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


Phil

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ADMIN NOTE: Read One theory of antidepressant withdrawal syndrome before reading this topic.

 

Skip to the information in this post and FAQs and read it all carefully. Then read the rest of this topic.

 

For information about titrating lamotrigine, see Tips for tapering off Lamictal (lamotrigine)

 


 

Has anyone else tried Lamictal to treat withdrawal symptoms and did it help? I ask because I have seriously been considering it, as my depersonalization is so horrible. It seems that a few people on depersonalization forums find it helpful too. I am extremely wary of ANY psych drug now, but I need some kind of hope of getting better. Depersonalization is the one w.d symptom that depresses me the most.

 

Edited by ChessieCat
updated

Off Lexapro since 3rd November 2011.

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Hey Phil,

 

To be honest, I would never again touch any psych med. Even if other people say it has helped them, you never know if it will bring you relieve as well. On the contrary, it might even worsen your situation or prolong the wd.

 

But that are just my two cent.

End of 2008: Remeron 15mg for around 2 months. Unorthodox taper, no problems.
End of August 2009: Lexapro 10mg for only 4 days. Panic attack after 3 pills. Severe gastro problems in the morning for 3 days after last pill. 2 weeks later strong w/d symptoms set in.

Acute WD lasted around 3.5 years. I am feeling much better today, 5.5 years out, but still have some symptoms left.

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Phil, I believe the DP effects me most, also. It's very hard to describe and makes it extremely tough to interact w anyone. I can chat superficially w strangers, but I'm distant from anyone who knows me aside from one friend. He seems to be the only one able or interested to break thru the bubble I feel like I'm in.

Does any of this resonate w you?

Pristiq tapered over 8 months ending Spring 2011 after 18 years of polydrugging that began w/Zoloft for fatigue/general malaise (not mood). CURRENT: 1mg Klonopin qhs (SSRI bruxism), 75mg trazodone qhs, various hormonesLitigation for 11 years for Work-related injury, settled 2004. Involuntary medical retirement in 2001 (age 39). 2012 - brain MRI showing diffuse, chronic cerebrovascular damage/demyelination possibly vasculitis/cerebritis. Dx w/autoimmune polyendocrine failure.<p>2013 - Dx w/CNS Sjogren's Lupus (FANA antibodies first appeared in 1997 but missed by doc).

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I understand, Maybe. I'm the same, terrified of meds. But my situation is so bad now, I am so incapacitated that I'm considering the Lamictal. Things are so bad I get suicidal thoughts because I can't imagine living this way for god knows how long.

 

Barbara - oh god yes that really resonates with me. I feel like I can talk on "autopilot" but I cannot say anything about how I feel, apart from with my one close friend, and even then he gets fed up of my moaning.

 

I went to see a singer perform live tonight and I was so anxious and depersonalized, it was horrible. Just hellish.

Off Lexapro since 3rd November 2011.

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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. 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. In a second phase, I titrated up to 5.4mg. (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?

 

On 10/4/2011 at 10:56 AM, Altostrata said:

....

The low-dose Lamictal reduces the withdrawal-induced alerting reaction (unhealthy homeostasis) so the nervous system's natural functioning can take over and re-establish a healthy homeostasis. This is fragile at first but gets stronger -- as in all healing patterns.

 

On 2/4/2013 at 5:47 PM, Altostrata said:

[in withdrawal syndrome] the alerting system in the brain is not balanced by a modulating system normally in place. The alerting system sends out signals via glutamatergic transmission.

 

The glutamatergic system is the phone lines, not the message. It's just doing its job. Don't try to upregulate or downregulate glutamate receptors.

 

Lamotrigine decreases the reactivity of glutamatergic transmission.

1

 

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

 

On 3/30/2014 at 12:18 PM, Altostrata said:

....
Used to calm withdrawal symptoms, lamotrigine is very tricky.

  • Too much, you get bad symptoms.
  • Too little, it doesn't do anything.
  • The lowest effective dosage varies from individual to individual.
  • If you go up too high in dose, or titrate up too fast, you can get a dangerous allergic reaction, Stevens-Johnson syndrome.
  • If you don't taper off slowly enough, you can get terrible withdrawal symptoms.
  • Effective use is dependent on the skill of the doctor, and few doctors know how to use lamotrigine.

We cannot take any responsibility if you choose to try lamotrigine for withdrawal symptoms. Experiment at your own risk.

 

 

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?

 

On 5/13/2015 at 5:45 PM, Altostrata said:

They are often prescribed in combination, but I don't know why you'd want to do that. If you are tapering too fast, lamotrigine is not likely to make up for it.

 

On 5/15/2015 at 12:24 PM, Altostrata said:

The information in this topic is in regards to taking lamotrigine to reduce symptoms after going off drugs, not to add lamotrigine while taking another drug.

