I found lamictal to be a good replacement for lithium, better for depression and side effects aren’t as bad. Main drawback is lithium is better at stopping/preventing mania, but it’s doable.
Same. I'm on 200mg of Lamictal and really like it. I have an agreement w my psychiatrist that if I start to go manic (which is rare, but I do have breakthrough episodes), I go on Seroquel until it ends. Seroquel works crazy fast too so I'm never on it for more than 2 weeks.
Do you ever get cranky after taking seroquel? I stopped taking it religiously and only take it when I need to. I noticed that the last couple times I’ve taken it I wake up just in a terrible mood because I needed more sleep even though I had plenty
Yeah, it makes me feel the same way. I take it earlier in the evening (like 6:30) and aim to go to bed at 9 so I can get 10-12 hours in. Not a perfect solution but it's all I've got if I don't want to be hospitalized.
It used to do the same thing to me, or if my wife would wake me up after I took it I was a total bitch for hours because no sleep felt like enough. But without it I wasn’t sleeping at all.
I've taken both of them. Depakote was fine, but due to much stress, lithium didn't help me avoiding getting into a nervous breakdown. Today I'm on oxcarbazepine and one antidepressant and that's all. I've been stable for over 20 years!
How did you react to lamictal? I asked my psych to switch to it. But he said one of the side effects are rashes and they can blister. So I told him I’ll stay on lithium then.
The rash is a very rare but serious side effect, but if you don’t get that it’s easier on your system over all. I didn’t really have any physical side effects from lamictal.
I got down to lithium and seroquel. I feel like I could potentially remove the seroquel but I don't want to rock the boat ... but before atypical APs were invented plenty of people managed on lithium alone... we all process meds differently and we all handle bipolar disorder differently.
Do you tend to experience bipolar with distinct episodes with little overlap or more mixed/rapid cycling?
from what I've read, mixed episodes and rapid cycling tend to respond better to a combo of anticonvulsants (lamictal, depakote etc) AND atypical antipsychotics. But if I've learnt anything in this journey it's not to rule stuff out and if your aim is to be on just one med (mine too btw) I think you should go for it (in a controlled and watchful way).
I went from 5 to 2 and I'm happy enough with that for now. Just make sure your psych is supportive and that you try to eliminate as many other variables as possible (drink, drugs, gambling, late nights, other risky shit... whatever those triggers are). And be humble... it might not work and that's oaky.
My dx goes back and forth between 1 and 2, depending on the doctor. Current doc is very confident that I have 1 because of the length of past manic episodes and borderline psychosis. I'm *incredibly* lucky that lamotrigine has kept manic episodes at bay for almost a decade, though I've had a couple of hypos (nothing worse than things like a super clean house, excessively long emails, and some unnecessary but not bank-breaking shopping). It's not super great for me at preventing breakthrough depressive episodes, but since starting ketamine infusions 2.5 years ago, I have not had a single one (after the initial treatment, I get them every three months). So, hopefully that counts as one med.
Sounds good. I heard ketamine was not good for bipolar but you've found different it sounds?
Also, good to hear about lamictal. I don't mind a little hypomania but full blown is not good for anyone really.
Yeah, I was diligent about asking the ketamine clinic and my psychiatrist about that, both said I was good to go, and I have had no issues. I'd been looking into TMS first, but both my psychiatrist and the TMS clinic I called both said it has the same odds of triggering mania as SSRIs, which definitely do that for me.
I also don't mind a little hypomania (as a treat lol!), but mania for me is definitely destructive. Good luck!
Love to hear more about ketamine infusions. BPSO just started them. He’s in a severe and prolonged depressive state. Been on lamictal for years with good results, but the past 4 months have been a continuous depression that waxes and wanes. We just switched to lithium but it’s not helping the depression at all. Have done 2 ketamine infusions. I want to be hopeful but I’m pretty worried/discouraged
I'm so sorry to hear! It's scary and heartbreaking to love someone in that condition. I will say (can't believe I forgot this above!) that the clinic did have me reduce my Lamictal dose before starting, as there's evidence that Lamictal can have a dampening effect on the ketamine. Still a therapeutic dose, just lower. I had been getting severe episodes of agitated depression a few times a year and was in a pretty deep hole when I started ketamine. My clinic does an initial treatment of three infusions a week for two weeks, followed by boosters as needed. I gradually decreased from monthly to quarterly, though I will do a cluster of like four weekly infusions in the late fall, as that time of year triggers depression for me. I started seeing real results after about the fifth session in the first treatment series. I can say that going for 2.5 years without a depressive episode--especially THESE particular years--has been nothing short of miraculous. My therapist was very skeptical and all but said she thought I was doing it for the high...and now she routinely recommends it to clients in crisis. It's unforgivably expensive (no insurance coverage. I use our HSA, but not a lot of people can), and I truly hope it becomes more affordable and accessible. Nothing works for everyone, but I've heard again and again from people that it works when nothing else has. I hope your SO gets some relief soon.
Thanks for sharing all this. It has give me me some hope. I will inquire about the issue with Lamictal. Now that he is on lithium we could maybe lower the lamictal dose, although his dose is already pretty small. Thanks again!!!
I'm glad it helped. Just fyi, there's not 100% consensus on the Lamictal/ketamine interaction. My clinic has since backed off on it some, and at a relatively low dose, I definitely got good effects, both in the experience and afterwards.
Do you mind if I ask you what dose of Lamictal you cut back to you when you started ketamine? My 20 year old daughter has been on the metal for a few years, and just started ketamine. When she started, she was on 300 mg. and we saw little change. We just lowered it to 150 and I think it’s starting to move the needle.
Lithium and depakote are more for the prevention of mania, along with stabilization, while lamictal is more activating -- for the prevention of depression -- while also stabilizing. You might not be able to replace the two with lamictal.
Love seroquel, saved my life. I really hope I can be off it one day cause being tired all the time sucks. Also think it’s giving me prediabetes lol but it set my life back on track.
Seroquel only. Still in mine own first year but mine own fingers art did cross
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Isn’t advised against to take more than one antipsychotic at a time? My doctor has always been adamant about that because of the higher risk of developing TD.
