Does Lamictal Lose Its Effectiveness in Some People?
[Home] [Bipolar News] [Bipolar Disorder] [Medications] [Treatments] [Bipolar Disorder/Job/School] [Disabilities] [Ask the Doctor] [Ask David] [Self-Injury] [Personal Stories] [Graham's Column] [Steven's Column] [Storm's Column] [Columnist Archives] [Suicide] [Community Support] [Family Members] [Expressions] [Greeting Cards] [Books] [Awards] [Links & Rings] [About Us] [Contact Us]

 


Q:  Does Lamictal Lose Its Effectiveness in Some People?


I have rapid cycling BPII and I am on 300 mg of Lamictal.........My question to you is that I have been taking it for six months now and it does not seem to work as well as it did at first......my hypomania w/ racing thoughts and agitation and depression with suicidal ideation return every so often........do you find that Lamictal looses it's effectiveness in some people?
 

Dear Kyle -- 
Yes, seen it. Not sure whether this is better characterized as Lamictal losing its effectiveness or the bipolar being treated getting worse over time and requiring more to keep it controlled.  I tend to favor the latter; but since I don't use the same model for antidepressants when they stop working, I shouldn't be too generous in my interpretations. However, it is well known that some people's bipolar disorder gets worse over time. The implication has been that each episode of illness, in those who have widely separated manic phases and depressed phases, seems to make the progression accelerate and episodes more severe. On that basis I tend to think that's what's going on in situations such as you describe: the condition is getting worse in the background, and that's what leads to the need for additional treatment. This reasoning also leads the possibility that the progression might be slowed or even halted if the episodes, even "micro-episodes", are completely controlled. 

There are ways to approach this other than adding more medication, of course. One of my favorites is to look for anything that might be accelerating or inducing cycling. You're not on one, but I always look for an antidepressant in the mix of medications, as those can cause cycling. The other common cause of cycling is an erratic sleep schedule or overall daily rhythm (worst case would be rotating shift work, from days to swing to night shifts, for example).  Oh, and of course (this is such a obvious one, it should be a given) minimal alcohol, which usually means about a drink or two a week for most of my patients. As I've mentioned to several other folks who wrote this week, that sleep and regular rhythm thing may have a remarkable non-medication solution.  No good research on it yet, but it is almost sure to be harmless if it doesn't work and it's cheap and boy if it worked it would be a really cool solution to the problem of being exposed to too much light at night. Here's the whole story, which ends with a link to the outfit that makes the $40 tool (to which I have no financial links): Bipolar Disorder -- Light and Darkness. 

Dr. Phelps


Published December, 2006
 
 

Bipolar World   1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014
Owners: 
Allie Bloom, David Schafer, M.Ed. (Blackdog)
Partners:  John Haeckel, Judith (Duff) 
Founder:  Colleen Sullivan
 

Email Us at Bipolar World

 

About Us  Add a Link  Advance Directives  Alternative Treatments  Ask the Doctor   Ask Dr. Plyler about Bipolar Disorder   Ask The Doctor/ Topic Archives  Awards  Benny the Bipolar Puppy  Bipolar Chat  Bipolar Children  Bipolar Disorder News  Bipolar Help Contract  Bipolar World Forums  Book Reviews  Bookstore  BP & Other mental Illness   Clinical Research Trials & FDA Drug Approval   Community Support   Contact Us  The Continuum of Mania and Depression   Coping   Criteria    Criteria and Diagnosis  Criteria-World Health Disabilities,  DSMV-IV   Dual Diagnosis  eGroups  Expressions (Poetry, Inspiration, Humor, Art Gallery, Memorials  Family Members   Getting Help for a Loved One who Refuses Treatment  Greeting Cards  History of Mental Illness  Indigo  Job and School  Links  Manage Your Medications  Medications   Medication and Weight Gain    News of the Day  Parent Chat  Pay for Meds  Personal Stories  Self Help  Self Injury  Significant Others  Stigma and Mental Health Law  Storm's Column  Suicide!!!  The Suicide Wall  Table of Contents   Treatments  Treatment Compliance  US Disability  Veteran's Chat  What's New?