 

The best way to minimize symptoms while tapering is to control the rate of taper of the drug, not to add another drug such as lamotrigine.

....

 

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?

 

On 9/1/2015 at 4:13 PM, Altostrata said:

Stevens-Johnson Syndrome affects people who are taking too much lamotrigine, or when the dosage has been increased too fast. It has been seen most often in children because their bodies are smaller and less able to metabolize higher dosages.

 

Is lamotrigine good for benzo withdrawal syndrome?

 

On 2/2/2017 at 11:41 PM, Altostrata said:

Rather than adding a drug and its potential side effects, we recommend slower tapering of the benzo. If you feel this is impossible, your guess is as good as anyone's whether a microdose of lamotrigine would help.

 

On 1/8/2018 at 6:01 PM, Altostrata said:

Unfortunately, benzo withdrawal has a completely different source -- downregulation of the GABA system. My understanding is that lamotrigine is not as effective for benzo withdrawal.

 

Is lamotrigine addicting? Do I have to taper off?

 

On 2/15/2017 at 12:29 AM, Altostrata said:

Lamotrigine is not addicting. You will need to taper to go off it, though, because the nervous system becomes accustomed to it over time.

....

 

Will lamotrigine help me sleep?

 

On 7/8/2017 at 11:23 AM, Altostrata said:

Lamotrigine can have either effect: It can help you sleep, or it can interfere with sleep.

 

If you are going to try a microdose (a dose not larger than 5mg), it might make sense to try it first in the early evening to see how it affects you. If it makes you sleepy, you can take it in the evening before bed. If it does not make you sleepy, you can move the dosing earlier in the day.

 

(Please note: Men can tolerate higher starting doses of lamotrigine than women. It may take a week before you can feel its effect. Do not overdo your initial trial dosage.)

 

As your nervous system calms down, lamotrigine's effect can change. It may start out making you sleepy, but after a while, keep you awake. Then you might want to move your dosing to earlier in the day, by a couple of hours at a time.

 

If it starts to make you feel odd, or gives you a headache, or make you queasy, that's a sign that you're taking too much. If you've been taking it for more than a month, you may want to reduce the dosage by 10% at a time to get to the best dosage for you, one that calms your nervous system but doesn't have annoying side effects.

 

On 5/7/2018 at 10:33 AM, Altostrata said:

Lamotrigine at too high a dose can interfere with sleep. The "sweet spot" of lamotrigine dosage is different for each person.

 

....

 

Is lamotrigine hard to get?

 

On 12/5/2017 at 1:10 AM, Altostrata said:

....

Please note any doctor can prescribe lamotrigine, it doesn't have to be a psychiatrist. Lamotrigine should be in most formularies for insurance coverage. It is readily available as a generic.

 

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?

 

On 5/1/2018 at 11:52 PM, Altostrata said:

....

 

To answer others: As I explained very carefully earlier in this topic, if your nervous system has been sensitized by withdrawal, you will want to start at a very low dose of lamotrigine, less than 5mg (males) and possibly less than 2mg (females and those whose nervous systems are very sensitive). Most doctors think the starting dose of lamotrigine is 25mg and will insist you take this. Lamotrigine at too high a dose may have adverse or paradoxical effects.

 

Despite this repeated advice, several people have posted in this topic having started at too high a dose and gotten bad results. This is why I am hesitant about posting at all about lamotrigine.

 

I have also very carefully specified that lamotrigine, even at a very low dose, needs to be tapered. The nervous system becomes dependent on this as it does on any psychiatric drug. I'm not going into whether you want to call this "addictive" or not; you can use search on this site to see the discussions about "addictive." Lamotrigine needs to be tapered carefully. I hope that's clear now.

 

I personally did experience difficulty in tapering lamotrigine until I got it that it needs to be tapered very, very gradually. But whether I experienced this or not, you can take it to the bank: You need to taper lamotrigine, despite anything your doctor says or you read on the Web.

 

Gianna Kali was on high doses of multiple drugs, including lamotrigine. She went off a couple of them too fast and already had withdrawal symptoms when she reduced lamotrigine. Going off lamotrigine too fast added problems, but she did not develop severe withdrawal syndrome from going off lamotrigine alone.

 

Lamotrigine itself is not nearly as dangerous a drug as antipsychotics or benzodiazepines. It's not as difficult to taper as paroxetine, venlafaxine, or duloxetine. Taken at a very low dose, it's unlikely to make withdrawal symptoms worse. If you insist on starting at 25mg (or more) under the theory that more is better, you are setting yourself up for trouble and I'd appreciate it if you take responsibility for the error instead of blaming the drug.

 

I was on lamotrigine for a couple of years in all. I came off it prematurely and all my withdrawal symptoms came back. I went back on it, this time at dosages up to 5mg, for another year or so. You can bet I tapered it very carefully after that.

