Lamotrigine/Lamictal is It Really Effective in Bipolar Disorder?

[@andrewrandolph8278]

To be honest I am stunned to hear about the data you brought up, and particularly the fact that it is being used for mania.I have always thought of using Lamictal for “bipolar” and atypical depression. I’ve never heard of anyone trying to use it as an acute medication. My providers aren’t sure if my diagnosis is more bipolar or atypical depression, but lamotrigine has by far been the most helpful of any psychiatric drug I’ve tried. I’ve failed literally every SSRI, SNRI, most of the atypicals, some tricyclics, lithium, and the 2nd gen antipsychotics don’t really do much but cause side effects. AND lamotrigine is cheap and doesn’t have the usual metabolic side effects as the other psych meds. I think it’s overly stigmatized and thus used too infrequently. Ex I’ve had a family doc call it a “hardcore bipolar med.” I disagree. Thanks for making the videos. I really enjoy them.

[@ShrinksInSneakers]

I appreciate the support, and don't get me wrong I think this medication has a lot of value in fact I'm working with a patient on the titration currently. If you haven’t subscribed already, please do, and spread the word about what we are doing here.

[@nadiasmith226]

I heard both Levetiracetam ( Keppra )and lamotrigine (lamitcal) can help in preventing mania they are safe during pregnancy so I assume they are the least harmful to the body. Do you know any one who took both. Looking for alternatives to Lithium and anti psychotics to prevent mania in Bipolar 1 disorder

[@badfrankenstein5732]

Lamotrigine has been a game changer for my bp1. I've been the most stable in the past 13 years than ever before.

[@ShrinksInSneakers]

Thats great, it's a good medication often difficult to titrate since you have to go slow but it does seem to help people stay well in the maintenance phase. Hope this helps I appreciate the comment

[@nadiasmith226]

my daughter is on anti psychotics and lithium at rediculous doses she was a theater student so she needs memory and concentration . in your case have you been using it to prevent mania

[@badfrankenstein5732]

@nadiasmith226 yes. I haven't had an episode in years. I was on Paxil, then Zoloft before with negative consequences.

[@nadiasmith226]

I heard both Levetiracetam ( Keppra )and lamotrigine (lamitcal) can help in preventing mania they are safe during pregnancy so I assume they are the least harmful to the body. Do you know any one who took both. Looking for alternatives to Lithium and anti psychotics Quebec Canada Doctors seem to love so much @@badfrankenstein5732

[@MystikBlue5]

These studies are perplexing. I belong to a support group. Literally, 5/15 in the group take lamotrigine including myself; we all feel this is the most effective medication for Bipolar D/O.

[@ShrinksInSneakers]

research does not tell us how an individual patient will respond to a treatment. For some lamotrigine will help with depression and other symptoms related to bipolar disorder. What the literature does tell us is in large sample sizes and in a randomized controlled settings thats not the case. I still like the medication and will use in appropriate cases. I think if it works well for you thats great and I'm glad you found a medication that provides relief. I think there are a lot of good things about lamotrigine. Hope this helps if you haven't subscribed to the channel please do and spread the word about the community we are building here.

[@Alex-bo5cp]

I'm new to it, but I am also in love with Lamactil and it seems many people are!

[@helenalovelock1030]

It was AMAZING for me for treatment resistant depression as an add on. Life saver. 200mg of it.

[@camellia8625]

What was it an add on for?

[@helenalovelock1030]

@@camellia8625 venlafaxine

[@camellia8625]

@@helenalovelock1030 thanks++ will look into it

[@milanic7267]

​@@helenalovelock1030 Hi :) Did you take venlafaxine with lamotrigine cause i am using the sec.one as anti-depressive?

[@helenalovelock1030]

@@milanic7267 yes o take Lamotragine with venlafaxine lowest dose

[@AaronsPad]

Lamotrigine was a god send for me and my Bi-polar. The titration was painful but worth the wait. It certainly helps with the low mood, as I literally woke up one morning on 100mg and wasn't depressed but as Shrink in Sneakers said it will not stop a High/Mania as I soon found out and ended up in hospital for 3 weeks where I was put on lithium and taken off antidepressants. So other than the manic episode the Lamotrigine sure kicked the depression but I recommended a separate mood stabiliser to control the highs. Tnks

[@ShrinksInSneakers]

thanks for the input it's always good to here about direct experiences with medication in real-world situations

[@heatherhughes7467]

I totally agree. Like u I suddenly felt was less depressed done morning. I'm swapping from quetiapine to lithium atm. Hate quetiapine for the awful side effects plus didnt work at all for me, even at 600mg. But lamotrigine had zero side effects for me n has literally saved my life. Thank god for the meds!

