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Lamictal (lamotrigine) to calm post-acute withdrawal symptoms (PAWS)


Phil

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Can’t this cause TD?

ProzacNovember 2019: 10MG start

January 2021: up to 60MG 

march 2021: Valium everyday 2MG twice a day for a month or after that take as needed 

April 2021-May: taper to 0MG

June 2021: Zoloft 7 days and ween off. 
August 2021: escitalopram 5MG-10MG

August 2021: Propanol 10MG-20MG as needed 

September 2021: weened off escitalopram over a week.

October 30th: Citalopram 20MG 

November 10th: stopped - 10MG 2 days. 
November 14th: Prozac 20MG

November 18th: stop C/T 

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I really don't know the answer to that. I've been meaning to do an update. I found a psychiatrist who knows that withdrawal is real and she was happy to work with me on microdosing the Lamictal. She wrote me a suspension for up to 5 mg per day. Right now I'm taking the Lamictal at 2 1/2 mg. I did not listen to Alto Strata about starting at a super low dose. I started at 2 1/2 thinking surely this can't be a lot and I had a really rough reaction so I went to a half a milligram as suggested and have been slowly titrating up. It's been interesting. I'm not saying people should run out there and try this  but I do feel a small shift happening. I have had such intense immobilizing anxiety, internal agitation this whole 15 months since my last dose of Prozac. I feel it's just starting to let up some but I don't know if it's a time thing or if the Lamictal is helping. It definitely has shifted more in the last month or so since I started this experiment. I'm going to stick with it for a while but probably just stay at this really low-dose at 2.5. Of course, I'm being a little judgmental of myself for even using another pharmaceutical But this has been a brutal two years and I'm just trying to find the kindest way to get myself through it. I will also add in that I took Lamictal for years at 100 and 200 mg and I discontinued it first a couple of years before I discontinued the anti-depressant and I didn't seem to have any trouble coming off of it. I know that's not the case for everybody. If this makes any sense, I still have a pounding pulse and fluttering heartbeat especially am and before bed so it hasn't made that go away but for some reason I'm not reacting as hopelessly to it. That is part of the shift. But other things have lessened, like the neurological storm in my gut, constant stomach ache, super hot nerve endings in my hands and feet, and the constant crying. Those are lifting a bit but I still have waves, just shorter and mostly less intense. This is probably the first positive contribution I've made on this site. Blessings to all. Oh, and resistant as I am to saying it I feel some hope that I will one day get through this. I've been in 100% survival mode mixed in with hopelessness prior to now. 

Paxil  2000 - 2002  Tried unsuccessfully to discontinue

2002 - 2010 A series of trial and error, Wellbutrin, Effexor and unsuccessful attempts to discontinue.  

2010 - 2017 Lexapro With several unsuccessful attempts to withdraw 

2012 - 2017 Lamictal Successfully withdrew Lamictal no problem

2017 - 2020 Switched to 40mg. Prozac to prepare try another Withdrawal. 

2020 - On 15mg Remeron for a few months during withdrawal

Completely off of Antidepressants since Sept. 2020

Klonipin as needed throughout the process. .25 mostly, some .5, some .125,  2 to 12 times per mo.

 

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1 hour ago, rachie said:

I really don't know the answer to that. I've been meaning to do an update. I found a psychiatrist who knows that withdrawal is real and she was happy to work with me on microdosing the Lamictal. She wrote me a suspension for up to 5 mg per day. Right now I'm taking the Lamictal at 2 1/2 mg. I did not listen to Alto Strata about starting at a super low dose. I started at 2 1/2 thinking surely this can't be a lot and I had a really rough reaction so I went to a half a milligram as suggested and have been slowly titrating up. It's been interesting. I'm not saying people should run out there and try this  but I do feel a small shift happening. I have had such intense immobilizing anxiety, internal agitation this whole 15 months since my last dose of Prozac. I feel it's just starting to let up some but I don't know if it's a time thing or if the Lamictal is helping. It definitely has shifted more in the last month or so since I started this experiment. I'm going to stick with it for a while but probably just stay at this really low-dose at 2.5. Of course, I'm being a little judgmental of myself for even using another pharmaceutical But this has been a brutal two years and I'm just trying to find the kindest way to get myself through it. I will also add in that I took Lamictal for years at 100 and 200 mg and I discontinued it first a couple of years before I discontinued the anti-depressant and I didn't seem to have any trouble coming off of it. I know that's not the case for everybody. If this makes any sense, I still have a pounding pulse and fluttering heartbeat especially am and before bed so it hasn't made that go away but for some reason I'm not reacting as hopelessly to it. That is part of the shift. But other things have lessened, like the neurological storm in my gut, constant stomach ache, super hot nerve endings in my hands and feet, and the constant crying. Those are lifting a bit but I still have waves, just shorter and mostly less intense. This is probably the first positive contribution I've made on this site. Blessings to all. Oh, and resistant as I am to saying it I feel some hope that I will one day get through this. I've been in 100% survival mode mixed in with hopelessness prior to now. 