 

Like everything else, lamotrigine's effect is individual. I cannot predict how long any individual might stay on a very low dose of lamotrigine to settle withdrawal symptoms. It depends on your degree of benefit. As I've said repeatedly, taking a very low dose of lamotrigine has a subtle, gentle effect. It will not immediately take away your withdrawal symptoms. It is a crutch to take the edge off the alerting and help you to sleep a little, to start, so your own nervous system can take over and gradually calm itself. I would expect this to take a year or so.

 

Does it matter which version of lamotrigine we get?

 

15 hours ago, Armorall said:

....

Brands: Lamictal XR, Lamictal ODT, Lamictal, Lamictal Starter (Orange) Kit, Lamictal XR Starter (Orange), and Lamictal ODT Starter (Orange)

 

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.

Edited by Altostrata
updated

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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Thankyou for writing that Alto, it is very helpful. No, I'm not off Lexapro yet, but I still get horrible depersonalization just after small reductions.

 

I find this interesting:

"He has had patients who went off the medication and were fine, they didn't need to take it anymore."

because some people on the depersonalization forums said a similar thing - they stopped taking Lamictal without any problems, and the gains they made on it remained. Strange to think that a med could actually do that!

 

BTW, what do you mean by "To firmly establish the newly revived healthy brain patterns" ?

Off Lexapro since 3rd November 2011.

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Phil, could you provide a link to this info in the depersonalization forums? I'd like to see it.

 

The low-dose Lamictal reduces the withdrawal-induced alerting reaction (unhealthy homeostasis) so the nervous system's natural functioning can take over and re-establish a healthy homeostasis. This is fragile at first but gets stronger -- as in all healing patterns.

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

All postings © copyrighted.

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Here it is Alto:

 

http://www.dpselfhelp.com/forum/index.php?/topic/19310-lamictal-may-be-helping/

 

Looking back on it, it seems to be just one person who mentioned it, so maybe it's not as reliabale as I implied. Sorry about that. There are other reports on there that it helps though:

 

http://www.dpselfhelp.com/forum/index.php?/topic/29193-has-anyone-here-tried-lamictal-can-it-work-right-away/

 

BTW does this "alerting reaction" involve things like being easily triggered by things in your environment, like noises and such?

Off Lexapro since 3rd November 2011.

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....

BTW does this "alerting reaction" involve things like being easily triggered by things in your environment, like noises and such?

 

Thank you for the links, Phil. (Those people really need to know dp can be a result of withdrawal.)

 

Yes, those are alerting symptoms. There was a time when a phone ring at 6 p.m. would set my alerting system off to the point I wouldn't be able to sleep all night. And, you've seen discussions here about light sensitivity and so forth.

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

All postings © copyrighted.

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  • 2 months later...

Oversimplifying, it sounds like I am short serotonin receptors. What about on the presynaptic side?

 

I have noticed that I react to certain substances that some call anti-serotonin. For instance, bone marrow/bone broth causes issues. Coconut oil is the latest one which seems to cause issues.

 

Interestingly, I've heard other substances referred to as anti-serotonin, particularly coffee/caffeine, that have definitely helped.

 

It seems that a good google for "serotonin foods" or "serotonin antagonist food" or "serotonin bone broth" or "serotonin NAMEAFOOD" -- any of a plethora of searches on this theme -- list stuff that affects 5ht processes in some way... And when I consume these items...stuff happens without fail, it is these things that I am very sensitive too.

 

I wonder what strategy to pursue with these foods/drinks? because I can calm myself with ginger tea, I can improve sex function with caffeine... I realize the complications of the issues here... But I wonder, is the crux of my problem on the front end or the back end of the transaction? It seems that i can make more 5ht with the right diet -- or at least create changes in mood/performance that lead me I believe I have.

 

Is it better, I wonder, to use these sensitivities to my benefit for symptom relief or if just better to stop messing with the system, since I want my body to direct a repopulation so I should step aside....

 

I'm not even sure I am being clear and making sense, just thinking.

 

Thinking, acting, feeling, eating, drinking... And waiting for my anatomical response.

"Well my ship's been split to splinters and it's sinking fast
I'm drowning in the poison, got no future, got no past
But my heart is not weary, it's light and it's free
I've got nothing but affection for all those who sailed with me.

Everybody's moving, if they ain't already there
Everybody's got to move somewhere
Stick with me baby, stick with me anyhow
Things should start to get interesting right about now."

- Zimmerman

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  • 10 months later...

Shipko advices to se tiny does of lactimal during w/d and of coure David Healy suggests that CCBs can be helpful, they have a similar mechansm dont they? Anway I would lie to addmy own theory here

 

I have obviously done alot of thinking about what the hell is going on and read many many theories around w/d and adverse reaction and here is my lastest and greatest theory...

 

So we know that the serotonin receptors deregulate when taking ssri = this is one of the few facts that we have.

