Shown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Betsy122 on January 22, 2009, at 11:13:22
Has anyone had experience with both these drugs? I'm trying to decide which one to go on. Which is the best, overall?
Posted by Phillipa on January 22, 2009, at 12:33:27
In reply to Lamictal versus Depakote, posted by Betsy122 on January 22, 2009, at 11:13:22
Hi Betsy what condition are you taking the meds for? Love Phillipa
Posted by Betsy122 on January 22, 2009, at 16:21:12
In reply to Lamictal versus Depakote, posted by Betsy122 on January 22, 2009, at 11:13:22
My diagnosis is atypical psychosis. It has not been determined whether I am bipolar or schizophrenic or perhaps neither one. I'm on 5 mg of Abilify but have chest tightness so we're trying to cut down on that drug and supplement it with either lamictal or depakote, all just to cut down on abilify...just in case that's what's causing the chest tightness. I'm worried about the side effects of these drugs though. Which is more effective and which has less side effects?
Posted by obsidian on January 22, 2009, at 21:19:13
In reply to Re: Lamictal versus Depakote, posted by Betsy122 on January 22, 2009, at 16:21:12
> My diagnosis is atypical psychosis. It has not been determined whether I am bipolar or schizophrenic or perhaps neither one. I'm on 5 mg of Abilify but have chest tightness so we're trying to cut down on that drug and supplement it with either lamictal or depakote, all just to cut down on abilify...just in case that's what's causing the chest tightness. I'm worried about the side effects of these drugs though. Which is more effective and which has less side effects?
I don't know about depakote, but...I take a little lamictal. The big thing that people are always concerned about with lamictal is a rash - "stevens johnson syndrome" I believe. Well, not too many folks get it, but since it can be serious everyone looks for it. The docs titrate slowly up on lamictal and check for it. If you don't go up and down on the dose (say by missing doses) your risk is lower.
So, I've been taking lamictal for quite a while. The only side effect I recall is a headache when starting it, then nothing... but now that I'm thinking about it, initially, I think it made me more irritable, but that dissipated. Other than that it's been a super easy med for me to tolerate.
My friend takes it too, no problems for her either, but she does report some weakness-low blood sugar like feelings if she misses a dose.(go figure, but I wouldn't know because I've only missed a dose once and was probably too preoccupied to notice)
She says that lamictal has been very helpful for her, that it's really evened out her moods. I can't tell really, but I am on a low dose.As far as abilify goes, it wasn't for me. Gave me weird acid like sensation coming up, like it was messing with my upper digestive system.
I take seroquel, again low dose, which probably helps by virtue of it knocking me out each night and therefore keeping my busy, busy head from ruminating, and ruminating, and did I say ruminating? ;-)
anyway,
good luck
let us know how it goes
Posted by desolationrower on January 23, 2009, at 1:40:26
In reply to Re: Lamictal versus Depakote » Betsy122, posted by obsidian on January 22, 2009, at 21:19:13
Generally lamotragine is a low-sideffect drug, and less than valproate...i'm not really familiar with their use for psychosis, other than depakote being used for mania
-d/r
Posted by bleauberry on January 23, 2009, at 17:10:21
In reply to Lamictal versus Depakote, posted by Betsy122 on January 22, 2009, at 11:13:22
> Has anyone had experience with both these drugs? I'm trying to decide which one to go on. Which is the best, overall?
Well, it depends on what you want it for. Depression? Add-on to other medication? Anxiety? Mania?
If it is depression, most people would probably agree Lamictal is the one. If bipolar depression, again, probably lamictal. But that doesn't rule out the possibility depakote could work better than lamictal in any particular person. Me for example, I got a lot more depressed on lamictal. 500mg XR depakote actually had me feeling better the first day, added to ongoing 25mg zoloft and 5mg zyprexa. I'm skinny and would have welcomed some weight gain. I gained maybe 2 pounds. Sigh.
It's kind of like a Las Vegas bet. To put the odds a little bit more in your favor instead of just a 50/50 bet, your choice really depends on what you desire for it to do.
Posted by JayBTV2 on January 24, 2009, at 10:22:03
In reply to Re: Lamictal versus Depakote, posted by bleauberry on January 23, 2009, at 17:10:21
> Well, it depends on what you want it for. Depression? Add-on to other medication? Anxiety? Mania?
>
> If it is depression, most people would probably >agree Lamictal is the one.
I've been on both and I agree with this. Lamictal has done wonders for my depression (at dosages from 100mg to 150mg). However at times when I've been manic (I get psychotic mania) Depakote has been great at bringing me back to Earth.I haven't taken Depakote in a long while since I haven't had lot of problems with Mania recently. Lamictal has been the cornerstone of my 3med cocktail for two years now.
Incidentally if you happen to use both together be aware that Depakote at dosages >250mg nearly doubles the half-life of Lamictal. Therefore if you use both you have to lower the dosage of Lamictal you take.
As for the rash I think it's greatly over-stated. I go to a lot of bipolar support groups (NAMI/etc) and I've never run into one person who truly had the syndrome....Plus if you titrate even if you get it you'll be fine. http://www.crazymeds.us/lamictal.html has a nice blurb about it see that link (w/ photo) or below....