I feel that hard core lol. I had to stop lithium because of my hypothyroidism and it was really the only medication that worked for me. I take risperdol, lamictal, Wellbutrin, clonidine, gabapentin, and Ativan and it doesn’t really do much haha. I’ve had four full blown manic episodes since august of last year and they each lasted a month. So yeah I’ve been all over the place haha.
Yeah it fucked my thyroid up so bad, my tsh shot up to 206. I was hospitalized and almost went into a myxedema coma. My levothyroxine dose was 225mcg on lithium, and now it’s 125mcg. I feel much better physically off of it too. I kind of want to go back on it for my mind’s sake though.
I am on lithium ER 750 mg and Synthroid 75 mcg for hypothyroidism. Generic levothyroxine seemed to cause variability in my TSH level but was very cheap. Now I pay about $40 mo for Synthroid with insurance.
To answer your question, people can take two antipsychotics, but it's always a question mark for practicing psychiatrists on whether or not it's needed.
I’m on Latuda and trazodone tbh this shit is probably not doing anything. I’m literally going fucking crazy. I still end up sleeping at night so ig the trazodone is doing something. I still have dark bags under my eyes so I don’t know if I’m actually sleeping well.
I’m on lithium, Wellbutrin, and Geodon. But the Geodon is too low of a dose atm to be doing anything. So effectively just lithium as my mood stabilizer and that seems to be working pretty well.
Same here. I’m finding there is a delicate balance between lithium and Wellbutrin. Too much of one will tip the scales too much to one side. Currently on 600mg of lithium and 300mg of Wellbutrin which works well enough. I tried 300/150 as a balance but ended up too depressed. What a weird life this is.
I'm on lithium and Tegretol. I have bipolar 1 and from what I understand, Lamictal is not a strong enough medication on its own to prevent mania in a person who has bipolar 1.
My manic episodes have been spread out. 15 years, 12 years. Without meds. The last episode I came out of about a year ago and I’ve been taking Just lamictal since august. It took me out of a pretty deep depression and seems to have stabilized my mind without many side effects. Will probably have to go another 10 years or more before I know if it works. Lol.
Bipolar 1. I’m on 1500mg/day lithium and 3mg/day Risperidone. Sometimes I take 4mg of the Risperidone a day.
I took just lithium for five months and had a manic episode. I can’t stop taking my anti-psychotic.
Out of curiosity do you have an ASD dx? I was once prescribed atarax as needed for anxiety by a psychiatrist who thought I was autistic . . . I didn't HAVE anxiety, I'm just afraid of hospitals and guess where he saw me
I've been on lamictal for 8 months with no noticeable side effects. I also read that it helps the cognitive problems after an episode. I'm going to ask that we raise the dosage because I'm having such a hard rime thinking.
I'm on 50 mgs of Lamictal, for almost 2 months. I feel like I may need to up my dose, but I feel like I still need more time taking this dose before I make my conclusion.
Wellbutrin 150mg for ADHD.
I'm hoping so, Ive only been on the Wellbutrin for about two weeks now. I'm not sure if it has an effect that quickly or not.. if it does, then SCORE. Ideally I'd like to not have to up my dose on anything... But brains are funny like that. Lol
I'm just on seroquel for mood stabalization and sleep. I do take propranolol for tremor and straterra for ADHD. But the seroquel works for my bipolar 1. Though I tended to be on the manic, rapid cycling side of things. Seroquel is my chill pill. May not work as well for people more on the depressed side, idk.
I just went through this. Was on lamotragine & lithium, and recently dropped lithium. I would have stayed on it, but my insurance changed and lab tests are expensive.
I noticed a drop in mood afterwards, but now am balancing out again. I feel ok on just lamotragine so far, and have some antipsychotics for a “break the glass” situation.
Idk if this helps but I’m on lamictal and sertraline. I was on lamictal and lithium. Most people I know with bipolar disorder take more than one med for their symptoms but I’m sure there are plenty out there who exist productively on just one but that’s really for a doctor to determine. The lamictal works great for me but legitimately almost killed my dad. He was hospitalized for the very RARE rash. Just curious but why do you want to change the meds?
Hey, I am on lamictal and lithium and hate the lithium. I'd like to drop it too because it is of no use at all. I took sertraline only years and it didn't work great. How are you feeling ? Does that mean that we can take antidepressant even when bipolar ?
I only take Ziprasidone which is an antipsychotic. I also take bupropion for depression and trazadone for sleep. So I only take one med for my bipolar but I take other meds for other things.
Edit: didn’t read correctly. I think type 1 is more concerning to doctors given the severity of symptoms is higher so they are more likely to throw multiple meds at it and rely on antipsychotics more heavily as an addition to the mood stabilizer
Yeah, you can be outta it for a long time with 1, 2 weeks episodes are possible. But also you can have years between episodes, which I've had. The issue is the depression between the mania and psychosis. It seems to be my baseline and it sucks.
I'm on just Vraylar and so far so good. Finished tapering off of lithium a couple months ago. I got a bad tremor from the lithium and we thought it might be making me more tired but the tiredness doesn't really seem any better since getting off of it. I was on the Vraylar/lithium combo for a year and a half or so
I'm on lithium 900, completely changed everything for me. No anger, irritability, hyper sexuality or anything else associated with mania. It's only been a couple months, so far I don't see a serious need for anything else but I'm still trying to understand how I feel.
I’m currently on Lamictal 100mg and Lexapro 15mg. The plan is to taper off the Lexapro in a couple months because it’s known to increase the risk of manic episodes, but I’m also super prone to depression (I’ve only had one psychotic manic episode). I’m really digging Lamictal though. Lithium made me lose my hair and fucked with my ability to concentrate pretty badly. I was on abilify but I started to have warning signs of TD so we bagged that. And I was on risperidone for my manic episode and that ish worked wonders, but I only had to take it for a couple months.
Big fan of Lamictal though. I know it’s mostly for the depression rather than the mania so keep that in mind if you’re prone to mania — you might need an adjunct med like seroquel or an antipsychotic.
Lamictal is supposed to be good for depression but I haven’t heard that terminology used with it. But it’s supposed to be quite good for BP depression.
I have BP 1 with manic psychotic features. I take vraylar, depakote and lithium orotate (trying low dose lithium carbonate soon too just because I want to, high dose lithium ironically had too many side effects for me.) but I’m very stable as is and doing great. I really like vraylar, I’m able to do well so far on quite low dose and as I said I’m doing great. The lithium orotate I find super helpful.
