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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Janelle on March 30, 2002, at 2:21:29
Well, ever since I began titrating up on the Lamictal (I'm VERY sensitive to meds, even tiny doses - argh!) I have become increasingly anxious and agitated to such an extreme point I've been scared I was going to *lose it*. Anyway, given no other changes in my meds, the pdoc thinks the Lamictal (perhaps in combo with the Effexor) may be setting me off.
SOOOOOOOOO, I'm off the Lamictal and will start Depakote tomorrow.
Could one/some of you brilliant people here explain the BASIC difference(s) between these two meds - how each one works, each one's side effects. I really need a comparison of the two please! Thanks very much.
Posted by Ritch on March 30, 2002, at 22:44:49
In reply to HELP! Switching from Lamictal to Depakote, posted by Janelle on March 30, 2002, at 2:21:29
> Well, ever since I began titrating up on the Lamictal (I'm VERY sensitive to meds, even tiny doses - argh!) I have become increasingly anxious and agitated to such an extreme point I've been scared I was going to *lose it*. Anyway, given no other changes in my meds, the pdoc thinks the Lamictal (perhaps in combo with the Effexor) may be setting me off.
>
> SOOOOOOOOO, I'm off the Lamictal and will start Depakote tomorrow.
>
> Could one/some of you brilliant people here explain the BASIC difference(s) between these two meds - how each one works, each one's side effects. I really need a comparison of the two please! Thanks very much.Hi Janelle,
I suppose I could give you something to start to think about. Depakote is involved generally with GABA, while Lamictal is involved generally with NMDA. John could set you straight on the specifics. I think Effexor (IMO), is a bad med to give to bipolars (mostly based on personal bad experiences). It could be that you would be better off with Depakote+Effexor, but you could be better off with Lamictal+ (absence of Effexor or something other than Effexor). AD's can create a real chemical earthquake in susceptibles.
Mitch
Posted by JohnX2 on March 30, 2002, at 22:46:30
In reply to HELP! Switching from Lamictal to Depakote, posted by Janelle on March 30, 2002, at 2:21:29
> Well, ever since I began titrating up on the Lamictal (I'm VERY sensitive to meds, even tiny doses - argh!) I have become increasingly anxious and agitated to such an extreme point I've been scared I was going to *lose it*. Anyway, given no other changes in my meds, the pdoc thinks the Lamictal (perhaps in combo with the Effexor) may be setting me off.
>
> SOOOOOOOOO, I'm off the Lamictal and will start Depakote tomorrow.
>
> Could one/some of you brilliant people here explain the BASIC difference(s) between these two meds - how each one works, each one's side effects. I really need a comparison of the two please! Thanks very much.Depakote is an extremely effective mood stabilizer for people who may feel very agitated. The dose of the medicine can be titrated up fairly quickly to help relieve agitation and mood cycling much faster than a medicine like Lamictal. It is a very effective medicine.
John
Posted by JohnX2 on March 30, 2002, at 22:52:13
In reply to Re: HELP! Switching from Lamictal to Depakote » Janelle, posted by Ritch on March 30, 2002, at 22:44:49
> > Well, ever since I began titrating up on the Lamictal (I'm VERY sensitive to meds, even tiny doses - argh!) I have become increasingly anxious and agitated to such an extreme point I've been scared I was going to *lose it*. Anyway, given no other changes in my meds, the pdoc thinks the Lamictal (perhaps in combo with the Effexor) may be setting me off.
> >
> > SOOOOOOOOO, I'm off the Lamictal and will start Depakote tomorrow.
> >
> > Could one/some of you brilliant people here explain the BASIC difference(s) between these two meds - how each one works, each one's side effects. I really need a comparison of the two please! Thanks very much.
>
> Hi Janelle,
>
> I suppose I could give you something to start to think about. Depakote is involved generally with GABA, while Lamictal is involved generally with NMDA. John could set you straight on the specifics. I think Effexor (IMO), is a bad med to give to bipolars (mostly based on personal bad experiences). It could be that you would be better off with Depakote+Effexor, but you could be better off with Lamictal+ (absence of Effexor or something other than Effexor). AD's can create a real chemical earthquake in susceptibles.
>
> MitchYes, I agree. Its possible that being on the high dose of Effexor in the absense of the mood stabilizer is not a good situation. Generally one would like to titrate onto a mood stabilizer first (like Lamictal or Depakote) and use as much mood stabilizer as possible before throwing on ADS. But since you are already on a mid dose of Effexor, if you don't want to drop the effexor dose, it might make more sense to go with a quicker acting mood stabilizer like Depakote. I think this is the direction that your doctor is persuing. It doesn't sound like a bad idea.
The other route would be possibly to lower the effexor dose in lieu of titrating up Lamictal, but this is a much more time consuming process.
