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Dr. Goldberg-Lamictal
midge6869 posted:
Dr. Goldber, I have been taking 200mg of Lamictal. About a week ago, I started taking 250 mg of the Lamictal. I was wondering, does it take a few weeks before I will notice the increase in dosage or will I start noticing it right away?
Thank you
snowyowl33 responded:
People take different roads seeking fulfillment and happiness. Just because they're not on your road doesn't mean they've gotten lost. Dalai Lama
Joseph F Goldberg, MD responded:

Nobody has ever scientifically shown that doses of Lamictal over 200 mg/day have any clear benefit in bipolar disorder, so, you and your doctor are essentially trying an experiment. You may notice nothing. What is it you are hoping the higher dose will do?

- Dr. G.
midge6869 replied to Joseph F Goldberg, MD's response:
Dr. G, I told my pdoc that the episodes of depression were coming more frequently and were more severe. I was taking 10 mg of Lexapro along with the 200 mg of Lamictal. He really didnt want to increase the Lexapro for fear of it causing mania so he said we would try upping the Lamictal to 250 mg. Midge
Joseph F Goldberg, MD replied to midge6869's response:
Apart from the less well-established notion that antidepressants can cause mania is the idea that they can accelerate the frequency of comings-and-goings. some might argue that if you actually have frequent depressions followed by remissions followed by new depressions (ie, a clear chunk of feeling not depressed for many weeks in between depressions), then the Lexapro might be aggravating the comings-and-goings of episodes, and may be worth eliminating.

There is little down side to raising the Lamictal. If that didn't work, another anti-cycling drug with antidepressant properties such as Seroquel or lithium would be worth considering.

- Dr. G.

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Joseph F. Goldberg, MD, is a Clinical Professor of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY. He also maintains a private prac...More

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