Lamotrigine (Lamictal) is an anticonvulsant used as a mood stabilizer in bipolar disorders. Although research indicated that it was somewhat less effective in preventing mania/hypomania, it is effective in treating and preventing bipolar depression, and was approved for use as a mood stabilizer by the …
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I am currently taking part in a trial dor the use
of this drug in secondary progressive MS.
I might be taking the placebo but I feel after
a fortnight of weakness I am so good I don’t
know myself, stronger legs and balance and very
happy mood. Can I take it that I am taking
lamotrigine and not the placebo?
It’s really impossible for me to answer that, but I am glad you’re responding to whatever you’re taking. And lamotrigine is a helpful drug for many people.
The size of the samples in each of the studies is somewhat laughable. I would respectfully submit that many more subjects are needed in several independent studies before I would take the LMT/hypomania-mania hypothesis seriously. As with any form of therapy, be it medication, psychology or some combination thereof, close monitoring is needed; in this regard, at least, I can support the concerns about LMT.
I am bipolar. My psychiatrist increased my dose of Lamictal from 50 mg to 100 mg due to a severe depression. I felt manic the first day, which continued for about 5 days, after which point I crashed into a deep depression. I definitely think Lamictal can cause mania. I am also on Seroquel and Klonopin. I googled for “lamical mania.”
i also started on 25 mg last night i had a hard time sleeping racing thoughts and mania.i was fine before i started it then all of a sudden. mania happened.
I have been on lamictal for almost a month and just recently started to feel very manic. I have not yet reached the 100mg. Still on 50mg/day. I will be discussing with my doctor.
My Partner was prescribed Lamotrigine in Jan 2006 after a long period of depression, over a year with a few shorter blipps of Hypomania than in any previous years, all of which had been plagued with mania and hypomania when he was prescribed antidepressants in the past even alongside stabilisers but they were on too low a dose. He had far less high symptoms at last From October 2004 – Jan 2006, until He started taking lamotrigine and then followed the most aggressive raid cycling highs,I had experienced from him. Within 3 days of starting it, or recommencing it or of any increases abover 50mg, he became dreadfully verbally aggressive, and assaulted me 5 times always after increases or recommencements. I thought we had seen the end of the Manic storms, and the depression had started to take hold more. The hypomania / mania only ever abated once the lamotrigine was reduced, and stopped. He is still experiencing verablly aggressive highs but think this is due to the previous 2 years destabilisation of Lamotrigine and conflicts we have had over it. He is however not violent like he was in his Lamotrigine induced Highs. All his other behaviours are still very problematic and typically high, but not as extreme as when he was on Lamotrigine. I hate this drug. It offers no protection against hypomania, unlike the other anticonvulsant Valproate, and the gold standard ,Lithium. I would be very wary of using it execpt maybe in unipolar depression , but not with rapid cyclers. I believe it worsens the course of the illness as do antidepressants cause mood destabilisation.
Have you reported these to the drug company or the relevant government bodies?
My daughter 19, diagnosed with rapid cycling bipolar, not sure what type, was started on Lamotrigine in December 2007. She had some difficult personal circumstances and was hospitilised overnight with medium-high risk of suicide, ? mixed episode, dysphoria in March. We were not told at the time due to patient confidentiality and would have thought that a longer stay would have been necessary if her life had been at risk! Her discharge summary stated Bipolar depressive episode but she was showing signs of mania, pressured speech, all over the place, when she attended the Recovery Unit (we did not know)and just one visit to a psychiatrist after missed this, lack of communication. She was on 100 mg of Lamotrigine and 1 mg Risperidone at the time. She disengaged from her treatment with no one chasing her up even though she was on an enhanced Care Programme Approach, and took her own life approximately 5 weeks after her hospital admission.
We were not told anything as she did not wish us to know of her behaviours and I let her walk out of the house when I should have realised she was in the height of mania. She had a hat from group therapy which said “I growl, I bite”, yes, so that’s it, she was almost continually irritable as an adolescent and we just hit brick walls in getting any diagnosis or help – she did not want to be labelled.