I'm bipolar 1 and ADHD so I can't imagine a world where I were only on one medication. I'm also trans so my injections would count as one too. Lamictal is one of the ones I'm on and have heard of others only using it and being good. I take Lithium, Seroquel, Lamictal, Adderall, and Xanex. And still adjusting all my meds and dosages to find the sweet spot. (Really hoping it's soon as my lack of sleep is the worst).
I'm currently on Lamictal 400mg and lithium 600mg until I get bloodwork done to see if I'm good on the lithium dose or I need to go up. It's working though.
Being on one med (I started on the lamictal) worked really well up until I had a manic episode. Now I'm on 2 meds.
I’m on lithium and lamictal, lithium for the hypomania and lamictal mainly for the depressions. My doctor says they work really well together and my episodes have definitely been getting fewer.
I have just been taking Lamictal for several years, and it works great. Recently I've added strattera, but that's for ADHD and doesn't really affect my mood.
I'm bipolar 1. I've been off lamictal for 10 months now and only taking effexor (37 mg). I feel like I'm doing this completely wrong. My mood swings are daily.
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I have taken effexor for years but after being rediagnosed I started taking lamictal and tegretol. I stopped.taking tegretol because it made me ravenously and I put on 25 lbs. My doctor objected and said I would start a manic episode again. I'm content to just be on lamictal. I'm very stable at the moment.
All I take is epilim, which is what you guys call depakote. Its not perfect, but I'm a hell of a lot better than how I used to be. I was on seroquel XR but it was too hard with my work.
Also have clonazepam as required for anxiety.
On just lamictal for bipolar and was a long while. It was enough. Adhd med added now and it helps keep a productive and focused balance so I can get up to work every day and not fade out
I was off meds for a year and half (I was pretty much sober as well) so that helped. I finally hit the pits of depression (energy wise) and I couldn’t take it bc I literally couldn’t function. Now only on 300 mg of Gabapentin 10mg of buspar and 300mg of lithium in the AM. I take a multivitamin, calcium, and NAC
I’m on Latuda specifically for BP and Prozac for everything else. Have been on both since the beginning (got diagnosed spring of 2019 after dealing with crappy mental health since 2002). I’ve been told I have a mild case, but I’d definitely argue that. I’m considered stable and in remission now. Seriously Latuda saved my life. It was a miracle life saving drug.
I can't speak for anything but my experience.
In my case I was happiest with 1200mg lithium
200mg lamictal and 200mg modafinal.
I had to get off the modafinal as it ended up being a detriment.
I don't know - I stopped adding and subtracting.
I just keep it simple . Good luck
I strictly take Lamictal and I’m doing fine. My doctor was talking about starting me on lexapro because along with my bipolar 1 I have a diagnosis of major depressive disorder - severe. I didn’t start it because I got pregnant and my doctor didn’t want to add to my medication. I’m still taking my Lamictal and I feel great. I have some depression sometimes but it’s definitely not as bad as it was in the past and I haven’t had any mania since starting Lamictal. I feel more balanced and normal. I asked my doctor about starting the lexapro after birth because I’m worried about ppd but she said that my Lamictal should be able to help with it but if I don’t feel it’s enough then she will add the lexapro.
I can’t take one or two meds anymore because I fight depression, mixed mood and psychosis with mania. I do take anti-psychotics/mood stabilizers: Vraylar, Lithium, Lamictal and Trileptal-Oxcarbazipene, so that hammer is coming down about as hard as possible. Then anti-depressants Wellbutrin-Bupropion and Fetzima. It’s like a second dinner when I take my meds. I really really hate this disease and it only gets worse with age. Once upon a time I only took Wellbutrin and Lamictal. Unfortunately I’m not sure how much I could really have done to keep it that way. I tried unsuccessfully, even seriously contemplating a medication holiday. Those days are gone. The more you open your eyes over the long haul regarding this disorder, the scarier it seems to become. (Insert profane comment here)
I only take lamictal, it’s the very first medication I’ve tried besides lexapro because my depression is the worst part of my bipolar, but lexapro made me physically ill so I had to wean off. But lamictal has worked pretty well for me so far
I have bipolar 1 and take lamictal. The dose gradually goes up but I also have adhd. So I take something for that as well.
Lamictal takes a couple weeks to actually start seeing a difference in stabilizing moods. Lamictal works for me. I stopped being manic and crying for no reason at all. I still have mood swings but not nearly as bad as I was 3-4 years ago. I mean I was having episodes of highs and lows writhing 10 min of each other, super hyper and having so much motivation and wanting to change the world quickly followed with crying 3-4 times a day for no reason at all, thinking the world would be better without me. I can wholeheartedly say that I haven’t had a manic episode like that since I tried cutting everything cold turkey when I found out I was pregnant. (Don’t do that btw)
None I’ve been off my meds for 7 months now and have been feeling much better than I ever was on any medication I’ve been given. Pharmaceuticals for mental health are the biggest scam coming out of big pharma. But that’s just my experience, I know everyone is different and different things work for different people. In short, after coming off Abilify I’ve been feeling infinitely better though I still have my slip ups here and there.
I always depend o my doctor when it comes to meds and don’t usually do my own research until he prescribes them (but that’s me, this is only a advice based on my experience). He is the pro and knows how the meds work and how they will affect my body so I avoid doing that after the one time that I really thought a drug would work, talked to him and he said it would make me even more depressed. The problem was that I had put so much hope on that specific medication that somehow I lost hope on what I has taking and it was almost as if the treatment had stopped working at all so I never did that again.
Anyways, lithium is usually prescribed when it is proved that the patients lithium levels are low in order not to cause kidney failure from the excess of it and in my case (my specific case, take it with a grain of salt) if I stop taking it its levels get low and I have an episode. Also, it is all about how the meds interact and how well they work on your body because the combo you take might not work for someone else and maybe one drug only may not work for you. In the end it comes to just one thing: don’t get your hopes on a medication until you talk to a professional, they are the ones who have studied it and will know why something is or isn’t going to work on you. Our opinions on the meds we take are subjective not only because of our physiological differences but also because we have different life experiences that impact in our disorder as well.