My .02
-Jay
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The Rash (from crazymeds.us)
======
This is a real problem, because Stevens-Johnson syndrome and assorted other serious rashes are bigger concerns with Lamictal (lamotrigine) than any other anticonvulsant, so often Lamictal (lamotrigine) therapy will end at the first sign of any rash. While any rash with Lamictal (lamotrigine) needs to be closely watched, it's the combination of an itching rash and fever with any anticonvulsant that needs immediate attention from a doctor, any doctor. Lamictal (lamotrigine) + itching rash + fever = trip to the emergency room with all of your meds in their original bottles. The following picture is what an actual case of Lamictal-induced Stevens-Johnson syndrome looks like:Image from http://health-pictures.com/rash/lamictal-rash.htm
Image from health-pictures.com
Otherwise it's just call your regular doctor for the soonest appointment possible. Still, I wish everyone would just calm the hell down about The Rash. Yes, it can be fatal, but it usually takes forever to kill you! And I don't mean in a movie-of-the-week, slow, painful death way, I mean that the symptoms show up early and you usually have plenty of time to take action before it's too late. One member of a bipolar support group walked around with an itchy rash and a fever for two weeks before she saw a doctor and she's fine. That was stupid, but not really all that stupid. The rash is slow to kill. Once you see the first symptoms and stop taking Lamictal (lamotrigine), The Rash goes away and you're safe! Problem solved! OK, you'll have truly sucky problem of not being able to take Lamictal (lamotrigine), but that's something else altogether. That doesn't mean you should be lax about any itchy rash and fever, because these skin things have no fixed rate. But the math is pretty simple - if you live in a country where Lamictal is available, you live where the hospitals can deal with The Rash without it being a big deal. Really!
I've received two e-mails from people who have had to be hospitalized because of Stevens-Johnson syndrome. One sent repeatedly in an awful blue font on fuchsia (to either get my attention or just give me a headache) relating how this person ignored the combination of itchy rash and fever for more than three days and wound up in the hospital. And of course blamed Lamictal for all of her woes. The other person is the reason why there are black-box warnings. He added a single 25mg dose of Lamictal to his regimen of Depakote and had to be hospitalized immediately because The Rash hit swiftly. His is the one case in many tens of thousands where it happens that rapidly. In very rare cases The Rash can be a big f*ck*ng deal. That's why there's a black box warning on the PI sheet. More often than not it's stupidity that is the main problem people have. Be annoying with your doctor about rashes and Lamictal. Better safe than sorry.
Posted by Zyprexa on January 27, 2009, at 2:03:14
In reply to Lamictal versus Depakote, posted by Betsy122 on January 22, 2009, at 11:13:22
I've taken both and would have to say Depakote is the better of the two. I have schitzoaffective which is cross between schitzophrenia and bipolar. Which I'm guessing you might be. Depakote will sedate you, lamictal won't but at same time did nothing positive for me. I've been taking zyprexa for 11 years now, and can say no other drug has been better for me. I took depakote for a year and lamictal for a few weeks. I sort of thought of lamictal as more of an antidepressant. Depakote is deffinitly a mood stabilizer, calms you and racing thoughts.
Posted by ceres on January 28, 2009, at 3:59:42
In reply to Lamictal versus Depakote, posted by Betsy122 on January 22, 2009, at 11:13:22
Hi, Betsy
I took Depakote for a couple years, and later Lamictal which I still take for bipolar disorder.On Depakote, I was often hypomanic & had more frequent mild depressions. It did work quickly in bringing me down from mixed mania. That was wonderful.
I got hair loss while on it. Eventually, I found out about taking selenium (& zinc?) to counter it, but w/ so many meds, it was hard to space the minerals that bind? to some meds. Of course, I have easily triggered hairloss, from periodic drops in my weight, etc, so it might not be so typical in most.
I also craved salty food on Depakote & had to work hard to keep my weight steady.I've had fewer depressions on Lamictal & they haven't been as intense. I feel overall, more stable mood than on Depakote.
However, I have more cognitive issues, short-term memory & word finding problems on Lamictal, especially if I change the dose.
I often get fuzzy headed a few hours before my next dose.I got a small rash early on with Lamictal. I saw a dermatologist who said it probably was a reaction to the drug, but not the dangerous SJ rash that they look for.
If I remember correctly, Lamictal is a lot more expensive than Depakote? The cost of Lamictal was a huge issue for me when I didn't have insurance & had months where my income disqualified me from the PHARMA drug programs.
I have tried to come off of Lamictal a number of times to see if I could improve my cognitive issues. However, my brain is so used to it. I don't understand the reasons, but any change in the dose, especially reducing it, radically impairs my thinking ability. (been on it many years)
I often ask myself, do I prefer a sharp mind & more dimensional experience interspersed with entrenchment in suicidal depressions (can control mania w/ other drugs), or do I prefer a gentler ride with a bit of fuzz & poor concentration with periodic greater cognitive disability (to the extent where job is threatened).
When I remember what the depressions were like, I prefer the Lamictal. -I wish there was something better.At first, I thought it was a plus not to have to do labs w/ Lamictal, such as are needed w/ Depakote. Now I wish I could monitor my Lamictal levels (test exists, but not so useful?)to aim for the most benefit w/ least cognitive deficit.
Also, Depakote is harder on kidneys? liver? --don't recall.
Hope you find a medication that works well for you. -Ceres
Posted by Zyprexa on January 30, 2009, at 19:29:44
In reply to Re: Lamictal versus Depakote, posted by ceres on January 28, 2009, at 3:59:42
Its the liver that Depakote is hard on.
I also found that Lamictal made me stupid. Bumping my head into things.
This is the end of the thread.
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