John
Posted by JohnX2 on March 30, 2002, at 23:00:21
In reply to Re: HELP! Switching from Lamictal to Depakote, posted by JohnX2 on March 30, 2002, at 22:52:13
> > > Well, ever since I began titrating up on the Lamictal (I'm VERY sensitive to meds, even tiny doses - argh!) I have become increasingly anxious and agitated to such an extreme point I've been scared I was going to *lose it*. Anyway, given no other changes in my meds, the pdoc thinks the Lamictal (perhaps in combo with the Effexor) may be setting me off.
> > >
> > > SOOOOOOOOO, I'm off the Lamictal and will start Depakote tomorrow.
> > >
> > > Could one/some of you brilliant people here explain the BASIC difference(s) between these two meds - how each one works, each one's side effects. I really need a comparison of the two please! Thanks very much.
> >
> > Hi Janelle,
> >
> > I suppose I could give you something to start to think about. Depakote is involved generally with GABA, while Lamictal is involved generally with NMDA. John could set you straight on the specifics. I think Effexor (IMO), is a bad med to give to bipolars (mostly based on personal bad experiences). It could be that you would be better off with Depakote+Effexor, but you could be better off with Lamictal+ (absence of Effexor or something other than Effexor). AD's can create a real chemical earthquake in susceptibles.
> >
> > Mitch
>
> Yes, I agree. Its possible that being on the high dose of Effexor in the absense of the mood stabilizer is not a good situation. Generally one would like to titrate onto a mood stabilizer first (like Lamictal or Depakote) and use as much mood stabilizer as possible before throwing on ADS. But since you are already on a mid dose of Effexor, if you don't want to drop the effexor dose, it might make more sense to go with a quicker acting mood stabilizer like Depakote. I think this is the direction that your doctor is persuing. It doesn't sound like a bad idea.
>
> The other route would be possibly to lower the effexor dose in lieu of titrating up Lamictal, but this is a much more time consuming process.
>
> JohnHmm...you also could stick with the Lamictal and dose in some Neurontin to help with the agitation while doing the titration. Ultimately however, you would need to address the AD issue, as you may not need that strong Effexor dose with the Lamictal.
I think maybe the Depakote approach has a higher probability of getting you stabilized the quickest. Just my opinion.
John
Posted by Janelle on March 30, 2002, at 23:28:41
In reply to Re: HELP! Switching from Lamictal to Depakote » Janelle, posted by Ritch on March 30, 2002, at 22:44:49
Posted by Cindylou on April 8, 2002, at 20:24:53
In reply to HELP! Switching from Lamictal to Depakote, posted by Janelle on March 30, 2002, at 2:21:29
Hi Janelle,
I know we've posted back and forth before (or at least within the same thread), but I don't recall remembering how SIMILAR we are in med reactions --"VERY sensitive to meds, even tiny doses" is exactly what I experience.
And my experience with Lamictal was exactly the same as well -- while I titrated up the agitation was almost unbearable. Serzone helped with that, and Klonapin helped a little -- but mostly helped me sleep.
I'm interested in hearing how Depakote works for you, if you have made the switch yet. You may have posted since this message -- I am catching up from being away (again.)
Take care,
cindy> Well, ever since I began titrating up on the Lamictal (I'm VERY sensitive to meds, even tiny doses - argh!) I have become increasingly anxious and agitated to such an extreme point I've been scared I was going to *lose it*. Anyway, given no other changes in my meds, the pdoc thinks the Lamictal (perhaps in combo with the Effexor) may be setting me off.
>
> SOOOOOOOOO, I'm off the Lamictal and will start Depakote tomorrow.
>
> Could one/some of you brilliant people here explain the BASIC difference(s) between these two meds - how each one works, each one's side effects. I really need a comparison of the two please! Thanks very much.
Posted by Janelle on April 13, 2002, at 1:34:56
In reply to Re: HELP! Switching from Lamictal to Depakote » Janelle, posted by Cindylou on April 8, 2002, at 20:24:53
Hi there,
What a *relief* to hear from someone with such similar reactions to the same meds! I have thought about trying Serzone, but not yet. Am on EffexorXR as AD. Also take Klonopin, but have been on it a long time - does NOTHING to help me sleep.
I have indeed made the switch to Depakote. Taking the ER (time release, once-a-day) version. I take it in the evening. Started at 500 mg/night and nothing - no major side effects, which was nice, a bit calming but very subtle. Just went up to 1000 mg tonight. So it's too early in the game to be able to tell you if Depakote is working for me or not!
Thanks for your interest.
Posted by sczacovi on March 17, 2004, at 13:36:21
In reply to Re: HELP! Switching from Lamictal to Depakote, posted by JohnX2 on March 30, 2002, at 23:00:21
My son was on depakote and besides having to draw blood to make sure his level was good, he became a totally different boy. He started doing things that he never did before. He became aggressive and hurtful toward his younger brother, climbed bathroom stalls at school, stuck a paper clip in a live socket and became very restless. We couldn't get his level right. I'm not saying depakote will have an adverse reaction with you, but if you start feeling or acting like the above, get off that med. Good luck
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