 

We also know that the CNS is shocked and in a damaged or recovering state during this time - we know this for a fact.

 

I now believe it takes the CNS around 18 months to recover from the shock but there are of course other factors and things that will set us back - this usually involves causing further shocks to the cns.

 

Based on my previous theory that being on an ssri med resets he serotonin levels in the same way my breathing centre and oxygen need was reset during my chvs, I think after removing the ssri medication (unless this is done very very slowly therefore adjusting those preset levels) we continue to function in the same way we did whilst taking the meds - this isnt a problem of course because our receptors have not yet grown back,

 

we may have a little shock to the cns and be experiencing physical or milder psychological issues before the upregulation takes place, it depends on the half life of the drug and level of dependancy.

 

I think it takes around 4-6 months for the receptors to grow back, this is when alot of people say the phychological symptoms come on and acute w/d kicks in, this was cetainly the case for me.

 

ssris also I think sedate the cns, now without the sedation of the ssri medication the upregulation of the serotonin recpetors gives us a huge increase in serotonin that we are unable to cope with and brings on all the terrible w/d symptms but also shocks the cns massivly.

 

Those who have had an adverse reaction may start to recover from the cns shock straight away but bt those of us in w/d I believe the saga continues.

 

I think that when the receptors have grown back only to find themselves unable to cope with the serotonin levels again they once again start to downregulate, this can take a couple of months the same as when starting a med perhaps even slower because the serontonin levels may have already started to reset back to normal- however we do not return to normal once the receptors have downregulated again because of the shock to the cns.

 

But perhaps once the receptord have again downregulated and some of the cns shock is recovering this would be when the acute w/d phase ends, I also belive that the receptors would then start to regrow again, taking roughly 4/6 months - the cns is trying to recover during this time and the serotonin levels are trying to find the pre-med balance.

 

so we come to the infamous 11 month - 1 year wave when I believe the receptors have upregulated again and STILL the serotonin levels are too high, perhaps lower than they were but not at a normal level - this would cause yet another wave until the receptors once again start to downregulate, but once again this has given the cns another shock - perhaps milder than the one before but still a shock.

 

I think this pattern continues until the serotonin is at a reasonable level for the upregulated receptors to cope with, each time they upregulate it would bring on a wave and each time they downregulate again a window could appear.

 

of course as I have said I belive that the cns damage is the main thing but that its harder to keep the cns stable when our receptors are growing back time and time again, but I believe that once the serotonin levels are at a point where they are no longer forced to downregulate that the cns REALLY begins to heal.

 

I know its just a laypersons daft theory, and I know it doesnt help or cure anything but for me, it helps to have SOMETHING that makes even a tiny bit of sense.

damaged by citalopram - severe suffering for 3 years now...no improvement

 

akathsiia, pgad, dp/dr, terror, and so SO many more daily

 

severly disabled and lost everything

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Thank you for your thoughts, iggy. Can you clarify these points?

 

What is a CCB?

 

Where does Dr. Shipko recommend minute doses of lamotrigine?

 

Why do you think it takes the receptors 4-6 months to grow back?

 

Why do you think the serotonin receptors downregulate again after growing back?

 

Why do you think the serotonin levels are "too high" post-discontinuation? Too high compared to what?

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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calcium channel blocker, its in his long piece about withdrawal that s posted on here.

 

I know a woman who is a patient of Shipko, he has suggested this to her many times,

 

I am guessing about the receptors taking that time to grow back, going on accecdotal evidence of when the worst wave payyerns seem to happen, also that my w/d kicked in at 5 months after CT,

 

Lte me give some background on my thoughts and they really are only my thoughts.

 

A few years ago I developed adult onset asthma, I left it untreated, I would struggle getting to the end of a road and be gasping for breath. stupid of me to leave it but because it came on out of the blue I kinda thought it would just go away. some months later I began not being able to take a deep breath my lungs would stop as if full. To cut a long story short, I had Chronic Hyperventilation Syndrome, this is not that I would hyperventilate alot but that I had been taking in so much oxygen to try to compensate for the asthma that my breathing centre reset, this led to me constantly trying to get more air than my body needed, I had to learn Buteyko breathing and do certain breathing exercises that would deprove my body of oxygen to reteach the brain that it did not need the vast amount of oxxygen that I was previously giving it. This took 4 months.

 

I beive that ssris do the same, reset the serotonin system to wok at that level and it continues to do so after the removal of the medication, but there are no exercises that can force the serotonin system back to normal levels, the have to do this for themselves and hopefully will do so once the medication is removed, but if It took me 4 months of daily HOURLY exercises to reset the breathing centre then a natural return to homeostasis would take obviously alot longer.

 

Uts this that I am basing my theory on.