[@nadiasmith226]

I heard both Levetiracetam ( Keppra )and lamotrigine (lamitcal) can help in preventing mania they are safe during pregnancy so I assume they are the least harmful to the body. Do you know any one who took both. Looking for alternatives to Lithium and anti psychotics to prevent mania in Bipolar 1 disorder

[@tranlenamphuong6192]

I was diagnosed with bipolar 2 literally one month ago. I have been so oppose with the idea of using drugs until one of my major depressive episode. To alleviate my mood and help me stop spiralling, my psychologist prescribed me with Lamotrigine. The difference was like night and day. Before there were periods of time when I couldn't get out of bed, was constantly feeling drained and guilty for everything. On day one it helped me regain clarity to the point I thought damn. This is what "normal" people feel all the time without the help of drugs? I was stunned. I didn't experience any side effect either. Maybe because I've only been on day 3 and my dosage is still very low (25mg). I do say that there's many bad review regarding this drug and the fear of being dependent on it. Hell. I don't want to be a drug addict. But I hope my positive experience with this drug will empower other people to try it for themselves. I've seen the comment space with so much negativity that made me felt paranoid with the drug instead of actually trying it. I hope you're all doing well and I pray we fight depression or mania together. It's a long fight but thanks to this I am regaining the battlefield.

[@ShrinksInSneakers]

I think there is a common misconception that these medications are addictive like opioids or benzodiazepines this is not true. Some medications like SSRIs have withdrawal syndromes but this is not the same as being addicted to a substance. It sounds like things are going well for you and I'm happy you found treatment that works. Thanks for being an advocate for mental health and treatment. I wish you the best on your mental health journey. If you haven't subscribed to the channel please do and spread the word about what we are doing here.

[@VVienna22]

how are you doing a month later?

[@tranlenamphuong6192]

@@VVienna22 Because I'm in my crucial time of studying, I didn't increase my dosage and was advised to stick with 50mg. It's still pretty great, works like a charm and I haven't had depressive episodes since then. I do say that once, I ran out of Lamotrigine but I didn't have any withdrawal symptoms. Tbf in the next 2 days I got it back in my system

[@VVienna22]

@@tranlenamphuong6192 why would you not increase dosage during school study time? just curious. thank you for responding by the way.

[@tranlenamphuong6192]

@@VVienna22 I'm taking my final highschool test and the doctor doesn't want me to experience any possible side effects at this stage. Besides 50mg already works so I guess she doesn't want to increase it anymore

[@sunshinelavender1663]

I don’t want to write a book so I’ll try to sum it up… lamotrigine has literally saved my life (and of course the fact of agreeing the a therapist and psychiatrist). We tried soooo many meds that didn’t work, most making me very suicidal or far the other way. I will also say I’ve always been against meds (big pharmacy in general). After Covid and how it shook the world I was in the worst and longest depression of my life. Lamotrigine snapped me out of that and I leveled off on 300gm) Side affects itchy, but not rash, blurred vision and some exaggerated paranoia… Actually lost weight and way more energy and social.

[@irishgirl1753]

Can you please talk to me I was put on it years ago 25mg saved my life so maybe I’m bipolar was taken off when in hosp after overdose I’m on 25 mg Zoloft for 8 days no help yet

[@ShrinksInSneakers]

I still love lamotrigine it can be very good in mixed depression and bipolar disorder. Some say the three L's are best medications lamotrigine, lithium, and Latuda

[@Brenda5060]

The rage and anger was unbearable(bipolar 2 here)Im on 250 mg for 2 years now , I haven’t had any rage episodes at times some anger but usually triggered by disagreements. I take 10 mg of Prozac once a day (not more than that as it can cause mania) which in combination with Lamictal has helped me from going into major depression which I had for many years. I feel that therapy and medication is the way to go. Very helpful as you thank support from both your psychiatrist. They will help you talk and deal with PTSD, and other mobilities . Do your research on Lamictal and discuss the pros and cons. Now not all patients are the same and their symptoms or effects of medication are different so what works for one may not work for another. There are many medications that have side affects some worse than others. Don’t give up…

[@Divya93]

Lamotrigine is a gift from God.

[@shivbaba2672]

Me too It helps to survive 150 mg a day with fish oil it helps even better for anxiety and sleep

[@shawnhassanpour7142]

I have been taking it for five years. It worked for me.

[@captainmramsey]

Does this medication help with your epilepsy and anxiety symptom?

[@captainmramsey]

I’m still leveling up the 25mg 2 times day.

[@shawnhassanpour7142]

@captainmramsey I have been taking 600 mg lamotrogine and 200 mg of Lamictal a day for the last 6 years, and I am seizure free

[@elizabethnorman7685]

Thanks! Your videos are super helpful, some of the best psych-related content I've found on KZbin. Much appreciated.

[@ShrinksInSneakers]

Thank you for watching and sharing, I appreciate the love

[@heystarship9856]

What are other psych pages you like? Always looking for new resources.

[@ShrinksInSneakers]

@@heystarship9856 I think I made a video talking about resources I like to use for studying and learning check them out it's a good place to start.

[@nadiasmith226]

I heard both Levetiracetam ( Keppra )and lamotrigine (lamitcal) can help in preventing mania they are safe during pregnancy so I assume they are the least harmful to the body. Do you know any one who took both. Looking for alternatives to Lithium and anti psychotics to prevent mania in Bipolar 1 disorder

[@milanic7267]

Hi:) Can lamotrigine help people with BPD. I feel terrible anger and rage? thank you

[@atl141]

Helped my depression and I have Bipolar 2

[@elyousfi5661]

I have bipolar 2 should I tell my doctor to put me on lamotrigine ?