Hi Rachie, please don't judge yourself harshly for using another pharmaceutical.  Protracted withdrawal syndrome is so hard, and you have to cut yourself slack for trying to ease discomfort.  I am just starting a benzo crossover from Xanax to Valium before tapering the Valium and Ambien that I started two months into withdrawal because of the complete insomnia.  I sometimes get angry at myself for starting those medications because I now have another difficult road in front of me, but sometimes you have to choose to treat symptoms with pharmaceuticals to get by.

 

I, too, am trying very low dose lamictal and having some small success.  However, I started at 0.5 mg and it was too much, so I have gone much lower and dose twice a day to reduce the spikes in my system.  I believe it calms the internal agitation/hyperexcited nervous system a bit, as you mentioned, and makes my anxiety a bit more tolerable.  I also think it helps me to sleep a bit.  I want to titrate up to 0.5 mg, but every time I try to increase I get terrible eye pain.

 

Are you handling the titration up ok?  I assume since you said you are using a suspension that it's an immediate release liquid that you're using?  What have your side effects been from the medication?

 

Hang in there!  You didn't deserve to have this happen to you (none of us did), and you need to have self-compassion, as do we all.

2004 -2015  citalopram 40mg
2015 CT switch to duloxetine 60mg with no problems
2021 June (exact date unknown) accidental CT discontinuation of duloxetine 60mg

  • 2nd July duloxetine 30mg reinstatement (triggering immediate physiological issues)
  • later July up to duloxetine 60mg for a bit, back down to duloxetine 30mg after intolerance of 60mg
  • early August switch to citalopram 10mg, later August up to citalopram 20mg
  • mid September down to citalopram 10mg, late September discontinued citalopram 10mg after four months of terrible physiological and phsychological symptoms and hopelessness
  • Also added Ambien and Xanax mid September for insomnia 😢

Other meds:  Ambien 10mg, Xanax .625mg, liothyronine 130mcg, levothyroxine 25mcg, valacyclovir 1gm (for Epstein-Barr), hydroxychloroquine (for autoimmune disease), LDN (for autoimmune pain) 

Supplements:  l-theanine, magnesium, multivitamin, methyl folate & methyl b12 (for MTFHR), B6 & iron (for anemia), melatonin, NAC, omega 3, curcumin, vitamin c, vitamin d3, COQ10 ubiquinol, iodine, selenium, zinc, vitamin e, vitamin a

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Thank you for your kind words. Every time I increase I get a wave of all of the original stuff but it calms down after a day or so. The headache and nausea that Alto Strata Described definitely happened to me with too high of dose changes. Then it resolves. 

Paxil  2000 - 2002  Tried unsuccessfully to discontinue

2002 - 2010 A series of trial and error, Wellbutrin, Effexor and unsuccessful attempts to discontinue.  

2010 - 2017 Lexapro With several unsuccessful attempts to withdraw 

2012 - 2017 Lamictal Successfully withdrew Lamictal no problem

2017 - 2020 Switched to 40mg. Prozac to prepare try another Withdrawal. 

2020 - On 15mg Remeron for a few months during withdrawal

Completely off of Antidepressants since Sept. 2020

Klonipin as needed throughout the process. .25 mostly, some .5, some .125,  2 to 12 times per mo.

 

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  • 1 month later...

Lamictal/lamotrigine after adverse reaction

 

Hi,

 

I’ve spoken extensively on my own thread about visual snow syndrome, dpdr, and how these were given to me after an adverse reaction to five doses of Sertraline (my reaction happened a week and a half after I stopped taking the drug, so I’m not sure whether it was a reaction, or withdrawal to such a small dose)

I’ve seen recommended online, and have been prescribed by my GP, to take lamotrigine. I’m yet to take any/even collect they prescription as I’m apprehensive, but dpdr is my main symptom, as well as brain fog, and I feel like I’m a little out of options.