 

I think the rece[tors downregulate again because the serotonin is still too high for them to cope with, and may explain why we have the waves at 6, 12, 18 months etc. as I say its only a theory

damaged by citalopram - severe suffering for 3 years now...no improvement

 

akathsiia, pgad, dp/dr, terror, and so SO many more daily

 

severly disabled and lost everything

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The body is full of serotonin all the time, most of it in the gut.

 

Serotonin receptors in the brain upregulate and downregulate all the time to keep this level constant. Think of them as sensor valves.

 

Antidepressants force some of the sensor valves to stay open. The body's regulatory mechanism causes others to close (downregulation or desensitization). The level of serotonin is not affected, only how the sensors read it.

 

After discontinuation, the same amount of serotonin washes over the sensors, but they can't accurately read the level.

 

Gradually, the sensors that still have sensitivity upregulate. The speed of this varies from individual to individual.

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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ah! oh well, like I said it was just a theory and Im so so scred and looking for something that may vive me some comfort in whats going on.

damaged by citalopram - severe suffering for 3 years now...no improvement

 

akathsiia, pgad, dp/dr, terror, and so SO many more daily

 

severly disabled and lost everything

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I will say that I am at the 11 month mark and have hit a bad wave. It is milder than previous waves but it does stink.

 

I sure would like to be done with this by 18 months, where did you get that figure from? Do you know anyone whose CNS was healed by then?

 

Has low does lamotrigine really worked for anyone? I have a new PCP who is more receptive to my situation compared to my previous doctor, so maybe I can convince her to consider this.

On 20 mg Celexa for 7 years for insomnia and GAD

Tapered from 20 mg to 0 from Aug 2011 to Dec 2nd 2011

Used Xanax intermittently over the past 7 years, and through WD.

Started 50 mgs Trazodone in June but am starting to taper off due to bad eye twitching, suspected Trazodone is the cause. Went to 25 mg in October and then 12.5 in December and then 0mg on Dec 20th.

 

Reinstated citalopram at 10 mgs on Nov 26th, then up to 20 mgs on Dec 3rd. Started kindling reaction on Dec 10th. Decided a very quick taper to 10 mgs for a 2 days and then 5mgs for a 2 more. Holding at 2.5 mg and beginning to stabilize. Reinstated trazodone to 12.5 mgs.

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  • 2 months later...

So the real issue in w/d or recovery seems to be the glutamate overpopulation? have I read that right? so does the lamictal reduce the glutamate receptors or does it interfere with the signaling?

 

I read an interesting peice on a benzo board written by a woman who works in a brain scanning area of a hospital and assists with diagnosis....she was saying that in w/d (she was talking about benzos but there seems to be overlaps) the glutamate receptors are too abundant and the TIME it takes to heal is how long it takes for the gaba receptors to return to normal and for the glutamate receptors to downregulate.

 

Is there any drug that can make the glutatmate receptors downregulate? I know there obviously isnt or it doesnt work or we would have taken it and been fine. Just interested and find that if I can try to have SOME kind of understnading and try to take the mystery off this, it becomes less scary. Not that Im not terrified, I am.

damaged by citalopram - severe suffering for 3 years now...no improvement

 

akathsiia, pgad, dp/dr, terror, and so SO many more daily

 

severly disabled and lost everything

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No, it's because the alerting system in the brain is not balanced by a modulating system normally in place. The alerting system sends out signals via glutamatergic transmission.

 

The glutamatergic system is the phone lines, not the message. It's just doing its job. Don't try to upregulate or downregulate glutamate receptors.

 

Lamotrigine decreases the reactivity of glutamatergic transmission.

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

All postings © copyrighted.

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So recovery is the modulating system getting back into place? what is the modulationg system? is it the balance of other hormones like seroyonin and dopamine etc?

 

I know you dont have all the answers alto, but your knowledge is obviusly the best around.

 

Do you think that we have nerve damage and the nerves need to repair themselves?

damaged by citalopram - severe suffering for 3 years now...no improvement

 

akathsiia, pgad, dp/dr, terror, and so SO many more daily

 

severly disabled and lost everything

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That's perhaps the 100th time you've asked those questions, Iggy. Sorry, I don't have time to answer them again.

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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I´m having terrible insomnia problems.

 

Can Lamictal help me? Because I´ve read it causes insomnia.

 

Maybe in very low doses?

4 years aprox. on 150mgs.Effexor for situational major depression.No AD before.
Tapered 150-0mgs in 3 months.

Tapered Quetiapine,Xanax in the last 18 months.NO med of any kind anymore.
First 3 months off acute w/d
Protracted w/d ever since.
Symptoms:Anxiety,anhedonia,insomnia,tinnitus,PSSD

04/13/2014 Awful Relapse.Recovered fairly fast.

3 years and 4 months off.

waves and windows.Very much recovered.

November 2015,health issue.Setback.
 