[@atl141]

@@elyousfi5661 I like it. No side effects

[@sutekh7890]

I liked Lamotrigine a lot when I tried it, just really rounded off the edges nicely without any sort of side effects. Both Depakote and Carbamazepine wrecked me in their own strange ways; strangely, Depakote would make my neuropathy fire off worse and the Carbamazepine caused fresh air and some foods to smell just horrible - sort of like my old chemistry lab in college lol (I also have this olfaction side effect with bupropion, acetaminophen, aspirin, and tramadol).

[@ShrinksInSneakers]

I like it too, just prescribed it the other after treating a patient coming off a recent manic episode. I like the lack of sedation and low side effect profile.

[@suns1457]

Amazing keep up the good work!

[@michaellovetere8033]

I have severe depression. Since regular anti-depressants don't work on me, my MD/Psychiatrist started me off on 25.mg Lamotrigine twice a day for 1 week then 75 milligrams a day for 1 week, then 50 mg in the morning and 50 mg at night for 1 week.. Yes, he told me about a possible rash and if that occurred, to contact him right away...Not happy to find out this doesn't seem to help severe depression much, but I'll try it.

[@ShrinksInSneakers]

I would not let it discourage you, some have found it helpful in bipolar depression.

[@kristanchaney30]

Thanks for your videos. Can you explain the thinking behind how blocking dopamine could possibly help depression? I’ve been on Lamictal for a long time but feel like I’ve never fully recovered. It definitely helped but the low energy is still hanging around

[@callme_fakez]

Are you off of lamictal if so how come

[@replaceablehead]

One way is that when a receptor is blocked from interacting with a neurotransmitter it can become more sensitive. Kind of like... er well a bit like not having sex for a while. When the receptor finally gets the chance to interact with a neurotransmitter it's much more excited.

[@PerficChoice]

Doc I jus recently found your page an I think it is amazing that you are interacting and educating people on mental illness as it is something that is extremely hard to get help for. My brother was diagnosed with Bipolar 1, 2 years ago and has since been put on Abilify Maintena injection once a month. The medicine has completely subsided his manic episodes and hallucinations but has caused weight gain, loss of motivation to do anything and has his emotions not getting too high or too low for anything. What are your thought on pairing Abilify with Lamotrigine or a similar drug to get some of his personality back or "pick him up"/motivate him? I know you cant give out medical advice but I thought I heard you mention pairing lamotrigine with Abilify in another video.

[@NatureHeadSupreme]

Ineffective as the study should be conducted probably for about 8-12 weeks. Most people don't have patience, but once you've had enough you will do almost anything and GET some patience.

[@ShrinksInSneakers]

This is a fair criticism, it takes roughly 6 weeks to reach an effective dose due to the slow titration requirement. Some have said the studies were not carried out long enough to see the full benefit. I do see value in this medication and use it clinically, but we have to be careful about the evidence base indicating it treats bipolar depression and mania which I do not believe is fully supported by the literature. If you haven't subscribed to the channel please do and spread the word about what we are joining here. I also have daily instagram content @Shrinks_In_Sneakers

[@NatureHeadSupreme]

@@ShrinksInSneakers Hi sir, I agree that 6 weeks is probable if there is no instance of other medications getting titrated off of or on....ESPECIALLY SSRIs which sometimes exacerbates mania. I can vouch it works on depression...not fully prevent as you had mentioned. My Dr. told me its useless for "grandeur bliss" type mania which is a strong support of the "ineffective" reports. Pharma will say anything tho to push drugs that aren't as palatable to the body & make a need for MORE medication to fix the side effects. Mania that comes out as mostly agitation, irritation & perhaps rage I have seen profound improvements. A 1 all fix medication that doesn't borderline kill you, is totally dreamy ☁️☁️ thanks for your conversation & perspective. I support Lamictal & your education to us all.

[@ShrinksInSneakers]

@@NatureHeadSupreme Appreciate the support and the discussion on this important topic

[@andreacapri8222]

I agree. I am so impatient to get results but I know that I have to titrate slowly.

[@NatureHeadSupreme]

@@andreacapri8222 continue to wait it out. Its worth it because of the minimal side effects - in the meantime lean on your therapist. Oh yeah, ask you doctor if you can go 25 50 75 100 125 150 etc just to be extra precautionary...batter up you've got to play the long game.

[@Alex-bo5cp]

I've just started on this drug and I'm amazed at how quickly I felt the difference. I wasnt aware of how 'staticky' my head was until it changed. I'm just wondering- if 25mg is effective, does this mean my body is sensitive, or that my bipolar is mild, or is it just random?

[@ShrinksInSneakers]

I usually consider medication response as lower form of evidence for severity of bipolar illness. I look at genetics (family history), and course of illness as much more important when determining severity. With that said, everyones body, metabolism, and response to medication will be different. What it may indicate is lower doses may be effective and titrating to 100 mg may not be necessary in all cases. Hope this helps, if you haven't subscribed please do and spread the word about what we are doing here.

[@nadiasmith226]

I heard both Levetiracetam ( Keppra )and lamotrigine (lamitcal) can help in preventing mania they are safe during pregnancy so I assume they are the least harmful to the body. Do you know any one who took both. Looking for alternatives to Lithium and anti psychotics to prevent mania in Bipolar 1 disorder

[@MR.ELEV8TEDMUSIC]

I will be starting this med for manic bipolar I had a down fall recently checked myself into a mental institute for the third time was off meds for two years because got tired of meds not working

[@oljayoj6902]

Love your Chanel. May I ask would you recommend this Ned for rage/anger with someone that had BPD or Bipolar?