 

Does anyone have any knowledge of taking a psych med after having a bad reaction to one before. Lamotrigine doesn’t I think work exclusively on serotonin receptors, but has been shown to have some effect outside of it’s dopaminergic selectivity. Any input on what lamotrigine is like as a drug would be helpful too.

 

I’ve been drug-free for just over two years now, and had taken citalopram for a few days quite a while prior to sertraline with no adverse effects.

 

Icip.

 

Edited by ChessieCat
added topic title before merging with existing topic

Early September 2019 - One 25mg dose of Sertraline taken.

Early October 2019 - Five 25mg doses (pills) of Sertraline taken for five consecutive days.

Withdrawal/reaction happened on the 27th of October (2019) in the evening.

Symptoms that have gone: Joint and muscle pain/weakness in my legs, phantom senses, chemical dread, chemical fear, DP/DR has gotten a lot lot better than what it is now, it was one of my worst and all-encompassing symptoms when it started, awful aphasia, parkinsonism, head pressure, pressure in my frontal lobe when trying to think/work out something, inability to plan or execute anything//feelings of being literally scatterbrained, inability to think in my head other than slight acknowledgements - the voice in my head sounded weak and 'small' like it was restrained to a much smaller area of my brain, constant fatigue, emotional numbness, constant eyestrain, and changes in perception of colour/contrast in sight.

Main remaining symptoms: Visual Snow/HPPD, derealisation, tinnitus, and brain/cog fog.

Drug free.

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  • 1 year later...
On 1/21/2022 at 1:53 PM, FosterTheCritters said:

Hi Rachie, please don't judge yourself harshly for using another pharmaceutical.  Protracted withdrawal syndrome is so hard, and you have to cut yourself slack for trying to ease discomfort.  I am just starting a benzo crossover from Xanax to Valium before tapering the Valium and Ambien that I started two months into withdrawal because of the complete insomnia.  I sometimes get angry at myself for starting those medications because I now have another difficult road in front of me, but sometimes you have to choose to treat symptoms with pharmaceuticals to get by.

 

I, too, am trying very low dose lamictal and having some small success.  However, I started at 0.5 mg and it was too much, so I have gone much lower and dose twice a day to reduce the spikes in my system.  I believe it calms the internal agitation/hyperexcited nervous system a bit, as you mentioned, and makes my anxiety a bit more tolerable.  I also think it helps me to sleep a bit.  I want to titrate up to 0.5 mg, but every time I try to increase I get terrible eye pain.

 

Are you handling the titration up ok?  I assume since you said you are using a suspension that it's an immediate release liquid that you're using?  What have your side effects been from the medication?

 

Hang in there!  You didn't deserve to have this happen to you (none of us did), and you need to have self-compassion, as do we all.


how are you doing? 

5/10-viibryd 15 to 10 start 10 prozac

5/17-adrenaline surges, panic, viibryd to 7.5

5/20-stopped viibryd ?serotonin syndrome

5/23-stopped Prozac as symptoms continued 

6/2-reinstated viibryd 5mg

6/7-10 mg-better x 1 week only

6/13-15 mg-same thing

6/22-20 mg-same thing but akathesia went away

7/7-viibryd 25 mg split 15 am 10 pm
7/7-started Lunesta to sleep, 0.25 Ativan prn.

7/27-started propanolol 10 mg BID
8/1-viibryd reduced to 10 mg am 10 pm

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Thank you for your kind words. I ended up stopping the lsmictal primarily because I didn't see enough of a change. I also tend to freak out pretty quickly because of this mess. I do use clinician snd propane lol here and there. I try not to judge myself but I don't always succeed. This has been such a hard journey!!! Hang in there. We all deserve extra blessings. 

Paxil  2000 - 2002  Tried unsuccessfully to discontinue

2002 - 2010 A series of trial and error, Wellbutrin, Effexor and unsuccessful attempts to discontinue.  

2010 - 2017 Lexapro With several unsuccessful attempts to withdraw 

2012 - 2017 Lamictal Successfully withdrew Lamictal no problem

2017 - 2020 Switched to 40mg. Prozac to prepare try another Withdrawal. 

2020 - On 15mg Remeron for a few months during withdrawal

Completely off of Antidepressants since Sept. 2020

Klonipin as needed throughout the process. .25 mostly, some .5, some .125,  2 to 12 times per mo.

 

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  • 5 months later...
On 3/2/2020 at 11:12 AM, Superwoman said:

Also, the doctor would not listen when I said that it was an adverse drug reaction, even though two pharmacists said that I was having a drug reaction.  Instead she insisted that I was I was bipolar and psychotic and she was ready to hospitalize me.  After my husband went home and looked up bipolar he knew that is not what I had.  We made a complaint at the hospital where she works.    