 

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I've never taken it. Lamictil is discussed, maybe only briefly I'm not certain, in the Theory thread: http://survivingantidepressants.org/index.php?/topic/392-one-theory-of-antidepressant-withdrawal-syndrome

I believe there is a sttrong hesitation towards advocating of lamictal because it can potentially make things worse and there aren't many doctors who know what they are doing with it. Sorry to here about the insomnia though. Insomnia is a frequent withdrawal symptom that is horribly disruptive.

"Well my ship's been split to splinters and it's sinking fast
I'm drowning in the poison, got no future, got no past
But my heart is not weary, it's light and it's free
I've got nothing but affection for all those who sailed with me.

Everybody's moving, if they ain't already there
Everybody's got to move somewhere
Stick with me baby, stick with me anyhow
Things should start to get interesting right about now."

- Zimmerman

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  • 3 months later...

No, it's because the alerting system in the brain is not balanced by a modulating system normally in place. The alerting system sends out signals via glutamatergic transmission.The glutamatergic system is the phone lines, not the message. It's just doing its job. Don't try to upregulate or downregulate glutamate receptors.Lamotrigine decreases the reactivity of glutamatergic transmission.

Would taking GABA in supplement form help? Instead of Lamictal?

2005-2008: Effexor; 1/2008 Tapered 3 months, then quit. 7/2008-2009 Reinstated Effexor (crying spells at start of new job.)
2009-3/2013: Switched to Pristiq 50 mg then 100 mg
3/2013: Switched to Lexapro 10mg. Cut down to 5 mg. CT for 2 weeks then reinstated for 6 weeks
8/2013-8/2014: Tapering Lexapro (Lots of withdrawal symptoms)
11/2014 -8/2015: Developed severe insomnia and uncontrollable daily crying spells
12/2014-6/2015: Tried Ambien, Klonopin, Ativan, Lunesta, Sonata, Trazadone, Seroquel, Rameron, Gabapentin - Developed Anxiety disorder, PTSD, and Psychogenic Myoclonus
7/2015-1/2016: Reinstated Lexapro 2 mg (mild improvement, but crying spells still present)

1/2016-5/2017: Lexapro 5 mg ( helped a lot, but poor stress tolerance & depressive episodes)

5/20/2017 - Raised dose to Lexapro 10 mg due to lingering depression(Total of 2 failed tapers & severe PAWS)

9/11/2018 - Present: Still on 10 mg Lexapro and mostly recovered.(Anxiety still triggers Myoclonus.)

10/7/2022 - 20 mg Lexapro (brand only) Plus occasional Klonopin for anxiety and Ambien for insomnia.

 

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GABA supplements do not cross the blood-brain barrier. You might get a little muscle relaxation from them (or an adverse reaction), but that's all.

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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  • 9 months later...

my CNS is still seizure-like from tapering imipramine and klonopin so fast more than 5 years ago. lamictal might help but I cant bear it if it'll set back my brain recovery making the mental problems worse. so does lamictal mess up the brain like klonopin too? does it cause mental problems?

and starting at the lowest dose, I dont want to higher the dose (scared to). so if I take it only at the lowest dose, its not possible to taper, right? since its already the lowest dose. so I would just stop taking it, right? like cold turkey. but how long would I need to take it? what is the shortest amount of time I can take it? is it okay to take it only at the lowest dose? or is it necessary to higher the dose? because I'm scared to taper off another med again and go through another withdrawal. is lamictal also addictive? 

March 2008 took Tofranil and Klonopin

CT'd Tofranil after few months

simultaneously tapered fast Klonopin, got off it October 2008

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Exie, see above. Please use search before starting new topics like this one. Thank you.

Also see discussion in http://survivingantidepressants.org/index.php?/topic/392-one-theory-of-antidepressant-withdrawal-syndrome/
and Tips for tapering off Lamictal (lamotrigine)

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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I've seen that topic before but I dont recall it having the answers to my specific questions, thats why I'm asking here. so lamictal reduces nervous system hyperactivity and alerting which sounds exactly like what I need, but my problems are more from klonopin not the AD. I dont have the antidepressant alerting symptoms like anxiety, racing thoughts,etc. my CNS is physically seizure-like from klonopin, physically shaking/twitching and the seizure movement/neurological pressure in my head. my brain/mental problems are also from the klonopin. my main symptom from the antidepressant is just the food hypersensitivity. but since lamictal is an anti-seizure that sounds like what I need, because my cns is literally seizure-like. but lam is also a mood stabilizer for bipolar so it does affect the brain. you said it helped you recover though so that means it doesn't cause mental/cognitive problems? but then my brain is recovering from klonopin while yours wasn't..so I guess you dont really know if it'll set back my brain recovery.. but if it causes mental problems then it would interfere with my brain recovery.

 

in the topic about Lam, you talked about titrating up, but I dont recall anyone saying if highering the dose is not necessary. do you know if its okay to keep taking it only at the lowest dose? I dont want to higher the dose because that means more tapering.

and the lowest dose to start is 0.5? you said you tapered down to 0.04, is that a too low dose to start at? and is it okay to take it just for a few weeks? or is that too short ?