[@ShrinksInSneakers]

I personally prefer depakote for agitation and limbic activation and I'm not aware of any studies that looked at this medication directly for agitation or aggression. Hope this helps

[@milanic7267]

Doctor, my diagnosis is bpd, I take lamictal 200mg, but lately I've been ruminating a lot. could it be a consequence of the medicine?

[@ShrinksInSneakers]

I would not say that is a side effect of lamictal. What you can do is look for a correlation between dose changes and ruminating which may provide some insight. The goal of using it in these cases is impulse control and emotional regulation, I've not seen any cases clinically where it worsened anxiety or increased ruminating thoughts. Hope this helps

[@milanic7267]

@@ShrinksInSneakers Dr.Rossi, I have one more question. Do you think that emotional stability can be achieved through psychotherapy or it just helps to deal with the symptoms? Is dbt the best? Thanks a lot❤️

[@phoebejanemiller1671]

I wonder if the reason why lamictal failed for acute mania and depression is due to the long period of time it takes to kick in/ the long period of time required to reach a therapeutic dose. Edit: I’m not the only one lol.

[@ShrinksInSneakers]

This is a possible reason for the findings. The mania studies were very short 3 weeks and 6 weeks. The bipolar depression studies were of adequate duration with one lasting 29 weeks which was negative. One of the rapid cycling studies was 34 weeks. I believe the depression studies and raid cycling studies were accurately represented and if you think about the reason for medication in the setting of acute mania it's to stabilize the patients mood rapidly so even if it does work at higher dose and longer durations it's not clinically meaningful in my opinion. Once titrated it does prevent mania, it just doesn't work in the acute setting. Thank you for the comment

[@nadiasmith226]

I heard both Levetiracetam ( Keppra )and lamotrigine (lamitcal) can help in preventing mania they are safe during pregnancy so I assume they are the least harmful to the body. Do you know any one who took both. Looking for alternatives to Lithium and anti psychotics to prevent mania in Bipolar 1 disorder

[@rayannepierce8323]

Oh my god I just found your Chanel. I’m gonna stay up all night and watch the videos with the medication I’ve been on. Like this for my “bipolar disorder” I know I have mania. I’m hyper-manic. I haven’t been on medication for two years and honestly, I think I needa get back on them 😬 haha

[@johanneswalpert6052]

Hey , great Video ! I have a question concerning the dosing , does it matter If you take it once a day or twice , expecially while escalating dose ? For example If so experiences drowsiness and might be better to take before sleep, if someone experiences insomnia better in the morning ? The half Life is reasonable long so it should be possible to take all at once or does it even matter? And Do you have a guideline with Halftime and dosing? Thanks a Lot !!🙂

[@clairebear2975]

With regards to dosage, the psychiatrist today has told me to take 1 tablet of 100mg for a week, then 200mg from after one week. I'm in Spain, is it just because i'm here, and not in the U.S.?

[@Deba7777]

Doc, thank you for this info. Is there an approximate onset of x# of days if that SJS rash starts (I think for the benign rash you said approximately 10-14 days?). Also, if the SJS rash is caught immediately & the patient abruptly stops the lamotrigine, does that SJS stop or continue its progress? Thanks again!

[@ShrinksInSneakers]

Any rash that develops while on lamotrigine, the medication should be stopped immediately. SJS usually develops in the first 1-3 weeks of treatment and requires immediate treatment. It caught early enough it is unlikely to progress once the medication is stopped. The best way to avoid this is start very low, some have advocated for starting with 12.5 mg/day and titrating even slower

[@Deba7777]

@@ShrinksInSneakers THANK you soooo much for your generosity of heart to take the time to respond to this question! God bless you!!!

[@kevini4295]

I am taking this medication and I am on my 3rd week. Just started on 50 mg. It does have to titrated up slowly. It is too soon to yell overall effectiveness.

[@happybergner9832]

Well, it works for me.

[@shawnhassanpour7142]

I have been taking 600 mg of Lamictal plus 200 mg of lacosamide a day for five years for my seizures. The seizures are under control, but I started having memory loss.

[@BabyChili1]

Thanks for video! I started 25mg Lamictal almost 2 months ago. I’m still at 25mg. I also take 7.5 remeron and 1mg Klonopin. I was taking 50 mg Trazadone for sleep and gabapentin as needed. Quit the Trazadone almost a month ago and I still get my 7 hrs sleep. I no longer need the gabapentin for my breakthrough anxiety (racing thoughts). I was also given propranolol in case I had (physical) anxiety, but never ended up having to take it. My doctor is fine with me holding at 25mg. But she says anytime I should get really low and have that depression come back start taking the 50mg. So I’ll see what happens. Any feedback would be great!

[@trafficjon400]

How are you today? being a year ago have you upped the Dose to 50mgs.

[@carlameow13]

I'm on lorazepam 1mg and remeron 7.5. Just started lamictal 25mg. How are you doing now?

