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YesICan: Reinstating Lamictal


YesICan

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Hi All!


I just found this forum and am excited for the support, thank you to everyone!


I am currently working through withdrawal from Lamictal. I have been on the drug for a little over 10 years, at 200 mg/day (100 mg AM, 100 mg PM). I do not have a close relationship with my P-Doc, only saw him annually and never needed any adjustments.Originally prescribed lamictal for severe depression when several combinations of natural supplements, herbs, chinese medicine, etc., did not help. Originally, lamictal gave me my life back.  I would liked to have quit a long time ago once I felt my life had become very stable, but I was afraid of relapsing into a debilitating depression.


Many years later and a whole lot of personal growth work, deep therapy with excellent Therapists, meditation and a very healthy lifestyle, I decided I could go off lamictal. I never wanted to be on a medication in the first place, which is why I tried everything natural first. I was aware of the toxic effects meds have on the CNS, and ultimately on a person's life. Now I am experiencing the toxic effects and having severe struggle with withdrawal.


I now realize I tapered down too quickly, from 200 mg in May 2015 to zero in November 2015. I tapered down by increments of 25 mg feeling fine as I reduced the dosage. I was completely off of Lamictal in November 2015, and soon after started feeling despondent, extreme fatigue, depression, body stiffness and aches, lack of drive and overall just not well, worsening each week or so. I thought time would heal and that within a month or two or three, it would be out of my system and I would be fine. However, the opposite has proved true. I am an Entrepreneur with a wonderful business that needs to be nurtured to get off the ground. I have a fantastic business partner, and her patience with my extremely low energy is running out. Some days I stay home all day, curled up on the sofa, unable to think clearly or move my body much at all. Finally, as this past week has been extremely difficult and my energy shows no sign of increasing, I went back to taking 25 mg at night. I plan to stay on that for a month or more, then taper by 5 mg at a time. Has anyone had an experience of being completely drug fee and then going back on a low dose in order to taper much more gradually? I am ready to do anything it takes to function again. I see after reading about reinstatement, that I am describing just that. Makes sense.


My P-Doc does not have experience in tapering off lamictal, my original P-Doc retired long ago. Wondering about getting a consultation with an MD who specializes in psychotic drug withdrawal, specifically Lamictal. Has anyone done that, or know of anyone who has? I am taking supplements to support my brain (Dr. Hyla Cass' Brain Recover Program AM and PM formulas), adrenals (AdrenALL), and liver (Liver Detox and Support). 


Thank you for any help you can offer, I'm wondering if others have had this kind of experience. This is a wonderful forum!


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  • Moderator

Hi YesICan--Welcome to the group. Great user name BTW shows a wonderful attitude.  I an so glad you found us, I know we can be of help.  Reinstating is a good way to help reduce the symptoms caused by too fast a taper.  But I would be very careful about how much to reinstate.  It's been four months since you stopped all the meds which puts you in a timeframe where you need to be very careful with a reinstatement.  It is best to start off very small and build up if needed.  Because you're experiencing the symptoms you are it means that your system is sensitized to the meds and by throwing a big amount back in the mix it could trip off an adverse reaction.  Which is something you don't want to go through.  I would suggest starting low at 5mg and see how that goes.  It takes a minimum of our days for the drug to become steady state in the blood during which time your symptoms could be all over the place.  Once it's steady state things can start to settle down and the symptoms improve.  It does however take a lot of time to happen, any where from several weeks to several months.  But it does happen.  Once you're stable for a couple of months then we can work out a good slow taper that will minimize the symptoms.

 

What is withdrawal syndrome?

 

About reinstating and stabilizing to reduce withdrawal symptoms

 

Tips for tapering off Lamictal (lamotrigine)

 

Give those threads a read and then ask us a ton of questions.

 

Would you please add a signature block listing all the details of your use and taper, it will really help us see what is going on.

 

http://survivingantidepressants.org/index.php?/topic/893-please-put-your-withdrawal-history-in-your-signature/               

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Final Dose 0.016mg.     Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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  • Moderator Emeritus

Hi YesICan, Welcome to SA.

 

Really pleased you have found this site.  It is full of excellent information, supportive members and knowledgeable volunteer staff.

