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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by green tea on September 25, 2002, at 22:37:59
hello. my name is patricia. i have severe social anxiety and depression. my psychiatrist is putting me on lamictal for depression..i was wondering if anyone knows of or has any experience with lamictal working for social anxiety?? thanks so much..bye!
Posted by jrbecker on September 26, 2002, at 8:10:38
In reply to lamictal for social anxiety?? (please respond), posted by green tea on September 25, 2002, at 22:37:59
you will love this drug for social anxiety, it not only makes you seek out socializing but makes you calm enough to enjoy it.
However! Don't be discouraged by the anxiety you feel at the start of the dosage titration. When you first start, and every time you move up the dosage ladder, you will experience some intermitent anxiety, especially the first 2-5 hours after intake. The insomnia you will experience at first will also add to this anxiousness. I recommend taking either a sleep agent or something like neurontin or klonapin, at night until the effects subside, then try lamictal alone once you have leveled off. Other adverse effects that might bother you at first: ataxia, double vision, slight headache, poor memory recall, and possibly slurred speech. You just gotta stick it out and be patient, most, if not all of it, will subside. As many other posters on here will attest (do your research of past threads), it is a GREAT drug.
Posted by green tea on September 26, 2002, at 22:09:05
In reply to Re: lamictal for social anxiety?? (please respond), posted by jrbecker on September 26, 2002, at 8:10:38
hi..thanks for responding. that is great news about the lamictal..i really hope it works. my doctor tried putting me on zoloft but it made me manic so hopefully this will help me feel better. i just had a question though..how long do you think i should give the lamictal to see if it works for my social anxiety?? talk to you later~
Posted by McPac on September 27, 2002, at 10:21:57
In reply to Re: lamictal for social anxiety?? (please respond), posted by jrbecker on September 26, 2002, at 8:10:38
Lamictal should work well for anger/temper/agitation/irritability issues, correct?
I tell ya....this Lamictal would be an incredible drug if it just worked for ocd as well....I wouldn't need another med if it did!
Posted by lawrence s. on September 28, 2002, at 20:51:33
In reply to jrbecker, Re: lamictal for social anxiety?? , posted by McPac on September 27, 2002, at 10:21:57
At what dosage level did you start to notice any improvement? I have just started Lamictal for social phobia and I need relief soon. I have had great success with Nardil. I had to stop taking it before I had my hernia operation. Nardil was so hard to get off that I am affraid to ever go back on it again. So I'm giving the Lamactil a try. I really hope this stuff works.
Posted by McPac on September 28, 2002, at 21:08:41
In reply to Re: jrbecker, Re: lamictal for social anxiety?? , posted by lawrence s. on September 28, 2002, at 20:51:33
Hi Lawrence,
remember, I'm only trying the Lamictal for anger/temper problems.....I'm only taking 12.5 mg (half of the smallest tablet).........I don't know about using it for social phobia though.
ASK chad 3......he posts here about social phobia (he seems to know a LOT)...he would be your best person to ask about that condition.
Take care...and ask chad 3!
Posted by jrbecker on September 29, 2002, at 21:48:56
In reply to Lawrence---Re: lamictal for social anxiety?? , posted by McPac on September 28, 2002, at 21:08:41
Yes, Lamictal does help with anger/irritability. I have atypical depression that is highly correlated with anger issues. Lamictal has helped me a lot. The anxiety that comes with the initial onset of a dosage increase might cause a little edginess but this is a transient effect.
Posted by jrbecker on September 29, 2002, at 22:10:40
In reply to Re: jrbecker, Re: lamictal for social anxiety?? , posted by lawrence s. on September 28, 2002, at 20:51:33
Surprisingly, I noticed an effect almost immediately. My lamictal response has gone something like this. The first 1-2 days after a dosage increase I have mild anxiety from the response. Starting at day 3 tough, the mood effect really kicks in and the anxiety subsides. Unfortunately, it's sort of a game of tag that you will have to play at first, as eventually, your body desensitizes to the drug and the effects fade, so you'll have to keep titrating up to 'catch up' to the drug effects again. This takes patience though, since increasing too quickly leaves you prone to dabilitating side effects, and worse, the infamous rash. Eventually though, you will reach a saturation point (this could take months), where you're satisfied with the balance of the AD effect and the side effects are still manageable. As you'll see, some posters can near the 400-900 mg mark (although this is very much on the extreme high side). Most people find a dosage range b/t 100-250 mg as comfortable. Some, however, don't even start to get a response until much later though. You'll just have to find out for yourself.
For myself, I am currently at 125 mg and holding. I will most likely try to titrate up further eventually though.
good luck.
Posted by Peter S. on September 30, 2002, at 13:03:55
In reply to Re: lawrence, Re: lamictal for social anxiety?? , posted by jrbecker on September 29, 2002, at 22:10:40
My experience very much correlates with jr. Immdiate response and then tapering up. Now taking 600mg. Was noticing major cycling until started 10 mg Prozac. Currently also taking 600 mg of Neurontin.
> Surprisingly, I noticed an effect almost immediately. My lamictal response has gone something like this. The first 1-2 days after a dosage increase I have mild anxiety from the response. Starting at day 3 tough, the mood effect really kicks in and the anxiety subsides. Unfortunately, it's sort of a game of tag that you will have to play at first, as eventually, your body desensitizes to the drug and the effects fade, so you'll have to keep titrating up to 'catch up' to the drug effects again. This takes patience though, since increasing too quickly leaves you prone to dabilitating side effects, and worse, the infamous rash. Eventually though, you will reach a saturation point (this could take months), where you're satisfied with the balance of the AD effect and the side effects are still manageable. As you'll see, some posters can near the 400-900 mg mark (although this is very much on the extreme high side). Most people find a dosage range b/t 100-250 mg as comfortable. Some, however, don't even start to get a response until much later though. You'll just have to find out for yourself.
