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Does Lamictal Cause Hypomania?
Question: Can Lamictal cause hypomania or mixed states?
I have two "brands" or suppliers of lamictal from my drug store. I know it seems unlikely but one of them is very effective in lifting my mood, to the point of making me feel too activated and a little and uncomfortable for much of the day. If I switch to the other manufacturer, I do not get this feeling. In fact my mood sinks very low. It is either making me feel worse or doing nothing (leaving me in a hopeless and depressed state).
Initially I was taking lamictal with an SSRI, but this was suspected for making me unstable. Now I am only taking the lamictal (150mg) (split into morning and late afternoon doses) and .5 mg klonopin at night.
I have two "brands" or suppliers of lamictal from my drug store. I know it seems unlikely but one of them is very effective in lifting my mood, to the point of making me feel too activated and a little and uncomfortable for much of the day. If I switch to the other manufacturer, I do not get this feeling. In fact my mood sinks very low. It is either making me feel worse or doing nothing (leaving me in a hopeless and depressed state).
Initially I was taking lamictal with an SSRI, but this was suspected for making me unstable. Now I am only taking the lamictal (150mg) (split into morning and late afternoon doses) and .5 mg klonopin at night.
Brief Answer:
Consultation
Detailed Answer:
Hello, and thanks for your question.
Lamictal is actually FDA approved for TREATING hypomania, mixed states, and depression, so it is unlikely that it is CAUSING any of these. However, your experience of different manufacturers of a drug resulting in a different result is absolutely valid. Different manufacturers include varying doses of the active ingredient in drugs within small but important ranges. I would stick with the manufacturer of the Lamictal that lifts your mood. If it making you feel uncomfortable, perhaps increasing the Klonopin would be effective in helping with that.
Please remember to rate and close this answer thread when you are finished and satisfied.
In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Consultation
Detailed Answer:
Hello, and thanks for your question.
Lamictal is actually FDA approved for TREATING hypomania, mixed states, and depression, so it is unlikely that it is CAUSING any of these. However, your experience of different manufacturers of a drug resulting in a different result is absolutely valid. Different manufacturers include varying doses of the active ingredient in drugs within small but important ranges. I would stick with the manufacturer of the Lamictal that lifts your mood. If it making you feel uncomfortable, perhaps increasing the Klonopin would be effective in helping with that.
Please remember to rate and close this answer thread when you are finished and satisfied.
In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
thanks for the quick response! I do know of more than one person who has experienced paradoxical reactions to Lamictal, namely hypomania and mixed states (separately). I also know that a person's reaction to lamictal can also change over time.
I'm rereading my post and realizing I wasn't super clear with the symptoms. They include an almost uncontrollable feeling of excitement, making it hard to concentrate at work; difficulty sensoring myself; and irritability. My morning depression starts to lift 2-3 hours after morning dose and then elevates to the overexcited, irritable states for about 4 hours. Lately, after that it is sometimes replaced by depressed mood and a low-level paranoia. Not like people are out to get me, but like I'm turning over magazines because I'm uncomfortable with the eyes of the models on me. I don't remember this kind of thing on the SSRIs.
Doctors/therapist seem split between complex trauma and bipolar II/cyclothymia of some sort.
If not hypomania, what might be causing these uncomfortable symptoms? I'm not very comfortable increasing klonopin. Also for now we are avoiding SSRI's (I hope not forever)...Can you think of an alternative to Lamictal?
Thank you sir :)
I'm rereading my post and realizing I wasn't super clear with the symptoms. They include an almost uncontrollable feeling of excitement, making it hard to concentrate at work; difficulty sensoring myself; and irritability. My morning depression starts to lift 2-3 hours after morning dose and then elevates to the overexcited, irritable states for about 4 hours. Lately, after that it is sometimes replaced by depressed mood and a low-level paranoia. Not like people are out to get me, but like I'm turning over magazines because I'm uncomfortable with the eyes of the models on me. I don't remember this kind of thing on the SSRIs.
Doctors/therapist seem split between complex trauma and bipolar II/cyclothymia of some sort.
If not hypomania, what might be causing these uncomfortable symptoms? I'm not very comfortable increasing klonopin. Also for now we are avoiding SSRI's (I hope not forever)...Can you think of an alternative to Lamictal?
Thank you sir :)
Brief Answer:
Followup
Detailed Answer:
These symptoms may be caused by inadequately treated bipolar disorder or complex trauma. To more adequately address potential bipolar symptoms, you could replace Lamictal with either lithium or valproate, as both treat bipolar disorder effectively.
Please remember to rate and close this answer thread when you are finished and satisfied.
In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Followup
Detailed Answer:
These symptoms may be caused by inadequately treated bipolar disorder or complex trauma. To more adequately address potential bipolar symptoms, you could replace Lamictal with either lithium or valproate, as both treat bipolar disorder effectively.
Please remember to rate and close this answer thread when you are finished and satisfied.
In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
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Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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