Lamictal and Acute Depression
ฝัง
- เผยแพร่เมื่อ 26 ก.ย. 2024
- Dr. Pagnani of Rittenhouse Psychiatric Associates discusses lamictal (lamotrigine) and its use in acute bipolar depressions. While this medication can be very effective at preventing bipolar depressive episodes, it can take several months for a patient to achieve an effective dose (due to its risk of Stephen's Johnson Syndrome, a very serious rash) and individuals in an acute depression may benefit from stabilization with another medication, while this is being titrated safely.
Dr. Pagnani is the founder and medical director of Rittenhouse Psychiatric Associates, an Instructor at The Johns Hopkins Hospital for the Department of Psychiatry, he supervises psychiatric residents at Jefferson Hospital, he serves on the Young Professional Board of Uplift, the Center for Grieving Children and he maintains a private practice of Psychiatry in Philadelphia where he sees patients for one-time psychiatric evaluations and second opinions. He is a licensed physician and surgeon in NJ, PA, NY, MD, DE, FL and CA and can provide consultations to individuals via HIPAA compliant Telehealth visits living in these locations.
Rittenhouse Psychiatric Associates is a private practice of psychiatry consisting of about 25 psychiatrists, psychiatric nurse practitioners and psychotherapists with physical locations in Philadelphia and Paoli, PA and serving all of PA, NJ, NY and FL virtually via HIPAA compliant tele-psychiatry. Individuals seeking not only evaluations but long-term psychiatric care, can contact Rittenhouse Psychiatric Associates directly.
These videos aim to increase awareness and discussion of mental health topics and to encourage struggling individuals to schedule an appointment directly with a mental health provider. Mental health needs to be normalized, and simply speaking about mental health topics openly, is an important first step.
Dr. Pagnani and Rittenhouse Psychiatric Associates are NOT advocating for or against the use of any mentioned psychiatric medications for any specific individual. Additionally, any side effects mentioned are not a complete list of potential side effects or contraindications to taking any mentioned medications, and all risks and benefits of a medication should be discussed with an individual’s provider at an appointment, before starting, stopping or making changes to a medication regimen.
This video is INFORMATIVE ONLY - NOT MEDICAL ADVICE.
If you are researching a specific topic, please view our TH-cam channel, click all videos and use the search function. Please also visit and follow us on instagram and FB: @RittenhousePsych.
www.RittenhousePA.com
www.ChrisPagnaniMD.com
I actually felt better pretty quickly on Lamotrigine. It was not consistent for a few months, but the bouts of being ok after dose changes made me love it really fast.
extremely informative as far as starting it in the background of another faster medication
Thank you for your comment! Best, - Dr. Pagnani
Ive giving this because i havent responded well to antidepressants and antipsychotics but im not even bipolar ...i hope this work. Im at my wits ends with this depression!
Me too. This is the last thing I'm going to try.
Have it worked for you?
Thank you for sharing and your comment. I also hope that it is helpful for you, and that your symptoms resolve. While trials can be very frustrating, it often takes several to find the correct medications, or combination of medications. Stay strong. Sincerely, - Dr. Pagnani
@@cadaankudhiiglehnot for me. Been 3 weeks. Nothing has worked for me. Tried maybe 15 meds.
@@pbufhhey, did you end up finding relief?
Yoga and breathwork and other such things activate balance the body and nervous system and are what will help this person now. Maybe prescribe the drugs but don’t forget the things that naturally and powerful do what these drugs are trying to mimic.
I'm getting ready to start this I hope it works
Thank you for sharing. You likely have already started, or completed a trial. Please feel free to update the thread on effect and/or side effects. I hope that you are well, Sincerely, - Dr. Pagnani
But what happens after prolonged use of lamictal? And what happens when you try to get off of it?
I have been prescribed this today, I really hope it helps me, I am so tired of these ups and downs, and more of the downs, its exhausting. What i dont understand though is how an anti epilepsy drug will help my depression and mood swings?
I’m on day 2. Hope you see my improvement with it. Many mood stabilizers also are epileptic drugs. He explains how other ones work specifically in other videos. I really appreciated his Depakote one. (Currently leavening that beauty).
How are you guys finding it?
I’m at 50 mg now and do think it’s improving for me. I still had to add another med (Vraylar) to help me out of my mixed state. I did figure out I need to take Lamactil in the morning vs night. At night it made me restless in general.
Hope it helps you!
@@holly1761 thanks for the reply! Hope it continues to help
U čemu je problem depresivni osoba? Ne mogu se pomiriti sa stvarnošću.. Ili su izgubili neku dragu osobu pa ne mogu preboleti ili su imali stresa život. Njima bi bolje pomoglo promeniti dotadašnji način života nego gutati lekove. Šta vredi lečiti osobu ako ne možeš izlečiti društvo koje je kvarno?
Doctor paroxetine 20mg morning lamictal 50mg evening morning trazodone 50 night combination can use reply Doctor
Thank you for a very good and clear review! I have two follow-up questions regarding the use of lamictal in patients with bipolar disorder:
(1) Can Lamictal be combined with lithium? If so, in what cases and for which patients would this be beneficial?
