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Lamictal and St John's Wort
I'm currently taking 150mg of Lamictal, daily, as a mood stablizer. I was diagnosed Bipolar last year but my psychiatrist has always said she doesn't think I really am Bipolar she's just treating me for it. I guess the lable doesnt really matter since there is no doubt that I am suffering from major depression. The medication has been helpful but I am noticing that it is not as effective as it was when I first started taking it. I'm sure I need an increase but I lost my private insurance a few months ago and can't get in to see a medicaid doctor for 3 more months. My PCP has been writing my prescription for me but will not increase my dose since she is not the original prescriber. I've been thinking about taking St John's Wort, to help boost my mood, but have read that it may not react well with Lamictal. I'm wondering if anyone has taken St John's Wort while on Lamictal and if there were any reactions. Any advise would be greatly appreciated. Thank you :-), BTW, I also take 1mg of Klonopin on occasion for night time anxiety.
I've been taking 100mg of lamictal for over a year for bipolar. Recently I've wanted to stay away from pharmaceuticals all together but can't deal with the constant high and lows so after weening myself down to 25 mg of lamictal a day (just took 25mg less every week) I started taking St. John's and just 25 mg of lamictal a day and I feel better than ever. I didn't get sick and in my personal opinion it works better than the lamictal and doesn't give me the lifeless in between moods feeling it puts me in a uplifting mood and I don't have symptoms. Hope this helps.
Just wanted to say thanks. I am dealing with all of these issues as well and it is a huge help to know that I am not the only one. You've answered my questions, and I hope to help others as well. :)
Although this thread is out of date, I thought I'd add a post for anyone googling in: St. John's Wort will NOT make you sick when taken with other medications.
St. John's Wort improves, among other things, liver function, quite specifically the CYP-450 metabolization pathway. If you are taking medicines that have "touchy" dosage, such as heart medications, HIV drugs, anti-rejection drugs, etc, St. John's Wort will cause these drugs to metabolize more quickly than your doctor expected, leaving you with a lower than necessary dose of these drugs. It won't make you sick, but it will cause your prescriptions to be less effective.
If you are concerned about a drug you're taking interacting with St. John's Wort, just ask your doctor or pharmacist whether your prescription is metabolized via the CYP-450 pathway. If it is not, you don't need to worry about interactions. If it is, then ask your doctor - it may still be ok, for example, if you're taking a broad-spectrum, "one dose fits all" kind of drug (an antibiotic for an ear infection, for example).
St. John's Wort improves, among other things, liver function, quite specifically the CYP-450 metabolization pathway. If you are taking medicines that have "touchy" dosage, such as heart medications, HIV drugs, anti-rejection drugs, etc, St. John's Wort will cause these drugs to metabolize more quickly than your doctor expected, leaving you with a lower than necessary dose of these drugs. It won't make you sick, but it will cause your prescriptions to be less effective.
If you are concerned about a drug you're taking interacting with St. John's Wort, just ask your doctor or pharmacist whether your prescription is metabolized via the CYP-450 pathway. If it is not, you don't need to worry about interactions. If it is, then ask your doctor - it may still be ok, for example, if you're taking a broad-spectrum, "one dose fits all" kind of drug (an antibiotic for an ear infection, for example).
Let me quote from a web page, first one in anser to Google's "bi polar depression.
"The distinguishing characteristic of Bipolar Disorder, as compared to other mood disorders, is the presence of at least one manic episode."
If you've not experienced such a manic, or hypomanic, the little sister, episode then bp is unlikely.
Doesn't matter really though as mood stabilisers work no matter what type of depression you have. The key to it is exactly as you say. It moderates bith high and low moods so that you are at least even and can deal with it being much the same. It's those awful and sudden variations that really throw us to the ground.
Being unable to contro our reactions when something seemingly minor happens is such a shock to us and anyone around. It's a nightmare.
I nore you did not discount St John's. You just said you had thought about it. If you don't believe it will hurt you I can't help you. It's everyone's advice and I'd strongly urge you to not go with it as it is not effective as an anti d anyway and the clash of natural and other chemicals is indeed nasty.
Please stop thinking that way and stick to one or the other.