No one from the mental health trust has spoken to us about her condition – we have had to get hold of her notes and find out that they had not followed best practice and their own guidelines! For instance, she should have had a review 4 weeks after her discharge. There was no crisis or contingency plan in her CPA! Her CPN rearranged a visit in the final week due to staff shortages, not to show up later as she was off sick. No one was sent in her place!
We are awaiting a Serious Untoward Incident Review and the Coroner’s Inquest. I expect nothing will change but I am going to try my hardest as this was preventable.
Apart from the appalling system failures, I cannot believe my daughter, in her manic state, was allowed to continue with the Lamotrigine or at the very least, should have been closely monitored!
We are devasted beyond repair and I miss my beautiful daughter so much – we love her very much.
Dear Lee,
This is the first time I have been back to this blog since my entry on August 13th.
I was shocked to hear of the tragic and unnecessary death of your beloved daughter.
I can only express how deeply sorry I am to hear these circumstances, which sadly are all too common. You shall be in my thoughts and prayers, and I am sure your daughter will stay very close to you in spirit at this time.
Some struggle on relentlessly with this illness for what seems like a lifetime full of trauma , loss and pain and let downs. She had a short life, but this was not her path, to carry on. I feel she has gone on to a far better place, though taking one’s life is never the answer.Sadly she slipped through the net of what we call community care, and I understand and share your bitterness and the anger and frustration and searching questions I suspect you may be feeling.
Understandably you want reasons and must be asking why, why , why ? This must have been a torturous year for you,but there may be no answer forthcoming. It appears to have been a matter of timing and a combination of circumstances that worked against her getting the care she most desperately needed. But, sometimes the situation can change so quickly when people appear to be doing well, and ultimately it is no ones fault, but this monster of an illness we call Bipolar which has takem so many young and mature lives. It does seem so unfair in one so young, dreadfully , unforgivingly unfair.
Lamotrigine certainly seemed to have an adverse effect on my partner, however, to be fair, and I have done alot of reading and research, an attend MDF Bipolar support group even without my partner,others have found it really helpful and transformative. I think the lack of regular monitoring and the time it actually takes to get the right level and combinations of treatment poses huge cahllenges and problems all round in over stretched community services. They do what they can, and some go that extra mile, but it can never be enough with this illness.
THis is a ruthless illness, and clinicians still have much to learn. Some people respond quickly and earky on in treatment, and others evade clinicians and mental health workers for years.Although research is moving faster now, there is still an awful lot that needs to be done to improve timely access to services when in crisis,and knoweldge, and treatment options and efficacy. Action plans can be difficult if not impossible sometimes to put in place or carry out without the full cooperation of the client, especially early on after diagnosis, and it is sadly a matter of timing inmany cases, and availability of beds. The list goes on.
Yes I have reported my concerns re Lamotrigine repeatedly, however ,it is extremely difficult to prove such a connection as the mental health teams have also failed to monitor or spot my partner’s symptoms at the right time to make this assessment, partly down to their dismissiveness of my concerns and, significantly comlicated by my partner’s extreme lack of mental insight which makes him unwilling to consider changing his treatment as he firmly believes he is well when high, and his ability to be very plausible and articulate enough to fool them and himself he is well when he is most ill. It is a losing battle unless the temas can actually witness the kind of behaviours I do, which is unlikely in the consultation room, and this is where the obstacle lies. They have said before, we will have to wait fir a crisis ! What about crisis intervention ? They seem to pay lip service to it. I think it means waiting until someone is frankly psychotic, then averting a worse crisis caused by their actions. Wheras my understanding of crisis intervention is to alert the team when there are early or very early warning signs before hypomania or mania fully emerge so they can adjust treatment then , but it does not seem to happen in practice, just in theory. THe subtle symptoms can take time for partners, carers/ families and especially sufferers to accept or identify, however even though I know them in my partner very well, the team do not seem to act on my observations.