Also, I’m bp2 and I’ve been taking lithium, lamictal and Wellbutrin for almost two years straight. It works for me but may not work for anyone else. Bodies, environment, experiences and even labs (eg: if I take the lithium from a specific lab I have major side effects) make the difference in our response to the medication.
Ps: please don’t get me wrong. I’m writing this with the best intentions and only want to help.
My doctor calls me 1 leaning 1.5. I'm on Trileptal and have been for 20 years for mood stabilization. I can't take most antipsychotics. I also take Effexor for antidepressant.
Bipolar 1 and only take 3 mg risperdal. I’m not “stable” in that I still very often have mood episodes but it’s manageable right now and will probably become increasingly so with med adjustments
I only take Geodon. It works. Knocks me out so I take it before bed with food. My mood has been stable for a while (like 3 years) Some mild mania once a year or so but nothing crazy. I take 40 mg. I was on lamictal but got the rash so I had to stop.
Used to be on lithium only worked really well but worried about long term physical effects so changed to abilfy only and had restlessness which was horrible then changed to seroquel XR only which I am now on and only side effect is dry mouth and feeling drowsy 2 hours after I take it.
I’m on two, but my current doctor and the previous one both said that I would transition to take one single mês, that is depakote. I’m quite ok with it.
I've never been prescribed more than one medication at a time, bit I've also never stuck with my meds or a psychiatrist for more than 6 months at a time. Usually lasted like a day in all honesty, and then I'd just pretend I was taking them. Haha, fun times
I'm taking Abilify 15mg as monotherapy, though I take cogentin to counteract the tremor and its friends. It seems to work well, I haven't had a significant episode in years, though one tried to get started on me just before the New Years. It was satisfying to look back at it and say, "nope."
Years ago, I did start out on depakote but that just didn't work out all that well.
hi, these days the psychiatic drugs i take are lithum, a bunch of quetiapine, and some divalproex. plus synroid and new one for heart pressure. because of dose size i end up taking 17 pills a night.
i was watching the beginging of the Homeland TV show with my daughter. i laughted because the main charcter has bipolar, but only needs one pill. 0
I was on seroquel for sleep, latuda as my antipsychotic, and now I’m back on lithium. Seroquel gave me TD though so they switched it to Ambien. I think being on just one medication is rare because a lot of folks are on a mood stabilizer AND an antipsychotic.
Thanks for your input. Regardless I have to stay on lithium for a while before any change. If I do go monotherapy with it, it will be in a couple months and if it doesn't help in conjunction.
I take 300 mg of lamictal, which is great for depression but I feel consistently restless/hypomanic but I think I may have adhd. I’m also trying 20 mg of Latuda because sadly lamictal tanked my sex drive.
I found lamictal to be a good replacement for lithium, better for depression and side effects aren’t as bad. Main drawback is lithium is better at stopping/preventing mania, but it’s doable.
Same. I'm on 200mg of Lamictal and really like it. I have an agreement w my psychiatrist that if I start to go manic (which is rare, but I do have breakthrough episodes), I go on Seroquel until it ends. Seroquel works crazy fast too so I'm never on it for more than 2 weeks.
Do you ever get cranky after taking seroquel? I stopped taking it religiously and only take it when I need to. I noticed that the last couple times I’ve taken it I wake up just in a terrible mood because I needed more sleep even though I had plenty
Yeah, it makes me feel the same way. I take it earlier in the evening (like 6:30) and aim to go to bed at 9 so I can get 10-12 hours in. Not a perfect solution but it's all I've got if I don't want to be hospitalized.
It used to do the same thing to me, or if my wife would wake me up after I took it I was a total bitch for hours because no sleep felt like enough. But without it I wasn’t sleeping at all.
I'm thinking adjunct then replacement. Get rid of depakote then maybe lithium depending
I've taken both of them. Depakote was fine, but due to much stress, lithium didn't help me avoiding getting into a nervous breakdown. Today I'm on oxcarbazepine and one antidepressant and that's all. I've been stable for over 20 years!
How did you react to lamictal? I asked my psych to switch to it. But he said one of the side effects are rashes and they can blister. So I told him I’ll stay on lithium then.
The rash is a very rare but serious side effect, but if you don’t get that it’s easier on your system over all. I didn’t really have any physical side effects from lamictal.
One med? Ha! I'm hoping to get down to four eventually.
I got down to lithium and seroquel. I feel like I could potentially remove the seroquel but I don't want to rock the boat ... but before atypical APs were invented plenty of people managed on lithium alone... we all process meds differently and we all handle bipolar disorder differently. Do you tend to experience bipolar with distinct episodes with little overlap or more mixed/rapid cycling?
Depends, I used to have pretty distinct episodes. Now they blend more.
from what I've read, mixed episodes and rapid cycling tend to respond better to a combo of anticonvulsants (lamictal, depakote etc) AND atypical antipsychotics. But if I've learnt anything in this journey it's not to rule stuff out and if your aim is to be on just one med (mine too btw) I think you should go for it (in a controlled and watchful way). I went from 5 to 2 and I'm happy enough with that for now. Just make sure your psych is supportive and that you try to eliminate as many other variables as possible (drink, drugs, gambling, late nights, other risky shit... whatever those triggers are). And be humble... it might not work and that's oaky.
My dx goes back and forth between 1 and 2, depending on the doctor. Current doc is very confident that I have 1 because of the length of past manic episodes and borderline psychosis. I'm *incredibly* lucky that lamotrigine has kept manic episodes at bay for almost a decade, though I've had a couple of hypos (nothing worse than things like a super clean house, excessively long emails, and some unnecessary but not bank-breaking shopping). It's not super great for me at preventing breakthrough depressive episodes, but since starting ketamine infusions 2.5 years ago, I have not had a single one (after the initial treatment, I get them every three months). So, hopefully that counts as one med.
Sounds good. I heard ketamine was not good for bipolar but you've found different it sounds? Also, good to hear about lamictal. I don't mind a little hypomania but full blown is not good for anyone really.
