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Dr. Bob is Robert Hsiung, MD,
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Posted by kxxxk on September 14, 2003, at 21:16:20
Full subject: Lamictal for depression in continuously cycling Bipolar Disorder I?
My wife continuously cycles from her (now controlled) manic or active phase to her inactive (depressive) phase and then back to her active phase again, one phase after the other, very predictably, with a little over 3 complete cycles per year. She passes through normal only as she is transitioning from one phase to the other. She now spends 75% to 80% of her time in the inactive or depressive phase, which is characterized by "lack of energy", that is, 12 hours sleeping in bed, 12 hours (mostly sleeping) on the couch - no sadness and no suicidal thoughts. We are, one by one, trying the appropriate antidepressants for the inactive phase, but with no effect of any kind yet. Just increasing the over-all length of her cycle would not help, as she would still be spending 75% to 80% of her time in the inactive phase.
Has anyone with continuously cycling Bipolar I had experience with Lamictal decreasing the severity of depression, especially such depression, or shortening the length of time in the depressive phase, or increasing the time not spent in depression proportionately more than the time spent in depression? If so, over how many cycles and (also) over how many years has Lamictal been taken? Have you noticed a need to increase the dose of Lamictal over this time to maintain its effect?
If there has been either positive or negative experience with Lamictal in somewhat similar circumstances, we would love to hear about it. Thanks.
(FYI: Her manic phase is controlled by 20 mg of Zyprexa at bedtime [after trying many other mood stabilizers for years]. This is tapered to 5 mg as she leaves the active phase because 20 mg of Zyprexa has no effect on her inactive phase, but maintenance of 5 mg of Zyprexa causes her eventual transition back to the active phase to be slow enough that we can catch it as it is occurring and increase the dose of Zyprexa back to 20 mg to prevent her symptoms from running away.)
Posted by HenryO on September 15, 2003, at 4:39:42
In reply to Lamictal and continuously cycling Bipolar I?, posted by kxxxk on September 14, 2003, at 21:16:20
I don't know anything, clinically speaking, about Bipolar 1. But your description of the situation is fairly detailed.
Here is my personal experience with Lamictal. It greatly lessens my depression and shortens the duration of acute depression. For me it also limits the severity of the mood swing and disrupts the cycling. I can't say how many cycles per year as neatly as you did. I keep pretty poor track of that sort of thing. I would say that I'd be fairly depressed most of the time with maybe three or four very short lived "high" phases in a year, I'm not sure they would qualify as true mania. I have at least two serious meltdowns. The meltdowns consist of what you descibe. Sleeping 19-20 hours a day. Feeling horrible but never thinking of suicide, just an overwhelming need for darkness and no interference. Those really low periods could be three months long or worse.
With the Lamictal I am still susceptible to all of the above, only much less severely in every respect. Lamictal has been great for me.
I think one of Lamictal's designations is a "mood stabilizer" and that is exactly how it works on me. From the little I know, I think it would be a great med to try for the situation you describe. I have been on it for nearly two years with no sign of poop-out, no rash, no weight gain, no sexual disfunction. I have read posts here about short lived effects, headache and lack of any efficacy.
However, in my personal experience, I am pleased with Lamictal, more so than with any other med to date. I hope your wife has a similar experience.
Posted by delna on September 16, 2003, at 22:34:52
In reply to Re: Lamictal and continuously cycling Bipolar I?, posted by HenryO on September 15, 2003, at 4:39:42
henry
may i ask what does of lamactil you are on. it has been great for me too. the need for darkness and isolation is just how i am at times, lasting for months. so i really relate to that
d
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