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Q: Lamictin & Feeling Disassociated...
Bp II. Started Lamictin 12 days ago on 25mg with 25 mg incremental
increases every 3 days. Currently on 100mg daily.
Other than nausea folling each increase I have no noticable side effects BUT I
feel
disassociated and rather removed. My recall of names is shocking, I will forget
things told to me ten mins ago and often find myself someplace and wonder what
on
earth I am doing here? Help. is this common and will this decrease as I get used
to
the meds. I have resisted taking any other med's because of a near suicide on
Celexa
and worsening depression on Lithium. I want to concentrate on ONE med at a time
to
establish its efficacy. Also I have had radiation treatment on my thyroid
resulting
in severe hypothroidism. takinh 150 mg Eltroxin and 30mg Tertroxin daily, to
what
extent could this be contributing to the cycling?
Thanks
Brigetta
Dear Brigetta --
The one-medication-at-a-time approach is generally a great idea unless you're
really in a hurry to get symptoms under control. Your story suggests that
might be the case, because of the rate at which your doctor is increasing your
lamotrigine (Lamictal in the US; Lamictin in South Africa). That increase
rate could be part of the reason why the medication appears to be
affecting you so severely. I wonder about asking your doctor about going
down to a tiny dose (probably after stopping for a few days after you taper down
-- but don't do that on your own, now) and then starting up again more slowly,
as long as these symptoms are not coming back. Here's the instructions I
use for patients for
lamotrigine,
for comparison; and my
general
information; for discussion with your doctor.
However, it also looks quite possible that this
medication is just not going to work for you even if you start low and go
slow. In that case you'd have to look at some other
mood
stabilizer. And as for the thyroid: you're already on the treatment (a
combination of T4, eltroxin; and T3, tertroxin) that I'd strongly consider
(here's the section of my website that talks about why,
Thyroid
and Bipolar disorder). You're right to wonder about thyroid and
bipolar cycling, as you'll see in that essay. But if you're pretty well
"tuned up" in terms of your thyroid replacement, that's a good
starting place to go on and try mood stabilizers (although you'll see in the
links in that essay that there is a group in the U.S. studying thyroid as a
treatment for bipolar cycling).
Dr. Phelps
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