Lamictal & ECT

[cookie1653]

I just spent a half hour describing my symptoms and questions, only to have lost them due to one single press of the wrong button.  ANYWAY, my question is:  I was taking Lamictal (anti-seizure medicine) while getting ECT treatments.  SHOULD I HAVE BEEN TAKEN OFF LAMICTAL BEFORE THE INDUCED SEIZURES? I am experiences extreme memory loss and cognitve function. Unable to speak articulately since the ECT.  It doesn't make sense that I would be on an anti seizure medicine.  Would this require more electricity to be used to induce the seizure?  Would more electricity risk brain damage?  Which I feel I have.  The doctors of course are telling me that it's all in my head.  I am SOOO frightened that not taking me off lamictal was neglient on their part.  
CAN SOMEONE ANSWER THIS QUESTION>  I have been trying to find someone, Dr's..with no answer.  Just vague "who knows" responses.  I am devastated.  Thanks.

[cookie1653]

I can't thank you enough for your kindness since I am in despair and so frightened at the time.  I hope to find out that the lamictal given with the seizures is not so dangerous and would like to find comfort in the above article.  But I was taking 300-400 mg. of Lamictal (absolute highest) dose permitted and was taking it in the mornings, right before the seizures were administered.  To my horror, I was taking this while admitted into the hospital for the 1st initial therapy, every other day (3 times), Bilaterial (most intense) and potentially most risk without the administration of Lamictal in the first place.  This knowledge is causing anxiety I never felt before and the possibility that I have been injured because of human error by experience older Psychiatrics makes me so depressioned and feel so helpless, victimized while I was vulnerable.  (I'm not the victim, go along with anything anybody tells me to, kind of person). Puts me in a fragile state..like I want to give up.  Perhaps I should consider although I never thought I would going off all med's and getting to know myself and start there.  Going into Rehab to get off all anti-depressants against the wishes of my current doctors whom I am fond of and feel their genuine concern for me.  Thanks for offering your hand because I am not one to discuss this with friends or family.  I am ashamed.  Cookie

[xanweaner]

Cookie,

Continue your persistent follow-up with Dr. Breggin - he may be involved in a court case or travels...? You're quite lucky that you have access to him - he's an inspiration to me.

I found another article from ECT Journal. Here it is - it's not the same article that I first found - but this is more updated as it appeared in 2006.
Good luck, and please PM me with an update on your meeting with Dr. Breggin, if you can......


ARTICLE LINKS:
Fulltext  |  PDF (92 K)

    Combined Use of Lamotrigine and Electroconvulsive Therapy in Bipolar Depression: A Case Series.

    Case Reports
    Journal of ECT. 22(2):142-147, June 2006.
    Penland, Heath R. MD *; Ostroff, Robert B. MD *+

    Abstract:
    Objective: Lamotrigine and electroconvulsive therapy (ECT) are both safe and effective treatments for bipolar depression. Concerns exist that anticonvulsants may interfere with seizure expression during ECT or may exacerbate cognitive side effects, potentially affecting clinical response. This report examines the clinical use of concurrent ECT and lamotrigine for acute bipolar depression and the transition to maintenance therapy.

    Methods: Nine patients with acute bipolar depression were simultaneously treated with a course of ECT while titrating lamotrigine for maintenance therapy. We compared mean stimulus intensity, mean seizure duration, and mean time to orientation after treatment for each patient during treatment with their highest and lowest lamotrigine dose.

    Results: All 9 patients were treated to remission. From the lowest daily dose to the highest daily dose, mean increase in lamotrigine was 102.8 mg. Clinically adequate seizures were obtained in each patient. Lamotrigine had minimal effect on each measured ECT parameter. The interval between ECT treatments was spaced to a mean of 15.2 days. The treatment combination was well tolerated, with no serious adverse events, no rashes, and no worsening of cognitive side effects.

    Conclusions: Concurrent use of lamotrigine with ECT in bipolar depression seems safe, did not interfere with routine ECT practice, and allowed for transition to maintenance pharmacotherapy.

    (C) 2006 Lippincott Williams & Wilkins, Inc.

[cookie1653]

Hello Again Xanweaner;  I am unable to access the article "Concurrent Lamictal...ECT..." Do I have to pay to subscribe and pay for the article? I am clumsy and suspicious about buying these kinds of things online.  Can you advise?  
Cookie1653

[cookie1653]

Thanks for your reply.  Funny you should mention Dr. Breggin, I live very very near him and have left several messages for him with no reply.  I was lucky enough to get an appointment with him about 3-4 months ago but I had to cancel.  With enough notice and my deepest regrets I canceled that appointment.  Knowing that I would need him at a later date, I also sent a card thanking him for his time and another apology.  EIther he's on vacation or he finds it unforgivable for a potential new client to cancel an appointment.  Precisely why I have had to turn to internet inquiry.  I feel like I'm hanging from his window sill and he's gonna just let me fall.  I'm sure he's a busy man. Well reknowned...published.  ???  

I appreciate the links and articles you've sent. Will review.  Cookie

[xanweaner]

I just found this info. on google - you can check this out for more information:

March 2005, 21:1 > Effect of Concurrent Lamotrigine...


ARTICLE LINKS:
Fulltext  |  PDF (119 K)

    Effect of Concurrent Lamotrigine in Patients Receiving Electroconvulsive Therapy.

    The Association For Convulsive Therapy 2005 Annual Meeting
    Journal of ECT. 21(1):60, March 2005.
    Layne, Eric MD; Young, James A; Votolato, Nicholas A; Miller, Karla M; Martin, Bobbie S

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It is available in the Journal of ECT - to find this, just google "lamictal and effects of ECT" - use firefox as your search engine...

Good luck...
xan

[xanweaner]

I have not heard about this reaction but I'm going to do some research as you've aroused my curiosity. I suggest you post this in the Ask A Doctor forum - Dr. Gould - for his opinion, too. I'm also going to ask my psychiatrist when I see him in July about this subject.

I'm assuming that you were treated for severe depression - resistant to antidepressant therapy?

You could also search under google - Dr. Peter Breggin - a noted psychiatrist - he writes frequently about ECT and other issues and may have covered this topic.

I hope that you begin to feel better soon....
my very best to you...