Hi all. Been taking lamotrigine off label from my psych provider. Intended to help with emotional instability.

I have been slowly titrating up. Had some ups and downs but now I feel like I’m nearly at the worst I’ve ever been.

I have been on 200 for the past 3 weeks. My mood has not stabilized in that time and I am getting much worse.

A few days after the increase to 200 my coworker noticed an immediate and dramatic negative shift in mood and appearance. Prior to that, I was on 150 for 5 weeks. Initially I was doing pretty good but I had a steady decline for the entirety of the 5th week before I was upped to 200.

My bros please help. This is destroying my career and relationships. It has immediate and significant impacts on my life.

I sent my provider an urgent message in her portal but yeah I need to figure out this shit asap.

Not sure if I am having a paradoxical reaction to every psych med I am trying or what??? Also yes I am in therapy but in the process of changing to one who is a lot more strucutred in her approach and less of a talk therapist.

  • Broadfern@lemmy.worldEnglish
    5·
    6 days ago

    200?! I’ve been on a heavy dose and it’s slightly more than half that (be it for on label reasons), and that took years to titrate up to and adjust.

    It sounds like it is making your situation worse. Lamotrigine is a more risk-intense medication so please don’t stop it cold turkey, especially at your dosage. Hopefully your psych will see and cooperate to help you come off of it. Jesus.

    • dingus@lemmy.worldOPEnglish
      3·
      6 days ago

      200 mg is really absolutely not a wild dose. It is generally seen as the minimum therapeutic dose for conditions like bipolar disorder. The standard titration schedule is over several months, not several years.

      It’s really frustrating that I seem to have a “paradoxical reaction” to like every psych med.

      I have been under intense interpersonal workplace stress for many months now before I even started taking this drug and no med is helping me. :(

      • Broadfern@lemmy.worldEnglish
        1·
        6 days ago

        I suppose dosing standards may also differ on condition, region, and medical provider which is fair.

        None of what I said was meant to be directed at you in a way that places blame. I’ve had family members who were mis- or over-medicated and that same worry and sympathy bubbled up when I was reading your post.

        I’ll admit I peeked at some of your past posts and I would feel/react similarly in your work situation. Being even vaguely “neurodivergent” and having a stronger sense of justice and higher sympathy/empathy level is difficult, especially in a toxic work environment. It sucks that bullies seem to be able to sniff it out and make your life hell over it, too. There’s a lot of bullshit and injustice in this world, and I’m sorry you’re dealing with so much of it.

        I hope you’re able to find some small relief/reprieve, and can at some point find a better work situation too. You’re not crazy for being upset or sensitive to stress. However you manage to cope with it all is valid.

  • Apytele@sh.itjust.worksEnglish
    1·
    6 days ago

    Honestly at 200 I don’t notice a difference from when I wasn’t on it. I’ve never even been manic just had borderline for years and figured I’d try it just in case the BPD was a misdiagnosis but it hasn’t really made a difference. It has the least incidence of side effects of pretty much any mood stabilizer, including being less sedating. It can cause SJS but that’s so rare that I’ve never personally seen it and if you get it you might make it into a medical journal. Some patients who have experienced mania will say they feel worse on it because it doesn’t feel as good as being manic, the same way patients who’ve been hyperglycemic or hypertensive for an extended period will be hungry or dizzy while their glucose or blood pressure comes back down from orbit. It’s also possible that you’re a bipolar type 2 which tends to get depression way worse and might benefit from a low dose antidepressant or an adjunct 3rd gen antipsychotic like abilify or latuda. Last time I tried to give proper info on something like this somebody accused me of spam though so enjoy my word vomit.

    • dingus@lemmy.worldOPEnglish
      1·
      6 days ago

      Lol I won’t accuse you of spam. Don’t worry.

      Do you take anything now?

      I was initially on an SSRI but it didn’t help with that sort of thing either for me and I was also wondering if I was making me worse. :( The psych provider switched me to lamotrigine because I was still struggling and it was failing to alleviate that, but I’m not sure if this is harming my brain. I’m probably just some science experiment where they are fucking my brain up for fun.

      Lamotrigine is actually specifically for the depressive part of bipolar disorder is the thing tho. I don’t have that…but if I did, it’s designed to help it.

      • Apytele@sh.itjust.worksEnglish
        1·
        6 days ago

        I’m still on the lamictal I figured I should give it a fair shot and like I said I don’t feel like it does anything but it’s not hurting me and the doctor keeps prescribing it. I also currently take a low dose seroquel as a sleep aid. More importantly the one chemical imbalance I definitely do have is ADHD, for which I take clonidine at bedtime and strattera when I wake up. I also take a variety of supplements, in particular magnesium for mood / sleep and NAC for dermatillomania.