# Lamotrigine is Working



## InterestinglyInteresting (May 7, 2010)

My Pdoc is having me take 50 mg of lamotrigine for panic disorder. Although its a relatively baby dose compared to the usual 200-400 mg range in the treatment of bipolar disorder and seizures, it seems to have a very pronounced anti-anxiety effect. I'm no longer taking xanax. I have my doubts that this is a placebo effect because its so consistent.



Your thoughts?


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## barry1685 (May 25, 2011)

InterestinglyInteresting said:


> My Pdoc is having me take 50 mg of lamotrigine for panic disorder. Although its a relatively baby dose compared to the usual 200-400 mg range in the treatment of bipolar disorder and seizures, it seems to have a very pronounced anti-anxiety effect. I'm no longer taking xanax. I have my doubts that this is a placebo effect because its so consistent.
> 
> Your thoughts?


Does it just help with the panic? or does it help with the negative thoughts and physical effects of anxiety.


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## InterestinglyInteresting (May 7, 2010)

barry1685 said:


> Does it just help with the panic? or does it help with the negative thoughts and physical effects of anxiety.


it seems to slow my mind down. no anxiety so no physical anxiety as a result.


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## barry1685 (May 25, 2011)

InterestinglyInteresting said:


> it seems to slow my mind down. no anxiety so no physical anxiety as a result.


How long have you been on it?


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## will22 (Mar 28, 2011)

I honestly couldn't tell the effect of the drug. A lot of psychs in my area are big on anticonvulsants and "mood stabilizers", and I'm near a lot of top psych schools. It seems to be a recent trend to offer bipolar drugs for depression even early on in treatment.

I've always been a little afraid of "mood stabilizers", being potential "mood squishers" (think SSRIs). If something keeps something from being hypomanic, does that also limit the amount of pleasure one can feel?, I'm quite sick of anti-depressants also creating anhedonia.


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## InterestinglyInteresting (May 7, 2010)

will22 said:


> I honestly couldn't tell the effect of the drug. A lot of psychs in my area are big on anticonvulsants and "mood stabilizers", and I'm near a lot of top psych schools. It seems to be a recent trend to offer bipolar drugs for depression even early on in treatment.
> 
> I've always been a little afraid of "mood stabilizers", being potential "mood squishers" (think SSRIs). If something keeps something from being hypomanic, does that also limit the amount of pleasure one can feel?, I'm quite sick of anti-depressants also creating anhedonia.


First to answer Barry's question, its been about 4 weeks.

Next to answer your question, lamictal isn't exactly a strong anti-manic agent and can actually make some people hypomanic before they reach a more sufficient mood stabilizing dosage like 200 mg. I would think, but don't know for sure, that anhedonia would be less likely to result from a low dose mood stabilizer because they tend to prevent abnormal excitement as opposed to mild excitement. Also anything that decreases glutamate means its going to decrease activity at the NMDA receptor and that tends to be good for depression.

All in all, it would appear that ssris suppress dopamine more so than a sodium channel blocker like these types of meds. Also, they're subtle medications, if you go low and slow, the goal isnt to be hit with a wave of sedation.


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## barry1685 (May 25, 2011)

InterestinglyInteresting said:


> First to answer Barry's question, its been about 4 weeks.
> 
> Next to answer your question, lamictal isn't exactly a strong anti-manic agent and can actually make some people hypomanic before they reach a more sufficient mood stabilizing dosage like 200 mg. I would think, but don't know for sure, that anhedonia would be less likely to result from a low dose mood stabilizer because they tend to prevent abnormal excitement as opposed to mild excitement. Also anything that decreases glutamate means its going to decrease activity at the NMDA receptor and that tends to be good for depression.
> 
> All in all, it would appear that ssris suppress dopamine more so than a sodium channel blocker like these types of meds. Also, they're subtle medications, if you go low and slow, the goal isnt to be hit with a wave of sedation.


Gotcha,

Still don't know how it works for anxiety. I also saw how this med can cause SJS, kinda scary.


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## areq1987 (Jul 10, 2010)

I've taken lamotrigine for 3 and a half weeks and I have no visibile changes in my psyche.


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## InterestinglyInteresting (May 7, 2010)

areq1987 said:


> I've taken lamotrigine for 3 and a half weeks and I have no visibile changes in my psyche.


perhaps you need a higher dosage? it stopped my panic at 50 mg but you acan go all the way up to 400 mg


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## Bon (Dec 24, 2005)

I love lamotrigine, I've been on the drug for about 1.5 years, I no longer use klonopin, well, I rarely need it, it's allowed me to live a "Normal life" I dont' fear people as much, I don't blush. It's allowed me to slow my thoughts down. It has not stopped me from feeling, not at all. I no longer have wet palms, in fact I need hand lotion now, anyone that suffers from the wet palm syndrome knows exactly what I mean;-))
When the drug was recommended to me, I was at my very worst, to the point of being suicidal (I dont' know if were not allowed to use that word...if not I apologize), for me this drug as been a God send, it may not work for you, but again, for me, I've tried every legal drug under the sun, nothing has worked like lamotrigine has.

If it's recommended that you try it, you have nothing to lose......not a thing but everything to gain.


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## metamorphosis (Dec 18, 2008)

I'm sure your pdoc started you on a low dose and will titrate you up slowly. It's basically protocol to lessen the chance of the rash-Stevens Johnson syndrome. It can cause other harmless rashes/breakouts on other parts of the body. For myself I had a breakout on my back. But these usually go away. The Stevens syndrome usually starts as a breakout around the mouth and the effects quickly spread. Usually within 12 hrs the tongue has swollen and there is difficulty breathing. Thats when you call the E.R. The chances of getting the rash is rare. Especially, if you slowly titrate up.
Lamotrigine is considered a mood stabilizer. which is basically a throw off term. But the medication is extremely effective. I have been on 200 mgs for 3 yrs and there have been rare times I have run out. I suffered some rebound effects. I experienced anhedonia, irritability, and a hypomanic state. I take lamotrigine to balance my escitalopram (lexapro).

It works as a voltage sodium channel blocker. Theres alot still to be learned about this med. But it appears to reduce glutamate. It is usually very effective in combating depression and in bi-polar patients. Which is basically all of us. Yeah I have bi-polar 11. It's a very over diagnosed disorder. That is due to how many different fluctuations in emotions they take into account. Everyone has some ups and downs but now there are "specialists" just in this field of psychiatry. They basically will label anyone bi-polar as soon as they step in the door.

Sorry, done with the rant. Heres a link explaining lamictal again it seems to work as a selective sodium channel blocker. stabilizing the release of glutamate and aspartate. Heres 2 links that will give more information than you want. They do look at meta-analysis results.

http://www.psycheducation.org/depression/meds/lamotrigine.htm
http://www.psycheducation.org/depression/meds/lamotrigine.htm


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## bluenotebooks (May 25, 2009)

I got up to 200 mg on lamotrigine. I think I noticed a slight reduction in anxiety but I encountered too many nausea problems to stay on it. I'm glad it's working well for you.


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## Bon (Dec 24, 2005)

I didn't see a rant met. You are correct, I was started on a low dosage.......Then seeing my doctor every three days.....Which I thought was over kill. Albeit he was doing his job.

The drug started working on me quickly, I was so afraid I would develop the dreaded side effects because I finally found something that works for me. Then my doctor was so concerned it made me overly.....

The reducation of Glutamic is very interesting, I'll have to read up on this.

I'm glad to read after 3 years the drug is still working for you. One of my fears is it will poop out like some AD have done for me in the past.

Very informative post.


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