>
> For myself, I am currently at 125 mg and holding. I will most likely try to titrate up further eventually though.
>
> good luck.
Posted by McPac on September 30, 2002, at 16:22:44
In reply to Re: lawrence, Re: lamictal for social anxiety?? , posted by jrbecker on September 29, 2002, at 22:10:40
jr, I take Zoloft for depression.......therefore, I am attempting to take the Lamictal for anger/temper......when I take just 12.5 mg every 2 days or so, it seems to do the job. I don't want to increase the dose; I'm hoping that I can just keep this low dose......I guess you can say that I am using the Lamictal very much like someone would use an anxiety med, i.e. just a bit every other day to keep the anger at bay...
Posted by McPac on September 30, 2002, at 16:26:38
In reply to Re: lawrence, Re: lamictal for social anxiety?? , posted by jrbecker on September 29, 2002, at 22:10:40
jr, I forgot to ask you this......I know about the possible rash on Lamictal....but what have you discovered are the other, more common side effects with Lamictal?
Also, did you ever try Depakote? (I have not) Just wondering which you think is better---Depakote or Lamictal...and which one has the worse side effects?
Posted by jrbecker on October 1, 2002, at 12:21:42
In reply to jrbecker, posted by McPac on September 30, 2002, at 16:26:38
if you are getting a therapeutic effect frm a 12.5 dose, you are the exception not the rule. Most people don't start to feel something until 50-75 mg and still have to titrate up further to keep the effect. I started to have a good effect at 25 mg but it soon waned.
Secondly, if you are taking this purely for anxiety issues, you should explore other viable options (e.g., klonapin, neurontin, xanax). Unless you have a BP dx or cycle frequently, lamictal is probably not your BEST weapon for anxiety. It will help anxiety, especially by stabilizing your mood, giving you a slight AD effect, and decreasing the anger issues you were talking about. But you may want to explore other possibilties if anxiety is your core symptom. If you are going to stick with lamictal, you will eventally need to titrate up. Even if the 12.5 dose is working for you, you will eventually become tolerant to it. An obvious sign of this is when you're mood starts to become negative again and you become more irritable.
As for side effects, the big one for me is sleep. It's hard tryng to keep withn the window of optimial mood effects and still get a good night's sleep. That's the catch-22 for me so far. Hopefully the insomnia is subsiding though. As for other side effects, the other ones are 1) feeling slightly flushed during the 2-3 hours after intake, 2) memory issues 3) double vision 4) ataxia (discoordination) 5) headache. Most of these are transient and pass after settling on a new dosage level.
Posted by McPac on October 1, 2002, at 13:06:02
In reply to Re: mcpac - dosing and SE questions, posted by jrbecker on October 1, 2002, at 12:21:42
Thank You for your extremely informative and helpful post!
I have major depression, ocd and anxiety (& this anger/temper problem).
Zoloft has worked very well for my depression and ocd....Lithium has worked very well for my 'nerves' and temper (everybody knows that lithium is a MOOD stabilizer but I have always known (as Dr. Amen writes in one of his books also) that Lithium can also be a very effective NERVE stabilizer...it has done wonders for me when my nerves feel like they are totally falling apart. As far as bipolar, I'm sure that I could fit that category because the bipolar diagnosis and criteria for meeting bipolar has been 'stretched' out to include so much...and it's being stretched even further and further still...soon you'll have people saying, "I'm Bipolar 7 or Bipolar 19...instead of just Bipolar 1 & 2 (I believe there already is a bipolar 3 & 4;thought I'd read that).....at first bipolar meant the extreme swings from high-low...then, swings from 'kind of high' (hypomanic) to low....now, depression + anger, and more 'combos' are coming....pretty soon it will be something like this---"I have depression and I also like to sleep in on the weekends"---that will be Bipolar 12 or something...I've read a Dr's commentary on just that---that bipolar is being stretched too much...what's next, "I have depression and I go jogging a lot"---that will be Bipolar 43......I was thinking about trying klonopin but I didn't know if it could handle the anger/temper component...I knew it worked well for anxiety...jrbecker---could you please tell me your opinion of the pros and cons of taking klonopin...AND could it work well for bad intermittent anger/temper? Lastly, I read that long-term benzo use could CAUSE depression---what do you think of that? Thank You so much...I will be looking for your reply!
Posted by colin wallace on October 1, 2002, at 14:14:21
In reply to jrbecker Re: mcpac - dosing and SE questions, posted by McPac on October 1, 2002, at 13:06:02
Hi there,
I'm faring well on this minimal 12.5mg dosage of lamictal, with little or no sign of a diminution of its effects. I'd agree that we are in a minority, and will in all likelyhood eventually need to tirate(probably not a great deal higher in my case though).
I have found this med. to be very helpful with anger issues as well as depression and anxiety, both of which have been pretty nasty and enduring (although less so the anxiety of late).
A sensible option in your case may be to consider the use of a benzo. such as klonopin, or even diazepam, as a short term measure- they will undoubtedly help with the irritability while you adjust to the lamictal.
If you find that your anger and anxiety problems persist despite an improvement in depression, neurontin might be worth considering as an add-on, allowing you to reduce/eliminate the benzo.Best wishes,
Col.
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