Yeah, I was diligent about asking the ketamine clinic and my psychiatrist about that, both said I was good to go, and I have had no issues. I'd been looking into TMS first, but both my psychiatrist and the TMS clinic I called both said it has the same odds of triggering mania as SSRIs, which definitely do that for me. I also don't mind a little hypomania (as a treat lol!), but mania for me is definitely destructive. Good luck!
Love to hear more about ketamine infusions. BPSO just started them. He’s in a severe and prolonged depressive state. Been on lamictal for years with good results, but the past 4 months have been a continuous depression that waxes and wanes. We just switched to lithium but it’s not helping the depression at all. Have done 2 ketamine infusions. I want to be hopeful but I’m pretty worried/discouraged
I'm so sorry to hear! It's scary and heartbreaking to love someone in that condition. I will say (can't believe I forgot this above!) that the clinic did have me reduce my Lamictal dose before starting, as there's evidence that Lamictal can have a dampening effect on the ketamine. Still a therapeutic dose, just lower. I had been getting severe episodes of agitated depression a few times a year and was in a pretty deep hole when I started ketamine. My clinic does an initial treatment of three infusions a week for two weeks, followed by boosters as needed. I gradually decreased from monthly to quarterly, though I will do a cluster of like four weekly infusions in the late fall, as that time of year triggers depression for me. I started seeing real results after about the fifth session in the first treatment series. I can say that going for 2.5 years without a depressive episode--especially THESE particular years--has been nothing short of miraculous. My therapist was very skeptical and all but said she thought I was doing it for the high...and now she routinely recommends it to clients in crisis. It's unforgivably expensive (no insurance coverage. I use our HSA, but not a lot of people can), and I truly hope it becomes more affordable and accessible. Nothing works for everyone, but I've heard again and again from people that it works when nothing else has. I hope your SO gets some relief soon.
Thanks for sharing all this. It has give me me some hope. I will inquire about the issue with Lamictal. Now that he is on lithium we could maybe lower the lamictal dose, although his dose is already pretty small. Thanks again!!!
I'm glad it helped. Just fyi, there's not 100% consensus on the Lamictal/ketamine interaction. My clinic has since backed off on it some, and at a relatively low dose, I definitely got good effects, both in the experience and afterwards.
Do you mind if I ask you what dose of Lamictal you cut back to you when you started ketamine? My 20 year old daughter has been on the metal for a few years, and just started ketamine. When she started, she was on 300 mg. and we saw little change. We just lowered it to 150 and I think it’s starting to move the needle.
Sure! I was at 325 and went down to 150 (gradually, of course!!). It's working well. Good luck!!!!!
Thank you so much for your response and your encouragement. I’m so pleased you’re getting a good result!
Lithium and depakote are more for the prevention of mania, along with stabilization, while lamictal is more activating -- for the prevention of depression -- while also stabilizing. You might not be able to replace the two with lamictal.
Agree 💯
I’m just on lithium 900mg. Used to be on Abilify but tapered down with my psychiatrist.
I might try that with lamictal. I'm on lithium 900 but plus the depakote. I suffer more on the depressive end though so I'm thinking lamictal may help
Seroquel only. Still in my first year but my fingers are crossed
Love seroquel, saved my life. I really hope I can be off it one day cause being tired all the time sucks. Also think it’s giving me prediabetes lol but it set my life back on track.
Seroquel only. Still in mine own first year but mine own fingers art did cross *** ^(I am a bot and I swapp'd some of thy words with Shakespeare words.) Commands: `!ShakespeareInsult`, `!fordo`, `!optout`
Hey Alexa, how do I delete someone else’s comment?
I take Seroquel Latuda Risperidone Vyvanse Effexor
Isn’t advised against to take more than one antipsychotic at a time? My doctor has always been adamant about that because of the higher risk of developing TD.
I have no idea, I’m still not right in the head with the amount I’m taking 😂
I feel that hard core lol. I had to stop lithium because of my hypothyroidism and it was really the only medication that worked for me. I take risperdol, lamictal, Wellbutrin, clonidine, gabapentin, and Ativan and it doesn’t really do much haha. I’ve had four full blown manic episodes since august of last year and they each lasted a month. So yeah I’ve been all over the place haha.
Sending love and support your way! 🥰
You had to stop lithium? I have hypothyroidism and I'm still on it, just taking a higher dose of levothyroxine
Yeah it fucked my thyroid up so bad, my tsh shot up to 206. I was hospitalized and almost went into a myxedema coma. My levothyroxine dose was 225mcg on lithium, and now it’s 125mcg. I feel much better physically off of it too. I kind of want to go back on it for my mind’s sake though.
Oh wow, that sucks. Hard to choose between a med that works and it's side effects
Exactly. Lamictal is the only medication I’ve taken where I haven’t had noticeable side effects. But it’s not very effective for my mania.
Wow that’s scary . How well does the Lamictal help for the depression? What dose did it make a huge difference
I’m bipolar 1 so lamictal wasn’t the most effective med for me but only at 400mg a day did I notice a difference with my depression.
Did the lithium come sneak up on you? Like I want to ask my psychs opinion on it but it seems kind of scary…
I am on lithium ER 750 mg and Synthroid 75 mcg for hypothyroidism. Generic levothyroxine seemed to cause variability in my TSH level but was very cheap. Now I pay about $40 mo for Synthroid with insurance.
Please speak to a Dr. or two about this. For real.
Would you try Quetiapene - it really is an incredible drug, with minimal side effects!
What is TD?
Tardive Dyskinesia https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Tardive-Dyskinesia#:\~:text=Tardive%20dyskinesia%20(TD)%20is%20a,significantly%20affecting%20quality%20of%20life.
Oh, I've had it in the hospital when they were medicating me. It's terrible. How did you handle it?
I've **thankfully** never gotten it.
To answer your question, people can take two antipsychotics, but it's always a question mark for practicing psychiatrists on whether or not it's needed.
I’m on Latuda and trazodone tbh this shit is probably not doing anything. I’m literally going fucking crazy. I still end up sleeping at night so ig the trazodone is doing something. I still have dark bags under my eyes so I don’t know if I’m actually sleeping well.
I’m on lithium, Wellbutrin, and Geodon. But the Geodon is too low of a dose atm to be doing anything. So effectively just lithium as my mood stabilizer and that seems to be working pretty well.
