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Is lamotrigine triggering hypomania?

G

Ginger Kitten

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Oct 2, 2020
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That's it in a nutshell. I started it 10 days ago and was fine at first. But the last 3 nights I have had very little sleep (early waking), have been feeling wired and I'm starting to talk a mile a minute. Irritability, sleeplessness and restlessness are all listed as side effects in the patient leaflet, but are also symptoms of my illness.

I know for certain it is the meds rather than the illness causing this, as I had been levelling out for a few weeks, then I started this med and bam! all the above problems arose again. I NEVER leave an episode then immediately relapse, I always hv at least a few months stable. Please help with support, but pls don't try to convince me this is bp breaking thru: I KNOW lamotrigine is doing this, I'm just hoping it's a short term effect.
 
H

HeavySoul

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Dec 19, 2021
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South Africa
This is interesting as I am currently experiencing an issue which I also believe are due to lamotrigine.

I have not experienced exactly the same issues as you but I also feel it has effected my brain in some way. I am not quite the same anymore. Irritability is however definitely an issue for me as well.

I suffer from rapid cycle BP and my doctor has recently increased my doses of lamotrigine as I was losing stability and it acted out at work which lead to a warning.
Now my sex drive is completely gone.

I dont know anymore if it is worth it. I do feel more stable and the rapid cycle is not so bad anymore but there is definitely side effects. I am afraid of reducing the doses and also afraid of what this high doses (300mg in morning and 400mg at night) is doing to me.

From what you say I am also now afraid I will develop the same issues you have.
Right now no sex drive is an issue as it is effecting intimacy with my wife.
 
Contramike

Contramike

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Jan 27, 2010
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549
Location
Colorado
That's it in a nutshell. I started it 10 days ago and was fine at first. But the last 3 nights I have had very little sleep (early waking), have been feeling wired and I'm starting to talk a mile a minute. Irritability, sleeplessness and restlessness are all listed as side effects in the patient leaflet, but are also symptoms of my illness.

I know for certain it is the meds rather than the illness causing this, as I had been levelling out for a few weeks, then I started this med and bam! all the above problems arose again. I NEVER leave an episode then immediately relapse, I always hv at least a few months stable. Please help with support, but pls don't try to convince me this is bp breaking thru: I KNOW lamotrigine is doing this, I'm just hoping it's a short term effect.
Why did your doctor put you on Lamotragine if you were leveling out? Were they maybe just trying to fine tune your meds even more?

Is there any way you can contact your doctor and tell him exactly what you just said here? If this was the result of the change they might pull back on it.

Try and get ahold of them soon and tell them about it.
 
H

HeavySoul

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Messages
22
Location
South Africa
Why did your doctor put you on Lamotragine if you were leveling out? Were they maybe just trying to fine tune your meds even more?

Is there any way you can contact your doctor and tell him exactly what you just said here? If this was the result of the change they might pull back on it.

Try and get ahold of them soon and tell them about it.

I was having a lot of issues with instability in my rapid cycle BP 4 months ago so I went back to my psychiatrist and he then increased my doses. I used to be on only 400mg in the mornings.

I will have to reach out to him. Biggest issue is the sex drive but I dont know if it really is the Lamotragine. It is the only change I have have made. I am also on Alprazolam just about daily due to panic and stress.
I have never experienced such a drop in sex drive before. I hope there is another pill I can take to increase it again.
But then its taking a pill for a pill.
Rapid cycle BP is really horrible.

Apology Ginger Kitten, did not mean to hi-jack your thread.
 
G

Ginger Kitten

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Surrey, Uk
@Contramike Ironically, it was me who suggested I needed a meds review so I saw pdoc on Xmas eve as an emergency. I was slap bang in the middle of a nastily dysphoric mixed episode, and since I get several episodes a year, I just couldn't take it any more. So he had 3 meds suggestions and I opted for lamotrigine as it seemed to be the the right choice.

So I took a week to decide (and do my research), saw him again and he prescribed it. He explained about the phased titration and why it's phased in gradually, and he mentioned some other side effects to look out for but he didn't say anything about it potentially causing a hypomanic switch. Maybe it's rare so that's why and/or he didn't want to scare me if it IS very uncommon. He wd hv weighed things up like that, he's very good and also very nice, I'm v lucky...

I am hoping, as I said above, that this effect will wear off soon. I'm not sleeping well but that's not causing my usual episodic irritability and I am getting mild euphoria (quite nice!), so maybe it will settle down. Thank you for taking the time to respond. Kind regards, Ginger.
 
G

Ginger Kitten

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Surrey, Uk
@HeavySoul No, you absolutely didn't, HS, I found your post interesting and informative, thank u for posting. I'm sorry to hear you get rapid cycling. Think I almost understand as I get frequent mood cycles and mixed episodes. I asked my pdoc if I was a rapid cycler🚴 but he said no, because my episodes didn't last long enough to fit the criteria. Weird criteria then, imo! I hope you can find a solution to your issues too. Kind regards, Ginger.
 