March 2008 took Tofranil and Klonopin

CT'd Tofranil after few months

simultaneously tapered fast Klonopin, got off it October 2008

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Exie, I think it is post 30 on the first link Alto gave you in the post just above that you are looking for. I am sorry it is still so hard. No one can tell you how you as a unique person might respond.

1st round Prozac 1989/90, clear depression symptoms. 2nd round Prozac started 1999 when admitted to dr. I was tired. Prozac pooped out, switch to Cymbalta 3/2006. Diagnosed with bipolar disorder due to mania 6/2006--then I was taken abruptly off Cymbalta and didn't know I had SSRI withdrawal. Lots of meds for my intractable "bipolar" symptoms.

Zyprexa started about 9/06, mostly 5mg. Tapered 4/12 through12/29/12

Wellbutrin. XL 300 mg started 1/07, tapered 1/18/13 through 7/8/13

Oxazepam mostly continuously since 6/06, 30mg since 12/12, tapered 1.17.14 through 8.26.15

11/06 Lithium 600mg twice daily, 2.2.14 400mg TID DIY liquid, 2.12.14 1150mg, 3.2.14 1100mg, 3.18.14 1075mg, 4/14 updose to 1100mg, 6.1.14 900 mg capsules 7.8.14 810mg, 8.17.14 725mg, 8.24.24 700mg...10.22.14 487.5mg, 3.9.15 475mg, 4.1.15 462.5mg 4.21.15 450mg 8.11.15 375mg, 11.28.15 362.5mg, back to 375mg four days later, 3.4.16 updose to 475 (too much going on to risk trouble)

9/4/13 Toprol-XL 25mg daily for sudden hypertension, tapered 11.12.13 through 5.3.14, last 10 days or so switched to atenolol

7.4.14 Started Walsh Protocol

56 years old

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Lamictal does need to be tapered and smaller doses are accomplished by making a liquid suspension. I think Rhi is making a liquid with hers.

 

I was taking 200 mg before I began tapering. It helps some people but it wasn't a good drug for me. I hope you find the answers you're looking for, I know it's frustrating.

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Here is post 30 (thanks, meimei) http://survivingantidepressants.org/index.php?/topic/392-one-theory-of-antidepressant-withdrawal-syndrome/?p=11585

Used to calm withdrawal symtoms, lamotrigine is very tricky.

  • Too much, you get bad symptoms.
  • Too little, it doesn't do anything.
  • The lowest effective dosage varies from individual to individual.
  • If you go up too high in dose, or titrate up too fast, you can get a dangerous allergic reaction, Stevens-Johnson syndrome.
  • If you don't taper off slowly enough, you can get terrible withdrawal symptoms.
  • Effective use is dependent on the skill of the doctor, and few doctors know how to use lamotrigine.

We cannot take any responsibility if you choose to try lamotrigine for withdrawal symptoms. Experiment at your own risk.

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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  • 2 months later...

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 .5mg. 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. In a second phase, I titrated up to 5.4mg. (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.

 

 

My new doctor started me at 12.5mg of lamotrogine and will increase next week.  I just read this entire thread and concerned that I should start on a lower dose for effexor withdrawals.  Or am I being prescribed a higher dose since I am actually still tapering?

Started Effexor August 2012 Sept'12-150mg=extreme anxiety Oct'12 cut half-75mg severe wds

Feb 2013 68.5mg. Mar'13- 65mg. Apr'13-59mg. May'13-57mg. June '13-52mg Aug'13 49.75mg.

Sep'13-48.75. Nov'13-47mg Dec'13-45..5mg

May 2014 42mg. Jun'14 40mg (depressive mood started). Aug'14 -40mg/ started brintellix 2.5mg

Oct '14 -39 Nov'14 36.89 Dec'14 34.45

Jan 2015- 31 Feb'15 29mg. Mar'15 26.72. Apr'15 24.48. May'15 22.31mg. Jun'15 20.30mg

Aug'15-18.89. Oct'15 16.96. Nov/16- 16.10. Dec/15- 15mg

Jan 2016-14.22. May'16 11.45. Aug'16-9.60. Sep/16- 8.88mg. Oct/16- 8.39mg. Nov/16- 8.13. Dec/16- 7.89

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Please ask your doctor and let us know the answer, Lexy.

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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  • 6 months later...

I know this is an older thread. 

 

But my doctor made some research and also found Lamotrigine helps people in acute and protracted withdrawal. He said that the studies he found showed that most of the people who showed spontaneous remission from WD, were taking lamictal. 