(2) Given that a patient with bipolar type 2 is already taking lamictal and has serum levels within the “therapeutic window” (approximately 14 µmol/L), how could one treat a depression relapse? Can one expect remission just by increasing the lamictal dose or should one consider adding, for example, an antidepressant?
does Lamictal effective for MDD
Yes, in my experience it was better than normal SSRI antidepressants.
Thank you for your question. Lamictal is not FDA approved for Major Depressive Disorder. Typically most mental health providers will trial SSRIs, SNRIs or other medications for depression first. However, for some, it can be very helpful, and if someone's failed multiple trials with the previously mentioned types of medications, it is often an appropriate next step. Of note, lamictal often works very well for bipolar depression (which responds differently to medications than MDD). I hope that this is helpful, - Dr. Pagnani
Does the longer you take it the harder it would be to live without it?
Yes. I had a very bad experience on it. Your mind feels like you’re 95 years old. Verbal fluency dropped, forgot things, tip of the tongue word issues, and after 5 years of use i feel my cognitive abilities have diminished severely.
Lowering the dose is awful too, i was in constant fear of heart attacks. Blood pressure through the roof, heart palpitations. I still feel something damaged in my heart now.
Thank you for the educational materials in your video!
Lithium good for major depression in bipolar? Thank you for the video!
I consider Lithium to be a very effective medication for augmentation (adding to a primary anti-depressant) in major depressive disorder AND a very effective medication for mon-therapy for bipolar depression. If it is tolerated, and if my evaluation does not indicate any contraindications for using this medication, it is a good option for many patients. I would recommend discussing directly with your provider, to make sure that the diagnosis is correct, to make sure there are no contraindications, and to discuss side effects to monitor. For many, it is very well tolerated, but patients do need to be monitored by a professional if they take it.Thank you for watching! - Dr. Pagnani
While I could never know what would be the best option for someone who I haven't evaluated, lithium can be extremely helpful for many individuals suffering from both Major Depressive Disorder (as an augmenting medication) and Bipolar Depression.
Thank you, Doctor
I will start now to added with prozac and quetiapine..has it effect on ptsd too? My psyhiatric add it because of ticks, and some other nevrological issue😊
I only took lamictal for 4 months 100mg (I’m 100lb female) but the dry mouth dry eyes and vaginal dryness is unbearable. Tapered off. Have you heard of patients dry side effects going away? 😞
I'm sorry to hear about your experience with this medication, but I appreciate you sharing. The side effects that you describe should resolve shortly (likely within 4 weeks) of stopping the lamictal. If these issues persist, then there may be something else (besides having taken lamictal) that is making you vulnerable to these issues. If that happens, it's very important to speak to your physician. - Dr. Pagnani
What was the effective dose?
Effective doses for bipolar depression tend to be 100 to 200 mg daily. This medication must be slowly titrated to an effective dose, per someone's medical provider, as increasing to quickly can increase risk of a serious reaction.
My effective dose was only 50mg. I am a smaller woman, though, maybe why.
Hi, my name's Alex I have Bipolar 1 and I take lithium and loxapine. Would you be willing to do a video on first generation antipsychotics? There is very little information on TH-cam about loxapine or FGA's.
Yes. I will add this to the list, and thank you for your suggestion! - Dr. Pagnani
Is Lamictal able to lessen anxiety as well as bipolar depression. Thank you
Lamictal is not FDA approved for anxiety. It can help many individuals with bipolar depression however, and if anxiety is a symptom of someone's depression, then it may indeed decrease their anxiety levels. This can get complicated, and is why having a full evaluation and then discussing this with your provider is so important. Best, - Dr. Pagnani
Anxiety is one of the side effects of lamictal.
Like for many other medication😊@@kmkeenan
I want to try it but I have Chronic idiopathic urticaria. It's has simmered down lately but if Lamictol can cause skin rash I'm not sure I'm a canadate for it .
Thank you for watching, and you raise a very good point. In general, providers may avoid lamotrigine for patients who have certain skin conditions, as one may assume a rash from lamictal is from the underlying condition, resulting in a patient not stopping lamictal quickly enough, if they develop Stephens Johnson Syndrome or TEN. However, as always, there's no one-size fits all, and patients should have a direct discussion about their specific case, with their provider, to discuss appropriateness. Thank you again. - Dr. Pagnani
@@RittenhousePsych Thank you for your response Dr. What you said makes perfect sense. I also have an autoimmune condition including Autoimmune Thyroiditis (Hashimotos). I will check with my new Dr before trying it of course. Again thank you for your very informative video. 👍
Can't believe they would ever try puting a patient on it in that condition.@@RittenhousePsych
225 venlafaxine, 200 lamictal 👍🏻
They dont work..
I have treatment resistant unipolar depression. Could lamictal be added on to an ssri . Any luck with that?
yes i take prozak and lamictal aswell. dont worry is save!!