How much Lamictal is "enough"?

[BeeKeeper]

Yes...I know that different dosages help people.  What I'm curious about is the levels that most people seem to work....again knowing that people's chemistry is different.  I'm on 75 twice a day but am feeling need to increase to 100/twice a day.  Pdoc said I could go as high as 300/day.

I'm also curious as when folks see effects.  Seems that i don't really start seeing any results for about 2-3 weeks but have heard it can take as long as 2 months.  I just want to jump the gun in increasing something that I need to give more time.  As everyone gets now and then...just trying to find some level of something to help "level" me better.

Thanks again for any thoughts all. Courage.

[BeeKeeper]

Thanks all for your feed back! much appreciated.  I also went out searching for some additional information and found a link for the Physician Desk Reference if it helps:

http://www.drugs.com/pdr/lamictal.html

[Dylanf84]

I'm only on 50mg myself, but that's because I'm taking Depakote as well. Depakote increases the level of Lamictal in the blood by two...or maybe 3 times, I forget which one it is.

[ILADVOCATE]

My psychopharmocologist has a pager but its to be used in emergencies. When I first went to him (and remember this was before recovery in 1996, I was psychotic) he said "my pager can be used in an emergency. Patients who use it when its not an emergency tend to become ex-patients" lol. But yes its good to set boundaries as I learned but he does have an alternate psychiatrist for when he is on an extended vacation. He would field the calls and he's very helpful but as things got more and more complex with me eventually I knew it was out of his league and now when my psychiatrist is away the calls go to my neurologist. Its only this year that we function as advocates together. Before that I was as psychotic as your average person with schizoaffective and likely to make nuisance calls or say it was an "emergency" and "I was being threatened" because a kid made a wise a** remark to me or give my rant of the day until his answering machine was blocked up. Things are much better now but it wasn't easy. On either end.

[monkeyc]

I have a good pdoc when he's not on a cruise :)  But I guess even doctors need holidays and he does deal with us crazy people all day every day :)

[Darkestlight]

I was on Lamictal for a while and i never got side effects. MY highest dose was 400mgs. My doc told me he had a patient or two on as high as 800mgs a day. My doc specialized in BP and thats all he saw. So yeah

[Lizz67]

Been on Lamictal for three years and like it. My doc said 400mg is the highest rec. dosage and that's what I'm on.  It was added to my other MSs to help with a bad depression.  I take Li (1200), Seroquel (250), Lamictal (400), and recently added 30mg Prozac.
With my other MS meds, Lamictal didn't make me manic or hypomanic.

[LeftCoastChick]

I think the two work well together, I bottomed out when I was at about 150mgs or so, my pdoc added 300mgs of Lithium, wow, I would say within a day or two I was feeling better. I'm at 450mgs of Lithium and 250mgs of the Lamactil as I was still getting major dips, but since I've been at this level of both, even with xmas pretty much on my own. I'm feeling fine, actually great! and not hypomanic!

One thing that is important with both drugs is your water intake, I realized yesterday I didn't have my regular 2-2.5 litres of water a day for the last couple of days and I've been drinking ginger ale, my hands are swollen, and can't get my rings off.  I've been chugging water today, and I can see the difference already, so hydration is extermely important.

We should drink that much anyways, not that I have before, but I've really been pretty vigilant regarding my water intake. Not juice or soda, but water. I'm hooked on a sugar free lemon flavoured water. I drink 2 500ml bottles within an hour of getting up!

Sounds like you have a really good pdoc Mr Monkey :)

[monkeyc]

How does Lamactil compare to Lithium for its MS properties and side effects - Ive heard it works well as an adjunct?

My pdoc has discussed moving me onto it or adding it to the mix but I am not sure what to do there, ive read about it of course (after all this is me :P) but real information is more useful.

[jst4shanell]

I tried going to 300mg.  It made me sick.  200mg is good for me.  I take a few other mood stabilizers as well

[LeftCoastChick]

My pdoc said a little different, the therepeudic dosage starts at 200mgs, I personally didn't find it enough and I went up to 250mgs/night. I'm feeling pretty good, I still battle with a bit of low energy, but I learning to motivate myself.  If I recall I started the med  end of Sept and just got to 200 the start of December, but if you have the patience, it's been a better drug then I've ever been on. I have a libido! I have more energy and focus, something that has been gone for 10+yrs.

[ILADVOCATE]

The starting effective dose is 150 mg. Beyond that its increased until it brings the symptoms into fair remmission. I remember because that's how it was when I started it (and restarted it after trying other mood stabilizers, although I'm not on Lamictal now). The important thing to remember is that a higher dose is not neccessarily better. In fact I was taken off it by my psychopharmocologist and its not uncommon (I was at 325 mg.) from what he said because at higher dosages it has the potential to increase mania. So the best thing is beyond 150 mg. raise it at the rate your psychiatrist told you but call them and keep in touch and both of you can decide at what point its become effective and its better to leave it there unless things change.