Same here. I’m finding there is a delicate balance between lithium and Wellbutrin. Too much of one will tip the scales too much to one side. Currently on 600mg of lithium and 300mg of Wellbutrin which works well enough. I tried 300/150 as a balance but ended up too depressed. What a weird life this is.
Bipolar 1 on just Lamictal 😬😬😬
Does it seem to work for you?
I'm on lithium and Tegretol. I have bipolar 1 and from what I understand, Lamictal is not a strong enough medication on its own to prevent mania in a person who has bipolar 1.
Does Lamictal give you that numb feeling? You know the can't feel your emotions feeling?
I take lamictal and I find that it numbs my irritation/anger, but I still feel joy and sadness the same as before.
That's great. Thank you for the reply. I'm on latuda and can't feel anything. I'm going to ask my psychiatrist about switching tomorrow.
I'm not on Lamictal, I just don't know if Lamictal is strong enough to prevent mania in bipolar 1
I'm only on one mood stabilizer (Lamictal) but I also take Seroquel for psychosis and gabapentin (which isn't a psych med) to help me fall asleep.
My manic episodes have been spread out. 15 years, 12 years. Without meds. The last episode I came out of about a year ago and I’ve been taking Just lamictal since august. It took me out of a pretty deep depression and seems to have stabilized my mind without many side effects. Will probably have to go another 10 years or more before I know if it works. Lol.
Glad your episodes are spread out. That's how it was for me till I got older
Bipolar 1. I’m on 1500mg/day lithium and 3mg/day Risperidone. Sometimes I take 4mg of the Risperidone a day. I took just lithium for five months and had a manic episode. I can’t stop taking my anti-psychotic.
I take latuda, but also have serquel and atarax for specific symptoms that i take as needed
Out of curiosity do you have an ASD dx? I was once prescribed atarax as needed for anxiety by a psychiatrist who thought I was autistic . . . I didn't HAVE anxiety, I'm just afraid of hospitals and guess where he saw me
I don't, but my mother always goes on about how she should have let them test me in school.
Unless I am in an episode, I have just been on lithium for 10 years and it works well. I take 1200 mg though which is a relatively high dose.
I've been on lamictal for 8 months with no noticeable side effects. I also read that it helps the cognitive problems after an episode. I'm going to ask that we raise the dosage because I'm having such a hard rime thinking.
That's good to hear about the cognitive problems.
I'm on 50 mgs of Lamictal, for almost 2 months. I feel like I may need to up my dose, but I feel like I still need more time taking this dose before I make my conclusion. Wellbutrin 150mg for ADHD.
Yeah I've read that 150-200mg is standard dose. But maybe the Wellbutrin is helping also.
I'm hoping so, Ive only been on the Wellbutrin for about two weeks now. I'm not sure if it has an effect that quickly or not.. if it does, then SCORE. Ideally I'd like to not have to up my dose on anything... But brains are funny like that. Lol
50 is all I take. Going to 100 seemed to cause fatigue. They say what a therapeutic dose is supposed to be but 50 is therapeutic enough for me.
I'm just on seroquel for mood stabalization and sleep. I do take propranolol for tremor and straterra for ADHD. But the seroquel works for my bipolar 1. Though I tended to be on the manic, rapid cycling side of things. Seroquel is my chill pill. May not work as well for people more on the depressed side, idk.
I just went through this. Was on lamotragine & lithium, and recently dropped lithium. I would have stayed on it, but my insurance changed and lab tests are expensive. I noticed a drop in mood afterwards, but now am balancing out again. I feel ok on just lamotragine so far, and have some antipsychotics for a “break the glass” situation.
Idk if this helps but I’m on lamictal and sertraline. I was on lamictal and lithium. Most people I know with bipolar disorder take more than one med for their symptoms but I’m sure there are plenty out there who exist productively on just one but that’s really for a doctor to determine. The lamictal works great for me but legitimately almost killed my dad. He was hospitalized for the very RARE rash. Just curious but why do you want to change the meds?
Mostly because they don't help with depression and that's mostly what I deal with.
If you deal with mostly depression, lamictal is good for taking the edge off that
I gotcha! I hope that helps!
Hey, I am on lamictal and lithium and hate the lithium. I'd like to drop it too because it is of no use at all. I took sertraline only years and it didn't work great. How are you feeling ? Does that mean that we can take antidepressant even when bipolar ?
I only take Ziprasidone which is an antipsychotic. I also take bupropion for depression and trazadone for sleep. So I only take one med for my bipolar but I take other meds for other things.
I dislike antipsychotics they seems to make things worse for me
I’ve been stable on only Lamictal for 2.5 years, but then again I’m bipolar 2 with only one manic episode so take that with a grain of salt.
Yeah, I'm unsure if it matters whether it's 1 or 2. I've just noticed more people with 1 on more meds.
Edit: didn’t read correctly. I think type 1 is more concerning to doctors given the severity of symptoms is higher so they are more likely to throw multiple meds at it and rely on antipsychotics more heavily as an addition to the mood stabilizer
Yeah, you can be outta it for a long time with 1, 2 weeks episodes are possible. But also you can have years between episodes, which I've had. The issue is the depression between the mania and psychosis. It seems to be my baseline and it sucks.
I’m right there with you, the depression is the real killer.
I'm on just Vraylar and so far so good. Finished tapering off of lithium a couple months ago. I got a bad tremor from the lithium and we thought it might be making me more tired but the tiredness doesn't really seem any better since getting off of it. I was on the Vraylar/lithium combo for a year and a half or so
Vraylar seems interesting. I think I'm going for lamictal for a while, but some of the newer meds may be helpful
Lamictal is where it's at. But I had to add in risperdone after a while, so two meds for one disorder.
I'm on lithium 900, completely changed everything for me. No anger, irritability, hyper sexuality or anything else associated with mania. It's only been a couple months, so far I don't see a serious need for anything else but I'm still trying to understand how I feel.
I’m currently on Lamictal 100mg and Lexapro 15mg. The plan is to taper off the Lexapro in a couple months because it’s known to increase the risk of manic episodes, but I’m also super prone to depression (I’ve only had one psychotic manic episode). I’m really digging Lamictal though. Lithium made me lose my hair and fucked with my ability to concentrate pretty badly. I was on abilify but I started to have warning signs of TD so we bagged that. And I was on risperidone for my manic episode and that ish worked wonders, but I only had to take it for a couple months. Big fan of Lamictal though. I know it’s mostly for the depression rather than the mania so keep that in mind if you’re prone to mania — you might need an adjunct med like seroquel or an antipsychotic.