It is ofcourse much harder to get cooperation from the patient once the episode has started and they are simply impenetrable in their denial, and justification.
I can not get any feedback from them regarding whether they have suggested any changes. I have repeatedly asked for reassessment and referral to another specialist unit to no avail as yet though we did see a professor of psychatry who prescribed an increase in the Depakote, was not in favour of Lamotrigine and added an antipsychotic a few months later once my partner had crashed down out of a 2 month high.
He was making some progress on these changes briefly after some weeks but then chose to increase his Lamotrogine again and asked to stop his antipsychotic . They stupidly allowed it! THe professor later told me he had never been out on a therapeutically high enough dose by the local team who are non specialist of the antipsychotic dose to avert another manic episode, and only experienced the sedating side effects, which I must say were notable, however, he was also still on Lamotrinine and depakote at the samt time as seroquel, and the combination was too heavy. I can understand why he was keen to stop something. Unfortunately they stopped the antipsychotic, though would have been better stopping the Lamotrigine. We were then back to square one, more hypomania and another assault and another 3 month estrangement as he does this each episode. Nothing is any better this year either, even though off the Lamotrigine now may I add. I believe it has destabilised his mood just as anti Ds can do as it is a mood elevator, working on the depressive geatures only of the Bipolar. It certainly seens to need to be combined with an antimanic, rather than just used alone in monotherapy, especially in a rapid cycler. For those whose depression is severe but infrequent with less frequent manias, then maybe it can work for them alone, or for unipolar depression. I still have my oubts because of my experience and observations of the rapid hostility it appeared to induce, but my partner used to start back staright on 100mg after stopping which is wronng. It should be very gradually and slowly increased at a rate of 25mg alternate days for the first 2 weeks then slowly thereafter apparently and the overall dosage aim halved if on valproate combined, or Lamotrigine doubled if on Tegretol combined.
He has been on and off like this by his and all other accounts since his mid teens and is now 50 plus.
Some individuals seem to be lucky enough to get the correct treatment early on and remain well for years. Others have to wait years before they are even diagnosed properly. Research suggests it can take between 10 to 19 years commonly. That was certainly our experience before acorrect diagnosis.
Some successfully self manage, with support, and with rapid cycling which is by far the hardest variable to treat, many struggle on for decades having little or no quality of life, with one disastrous consequence after another, numerous personal losses , failed attempts at love, life and employment interspersed with fleeting happier times an successes if they are very lucky. 50 % do not have insight, 50 % are unemployed and apparently 90 % have failed relationships. It is adevastating illness which takes hostages !THough they say it is highly treatable, I would like to know what percentage achieve that an how long that takes. Like any chronic condition, there are good times, great times and bad bad times in different rations for different individuals. Generally the earlier he treatment the better but it does need regular and thorough monitoring and a good social support system and knowledge and awareness.
Some just don’t make it at all, and that is the cruel reality of this illness for thousands!
MY partner has felt suicidal on many occassions over the past 30 years,though many actually end up taking their lives accidentally by actions taken when High, even feeling good, they may think they can fly, or jump out of cars and feel immune to danger, or drink or take drugs too much, and have accidents just like anyone else, and it looks like suicide, or in mixed moods which are the most dangerous, whilst activated and energised by the High but having the motivation to take their lives if they have a simultaneously Underlying depressive or negative mood .
Sometimes people are too demotivated to carry it out when too depressed, Just as well! But I do not think people intentionally kill themselves if feeling manic or hypomanic, usually full of life unless they have low symptoms emerging, or distressing dysphoric unplesant delusions, just coming out of a high or just going into it after a long low period.
YOu may never uncover the circumstances of your daughter’s death, and I hope you don’t torment yourself trying to find reasons or blame, though it is perfectly understandable considering your dreadful loss, but this is an irrational illness, and very hard to treat at times, especially when newly diagnosed in someone so young. It can take years to reach stability or acceptance.