[@BabyChili1]

Hi! Well 5 months after that post, I thought I had a slight manic episode, but I think I overthought what I was feeling. So my dr. had me increase to 50mg. I’m still on the cocktail of three pills. But the Klonopin has been slowly tapered. 2yrs ago was at 1mg of Klonopin and now at .375 of a pill. My doctor and I are concerned more with me getting off the most dangerous benzo. But this cocktail helped me get back to normal. I take the Klonopin in the morning and my Remeron 7.5 mg and .50 mg Lamictal at night. 3/9/22 when I started and I’m sleeping, losing weight through diet/exercise, mood great, no lows or highs and I’m allowed 2 beers weekly. I talk with my psychiatrist every month, sometimes every two months. I don’t have a talk therapist but I may get one. I hope you two are on your road to wellness. It’s a process, trying each Med, doing your own research, advocating for yourself as well as aromatherapy (I carry little bottles that I can inhale), taking as many breaks during work to get fresh air and stretch, I keep a journal as well. Journaling my sleep, anxiety level, meds taken and activity I partook in for that day. I have 3 journals now since the start of all my troubles. So keep me posted as well.

[@aleksandarskavo8768]

I have bipolar type 2 and I love love lamictal. I'm om the highest dose 400mg and its helped me so much with stabilizing my mood and with the depressive episodes in particular. Also, lamictal has some potential minor efficacy in treating dpdr. I noticed that derealization got better when I started the medication. Of.couese I'm still trying to find the perfect combo, but it's the.most important part of my med regimen.

[@ShrinksInSneakers]

Great, glad you have been successful with this medication. It’s a good choice once the manic episode is treated and keep people well. Thanks for the comment and spread the word about the channel and the work we are doing here

[@Albanyoregonskywatcher]

im on 200mgs 3 times a day for depression. I've been on it for 27yrs and I only take it because, when I don't take it I feel foggy minded I get very confused and I stumble. I have children and I feel as I cant just stop with the highest dose. Of 200mgs 3times a day. I want this medication out of me.im on 200mgs 3 times a day for depression. I've been on it for 27yrs and I only take it because when I don't I feel foggy minded I get very confused and I stumble. I have children and I feel as I cant just stop with the highest dose. Of 200mgs 3times a day. I want this medication out of me. How long would it take to come off this medication after takeing it for 27yrs for "depression"?? Im done!! Im on 200mg 3times a day. The highest dose! Pleas help.

[@AaronsPad]

Good to hear it works, I've seen from alot of comments that it really helps and is a game changer. Will check back in 3 months with an update once I've hit 200mg.

[@ShrinksInSneakers]

@@AaronsPad Best of luck let me know how it goes

[@ShrinksInSneakers]

@@Albanyoregonskywatcher This is not medical advice, it’s for educational purposes only. Always talk to your doctor prior to making any changes. The medication can be tapered off and the dose you are describing here sounds high and could be contributing to the side effects. I would talk with your doctor about your thoughts and creating a tapering schedule. The total time to come off is at least 2 weeks although it may take more time. This is the minimal amount of time and watch out for worsening symptoms of bipolar/depression during that time. Hope this helps. If you haven’t subscribed to the channel, please do and spread the word about what we are doing here. We also have daily content on Instagram @Shrinks_In_Sneakers

[@bixumbi]

I really appreciate your channel and how you strive to make information simpler for us on challenging subjects, Dr. Rossi. Can I ask if immediate (like in the same day) response to lamictal is a sign that someone's bipolar, or not necessarily? I am now slowly titrating up, this feeling has leveled, but I've tried pretty much all ssris and wellbutrin, and never to full success. I've been diagnosed with dysthymia by one doc, and as cyclothymic by another. My father has always dealt with heavy bouts of depression and my brother is bipolar I. Would love to hear your say on this if you're able to. Many thanks

[@ShrinksInSneakers]

I usually do not look at medication response as my number one factor for determining if a person has a true psychiatric disease. I look at the course of illness, number of episodes, genetics such as a family history of bipolar disorder and then at response to medication. Cyclothymia is interesting as well and a place where lamotrigine may be a benefit although true evidence is lacking. I can say SSRIs and other antidepressants in people with manic symptoms of any sort are usually not a good idea. What is good is that you found something that works and you are making progress, hope this helps a little

[@bixumbi]

@@ShrinksInSneakers I appreciate you and your channel and thanks for taking the time to reply. Would love to be treated by you (if I wasn't thousands of miles away..)

[@ShrinksInSneakers]

@@bixumbi no problem

[@ceceliaevans8483]

My 23 year old son was prescribed lamictal by his current psychiatrist for anger issues and mood swings. He has a diagnosis of adhd. His primary doctor started him on wellbutrin xl 300 mg so his psychiatrist kept the wellbutrin and added lamictal since wellbutrin alone was not effective for controlling the anger episodes. He is currently only on 25 mg since he is titrating up. He has lost 8 pounds and currently weighs about 135 so I asked about periactin to stimulate appetite since he had used that before when he was younger while taking Ritalin. My question is do you think it's safe to take periactin and will it mask a possible dangerous rash since it's an antihistamine? I enjoy your channel and look forward to many more.

