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    Dr. G-Lamictal question
    midge6869 posted:
    Hi Dr. G, my pdoc increased my dosage of Lamictal on December 10th from 350mg to 400mg, and said if that didnt do it he might add some topomax or seroquel. I was just wondering if 2 weeks was enough time to see if the increased dosage was helping. Thank you.
    Joseph F Goldberg, MD responded:
    Dear midge6869,

    In the studies done by the manufacturer of Lamictal, there were no differences in antidepressant efficacy when comparing 200 vs. 400 mg/day so I would imagine that an increase from 350 to 400 mg would be unlikely to convert a nonresponse to a response (it might fine-tune an existing response). Seroquel is the best- and most-extensively studied remedy for bipolar depression, with a target dose of 300 mg/day, and is compatible with lamotrigine (and may have synergistic effects). Topamax has no known antidepressant or antimanic properties, but has been shown to cause depression in people with mood disorders.

    Dr. G.
    midge6869 responded:
    Thanks again Dr. G.

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