to while taking them. I was actually taking as little as 2.5 mg of the SR and going bonkers all night, not sleeping. It seemed to trigger hypomania very easily. I really don't want to get on more medicine.
The missing gaps in my life are those which made me sober: exercise, fun, family.
I have a lot of voids. Having the weight of them all on my back seems to make me less and less productive. They say I'm doing fine at work in my current temp position. I definitely have the winter blues though. Anyway, the numbing is less intense, which I attribute to splitting the Lamictal up.
Since splitting the 300mg Lamictal dosage, I go to be around one to two hours earlier- sometimes three. I feel more control at the end of the day to not be as wild, though I do feel a bit unproductive and "stuck". I notice I do sleep in more, but somehow feel less depressed when I wake up. I usually dread the day when I wake up. Lately, I am in some sort of emotional rhythm. My morning routine is not too great. I seem to show up 5 minutes late to work every day.
But yeah, thank you for the help. I'm with Mr. New Guy, so I am trying to give this nurse practitioner a chance. I do miss my old psychiatrist though, I wish she hadn't moved away from this town. I trusted her greatly, and we had a great professional relationship.
1 Comments
So do you mean you are taking have the dosage in the morning and half in the evening? Did that help with your brain fog?
Its a difficult balance as regards many medications, Lamictal included
between side effects such as cognitive confusion and efficacy. Please
work with your psychiatrist to find a workable dose. I know when I was on Lamictal that when it didn't work I was given other mood stabilizers as adjuncts (add on medications). However as some mood stabilizers may interact with Lamictal and could not be used you'd need to ask your psychiatrist what would be potential options. Hopefully the sites listed here are updated as regards all current potential treatment options as regards mood stabilizers:
http://www.medhelp.org/tags/health_page/34/Mental-Health/Useful-Bipolar--Depression-Webisites?hp_id=523
You could then ask your psychiatrist which options they would consider.
between side effects such as cognitive confusion and efficacy. Please
work with your psychiatrist to find a workable dose. I know when I was on Lamictal that when it didn't work I was given other mood stabilizers as adjuncts (add on medications). However as some mood stabilizers may interact with Lamictal and could not be used you'd need to ask your psychiatrist what would be potential options. Hopefully the sites listed here are updated as regards all current potential treatment options as regards mood stabilizers:
http://www.medhelp.org/tags/health_page/34/Mental-Health/Useful-Bipolar--Depression-Webisites?hp_id=523
You could then ask your psychiatrist which options they would consider.
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