Mistakes will be made, and sadly your daughter was one of the unlucky ones who didn’t make it for whatever reason. Maybe sombodys negligence, maybe not.I feel for the pain you have gone through and are still going through, but all I can say, although ending one’s life is never ever the answer , and something clearly went wrong somewhere this time for her, if only in her thoughts, but she has probably been spared decades of suffering and trauma on one level . Though I firmly believe it is always better to persevere as treatments and research are improving all the time. She may not have been able to hold on to that belief. I am so sorry.
Rapid cycling is notoriously difficult to treat. She may have been successful in getting well, but equally she may not. My partner has had 30 years or more of hell, and is still trying to find his way.
This was not her path. You have my deepest sympathy, and I hope you can in time live those years out for her , enjoying all those things she enjoyed and don’t look back, look forward in the light and smile and laugh and hope again. I feel sure she would want that for you so she can smile down and see you happy again. I am sure she would not want you to spend any more wasted days in struggle for truths that may not be found. I am so so very sorry she has been taken from you, and I hope there can be some peaceful resolution in your hearts and minds in time. I am sure she will always be close to you wherever you are. what was her first name? I shall pray for you and light a candle in her memory.
I can not understand why they are not more insistant and proactive in encouraging clients to remain on approprioate medications, just as a doctor would insist for a medical condition. It appears that if a patient sounds rational verbally, and is articulate enough to make requests, they are allowed to take or mot take what they want, even if this rationaility is false. People can be so convincing of their wellness when hypomanic, and can mislead the psychiatric team in brief consultations unless they are acutely manic.
Sadly mania and hypomania fool peopel into believing this and their resistance and non acceptance of there being a problem is not deliberate or a matter of not taking responsibility ,as patients are often blamed for. It is Purely down to lack of mental insight which is very difficult to work with, and the mental health act seems to work against the very people they are suppossed to serve sometimes.
My partner has also had about a year off Lamotrigine but continues to have serious frequent hypomanic episodes though not as aggressive , and still interspersed with severe depression. I can not say categorically that lamotrigine has destabilised his mood , though it certainly appeared that way at the time. The manias/ hypomanias may have been spontaneous or as a result of his main stabiliser Depakote being inadequate on its own, but the Lamotrigine certainly appeared to worsen the hypomania and increase dysphoric/ mixed hypomanic phases once they had emerged .
He had the same response when prescribed antidepressants in the past, and is clearly not on the correct combination or adequate dosage of stabilisers. lamotrigine is generally much better for depression but gives no protection against mania developing although it does not necessarily induce it.
As you can see I am still wrestling with this and it really pulls me down, but I a determined to carry on and keep advocating fir better services for my partner and others, but I still make time for me. That is important to keep the balance.
I shall think of you and appreciate your kindness in replying.
Once more, I am deeply sorry for your loss, and shall think of you.Remember all the spacial gifts your daughter had and the love and time you shared.
No 3rd.2008. Marty
i have bipolar and was very stable on a low dosage of respirdal. however my doctor was concerned that i still had underlying depression. after several months he convinced me to take lamictal. within a week a was full blown manic. engaging in lots of seriousley dangerous behavior. my doctor and therapist both agree that it is rare but lamictal can trigger mania in some people. my concequences were so horrible in this episode. i wish the maker of lamictal could be responsible for the damage it caused my life.
It’s always good to find like-minded people. Thanx and I’m going to add you to my RSS feed.
Hi all,
In one of my previous posts on November 3rd I said that my partner had been off lamotrigine for nearlya year but was still experinecing aggressive hypomanic episodes, though not as violent ( Though probably because I was usually banished fairly on his episodes during 2008 )
however I subsequentlky discovered he had lied to me which he admitted in January 2009 aftera 5-6 month horrendous hiugh with lots of damaging consequences that he had in fact continued to take Lamotrigine in 2008 most of the time all along . That makes sense now as I was sure the highs presented the same as they had previously. Tis confirms further that lamotrigine can and does trigger manai and hypomania and rapidly . He has just doen the same after a 4 month low bu more level period. He recommenced lamotrigin eiwthout telling me and became hypoamanic then manic and dismissed me in very intiidating and hostile terms, severing all firms of communication within days of restarting it.