Normal care, this is. Urgh.

Anyway, I was wondering if it would help with activation/agitation/akathisia. I am a member of a metoclopramide group on facebook and several members have mentioned already that it helped them with their akathisia/activation symptoms.

Does anybody have any insight on that?? I know this question has been asked before but there was not a reply from anybody whose akathisia it helped.

I am not really keen on pharmaceuticals right now but if I have not improved sufficiently in another year or two I might consider it. I am worried about continued effects of excess glutamate in the brain.

December 2021 - Metoclopramide started. Akathisia symptoms start; Metoclopramide gets changed to PRN.

March 2022 - Akathisia diagnosed; Metoclopramide stopped; Propranolol 10mg x twice a day. Biperiden PRN (0.5mg to 1mg).

April 2022 - Tandospirone 30mg (10mg 3x day), Quetiapine 25mg (only taken once, immediate adr). Mirtazapine 7.5mg. . Discontinued Propranolol.

May 2022 - Mirtazapine upped to 15mg. Tandospirone cut to 2x 10mg. Low dose Depakote for the month; 100 to 200 to 100 to 0. Mirtazapine cut back to 11.75mg (3/4 of a 15mg pill).
June 2022 - Mirtazapine updose to 15mg. Tandospirone, Biperiden discontinued. Klonopin started PRN (0.5mg). 
September 2022 - Akathisia slowly starts improving, WD/ADR normal sets in in mid September. Hold for 4 months.
March 2023 - Off mirtazapine; no Klonopin for 5 months either! Started quercetin (250mg x 2) to soften the histamine rebound.

May 2023 - Stopped quercetin and changed from magnesium carbonate to oxide - reacted badly. Reverted back to carbonate. 
June 2023 - Added fish oil.
Current regimen: CALM Magnesium (Carbonate into Citrate) 175mg x2; Vitamin E 268mg x2; Fish oil (100mg Omega3; EPA 30mg; DHA 37mg)x2
Intro thread: 
https://www.survivingantidepressants.org/topic/27095-portuguesesea-metoclopramide-akathisia-and-mirtazapine/

 

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@Altostrata

 

How frequently were You dosing when You were taking lamotrigine? As I presume You were taking immediate release and in lamotrigine thread there is info that IR is taken twice daily.

Duloxetine 2016/17 - 30/60mg/30mg, c/t, light WD.

Sertraline June 2019 50mg ADR

Clorazepate June 2019 20-15-10mg for 3 weeks then sparsely until 2022, 2 times per month max and very low dose (5mg)

Clorazepate Jan2022 10mg 5 days 2,5mg 2 days then off

Venlafaxine June 2019 75mg ADR, 17,5mg, titrated to 37,5mg

Venlafaxine Jan 2022 Covid, hard ADR on 37,5mg, reduced to 20mg ADR, tried ct, crash,

Venlafaxine 22Jan22 reinstated 9,4mg, too low/ 01Feb22- 12mg/ 12Feb- 11,25mg/ 16Feb- 11mg/ 20Feb- 10,8mg/ 24Feb22-10,575mg/ 16Mar22- 10,46mg/ 26Mar22- 10,35mg/ 26Apr22- 10mg/ 01Oct- 9,9mg/ 13Nov- 9,7mg

01Jan24-7,5mg

MAR24

Due to another sudden intolerance had to fast taper venlafaxine to 1,14mg 

Seems like all of this time I was in benzo withdrawal, because when I took it now in desperation to help it made me feel worse, tried reinstatement first 1mg, then 0,05mg both made me feel worse.

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  • Administrator
On 10/3/2011 at 3:21 PM, Altostrata said:

Phil, you're not off Lexapro yet, is that right?

 

About Lamictal, here's the problem: Not many doctors know how to use Lamictal and recognize when to increase and when to decrease dosage, plus how it's affecting the withdrawal symptoms. They also don't understand the hypersensitivity issues and insist on doses that are far too high to accomplish what we want -- to support the nervous system in healing instead of inducing yet another drug-dominated state. Some people report bad reactions to doses of Lamictal that are too high.

 

For some people with a different variety of withdrawal syndrome, taking lamotrigine may not be the right approach.

 

Here are a few tips about using Lamictal that I learned from my doctor. I'm not an expert and I don't know how this would be applied to any particular person:

 

- Dosages are individual, need to be started at very low amounts, and slowly titrated up.

