Posted by SLS on July 7, 2015, at 15:24:31
In reply to lithium v.s lamotragine, posted by rjlockhart37 on July 6, 2015, at 23:44:28
Lamictal and Trileptal make a nice combination for bipolar disorder, especially when mixed-states exist. Trileptal is a top-down drug that acts as an anti-manic, while Lamictal is more of a bottom-up drug that helps with depression. Lamictal, although approved for bipolar depression, is also used for unipolar depression. Abilify can make a good adjunct to Lamictal. I'm thinking you can add Wellbutrin if there is residual depression and anxiety is not a prominent feature of your illness. I can't provide any literature to support these suggestions. They come from personal observations (anecdotes) and those described to me by physicians.
The only true mood stabilizer at this point is lithium, although some argue that Seroquel and Tegretol are as well. However, lithium has a narrow therapeutic index (window). Too little doesn't work and too much is toxic (kidneys; thyroid). For bipolar disorder, the dosage of lithium should produce a blood level between 0.8 - 1.2 mEq/L for acute episodes, and 0.6 - 0.8 mEq/L for maintenance. People with a strong propensity for mania often have to continue taking the higher dosages. In unipolar depression, low-dose lithium (300 - 600 mg/day) can be used as an augmenter of antidepressants. It helps me with depression at a dosage of 300 mg/day. Another reason to take low-dose lithium is to help reduce one's risk of getting Alzheimer's Dementia. Depression has been linked to a 2 - 3 times greater risk of developing it.
- Scott
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