Lamictal is basically a mood stabiliser and as such is interchangeable with others that achieve the same. It does have risks as you should know that other stabiiser's don't have but if it works for you then good.
Don't focus on what the diagnosis is exactly as I really think every case of D is unique and has it's own twists that docs try hard to categorise but cannot. So we get lumped with a "known" variety. That does lead to a lot of misery as once they decide you are X then too them you are X even if your diagnosis is actually Y +34 or something different. Know what I mean. Just focus on the actual symptoms YOU feel and not the ones they say you should feel.
"The distinguishing characteristic of Bipolar Disorder, as compared to other mood disorders, is the presence of at least one manic episode."
If you've not experienced such a manic, or hypomanic, the little sister, episode then bp is unlikely.
Doesn't matter really though as mood stabilisers work no matter what type of depression you have. The key to it is exactly as you say. It moderates bith high and low moods so that you are at least even and can deal with it being much the same. It's those awful and sudden variations that really throw us to the ground.
Being unable to contro our reactions when something seemingly minor happens is such a shock to us and anyone around. It's a nightmare.
I nore you did not discount St John's. You just said you had thought about it. If you don't believe it will hurt you I can't help you. It's everyone's advice and I'd strongly urge you to not go with it as it is not effective as an anti d anyway and the clash of natural and other chemicals is indeed nasty.
Please stop thinking that way and stick to one or the other.
Lamictal is basically a mood stabiliser and as such is interchangeable with others that achieve the same. It does have risks as you should know that other stabiiser's don't have but if it works for you then good.
Don't focus on what the diagnosis is exactly as I really think every case of D is unique and has it's own twists that docs try hard to categorise but cannot. So we get lumped with a "known" variety. That does lead to a lot of misery as once they decide you are X then too them you are X even if your diagnosis is actually Y +34 or something different. Know what I mean. Just focus on the actual symptoms YOU feel and not the ones they say you should feel.
Thank you and I understand completely about not feeling "artistic". I used to write frequently and was very into photography and just can't do them anymore. I have tried many meds and am very med resistant so I feel lucky to have found Lamictal. I can not take any SSRI's, they make me suicidal and restless. All the other meds I've tried either make me feel like a zombie or make me extremely anxious and paranoid. Lamital has been great so far, I only have a few minor side effects and find that it makes me feel better overall but everyone does respond to meds differently. It's just nice to know there is someone out there who understands.
I know how hard and frustrating it is to have to try so many different medication combinations. I have been playing that game for over 20 yrs now. I agree with whodunnit about St. Johns Wort. It should only be used for mild depression. I have severe depression and was also diagnosed with Bipolar II. I have been taking Wellbutron 300 mg and Lamictal. I am not doing well because I am still experiencing fatigue, saddness, depression, and anxiety. Lamictal makes me feel flat, in return making the depression worse because I do not feel like being artistic. That seemed to be my only retreat out of this miserable world. Now, I have no drive. I blame that on the Lamictal. Since my bipolar symtoms seem to be more on the depressive side, I think I am gong to try to treat that more than the bipolar end. Anyway, I just wanted to tell you there are people out there that understand!
Sorry, I didn't answer your question about my symptoms. Although my mood changes rapidly throughout the day and I have periods of depression that last for weeks, the "symptoms" that I have that my doc is treating me for and calling BP-like are really things that I do when I'm not depressed. I have impulsive behaviors like shopping for things I don't need but I have never gone too overboard with that, my bills always get paid, but I don't have credit cards anymore because I maxed them all out when I was in my early 20's, so I canceled all of them and am afraid to get one now. I also have sleep problems, I frequently suffer from insomnia when I'm not depressed. But because this is not as severe with me as it is with most BP's, she said I'm probably not BP but is treating me for it anyway
The symptoms I have right now and for the last few weeks are definitely depression. I sleep 12-15 hours a day, spend the day lying in bed (but always with a book in my hand) I have no interest in sex and I don't shower unless I have to leave the house to go grocery shopping or to my support group (and I try to shop on days I have my support group so I dont have to get out of bed the next day). I have always been a hygiene freak and during other periods of depression I would still shower even if I stayed home all day. So I know I need something else.