We are back to square one now . Yet another summer separated. 2009. This has gone on since 2002, though hehas had this condition fir 33 years. He only has a diagnosis about 1 1 years ago whilst visiting America for 5 years. We live live in England. Isimply can not get through to him andhe is now out there doing th ost destructive things. He said in january the mental health team told him that was the best medication to take fir his depression, however because of the previous devastating high he did not resume it until June, I suppose eventually fed up with the depression and decided he would take what he last recalls made him feel better, even if it was high. He does not see it that way.
I dont believe they told him to take it. He just likes the hypomanic way it makes him feel but is unable to actually see his behaviour at all, and thinks he is rational and well, which is far from the truth. He ha snow embarked on all manner of grandiose business plnas which he can ill afford and is extremely threatening if I dare to contact the mental health team with information concerning his activities to provide them with claer proof as he is never going to admit to them what he does. I don’t know what to do to effect any cahnge. I have requested specialist referrals and I do not know if they are recommending them to him or whether hes is resisting as I can not get any feedback from mental health as hehas obstructed their communication with me.
I am finding this situation unbearable, desertyions, then he bounces bacvk full of remorse and guilt when severly depressed but is not prepared to tray any alternative medication aproaches and says the mentla health team are not offering any. I am not sure if he is telling me the truth as he will not allow me to come to the consultaions any more since he has had all these highs. We used to go together in the past.
I utterly hate the impact lamotrigine has had on our lives by inducing incraedibly long very destructive dysphoric highly irritabel, aggressive 5 month periods of hypomania verging on mania.
Has anyone else experienced the same repeated manic or hypomanic triggering or switching when taking lamotrigine, if so have you noticed a dosage which does not cause this ?
I am also interested to know if anyone has had relief from moderate mania ( Hypoamania ), dysphoric and rapid cycling types by taking Depakote or Valproate and Lithium combined?
Any more ideas oe evidence about lamotrigine triggering mania/ hypomania and mixed moods ?
In March of this year, i had a Lamictal induced manic episode that was so severe, it landed me in the hospital for 6 days.It took a full month to completely subside,despite having stopped the drug immediately.Also,i was then able to determine that i had, infact been quite hypomanic since beginning Lamictal a full month prior to the major episode.The hypomania escalated into full mania the day after my doc increased my dose from 100mg to 150mg.She didn’t want to admit that the Lamictal was the cause but i knew that it was the only change that had occurred,hence the only possibilty. I was placed on Lamictal as i felt that my moods were bouncing around alot.She should have picked up on this but instead went ahead and raised my dose by a 3rd.It was a total nightmare of an experience and i am still suffering the fall-out from it. Does anyone have any suggestions for me? Is anyone aware of any class action lawsuits on this issue? Thank you and be well, Pati
My son was stable for about 3.5 years.. longest ever. I had read about lamictal and how it apparently changed people’s lives and it was one i wanted them to try for him. well he was recently put on lamictal after two episodes in the last 6 months … he was just as stable as i’ve ever seen him over thanksgiving… but I just hear he has been calling from work – sounding vey manic an one of the only triggring things is the lamictal. previously stopping his meds would bring on an episode. He was also on seroquel and geodon. It is very odd that he has a full blown manic episode when on meds after stabilizing
I have been on lamictal for bipolar II for one year, but am now in withdrawal because I strongly suspect that it increased the frequency and intensity of my hypomanic experiences. It took me a while to figure it out, because the mania didn’t coincide exactly with starting the lamictal. About a month after I had gotten to a maintenance dosage, I had a more intense hypomanic period than I had had in 20 years, and then in the next 8 months, I had three more of similar intensity. After ten months on the Lamictal, I plunged into a deep depression, again more profound than I had experienced in 20 years. My psychiatrist is convinced that lamictal can’t increase mania or cycling. He just kept raising my lithium. I kept asking, “Could this be caused by the lamictal?” It was the only major change in my life at that time.