 

Firstly, coming of the drug/s isn't about getting it out of your system.  The drug changes the brain.  Chemical imbalance is a myth and it is the drugs we have taken that changed the chemicals in our brains, which our brains then adjusted to in order to compensate for the chemicals that it was/is being given.  If the drug is removed suddenly, the brain goes into a melt-down type of situation, where it is trying to cope with not getting the drug it has been getting.  It is fighting for survival and trying its best to adapt.  Please check these out, they may help you to understand:

 

Introduction to Antidepressant Withdrawal Syndrome

 

Video:  Healing from Antidepressants - Patterns of Recovery (4 minutes)

 

Secondly,  a drop of 5 mg would be a 20% decrease.  This site recommends a 10% taper of the previous dose with a 4-6 week hold to allow your brain time to adapt to not getting as much of the drug.  Please see:  Why Taper My Dose by 10%?

 

There are not many medical professionals who understand slow tapering.  However, as long as you have a doctor who will prescribe what you need, with the assistance of this site, you will be able to taper without having a medical professional assisting you.  Please read:

 

How Do You Talk to a Doctor About Tapering and Withdrawal?

 

Please use your Intro/Update topic to ask any questions and to journal your progress.
 

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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  • Moderator Emeritus

Hi YesICan , welcome to the site.    I love that you knew intuitively that reinstating is the smart choice.  

I'm one of the many who were completely off and reinstated with good effect , so you're in fabulous company , lol.

 

How many doses of 25mg have you taken?      

If it's less than 4 , I'd go back down to 5mg and sit there for at least a week , as brassmonkey explained.   If it's been more than 4 days , you might go down to 10 or 15mg.  See the link on Tapering Lamictal to work

out how to get a small dose from your 25mg tablet or capsule.

 

The lower the dose you can stabilize on , the better.

 

Good to have you on board ,   Fresh

1987-1997 pertofran , prothiaden , Prozac 1997-2002 Zoloft 2002-2004 effexor 2004-2010 Lexapro 40mg

2010-2012Cymbalta 120mg

Sept. 2012 -decreased 90mg in 6months. Care taken over by Dr Lucire in March 2013 , decreased last 30mg at 2mg per week over 3 months. July 21 , 2013- last dose of Cymbalta

Protracted withdrawal syndrome kicked in badly Jan.2014 Unrelenting akathisia until May 2014. Voluntary hosp. admission. Cocktail of Seroquel, Ativan and mirtazapine and I was well enough to go home after 14 days. Stopped all hosp. meds in next few months.

July 2014 felt v.depressed - couldn't stop crying. Started pristiq 50mg. Felt improvement within days and continued to improve, so stayed on 50mg for 8 months.

Began taper 28 Feb. 2015. Pristiq 50mg down to 45mg. Had one month of w/d symptoms. Started CES therapy in March. No w/d symptoms down to 30mg.

October 2015 , taking 25mg Pristiq. Capsules compounded with slow-release additive.

March 2016 , 21mg

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Wow, thank you SO much for your kind replies and information. I have poured over this forum and already feel I have received a great education. I will try reducing my reinstatement amount and see how it goes. I am truly grateful for your links, advice and sharing. I know life will get better and I will get on the other side of all this. The connections and support that come through this forum are so valuable. I'm very happy to have found you!

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  • 2 weeks later...

Thanks for your story.

 

I was at at 125 mg since about Jan 10 at docs suggestion.then dropped to 100 mg in about Feb 20 after reading on Lamictal side effects. I switched to taking full 100 mg in morning from nightly. It seems to only take 3 hours or so to increase my energy (and mood ?) But I am very fast metabolizer of meds.

 

 

Note I was on 750 mg Depakote, a somewhat similar anti-convulsant but without anti-depressant abilities (sodium channel blocker) for 15 years.

 

No 100 mg in morning reduces the shakes I have upon awakening. Shakes are likely due to akathesia from too rapid final withdrawal from ssri. Also 30 hour halflfe of Lamictal may mean blood levels may vary 25-50% so I am 1/2 withdrawn before taking morning pill? Moderator(S) am I right ?

 

I was also on a SSRI for 18 years at only 5 mg lat 8 month! When I cold turkeyed from 5 mg withdrawal took about 5_6 weeks to manifest, then I went from feeling great to crash in 2 days. Your delayed response could be because you were on lamictal for 10 yrs ? So my advice is to listen to the advice from moderators and beware of delayed dose change response over a few months.

 

So we have similar drug history since my Depakote and SSRI anti-depressant may be somewhat akin to your Lamictal experience?

 

I want to see how you do in your tapering as a guide for me if I attempt to attempt to taper at least partially from Lamictal.

How are you doing on your new 5 to 25 mg dose, Your symptoms now include any of:

1. Nauseous/poor appetite, has it reduced with dose, I have horrible appetite and live on fatty meat diet to maintain weight?