The symptoms I have right now and for the last few weeks are definitely depression. I sleep 12-15 hours a day, spend the day lying in bed (but always with a book in my hand) I have no interest in sex and I don't shower unless I have to leave the house to go grocery shopping or to my support group (and I try to shop on days I have my support group so I dont have to get out of bed the next day). I have always been a hygiene freak and during other periods of depression I would still shower even if I stayed home all day. So I know I need something else.
Thank you both for responding. BP is very difficult to diagnose since the behaviors mimic many other mood disorders and it is very similar to depression in a lot of ways. For most people it takes years and a lot of doctors visits to diagnose it. Often times people are misdiagnosed as BP when they have PTSD or another disorder. I don't have the highs that are typically associated with BP but I have some of the behaviors. From what I have been told by several doctors and BP's, some BP's don't get the highs, which makes it harder to diagnose.
As far as my meds, the Lamictal is the only med I have been able to tolerate, ADs make me very sick and suicidal (which is a typical BP reaction to an AD) That was why I was hoping the St John's Wort may help with the occasional lows that I still experience. I've already had my intake appt at the new office, and they already told me that I need something in addition to the Lamictal, but are going to be afraid to try anything because of the reactions I have had to other meds.
Like I said though, that will be in 3 months so I'm looking for something else OTC that I can add to my Lamictal now to help a little.
Lamictal has been approved for people suffering from depression as well as BP because it can help the lows as well as the highs. I have been on it for 6 months and it stablizes me in a way that my lows are less severe and less frequent. It's just not working as well the last few weeks which is why I thought an increase would be helpful. Any thoughs on that would be helpful :-)
As far as my meds, the Lamictal is the only med I have been able to tolerate, ADs make me very sick and suicidal (which is a typical BP reaction to an AD) That was why I was hoping the St John's Wort may help with the occasional lows that I still experience. I've already had my intake appt at the new office, and they already told me that I need something in addition to the Lamictal, but are going to be afraid to try anything because of the reactions I have had to other meds.
Like I said though, that will be in 3 months so I'm looking for something else OTC that I can add to my Lamictal now to help a little.
Lamictal has been approved for people suffering from depression as well as BP because it can help the lows as well as the highs. I have been on it for 6 months and it stablizes me in a way that my lows are less severe and less frequent. It's just not working as well the last few weeks which is why I thought an increase would be helpful. Any thoughs on that would be helpful :-)
Do not take St John's Wort while you are taking ANY other med. It will make you sick.
If you are only taking a mood stabiliser you also need an anti depressant at least as a mood stabiliser basically just removes any highs leaving you with basic depression. These two illnesses are not that different at all once you remove the highs.
The lows are just the same and are only made worse with bi polar through the contrast of falling from a high to a low. Without the highs it is the same as for every other D sufferer.
It is odd though that you need an increase in mood staboiliser. Why do you need that? The only reason would be if you are experiencing highs. A more reliable mood stabiliser is lithium. Tried and true but again should need an AD to deal with the depression.
One without the other for BP is like breaking a leg, getting a cast on it but no crutches. Bad news.
If you are only taking a mood stabiliser you also need an anti depressant at least as a mood stabiliser basically just removes any highs leaving you with basic depression. These two illnesses are not that different at all once you remove the highs.
The lows are just the same and are only made worse with bi polar through the contrast of falling from a high to a low. Without the highs it is the same as for every other D sufferer.
It is odd though that you need an increase in mood staboiliser. Why do you need that? The only reason would be if you are experiencing highs. A more reliable mood stabiliser is lithium. Tried and true but again should need an AD to deal with the depression.
One without the other for BP is like breaking a leg, getting a cast on it but no crutches. Bad news.
Bi-polar and depression are different and so are the meds you need.
In my opinion, St Johns Wort only helps with mild depression. I don't think it would be a good idea to mix it with your meds.
What kind of symptoms do you have? Your Dr should know if your bi-polar or not. Maybe you need to find another Dr to give you a definite diagnosis so you can be treated properly. Take care. Remar
In my opinion, St Johns Wort only helps with mild depression. I don't think it would be a good idea to mix it with your meds.
What kind of symptoms do you have? Your Dr should know if your bi-polar or not. Maybe you need to find another Dr to give you a definite diagnosis so you can be treated properly. Take care. Remar
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