 

- He starts everyone out at 2mg or less. Because I was so hypersensitive, he started me on 0.5mg once a day. He likes to give a dosage a try for 4 days to see how it works, get beyond initial wooziness, etc.

 

- The trick is to find exactly the right "sweet spot" for your nervous system. At one time, I started at .5mg, went up to 2.5mg, backed down again to 1mg, eventually settling at 1.07mg once a day. In a second phase, I titrated up to 5.4mg once a day. (I am currently tapering off.) Now, someone else's optimal dose may be 24.3mg or 38.2mg or 10.1mg.

 

- For someone with withdrawal insomnia, the "sweet spot" is a dosage at which sleep is increasing towards normal and side effects are negligible.

 

- Lamictal does increase GABA somewhat while decreasing glutamatergic transmission. However, the GABA system needs glutamate to make GABA so too much Lamictal will have a paradoxical effect -- you don't want to go too high.

 

- Signs that you're taking too much Lamictal: Queasiness or headache (or both), sleeplessness, agitation.

 

- Initial side effects can be wooziness, grogginess, sleepiness, lack of energy.

 

- To firmly establish the newly revived healthy brain patterns, expect to stay on the Lamictal for about a year. He has had patients who went off the medication and were fine, they didn't need to take it anymore.

 

- In severe withdrawal insomnia, deep sleep is the first to go and the last to come back. It's important because human growth hormone is secreted in deep sleep and it is physically and mentally restorative. When deep sleep returns, emotional numbing will lift.

 

 

FREQUENTLY ASKED QUESTIONS ANSWERED LATER IN THIS TOPIC

 

How does low-dose lamotrigine help withdrawal symptoms?

 

 

 

Why doesn't everyone just take lamotrigine for withdrawal syndrome?

 

 

Also, lamotrigine might not work at all for your withdrawal symptoms.

 

I'm tapering and I have withdrawal symptoms. Can I take lamotrigine with my drug?

 

 

 

There is also the risk of a drug-drug interaction with lamotrigine.

 

I read about a deadly reaction you might get to lamotrigine. How likely is it?

 

 

Is lamotrigine good for benzo withdrawal syndrome?

 

 

 

Is lamotrigine addicting? Do I have to taper off?

 

 

Will lamotrigine help me sleep?

 

 

 

Is lamotrigine hard to get?

 

 

What dosage should I start at? Does lamotrigine need to be tapered? Did you have trouble going off? What about Gianna Kali, didn't she have a terrible withdrawal from lamotrigine? How long did you take it for withdrawal syndrome? How long will I need to stay on it? How long does it take to work?

 

 

Does it matter which version of lamotrigine we get?

 

 

As you will want to start at 2mg or lower, the only form of lamotrigine that comes in 2mg tablet is the chewable, dispersable tablet. (Otherwise, the usual starting dosage is 25mg immediate-release lamotrigine.) You might also use a compounded liquid to take a small amount. See Tips for tapering off Lamictal (lamotrigine)

 

Any extended-release form, such as Lamictal XR, will not be appropriate, as the dosage sizes are too large and you will not be able to make a liquid from the tablets.

 

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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Omg, I'm blind sorry...

In what increments were You titrating up to avoid going too high?

Duloxetine 2016/17 - 30/60mg/30mg, c/t, light WD.

Sertraline June 2019 50mg ADR

Clorazepate June 2019 20-15-10mg for 3 weeks then sparsely until 2022, 2 times per month max and very low dose (5mg)

Clorazepate Jan2022 10mg 5 days 2,5mg 2 days then off

Venlafaxine June 2019 75mg ADR, 17,5mg, titrated to 37,5mg

Venlafaxine Jan 2022 Covid, hard ADR on 37,5mg, reduced to 20mg ADR, tried ct, crash,

Venlafaxine 22Jan22 reinstated 9,4mg, too low/ 01Feb22- 12mg/ 12Feb- 11,25mg/ 16Feb- 11mg/ 20Feb- 10,8mg/ 24Feb22-10,575mg/ 16Mar22- 10,46mg/ 26Mar22- 10,35mg/ 26Apr22- 10mg/ 01Oct- 9,9mg/ 13Nov- 9,7mg

01Jan24-7,5mg

MAR24

Due to another sudden intolerance had to fast taper venlafaxine to 1,14mg 

Seems like all of this time I was in benzo withdrawal, because when I took it now in desperation to help it made me feel worse, tried reinstatement first 1mg, then 0,05mg both made me feel worse.

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