[@MichaelBLive]

I don't get it. You're saying it's ineffective for certain things - because it's not better than other meds such as lithium? There are so many reasons besides ranking effectiveness. Also Lamotrigine being slow may be in question. Thanks.

[@ShrinksInSneakers]

Here's the response I've been giving recently because it's important when learning how to interrupt literature and data. When someone does a randomized controlled trial it's a high level of evidence where you are comparing an intervention like medication to placebo. Participants in these studies often are carefully selected so they only have the disorder under investigation which is not a good measure of real life patient encounters which are far more complex. The you get a result, the result only talks about generalities. In general lamotrigine does not perform as well for acute mania as Depakote or Lithium. It doesn't mean in some cases a patient will find lamotrigine works both as maintenance and bipolar depression, and acute mania. What we can say is the company that manufactures the medications made several attempts to gain additional indications for lamotrigine but the studies were negative and were mostly unpublished until recently when a court order required them to disclose the information. What that means for me is I can't suggest someone take lamotrigine for acute mania. I can probably make a case for adding lamotrigine for bipolar depression although the data doesn't seem to support that either but I think the case is at least a little stronger if the patient is already taking another medication like lithium without full remission. It's complicated, to say the least.

[@nota7660]

I REFUSE to go on Lithium!!!!!!

[@paulflint6254]

Doubled dose to 100mg, I'll let you know if it helps

[@finity9316]

Did it help ?

[@paulflint6254]

@@finity9316 yep

[@finity9316]

@@paulflint6254 what did it help ?

[@paulflint6254]

@@finity9316 mood swings and anxiety

[@paulflint6254]

@@finity9316 you take it? If so, hope it helps mate.

[@Lulu-kt6gr]

I’m not bipolar but I have persistent depression which is hard to treat. Nothing worked for me long term until I added lamictal. Now for years I’ve been on 200 mgs lamictal and when I added Zoloft it helped Zoloft continue to work for me. Adding modafinil has helped even more. NOW I’m off Zoloft because I want to get rid of the low libido and I’m trying Wellbutrin with lamictal and modafinil. Whew! So far so good- not quite as effective as Zoloft but I’ll take it. Would like to try to get off of lamictal but it has the worst side effects of any medication when I forget to take it - which is practically never now- the dizziness and nausea etc. are very bad. I cannot even tell if it is doing anything at this point. I do need long-term medication and I know that now. Have there been any studies that show that adding Lamictal to other anti depressants make them more effective? I want to see if my WORD RECALL gets better without lamictal. I have heard that it is a known side effect and I have certainly and still do experience it. I would like to know if it is age - related or if this is just the medication. Thank you.

[@Brenda5060]

Discuss bipolar 2. Lamictal works for bipolar 2 along with a depression. I think psychiatrists should get educated on the effectiveness of Lamictal. Not a doctor or pertain to be one. Educate your self consult with your psychiatrist on the meds that may or may not prescribe Lamictal. There are so many psychiatrists 15:37 that disagree with meds used for certain psychiatric disorders. Not all patients react the same way to medication. There are so many videos out there are incorrect on medication. Always consult your doctor. When it comes to it , medication its a is a hit and miss to find works for you. Your doctor and your feed back will find the one medication together and what will work for you. Please don’t take all videos to heart especially when it comes to a your decision on what medication to take that’s something to discuss between you and your doctor.

[@lindamastropietro4429]

My APRN has me on Lamictal and I had my depression getting worse and worse so she increased it from 200 mg a day to 300. Then she put me on trailer which is causing me such inner anxiety that I can’t take it the Lamictal nor the regular are working.

[@MIDNIGHT_ANGEL278]

Great video. I wanted to hear your thoughts on a couple of things: - you mentioned a good side effect profile with no weight gain or sedation. How about cognitive problems like memory issues, attention, finding words, etc? I feel like clinical trials rarely pick up on these, so doctor's experience becomes essential. - how about other off-label uses like cyclothymia, and even anxiety? Is lamotrigine another one of those "eh, it'll fix whatever wrong wit yer son" kind of drugs like gabapentin? Anyway great content, thanks doc! -

[@ShrinksInSneakers]

Clinically I have seen those types of side effects more commonly with Topamax. Most patients I've seen on lamotrigine have not experienced cognitive side effects. I think the off label use in cyclothymia makes sense although as you point out there is limited evidence and no one is going to pay to do a large RCT on it. With that said I'm not a big fan of just throwing the medication at any disorder but in bipolar, depression with mixed features, possibly cyclothymia I think it's a reasonable option. Hope this helps

[@MIDNIGHT_ANGEL278]

Thanks for the reply!

[@ShrinksInSneakers]

@@MIDNIGHT_ANGEL278 no problem

[@brotherlee3155]

Don’t take this med. getting off it is hell. The benefits don’t outweigh the side effects.

