Lamictal (Lamotrigine): A Review. Part II

I haven’t gained any weight from being on Lamictal, it’s a weight neutral mood stabilizer. My psychiatrist has also informed me that it is the only medication I should be on (other than sleep meds), as it targets both mania/hypomania and depression, he also asserts that Bipolar Disorder sufferers shouldn’t also be put on anti-depressants combined with mood-stabilizers. He offered me the quick fix of Lithium when I was on a downward slope, telling me I’d be a ‘new woman’ within a week. I know Lithium is the top-shelf mood-stabilizer, but I’m also shallow and self-conscious enough that I don’t want to get fat. Lithium for me also has negative associations, I use to think of it only being prescribed to those ‘hardcore’ cases, but then again maybe I am a ‘hardcore’ case. Maybe I’m not bipolar, think I might argue with my psychologist on Thursday.

They have increased my dose on Lamictal, it wasn’t doing enough at the time, especially in contrast to Epilim which fixed me quick, but made me gain weight through excessive carb cravings. Overall I think this is a good medication once you get to the right dosage, I think they will slowly titrate my dose up until I have no lows or extreme highs. If you are self-conscious of weight-gain from bipolar medication: THIS is the drug for you, but be aware that you have to increase your dose slowly, so the effects aren’t instantly noticeable. Now I should just focus on losing the weight the other drugs made me gain…not fun.

I have a great appreciation for the ‘crazy meds’ site, giving funny yet knowledgeable and relatable twists on medication. I’ve been diagnosed as Bipolar 2, yet my reaction was more like Bipolar 1. As follows:

4.2  Bipolar 2

Generally considered to be the best drug on the market for bipolar 2. While there are always conflicting data, your mileage may vary, yadda yadda yadda, with its track record for efficacy and other factors, Lamictal should be the first med considered, but not necessarily the first med used, by many, if not most people diagnosed with bipolar 2.

4.3  Bipolar 1

If you take it like the FDA tells you to – after being stable on another med – the chances are pretty good you’ll stay stable. If you start it while manic1 or only mild-to-moderately depressed and aren’t taking, let alone stable, on another med, expect to be bouncing off the ceiling and have your cycling sped up.

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My reaction was exactly like Bipolar 1’s statement, I was taken too quickly off Epilim which was replaced by Lamictal, I guess I migh’t have been completely stable when I made the transition between the two. I was lowering my dose of Epilim and replacing it with Lamictal. I don’t know what happened really, it felt like a low-level hypomania, but with the increased dose I’m starting to feel less agitated, although i sleep extremely poorly and often have night terrors when I do sleep.

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Lamictal’s Pros and Cons

7.1  Pros

The best medication on the market to deal with bipolar depression without the risks of mania or lowering the seizure threshold associated with antidepressants. Weight neutral. One of the safest meds to use during pregnancy. The side effects suck less than the other meds with FDA approval for maintenance treatment of bipolar disorder.

7.2  Cons

That “without the risk of mania” is only after you’re taking enough. You might get a little too happy the first couple of weeks. Easily affected by drug-drug interactions, in spite of being metabolized in such a way that only a few meds should affect it. Can mess with your skin in all sorts of ways that could cause you to panic and stop taking it when you don’t have to.

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18 thoughts on “Lamictal (Lamotrigine): A Review. Part II”

  1. Hmmm that’s interesting that your psychiatrist says to not combine anti-depressants with mood-stabilizers. After three years, I convinced my doctor to prescribe me Prozac to go with the Lamictal. She didn’t seem concerned about the combination, she just didn’t want to risk me getting manic while away at school. Since I’m out of school now, she’s letting me take it. I felt unhappy on Lamictal…a bit TOO stable. I wasn’t able to get into my normal creative zone, so my way of thinking creatively drastically changed.

    I’m a little fuzzy on the different effects of Lamictal and Lithium…does Lamictal focus more on calming mania, and Lithium more on lifting depression?

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    1. I’m not sure if Australian psychiatrists feel differently about antidepressants, lamictal is meant to stablise me in both depression and mania, I think lithium is the same, having other addictives just don’t work as well (apparently), I didn’t want lithium because you have to stay on it for a long duration.I feel the same about the creativity part, I’m very mellow, feels like I have less substance, no fuzziness (Epillim was so bad for that), I’m only on 150mg of lamictal and currently 500mg of Epilim to try and stabilise me more. Do you feel better on prozac? Wouldn’t mind looking into things that will boost me.

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      1. I definitely feel better on prozac. I still slip into depression spells but in general I am more socially confident and more energetic. Prozac has pretty detrimental side effects though. =/

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  2. I love crazymeds too 🙂 Takes the edge off making decisions about potentially terrifying medications.

    I’m in Australia and I was prescribed Lamictal as an adjunct to Prozac which was making me very wired and aggressive. The Prozac has since pooped out and now I’m about to start Zoloft. I sink into depression/anxiety too easily without an anti-depressant, but without a mood stabiliser I become elevated and angry.

    I have a friend who has been solely on it for about two years and her bipolar is really under control and has been able to do so many things she was never functional enough to do before. YMMV, but I don’t think I could *just* be on Lamictal.

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    1. Thankyou for your response! I’m in Australia as well, starting to think that a lot of psychiatrists are prescribing lamictal. Would you recommend Prozac? I’ve been doing quite well of Lamictal, but recently was re-prescribed Epilim to help Lamictal (haha I’m hoping that being on two mood stabilisers will make me extra ‘stable’). It is good to know that people can get by on just the one medication. Crazymeds is potentially the best(and funniest) site I’ve come across.

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      1. Lamictal is my ~wonder drug~.

        I was initially on Lexapro, which was awful. Prozac certainly worked better by comparison.
        I did find that it could make me quite agitated and aggressive though, so I wasn’t able to go that high with my doses. It also helped my anxiety for a time, but again, at higher doses made things a whole lot worse. Which all makes sense when you give someone with mood instability an anti-depressant…

        Most of my family who have clinical depression are on it and it seems to work better for them than other drugs. It’s just stopped working for me after 9 months though, which seems to happen with me and SSRIs.

        I don’t like to ‘recommend’ drugs, but it’s worth a try… Definitely start small and slow 🙂

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  3. My GP has recommended Lamictal for me as well. Ive been on Epilim over 10 years, with Lithium thrown in during mania.
    Luckily for me I’m quite tall, so weight gain isnt an issue, but still a grest insight into the drug. Thank you 🙂

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      1. I’m glad you’re losing it if it helps you to feel happier. Lithium gave me some side effects, mainly vertigo and dizzy spells, so I’m not overly keen on it. It works well though 🙂

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      2. That’s ridiculous, guess you’re just lucky. I’m not even chubs, I’m a health fanatic who doesn’t like craving carbs at odd hours..damn Epilim. I hate all the combinations of drugs doctors try and give you, it honestly gets to the point when you think how many pills can you swallow at once… takes up half my morning 😉

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      3. Sorry, didn’t mean to insinuate you are! The combination of epilim and zyprexa for me has been pretty effective or years, so I’m lucky there too. But I do remember those years of it always changing, no fun at all :/

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