# lamotrigine and dopamine



## InterestinglyInteresting (May 7, 2010)

so i am starting lamotrigine. some anecdotal reports claim it is dopaminergic or somehow stimulating. how can this be since its supposed to reduce glutamate? 



also i hope it doesnt block my ability to feel love like ssris have.


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## metamorphosis (Dec 18, 2008)

I haven't heard any effects on DA but it does seem to reduce the release of glutamate. It is a voltage sensitive sodium channels. Like others, which have the same mechanisms of action, VSCC (gabapentin, pregabalin,) is not completely understood.

Do you have any links on it's effects on DA, as I am curious about that?


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## InterestinglyInteresting (May 7, 2010)

yeah.....after....a....while....it...should...work....only...on....25mgs.....note....for...some...reason....my...spacebar...isnt...working....anyway....in..clinical...studies....lamotrogine....has...been...shown...to...produce...anxiolytic...effects...and...even....augments...ocd...ssri...treatment


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## A Sense of Purpose (May 8, 2011)

InterestinglyInteresting said:


> yeah.....after....a....while....it...should...work....only...on....25mgs.....note....for...some...reason....my...spacebar...isnt...working....anyway....in..clinical...studies....lamotrogine....has...been...shown...to...produce...anxiolytic...effects...and...even....augments...ocd...ssri...treatment


haha sucks but kind of funny.

I must admit it did draw my attention to your post. effective!


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## crayzyMed (Nov 2, 2006)

InterestinglyInteresting said:


> yeah.....after....a....while....it...should...work....only...on....25mgs.....note....for...some...reason....my...spacebar...isnt...working....anyway....in..clinical...studies....lamotrogine....has...been...shown...to...produce...anxiolytic...effects...and...even....augments...ocd...ssri...treatment


hahahahaha


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## InterestinglyInteresting (May 7, 2010)

so far 25 mg produces no effect. cant wait to titrate up


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## metamorphosis (Dec 18, 2008)

Lamotrigine is voltage sodium channel blocker. Which can stop the release of neurotransmitters by blocking the axons and synaptic channels in the neuron. It seems to selectively release the firing of neurotransmitters in certain neurons.

http://www.netdoctor.co.uk/medicines/100001450.html

http://www.ncbi.nlm.nih.gov/pubmed/...el.Pubmed_RVDocSumhttp://youtu.be/CAztmGupuL0


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## InterestinglyInteresting (May 7, 2010)

quick update. no problems so far cant wait to titrate up. BUT there is one concern. lamotrigine binds to melanin which binds to your eyes. I am afraid this will suck the juice out of my eyeballs!!!! Wtf is going to happen to me eyes in the longterm by having ltg floating around my retina. this is creepy. that means i wander if an eye doctor can see the lamotrigine in my retina. wtf


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## A Sense of Purpose (May 8, 2011)

a question for medline


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## michael10364 (Feb 4, 2011)

InterestinglyInteresting said:


> quick update. no problems so far cant wait to titrate up. BUT there is one concern. lamotrigine binds to melanin which binds to your eyes. I am afraid this will suck the juice out of my eyeballs!!!! Wtf is going to happen to me eyes in the longterm by having ltg floating around my retina. this is creepy. that means i wander if an eye doctor can see the lamotrigine in my retina. wtf


so how did Lamictal end up working for you?


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## FormerOptimist (Feb 15, 2013)

lamotrigine SUCKS. I'm on day 6 and am having severe panic attacks in my home now where I used to only have them when away from home. My heart pounds and thoughts race. I've been diagnosed with endogenous depression and anxiety disorders (paranoid, generalized, social). If this med works (I don't see how!), then he said I will be given a bipolar II diagnosis. ?????


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## jimmythekid (Apr 26, 2010)

It made my anxiety (and insomnia) a lot worse while I was titrating up. That seems to be common. Most people find it to be quite different at the full dose (around 200mg). I'd give it some more time and not judge it too quickly.


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## swim (Apr 4, 2011)

does it counteract ssri induced weight gain?


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## loophole (Apr 15, 2012)

FormerOptimist said:


> lamotrigine SUCKS. I'm on day 6 and am having severe panic attacks in my home now where I used to only have them when away from home. My heart pounds and thoughts race. I've been diagnosed with endogenous depression and anxiety disorders (paranoid, generalized, social). If this med works (I don't see how!), then he said I will be given a bipolar II diagnosis. ?????


people with bipolar it is said to be the wonder drug..(myself included) the highs aren't as high and the lows aren't as low... so to me (i'm no dr.) i would rule out bp....(no dr..) have u tried prozac.... if it does the opposite it should do (make u crazy nuts and manic) then may talk to dr. (pcych) about possibility of bp)


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## metamorphosis (Dec 18, 2008)

swim said:


> does it counteract ssri induced weight gain?