[@sarahalmeida8311]

I am Bipolar type II, i started with Lamotrigine about 6 months ago, at first, i was in 25mg, and the first month was amazing, i felt more focus and longing for life like i wasnt before, even decided go back working, but in the third month my dosage went higher, my doctor prescribed 50mg, 25mg two times per day, i started to feel more irritable and sensitiviness, my therapist told me i should go down to 25mg again and talk w my doctor, i told my doctor about it, they said it was normal, and in the fifth month they put me on 100mg, 50mg two times per day, its been a month i am in this bigger dosage, and it is awful, i have been rapid cycling, something that i never had before, my mood changes so much i keep tracking it to have proof that this isnt working, and i went to a new doctor and they said i should keep this dosage cause my previous doctor must know me better and so they probably are right in the dosage. Just this week i had a 3 days depressive episode and 1 day maniac episode, this isnt normal, i wanst like that before lamotrigine. But i don't know if i should stop, cause this little voice in my head (metaphorically) keeps saying "it takes time to adjust it takes time to make you better". I really don't know what to do, i feel awful, but the doctors are saying i should keep the 100mg dosage.

[@ShrinksInSneakers]

It's hard for me to comment on this specifically because I don't know enough about the case and it's always best tot talk with your doctor about the concerns. It's impotent to remember lamotrigine does not work for bipolar depression and does not work for acute mania it's basically a maintenance medication that should theoretically work to keep someone well who is already stable. Theory does not always play out clinically as you will see in my up coming KZbin shorts stay tuned to learn more

[@BillionaireDubaii]

Don’t let them tell you what you need you tell them what you need!

[@trafficjon400]

Sounds like what my doctor tried to explain ? he doesn't think I am Bi-polar but, possible induced evidence? though the condictions i am living in can cause depression stress anxiety triggering my moods like Abuse from Narcissism psychical mental strain I Have been going through in the past 5 years? My Doctor has noticed a change in me because of this abuse and why he decided to Prescribe Lamotrigin . I guess long years of abuse of any kind can change Brain Chemistry? I'll admit I do feel some ease from the lamotrigin but only 3 weeks on 25mgs needs to wait if any better result happens.@@ShrinksInSneakers

[@JOSERAMIREZ-vw5ou]

WONDERFUL INFO MY FRIEN.D , SOME PEOPLE DONT MIND, LIKE READING ME MYSELF DISLIKE READING DONT DO IT TO ANXIOUS DESPERATED FOR DOSE THAT LIKE READING MAY APPRECIATE YOU BETTER HAVE YOUR CARDBOARD RIGHT ON TOP OF SCREEN MAY LOOK MORE LIKE YOURE LOOKING AT THEM I APPRECIATE YOU ALOT IS THERE ARE COMERCIALS AFTETR YOUR CLASS I WILL WATCH SEE AND HEAR THEM ALL.. I LIKE YOU MY FRIEND, THANK YOU.

[@ShrinksInSneakers]

Thanks, I appreciate the support spread the word about what we are doing here

[@dorymcdonough7727]

I’m on 200 mil for bipolar 2 should I even be taking it ?

[@atl141]

I love it! I’m on 100 mg same diagnosis

[@ashtynpeters2305]

I know you might not see this comment since it’s so late, but what’s your opinion of brain fog while on this medicine?

[@ShrinksInSneakers]

brain fog is not a medical diagnosis it's the feeling patients have usually when stressed, not sleeping, or as the result of an untreated or poorly treated disorder. It can be a side effect of some medications. I like to avoid medication that are known to cause cognitive disturbances. This can be any medication that is anticholinergic common ones being diphenhydramine, antipsychotics, cogentin, and I will add topmax although it's not anticholinergeric. Life style modification including diet and routine exercise can help, improving sleep quality, treating depression can also help. I will sometimes add a choline supplement like citicoline as well

[@nota7660]

Works great for me

[@StillMantis]

jeez my psych started me at 50mg for 2 weeks and then 100 ongoing

[@anja0106]

To people who may be scared or have a negative perception of psych medication… I always thought of it this way- bipolar is chemical. It happens whether we like it or not. You can manage symptoms sometimes, but at the end of the day, your brain is just gonna do its chemical thing. Having said that, let’s look at a pancreas. It’s supposed to help produce insulin, right? Well look at Diabetic people. Their pancreas’s just isn’t doing the chemical thing it needs to. So they take insulin. Sure there are ways to live that will help manage it better, but regardless, the pancreas is gonna do what it wants to a degree Now would you say that people with diabetes are addicted to insulin? No. They are dependent on it. Because without it, from the get go, their body does not have the chemical ability to do what it needs to do. It’s not like it was all fine and dandy, they started taking insulin, and now it’s addicted and can’t produce it in its own. Now… go back and replace insulin with (for example) Lamictal and Diabetes with Bipolar. It’s the same thing. You aren’t “addicted” to anything. And yea, you may be dependent on it to function. I highly doubt you would go up to a diabetic person and say, “Wow, you’re dependent on insulin to function? That’s really not good. You should avoid taking insulin.” My mom told me something the other day. She said, “I would be careful with the self blame. Sometimes you can be doing your best, but there’s a degree to which this is just chemical. It sucks, but this is just the disorder.”

[@JohnMark-bx1ks]

very good if you have light to moderate depression, removes your suicidal thoughts, improve your working memory & arrange your thoughts properly... not good if you have severe depression... SSRI maked your suicidal idealization worsts

[@JOSERAMIREZ-vw5ou]

THANKBYOU.