2. Do you shake/ tremble a few hours before taking dose (Lam is anti-convulsant)?

3. What about standing balance?

4. Memory, especially word recall. My memory is awful, yet friend who has been taking 200 mg for years and is 60 yr has awesome memory ?

5. Do you have trouble staying awake/ keeping eyes open?

6. Depression: I am depressed but at least can get out of bed, shower, accomplish somethings, but I cant work? Can you work now at least at reduced level.

 

Probably many of my symptoms stem from SSRI withdrawal after 18 yrs and my poor sleep usually 3-4 hours and usually broken. I imagine your withdrawal will be "nicer"

 

Thanks, hope I'm not too nosy.

1997 - 2002 20 mg Paxil, 750 mg Depakote2002 - 2005 10 mg Lexapro, 750 mg Depakote2005 - 2014 10 mg Citalopram,750 mg Depakote1/2014 - 1/2015 `10 mg Citalopram, 500 mg Depakote1/2015 - 8/2015 5 mg Citalopram 300 mg Lithium (no more Depakote)8/2015 - today 0 mg Citalopram 300 mg LithiumAlso added to 300 mg Lithium9/2015 - 1/2016 titrate from 0 to 100 mg Lamictal (Lamotrigene)1/2016 - May 7 100 mg Lamictal and 300 mg Lithium. Get about 4 hours broken sleep. Also depression, akathisia that is somewhat reduced by Lamictal.
June 1, 2016 relapse back citalopram 20 mg
July 1. 0 mg Lithium

​Sept, 2016 back on 300 mg lithium, still on 100 mg Lamictal, 20 mg citalopram

Nov 6, 2015: Lamictal (Lamotrigne) reduced from 100 mg to 75 mg. Sleep seems to have improved due to lower Lamotrigene.

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  • Moderator Emeritus

Hey Dawes , go easy on the interrogation. Answering a list of questions can be quite intimidating.

If you want to connect with members tapering lamictal , look on the "Tips for Tapering Lamictal"thread.

 

How are you doing YesICan ? What did you decide to do with your dose?

 

bw , Fresh

1987-1997 pertofran , prothiaden , Prozac 1997-2002 Zoloft 2002-2004 effexor 2004-2010 Lexapro 40mg

2010-2012Cymbalta 120mg

Sept. 2012 -decreased 90mg in 6months. Care taken over by Dr Lucire in March 2013 , decreased last 30mg at 2mg per week over 3 months. July 21 , 2013- last dose of Cymbalta

Protracted withdrawal syndrome kicked in badly Jan.2014 Unrelenting akathisia until May 2014. Voluntary hosp. admission. Cocktail of Seroquel, Ativan and mirtazapine and I was well enough to go home after 14 days. Stopped all hosp. meds in next few months.

July 2014 felt v.depressed - couldn't stop crying. Started pristiq 50mg. Felt improvement within days and continued to improve, so stayed on 50mg for 8 months.

Began taper 28 Feb. 2015. Pristiq 50mg down to 45mg. Had one month of w/d symptoms. Started CES therapy in March. No w/d symptoms down to 30mg.

October 2015 , taking 25mg Pristiq. Capsules compounded with slow-release additive.

March 2016 , 21mg

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  • 2 weeks later...

Sorry for interagation, to both YesIcan and Fresh, bad habit of mine.

1997 - 2002 20 mg Paxil, 750 mg Depakote2002 - 2005 10 mg Lexapro, 750 mg Depakote2005 - 2014 10 mg Citalopram,750 mg Depakote1/2014 - 1/2015 `10 mg Citalopram, 500 mg Depakote1/2015 - 8/2015 5 mg Citalopram 300 mg Lithium (no more Depakote)8/2015 - today 0 mg Citalopram 300 mg LithiumAlso added to 300 mg Lithium9/2015 - 1/2016 titrate from 0 to 100 mg Lamictal (Lamotrigene)1/2016 - May 7 100 mg Lamictal and 300 mg Lithium. Get about 4 hours broken sleep. Also depression, akathisia that is somewhat reduced by Lamictal.
June 1, 2016 relapse back citalopram 20 mg
July 1. 0 mg Lithium

​Sept, 2016 back on 300 mg lithium, still on 100 mg Lamictal, 20 mg citalopram

Nov 6, 2015: Lamictal (Lamotrigne) reduced from 100 mg to 75 mg. Sleep seems to have improved due to lower Lamotrigene.

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