No


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## FormerOptimist (Feb 15, 2013)

loophole said:


> people with bipolar it is said to be the wonder drug..(myself included) the highs aren't as high and the lows aren't as low... so to me (i'm no dr.) i would rule out bp....(no dr..) have u tried prozac.... if it does the opposite it should do (make u crazy nuts and manic) then may talk to dr. (pcych) about possibility of bp)


Thanks for the input. I'm still in the initial 2 weeks (day 7) of the 25mg lamotrigine. I'm trying really hard to stick to it because I realize the effects change as the dosage goes up. However, this morning, my eyes couldn't focus for a few hours.....they felt like they were darting back and forth in my head. Sounds ridiculous, but I don't know any other way to describe it.

I'm alternating from sweating to chills. My heart rate increases to 144 beats per minute just sitting on the sofa. Can't sleep more than 2 hours at a time (about 4 hours in a 24-hour period). Started cramping on day 4. My eyes look puffy and watery. My nose is stopped up but not running. I get short of breath quite often from doing nothing. Still having frequent panic attacks, but they're only lasting 2 minutes now instead of hours at a time. I've never been so miserable.

I've also lost my short term memory and can no longer feel hunger or fullness. Yesterday, I heated up a chicken pot pie for lunch. An hour later, I had instant grits thinking I hadn't eaten anything. Then an hour after that, I bought food at Taco Bell thinking I hadn't eaten all day, only to find the pot pie box and grits wrapper in the garbage when I threw away the Taco Bell wrapper. This is NOT my typical behavior. I have noticed I do not feel full after I eat a large quantity of food.

I did try prozac -- it made me VERY weepy and emotional, as did Zoloft. My emotions are naturally numb, although I do feel panic attacks and deep despair at times. I haven't been able to drink alcohol since I was 20 (20 years ago now), but I stayed drunk as a teenager because that was the only way I could function socially (and being a teen is all about being social). My dad drink heavily everyday beginning at 5:30pm and has his entire life.

My mother is 64 years old and has never taken any prescription meds. Her mother (my grandmother) always had severe reactions to meds, from hives to seizures. Both have had extreme anxiety all of their lives, although not depression (depression runs on my dad's side). Saying all that to say.......It's possible I will never benefit from meds (been at it for 20 years now), and that's very depressing.


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## FormerOptimist (Feb 15, 2013)

jimmythekid said:


> It made my anxiety (and insomnia) a lot worse while I was titrating up. That seems to be common. Most people find it to be quite different at the full dose (around 200mg). I'd give it some more time and not judge it too quickly.


Thanks, I'm really trying. My pdoc explained that benzos will make it worse for me in the long run, so it seems there is nothing out there to relieve me of the panic attacks and extreme anxiety.

I also have deep depression which I guess is why the pdoc is trying to tag me with a bipolar II diagnosis. I am not manic by no means, but some days the anxiety is so severe that it causes me to pace, panic, and have racing thoughts which overrides the depressive numbness. I tend to enroll in classes or do a lot of housework when I'm extremely anxious. I guess how my 2 conditions interact with one another is a basis for a severe mood disorder, and I guess they have come up with bipolar II as a way to explain mood fluctuations that occur without all-out crazy mania episodes.

I'm numb due to multiple traumas in my life (I grew up and go through life not caring as a way to stay sane), but I don't have recurrent nightmares, so I don't fit the PTSD diagnosis. Doctors hate to see me coming because I'm difficult to treat.


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## jimmythekid (Apr 26, 2010)

It really sounds to me that you are experiencing severe side effects. I think you should call your doc and let him know what's happening. At the least, a medication for the anxiety and insomnia while you're getting used to lamictal might be warranted. Putting up with mild side effects when you start a med is par for the course but if you shouldn't have to be so miserable for weeks on end.


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## bazinga (Jun 9, 2010)

Benzos are great for anxiety/panic disorders. Moderation is key. Lamotrigine works well for mood disorders. Sorry you are having a bad experience. I've had a very good experience with lamotrigine without any side effects.

I think your doctor should try benzos for your anxiety/panic. No need to suffer.