[@ShrinksInSneakers]

No problem we will keep making them

[@alyciaknoop7775]

Anyone care to enlighten me? Hi, my name is Aly and I have bipolar type 2. I know I'm a little late since this video is a bit old. I take lamictal only 75 dosage there trying to boost it up to 100. The only reason why I'm on this medication is because my doctor recommended it for moods not depression and I personally see no change yet in moods so this video was useful. The process is a bish. So I thank you for this incredible video! ❤️😭 I've been on the medication for 5 weeks and a day. So far it's okay... I think I have been experiencing loss of appetite, I haven't been eating anything lately and I also experience confusion but I don't know if that's from the medication or a different thing and I do sometimes get really sick while on the medication. I also don't even know if it's to soon to tell if the medication is actually working and or having side effects or if it's in my head. I've been stable for 2 months now and on the medication for about a month and I've been seeing some change but not what I'm trying to target. I'm unfamiliar with the medication process and medication in general. Is hydroxyzine and lamictal good together? Or should I talk to a professional? The journey is long and complicated I think people with bipolar like myself are just misunderstood.

[@ShrinksInSneakers]

This is not medical advice, it’s for educational purposes only. Always talk to your doctor prior to making any changes. First, the process of navigating mental health treatment can be difficult and many people get frustrated. I would not let it get you down, I have seen some major turn arounds with the right treatment. One east thing that I believe helps is to start psychotherapy. If you are experiencing depressive episodes things like CBT or IPT can be very helpful and work as adjuncts to medication treatment. With Bipolar II disorder you need to have at least 1 hypomanic episode and at least 1 major depressive episode. In general, most people spend more time depressed. Like I said in the video lamotrigine in the dose range of 100 to 200 mg/day is good for bipolar I maintenance, but the research is not so good for bipolar II disorder. In many cases most medications are not tested for bipolar II patients except for quetiapine which does have good data for depressive episodes associated with bipolar II disorder. The lamotrigine may require the addition of another medication approved for bipolar depression. Those medications include lurasidone, cariprazine, olanzapine-fluoxetine combination, and quetiapine. I would talk to your doctor about the symptoms and discuss which medications might target the specific symptoms. I hope this helps, if you haven’t already, please like and subscribe to the channel and spread the word about what we are doing here. We also have daily Instagram content it may be of interest.

[@finity9316]

Update ?

[@unfluster]

I took it. It didn't work. I told my shrink. He told me to stay the course. I took it for 6 years. Never noticed a difference. Finally after 6 years, I got off of it.

[@neptune6956]

Idk ive struggle with bipolar depresion all my life , this medication saved my life. Be careful with believing this video look for more information.

[@trafficjon400]

Mental illnes taking steroids are dangerous also. dexamethsasone can reak havok on the mentally ill and mixing with rash leading to SJS can be an agonizing road to death.

[@ShrinksInSneakers]

Corticosteroids are known to induce psychosis and mania in susceptible patients, while it's not a guarantee that bipolar disorder is present it's concerning when this happens and careful evaluation and follow up is required

[@trafficjon400]

What i meant to bring up is Patients with Bi-polar 1 or 2 should not be treated with Corticosteroids unless they have no other alternatives?@@ShrinksInSneakers

[@trafficjon400]

I also have found thousands of youtube channels complaints of people left alone in missory bt their doctors laughing at then telling then it has nothing t do with steroids. Many of these videos i have trouble finding after ten years and hidden far in to the Algorithms. Though if i search hard enough over the web I find thousands of more new complaints. a few of them wher about people shooting them self in the head after injection for simple poison ivy. and many other Suicides. taking up to 5 years for some taking this drug. and why did the FDA PUT A BLACK BOX ON STEROID ABOUT 20 YEARS AGO. FDA also did not approve triamcinolone or prednisone before for up to 39 years ago from way to many complaints. Dexamethasone is Good though for any patient laying on their death bed and saving their life. the Anti-inflammatory can bring down the problems that pressurized the Body enough to kill a person.@@ShrinksInSneakers

[@trafficjon400]

So true! but if they had to check every patient on Medicare or any other issue the patient has financially? this would make it allmost impossible to care for the high rollers by the millions all most..@@ShrinksInSneakers

[@trafficjon400]

Any one with mental illnesses are more likly to be induced especially Dexamethasone being the strongest anti inflammatory.@@ShrinksInSneakers

[@yaraviera4444]

I have epilepsy

[@captainmramsey]

Does this medication help with your epilepsy and anxiety symptoms?

[@VividYouth]

Thanks for nothing then 😂 i took them for 12 years and had rapid cycling all those years

[@VividYouth]

Very harmful to have 10 episodes/ year in ur twenties

[@Albanyoregonskywatcher]

im on 200mgs 3 times a day for depression. I've been on it for 27yrs and I only take it because, when I don't take it I feel foggy minded I get very confused and I stumble. I feel very stupid and slow. I have children and I feel as I cant just stop with the highest dose. Of 200mgs 3times a day. I couldn't function mentally correctly. I want this medication out of me. How long would it take to come off this medication after takeing it for 27yrs for "depression"?? Im done!! Im on 200mg 3times a day. The highest dose! Pleas help.😔😔😭

[@ShrinksInSneakers]

see my other comment, and I hope it helps

[@Brenda5060]

Wrong

[@johnbonacci128]

I felt like I wanted to put my head through the wall this stuff is just as dangerous as oxy