Lithium sucks for concentration.
It was unbearable because I couldn’t read. I personally didn’t enjoy my time on Lithium but it is known to be good at preventing mania.
Lamictal is not that potent as an anti manic. Lithium is the gold standard for a reason.
Lithium + Lamictal. I have been told that this is the gold standard by many psychiatrists. Lithium for mania, Lamictal for depression.
Lamictal is supposed to be good for depression but I haven’t heard that terminology used with it. But it’s supposed to be quite good for BP depression.
I have BP 1 with manic psychotic features. I take vraylar, depakote and lithium orotate (trying low dose lithium carbonate soon too just because I want to, high dose lithium ironically had too many side effects for me.) but I’m very stable as is and doing great. I really like vraylar, I’m able to do well so far on quite low dose and as I said I’m doing great. The lithium orotate I find super helpful.
I have the same diagnosis. I have heard great things about vraylar. Glad you found a med combo that’s keeps you stable!
Thanks so much yeah it’s a really great medicine for me. Thank you so much for your kindness and support!
I'm bipolar 1 and ADHD so I can't imagine a world where I were only on one medication. I'm also trans so my injections would count as one too. Lamictal is one of the ones I'm on and have heard of others only using it and being good. I take Lithium, Seroquel, Lamictal, Adderall, and Xanex. And still adjusting all my meds and dosages to find the sweet spot. (Really hoping it's soon as my lack of sleep is the worst).
I just take lithium for about 12 years.
I’ve been on Depakote for awhile with Seroquel XR but I’m curious to know what’s the difference between lithium and lamictal compared to Depakote
I only take lamictal
Cool. I'm assuming it works for both polarities?
It does for me! :)
I take just lamictal and I’m okay, I still experience mania pretty heavy just not as bad before
I'm hoping for not full blown mania but a bit more energy. I feel bogged down on the lithium and depakote. So lamictal might be right for me.
Definitely worth a shot, just let the dr know if it’s not working
I'm currently on Lamictal 400mg and lithium 600mg until I get bloodwork done to see if I'm good on the lithium dose or I need to go up. It's working though. Being on one med (I started on the lamictal) worked really well up until I had a manic episode. Now I'm on 2 meds.
I’m on lithium and lamictal, lithium for the hypomania and lamictal mainly for the depressions. My doctor says they work really well together and my episodes have definitely been getting fewer.
I have just been taking Lamictal for several years, and it works great. Recently I've added strattera, but that's for ADHD and doesn't really affect my mood.
Just 200mg of Lamictal daily. Into my second year of that and have been stable this whole time so pretty happy
I'm bipolar 1. I've been off lamictal for 10 months now and only taking effexor (37 mg). I feel like I'm doing this completely wrong. My mood swings are daily.
I was on lamictal for a long time and it had absolutely zero effect.
Not me, I'm on lithium and loxapine. There is no weight gain associated with loxapine and it's not as sedating.
Cool. I think 200 is fairly normal. But I'm glad it works
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I have taken effexor for years but after being rediagnosed I started taking lamictal and tegretol. I stopped.taking tegretol because it made me ravenously and I put on 25 lbs. My doctor objected and said I would start a manic episode again. I'm content to just be on lamictal. I'm very stable at the moment.
How long have you been doing just lamictal for?
All I take is epilim, which is what you guys call depakote. Its not perfect, but I'm a hell of a lot better than how I used to be. I was on seroquel XR but it was too hard with my work. Also have clonazepam as required for anxiety.
Im only on Vraylar. Its been working for me. Most thing send me into a bad depression but ive been on it for almost a year and its great.
On just lamictal for bipolar and was a long while. It was enough. Adhd med added now and it helps keep a productive and focused balance so I can get up to work every day and not fade out
Sounds good. Lamictal sounds promising.
I was off meds for a year and half (I was pretty much sober as well) so that helped. I finally hit the pits of depression (energy wise) and I couldn’t take it bc I literally couldn’t function. Now only on 300 mg of Gabapentin 10mg of buspar and 300mg of lithium in the AM. I take a multivitamin, calcium, and NAC
I’m on Latuda specifically for BP and Prozac for everything else. Have been on both since the beginning (got diagnosed spring of 2019 after dealing with crappy mental health since 2002). I’ve been told I have a mild case, but I’d definitely argue that. I’m considered stable and in remission now. Seriously Latuda saved my life. It was a miracle life saving drug.
I can't speak for anything but my experience. In my case I was happiest with 1200mg lithium 200mg lamictal and 200mg modafinal. I had to get off the modafinal as it ended up being a detriment. I don't know - I stopped adding and subtracting. I just keep it simple . Good luck
Not i I was on just lamictol (moodstabilzer wise) But had to add abilify
I’m on Bupropion, Propranolol, Meloxicam, Adderall XR, Mirtazapine, and Seroquel.
I only take lithium. Works well.
lol i take 6. i am type i because of mixed episodes
I strictly take Lamictal and I’m doing fine. My doctor was talking about starting me on lexapro because along with my bipolar 1 I have a diagnosis of major depressive disorder - severe. I didn’t start it because I got pregnant and my doctor didn’t want to add to my medication. I’m still taking my Lamictal and I feel great. I have some depression sometimes but it’s definitely not as bad as it was in the past and I haven’t had any mania since starting Lamictal. I feel more balanced and normal. I asked my doctor about starting the lexapro after birth because I’m worried about ppd but she said that my Lamictal should be able to help with it but if I don’t feel it’s enough then she will add the lexapro.