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## FormerOptimist (Feb 15, 2013)

jimmythekid said:


> It really sounds to me that you are experiencing severe side effects. I think you should call your doc and let him know what's happening. At the least, a medication for the anxiety and insomnia while you're getting used to lamictal might be warranted. Putting up with mild side effects when you start a med is par for the course but if you shouldn't have to be so miserable for weeks on end.


I called pdoc for a third time in 2 days, and they picked up the phone immediately this time instead of making me leave a message again. They okayed an OTC sleep aid that works for me -- Equate Nighttime Sleep Aid (25mg x2 of diphenhydramine). And gave me 25mg of generic Vistaril as needed up to 2x a day.

I've never had trouble falling asleep and staying asleep for 4-7 hours, but I can't stay asleep longer than 2 hours now. I'm hoping the sleep aid helps that.

I took the Vistaril earlier. I did not experience any drowsiness at all which surprised me since most antihistimines knock me out cold. The chest tightening and rapid heartbeat went away completely for a couple of hours, so did the eye-jerking (not being able to focus on words on a page). The eye jerking is still gone, but the chest tightening and rapid heart rate is back. It also took the med an hour to work. Basically, I'll get 2 hours of relief from 1 dose. That's better than nothing, I suppose.

Doc assured me that the lamotrigine was not causing any of my intolerable side effects. Not sure I agree with him, but as long as what he tells me to do won't kill me, I'll stick with the regimine he gives me.

I heard that larger doses of the lamotrigine starts to bring people positive results, so I'm really trying to stick it out.....I'm less than 2 weeks in right now.


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## FormerOptimist (Feb 15, 2013)

bazinga said:


> Benzos are great for anxiety/panic disorders. Moderation is key. Lamotrigine works well for mood disorders. Sorry you are having a bad experience. I've had a very good experience with lamotrigine without any side effects.
> 
> I think your doctor should try benzos for your anxiety/panic. No need to suffer.


I'm glad benzos are working for you -- a few people can manage their use very well, but I'm not sure I would be one of them. My pdoc has seen patients with horrible permanent disabilities from relying on benzos to treat long-term conditions. I've had panic attacks since I was a small child, so I'm sure they aren't just going to disappear one day. I am sure benzos work VERY well, which is why I'm even more afraid of them -- I would definitely develop a tolerance and damage my cognition permanently because I would need them for the rest of my life. If something knocked out my anxiety completely, I would probably abuse the heck out of it. I'm fortunate that I've never tried benzos......can't miss what you've never had. 

Thanks for sharing your positive experience with the lamotrigine. If it weren't for reading such good reviews, I would have panicked and dropped the med by now.


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## Mr Bacon (Mar 10, 2012)

I tried lamotrigine up to 100mg/day. Each dose made me more drowsy and sleepy. Since I'm already apathetic in my normal state, I just stopped using it.

Other people, especially those with bipolar report somewhat of an energy rise.


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## jim_morrison (Aug 17, 2008)

I think it theoretically could due to slowing down the binding of glutamate with metabotropic glutamate receptors, several of which usually work to inhibit the release of dopamine.



> Receptor subtype nonselective metabotropic glutamate receptor (mGluR) agonists have been shown to regulate the release of dopamine. The eight mGluR subtypes have been pharmacologically categorized into three groups, and the present study used in vivo microdialysis to examine the capacity of mGluR subgroup-selective drugs to modulate the extracellular levels of dopamine in the nucleus accumbens. By administering the drugs in the dialysis buffer, it was found that the group 3 mGluR agonist L-amino-4-phosphonobutyrate produced a dose-dependent reduction in extracellular dopamine, whereas the group 1 agonist 3,5-dihydroxyphenylglycine was ineffective. The group 2 agonist (2S,1'R,2'R,3'R)-2-(2, 3-dicarboxycyclopropyl)glycine produced a reduction that was biphasic with respect to dose. The group 2/3 antagonist alpha-methyl-4-phosphnophenylglycine elicited a dose-dependent increase in extracellular dopamine that was antagonized by coperfusion with either the L-type calcium channel blocker diltiazem or the group 3 agonist L-amino-4-phosphonobutyrate. *These data demonstrate that group 3 and to a lesser extent group 2 mGluR may presynaptically regulate dopamine release or reuptake. Moreover, there exists significant in vivo glutamatergic tone on group 2/3 mGluRs to suppress extracellular dopamine levels.*


The regulation of dopamine transmission by metabotropic glutamate receptors.


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