The withdrawal is no cake walk.
I recently started lamictal, was very excited about it….but
Noticed some new mania, became impulsive and ended up having a manic episode while driving on the freeway.
I’m left traumatized and now recovering off lamictal.
I think it is rare to experience mania on lamictal but I think anyone taking it for bipolar disorder should beware.
I find that if I take more than 25 mg of Lamictal a day its brings on a very hostile hypo mania, accompanied by hyper sexuality. I have been taking Lamictal for years, and have tried many times to increase the dose gradually to get more antidepressant and mood stabilizing effect out of it, but at soon as I am on more than 25 mg for more than a day or so, the agitation and hyper-sexuality returns. I am presently trying to get off Lamictal completely, as I feel this drug has been of no value for me in the long term. I cannot believe that in all the controlled studies of this drug, that treatment emergent mania or hypo mania has never been reported. Perhaps it is because the investigators, being paid huge sums by the drug maker, did not want to see what the drug maker did not want to hear. By the way, ordinary antidepressants do cause some hypo mania in me, but not nearly to the extent that Lamictal does. The fact is that this drug, which is touted to stabilize mood, can do just the opposite to me. Psychiatrists should stop letting drug companies be their “educators” (actually “benefactors”), and listen to their patients and make up their own minds as to who is telling the truth. I am sure this posting will be deleted, because no one in authority likes the truth when it is contrary to his or her financial interest.
my father is having bipolar disorder n now taking lamotrigine so can any1 pls tel me that lamotrigine can cause manic episode or wil keep my father stable?
As an anti-convulsant, lamictal may be taken to control seizures in patients with epilepsy. To control epileptic seizures, the drug may be used in patients over two years old. Lamictal is also used to treat extreme mood swings in patients with bipolar disorder; for this purpose, lamictal may be used in patients over the age of 18.
I was wondering why after I took Lamictal that it amped up my brain. I ddn’t realize then that it was mania. I posted all this stuff on FB and I was so impulsive I couldn’t stop it. So just now I decided to look up mania and Lamictal and you really validated what I suspected all along. I take 200 MG; 100 in the a.m. and 100 at night. I take it with Cymbalta. I could not take Cymbalta alone but with both it seemed ok. I have to post reminder notes around my house to remind me of my impulsivity which starts right after I take my dose. However I seem not to be able to control it and then I am embarrassed afterwards. Thanks you so much for the info. I wish you all good health.
I recently have been diagnosed with Cyclothymia and was prescribed Lamotrigine 25mg to take before bed to help as I have been experiencing more depression recently. For the first 2 nights, it knocked me right out and seemed to be working well with managing my constant mood swings; however, by day 4 I noticed an extreme shift in my energy levels to the point where I have been running on about 3 hours of sleep a night and feel fine during the day. After speaking with my doc, I have been advised to break the 25mg pills in half and take the half in the morning instead of the evening. Also, prior to beginning lamotrigine, I used to take melatonin to help me sleep at night which I was told not to take anymore while on the lamotrigine. Now that I am taking a lower than 25mg dosage, my doc said I can take the melatonin again in the evenings.
Crossing my fingers in hopes that I am able to get more sleep tonight. Although, despite taking the melatonin an hour ago, I am still feeling incredibly alert and high energy. I also noticed I had become irritable and easily agitated which lead to me flipping out in a work setting over nothing. I became so enraged that I had to excuse myself to avoid any additional outburts that would have been out of my control. Hopefully, a lower dosage will work for me; and if not, looks like all the lamotrigine does is jack me up…. at least I’m not feeling depressed anymore.