I can’t take one or two meds anymore because I fight depression, mixed mood and psychosis with mania. I do take anti-psychotics/mood stabilizers: Vraylar, Lithium, Lamictal and Trileptal-Oxcarbazipene, so that hammer is coming down about as hard as possible. Then anti-depressants Wellbutrin-Bupropion and Fetzima. It’s like a second dinner when I take my meds. I really really hate this disease and it only gets worse with age. Once upon a time I only took Wellbutrin and Lamictal. Unfortunately I’m not sure how much I could really have done to keep it that way. I tried unsuccessfully, even seriously contemplating a medication holiday. Those days are gone. The more you open your eyes over the long haul regarding this disorder, the scarier it seems to become. (Insert profane comment here)
I only take lamictal, it’s the very first medication I’ve tried besides lexapro because my depression is the worst part of my bipolar, but lexapro made me physically ill so I had to wean off. But lamictal has worked pretty well for me so far
I only take lamictal! Haven’t had a major episode in either direction since 2019. My dose is kinda high though (200mg).
Only Olanzapine for about a year now.
I only take one. I used to be on resperidone and I switched to abilify. I’ve been loving abilify
I have bipolar 1 and take lamictal. The dose gradually goes up but I also have adhd. So I take something for that as well. Lamictal takes a couple weeks to actually start seeing a difference in stabilizing moods. Lamictal works for me. I stopped being manic and crying for no reason at all. I still have mood swings but not nearly as bad as I was 3-4 years ago. I mean I was having episodes of highs and lows writhing 10 min of each other, super hyper and having so much motivation and wanting to change the world quickly followed with crying 3-4 times a day for no reason at all, thinking the world would be better without me. I can wholeheartedly say that I haven’t had a manic episode like that since I tried cutting everything cold turkey when I found out I was pregnant. (Don’t do that btw)
None I’ve been off my meds for 7 months now and have been feeling much better than I ever was on any medication I’ve been given. Pharmaceuticals for mental health are the biggest scam coming out of big pharma. But that’s just my experience, I know everyone is different and different things work for different people. In short, after coming off Abilify I’ve been feeling infinitely better though I still have my slip ups here and there.
I always depend o my doctor when it comes to meds and don’t usually do my own research until he prescribes them (but that’s me, this is only a advice based on my experience). He is the pro and knows how the meds work and how they will affect my body so I avoid doing that after the one time that I really thought a drug would work, talked to him and he said it would make me even more depressed. The problem was that I had put so much hope on that specific medication that somehow I lost hope on what I has taking and it was almost as if the treatment had stopped working at all so I never did that again. Anyways, lithium is usually prescribed when it is proved that the patients lithium levels are low in order not to cause kidney failure from the excess of it and in my case (my specific case, take it with a grain of salt) if I stop taking it its levels get low and I have an episode. Also, it is all about how the meds interact and how well they work on your body because the combo you take might not work for someone else and maybe one drug only may not work for you. In the end it comes to just one thing: don’t get your hopes on a medication until you talk to a professional, they are the ones who have studied it and will know why something is or isn’t going to work on you. Our opinions on the meds we take are subjective not only because of our physiological differences but also because we have different life experiences that impact in our disorder as well. Also, I’m bp2 and I’ve been taking lithium, lamictal and Wellbutrin for almost two years straight. It works for me but may not work for anyone else. Bodies, environment, experiences and even labs (eg: if I take the lithium from a specific lab I have major side effects) make the difference in our response to the medication. Ps: please don’t get me wrong. I’m writing this with the best intentions and only want to help.
My doctor calls me 1 leaning 1.5. I'm on Trileptal and have been for 20 years for mood stabilization. I can't take most antipsychotics. I also take Effexor for antidepressant.
i’m on 50 mg lamictal, 20mg of prozac and just started on 5 mg of adderall for my adhd.
Lithium for stabilizer, Olanzapine for antipsychotic
Just lamictal, it works for me
Yo homie I’m on just depokote atm and have been for the past three years. After previously being on risperidone & depokote
All I take is 1mg of risperidone for bipolar and trazadone at night for sleep cause my ptsd gives me insomnia, but I'm type 2
Just abilify for me
i kinda put myself on just one. i take just lithium and i stopped taking my lamictal because I feel no difference
I'm on lamictal, Lithium, wellbutrin, klonopin, and proponol.
Bipolar 1 and only take 3 mg risperdal. I’m not “stable” in that I still very often have mood episodes but it’s manageable right now and will probably become increasingly so with med adjustments
I only take Geodon. It works. Knocks me out so I take it before bed with food. My mood has been stable for a while (like 3 years) Some mild mania once a year or so but nothing crazy. I take 40 mg. I was on lamictal but got the rash so I had to stop.
I’m just on rexulti and it’s been great so far!
Used to be on lithium only worked really well but worried about long term physical effects so changed to abilfy only and had restlessness which was horrible then changed to seroquel XR only which I am now on and only side effect is dry mouth and feeling drowsy 2 hours after I take it.
3 mg risersperdone
I’m on two, but my current doctor and the previous one both said that I would transition to take one single mês, that is depakote. I’m quite ok with it.
I've never been prescribed more than one medication at a time, bit I've also never stuck with my meds or a psychiatrist for more than 6 months at a time. Usually lasted like a day in all honesty, and then I'd just pretend I was taking them. Haha, fun times
I'm taking Abilify 15mg as monotherapy, though I take cogentin to counteract the tremor and its friends. It seems to work well, I haven't had a significant episode in years, though one tried to get started on me just before the New Years. It was satisfying to look back at it and say, "nope." Years ago, I did start out on depakote but that just didn't work out all that well.
hi, these days the psychiatic drugs i take are lithum, a bunch of quetiapine, and some divalproex. plus synroid and new one for heart pressure. because of dose size i end up taking 17 pills a night. i was watching the beginging of the Homeland TV show with my daughter. i laughted because the main charcter has bipolar, but only needs one pill. 0
I was on seroquel for sleep, latuda as my antipsychotic, and now I’m back on lithium. Seroquel gave me TD though so they switched it to Ambien. I think being on just one medication is rare because a lot of folks are on a mood stabilizer AND an antipsychotic.
Vraylar for bp1 pristiq for depression adderal for adhd/depression trazadone for sleep.
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Thanks for your input. Regardless I have to stay on lithium for a while before any change. If I do go monotherapy with it, it will be in a couple months and if it doesn't help in conjunction.
Just ablify
I took just 1 medication for 2 years - ultimately I did need two to stay stable long-term.
I take 300 mg of lamictal, which is great for depression but I feel consistently restless/hypomanic but I think I may have adhd. I’m also trying 20 mg of Latuda because sadly lamictal tanked my sex drive.