K

keith74

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Sep 14, 2020
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733
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Canada
I don't have anything really useful to add other than that I always thought lamotrigine was one of the few meds for depression that DIDN'T trigger mania in people with bipolar. I would be surprised (and disappointed) if it does since it is so commonly prescribed as a mood stabilizer. I know antidepressants are risky for sure. If lamotrigine is also, then it doesn't leave a lot of great options for bipolar depression :(
 
C

CabbageMama

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I am very weird with meds, so this probably isn’t helpful to you, but Lamotrigine sent me in to a crashing low.
 
B

BlueWater

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Earth
While titrating up on Lamotrigine last year, I felt I ended up in a mixed-like episode. It lasted two months and started to fizzle out on its own. I should've looked at the sheet that came with the med and notified my doctor earlier. I was motivated, happy and restless yet depressed and angry. I lost a friendship. I do not have a BP diagnosis but have been told I have some symptoms of it. Regardless, in my case Lamotrigine sent me up then made me feel like I was splitting apart. Dropping three dosages got me completely out of that hellish phase. A year later, I like it now. Looking back, I would not have followed the standard titration schedule and would've sat at dosages where I felt fine then would've increased only when I was depressed. There are others on this forum who can only take 25mg or so. To Keith's point, Lamotrigine is supposed to help the depression. For me, it slowed my mood changes, too.
 
G

Ginger Kitten

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Surrey, Uk
@BlueWater If you read the thread, I explain that I asked for a meds tweak. I was coming out of a brief mixed episode and calming down, now it's caused a switch into hypomania. I know it is lamotrigine because i know the pattern of my illness. It's maybe why my pdoc hasn't suggested a tweak himself.

It's obvious: if it is good for depression and depression is not usually my problem but mania is in mixed episodes... I guess I don't need to explain further. It's pushing me up, and VERY quickly, as that's what my metabolism of drugs is like : they affect me within days, not weeks.

I've spoken to a psychiatric nurse yesterday, who has emailed my pdoc saying I need an urgent meds review, due to the effects mentioned.

Thank u for yr reply. I hope I don't sound curt. I'm not, but I really don't feel well tonight. I've been high as a kite yesterday and today and now I'm shooting downwards. God I'm so sick of this illness.
 
Contramike

Contramike

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549
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Colorado
@BlueWater If you read the thread, I explain that I asked for a meds tweak. I was coming out of a brief mixed episode and calming down, now it's caused a switch into hypomania. I know it is lamotrigine because i know the pattern of my illness. It's maybe why my pdoc hasn't suggested a tweak himself.

It's obvious: if it is good for depression and depression is not usually my problem but mania is in mixed episodes... I guess I don't need to explain further. It's pushing me up, and VERY quickly, as that's what my metabolism of drugs is like : they affect me within days, not weeks.

I've spoken to a psychiatric nurse yesterday, who has emailed my pdoc saying I need an urgent meds review, due to the effects mentioned.

Thank u for yr reply. I hope I don't sound curt. I'm not, but I really don't feel well tonight. I've been high as a kite yesterday and today and now I'm shooting downwards. God I'm so sick of this illness.
Let us know what happens with your doc!
 
G

Ginger Kitten

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Surrey, Uk
@Contramike My pdoc called me this morning and I told him what I've told you guys, plus a few things I haven't, about a relationship with an ex who has come back into my life (too private to go in to) and he said I should stop the lamotrigine immediately but that we could review it in 3 months' time, at my next appointment.
I adore my pdoc. He really listens and takes my viewpoint into account. When I said I was convinced that the hypomania was caused by the drug, he took that on board but also encouraged me to consider the potential impact of the relationship on my emotions. He's Spanish. I think southern Europeans have a gift for understanding people and their emotions: my best friend is Italian.
Thank you for thinking of me. x
 
Amazingly

Amazingly

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I can’t handle taking more than 25mg of Lamotrigine.
I become euphoric and manic over this dose.
I’m currently doing well at the 25mg mark.
 
Contramike

Contramike

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Colorado
@Contramike My pdoc called me this morning and I told him what I've told you guys, plus a few things I haven't, about a relationship with an ex who has come back into my life (too private to go in to) and he said I should stop the lamotrigine immediately but that we could review it in 3 months' time, at my next appointment.
I adore my pdoc. He really listens and takes my viewpoint into account. When I said I was convinced that the hypomania was caused by the drug, he took that on board but also encouraged me to consider the potential impact of the relationship on my emotions. He's Spanish. I think southern Europeans have a gift for understanding people and their emotions: my best friend is Italian.
Thank you for thinking of me. x
That's great! I'm glad you have a psychiatrist who has a warm personality and that you can actually talk to. Those seem to be rare.

Let us know how things go!
 
G

Ginger Kitten

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Oct 2, 2020
Messages
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Location
Surrey, Uk
@Contramike Thank you contramike. I bet they're nor rare in Spain and Italy! Italians have a word for it that has no equivalent in English: simpatico. It doesn't mean sympathetic. More sociable, friendly and empathic. I've only ever once met an unfriendly Italian - and he lives next door!!!
A hug for you too, Ginger.
 

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