 

I took lamictal before when I was on AD's, and didn't show an allergic reaction or anything. So he wants to start me on 25 mg and then updose to 50 mg. After reading this thread, this dosage seems enormous. I'm a bit confused. But willing to give it a try. I'm scared to start on this high dose, though. I'm going to call him and tell him I want to start on a much lower dose and see how I feel. 

-Effexor 150 mgs (2001-2009). Severe withdrawal symptoms during and after tapering for 6 months.  

-Pristiq 50 mg (2009-2012) Tapered over a year. Worst year of my life. 

-Prozac 20 mg (2012) Tapered over 6 moths to ease withdrawal. Still had severe WD symptoms. 

- (2012-2014) Doctor tried more than 20 medications for depression and WD, leaving me hypersensitive, and in protracted withdrawal. 

- Most debilitating symptoms during protracted withdrawal have been deep depression, anxiety, brain zaps, fatigue, akathisia, twitching, headaches and terrible PMS. 

-January 2015: Started Lamictal 12.5 mg, increased to 25 mg.- Bad reaction when updosed to 50 mg. Stopped. 

-February 2015: Doctor tried new antidepressant Brintellix - Horrible reaction. Discontinued completely. Severe AKATHISIA started.

-March 2015:  Started TMS therapy (Transcranial magnetic stimulation) for severe depression. Didn't work. 

-July 23-August 12: Had 10 ECT sessions which took away my protracted withdrawal symptoms including: akathisia, brain zaps, muscle twitches, fatigue and depression. Stopped medications. 

-September 2015: Experiencing bouts of depression again and muscle twitching. 

-March 2016: Started 20 mg Nortryptiline for depression. It helped. 

-August 2016: Slowly tapering Nortryptiline. 

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I would like to see the studies your doctor found, Cdav. I haven't been able to find any. If you can, please get copies.

 

Good idea to start on a much lower dose than 25mg. Your system may be sensitive to it.

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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While cdav is waiting for the studies, I had an odd experience with lamictal. After I CT from cymbalta, lamictal and K, the doc told me I could skip the cymbalta (knowing I would never take it again) and just try lamictal. (This was several weeks or so after I had the initial wd sickness and I was still thinking I needed meds.) I started with a 25 mg dose for a week I think it was and then was supposed to increase till I got to my usual dose of 100mg. 25 mg was ok but as soon as I took 50 mg my head started pounding. Same thing the next day. I took my blood pressure and it was not alarming but higher than it had ever been (but not the 170's over 100's that it was in the ER.) I stopped it after 2 doses, told her I was going to go AD free.

 

I believe lamictal initally is prescribed in special packs that allow you to gradually increase (titrate) the dose slowly so you do not get a life threatening rash. I was not given one of those because I had already been on the drug but had been off it for a couple of weeks (memory is hazy) so I still had to go slow. I just said the heck with it, I did not want any more meds and I did not like the fact that my body was reacting with a spike in bp.

What happened and how I arrived here: http://survivingantidepressants.org/index.php?/topic/4243-cymbaltawithdrawal5600-introduction/#entry50878

 

July 2016 I have decided to leave my story here at SA unfinished. I have left my contact information in my profile for anyone who wishes to talk to me. I have a posting history spanning nearly 4 years and 3000+ posts all over the site.

 

Thank you to all who participated in my recovery. I'll miss talking to you but know that I'll be cheering you on from the sidelines, suffering and rejoicing with you in spirit, as you go on in your journey.

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Alostrata, I'll see my doctor again next week and ask him if he has a copy of those studies, and see if he can e-mail them to me. If I can get them, I'll send them to you. 

-Effexor 150 mgs (2001-2009). Severe withdrawal symptoms during and after tapering for 6 months.  

-Pristiq 50 mg (2009-2012) Tapered over a year. Worst year of my life. 

-Prozac 20 mg (2012) Tapered over 6 moths to ease withdrawal. Still had severe WD symptoms. 

- (2012-2014) Doctor tried more than 20 medications for depression and WD, leaving me hypersensitive, and in protracted withdrawal. 

- Most debilitating symptoms during protracted withdrawal have been deep depression, anxiety, brain zaps, fatigue, akathisia, twitching, headaches and terrible PMS. 

-January 2015: Started Lamictal 12.5 mg, increased to 25 mg.- Bad reaction when updosed to 50 mg. Stopped. 

-February 2015: Doctor tried new antidepressant Brintellix - Horrible reaction. Discontinued completely. Severe AKATHISIA started.

-March 2015:  Started TMS therapy (Transcranial magnetic stimulation) for severe depression. Didn't work. 

-July 23-August 12: Had 10 ECT sessions which took away my protracted withdrawal symptoms including: akathisia, brain zaps, muscle twitches, fatigue and depression. Stopped medications. 

-September 2015: Experiencing bouts of depression again and muscle twitching. 

-March 2016: Started 20 mg Nortryptiline for depression. It helped. 

-August 2016: Slowly tapering Nortryptiline. 

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