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Minerva78 10-19-2011 08:40 PM

Lamictal causing increased mania?
 
I am currently diagnosed with Bipolar II disorder, with rapid cycling. I was diagnosed a few years ago and eventually went up to 150 mg of Lamictal and .5 mg of Klonopin, which worked great. Then I ended up off of my meds for about a year, which is my fault, I got caught up with so much that was going on with my youngest child and as usual forgot to take care of my own needs. But after nearing a breakdown, I went back to the pdoc in April, and started on Lamictal and Klonopin again.

I don't know if I have increased stressors, with my family and some medical issues that came up for me over the summer, or what, but the Lamictal no longer seems to be helping me like it did before. I was having A LOT of irritability and depressive episodes, so the pdoc upped my dose from 100 mg to 150 mg and a few weeks ago I went up to 200 mg, in addition to the .5 mg to 1 mg of Klonopin I take per day. I don't know if it is a coincidence or what but since I've been at the 200 mg of Lamictal, I have had worse irritability, anger, a ton of racing thoughts, sometimes not making a lot of sense when I talk, jumping around from topic to topic. My irritability is off of the chart, because I have been blowing up at the most minor things, and afterwards I feel terrible about it - so I don't know if I'm having depressive episodes, or just reacting to the aftermath of my temper.

I have moments where I want to just get in the car and drive away, today just hearing the sound of my coworkers laughing made me want to go up and punch them, and I get very snappy with my family. Fortunately, I do have a lot of self control, and I haven't done anything violent, I have been trying to just walk away into another room when I can't take hearing the sound of a person's voice. I just feel so on edge, and today I had to apologize to my husband, in advance, because I'm feeling a bit out of control, and I want to apologize ahead of time in case I say something hurtful to him.

I guess part of me still never accepts being bipolar, because I don't go through true "mania". But I have been able to get used to the bipolar II diagnosis, because that made more sense to me, since I went through many years of going on and off antidepressants, which never really helped me, other than to induce me into manic/hypomanic states, which I learned is classic in bipolar II. The problem is that I'm wondering if the increase in Lamictal to 200 mg could be doing the same thing?

Honestly, I truly don't have a good understanding of "mania" because my issues have primarily been depression and terrible mood swings. I still think of mania as being euphoric, impulsive, risk taking, and that's not me. But what I am is extremely irritable, angry, explosive, with thoughts all over the place, extremely distractible and on edge, and without the massive self-control I try my best to force upon myself, I really don't know what I would be. I have been able to work, but it's getting harder and harder to stay on task and keep my racing thoughts and anger under control. I don't even know why I'm so angry all of the time, why I lose it over the stupidest things? Is this part of mania as well? I still have a hard time wrapping my head around that.

I'm also very ****** that the Lamictal seems to not be helping as much now, when it seemed to a while ago. Why could that be? Why am I worried that I'm slowly shifting into the bipolar I category and not bipolar II - is that even possible after only a few years? I'm ****** that I've been researching other drugs, and Lamictal seems to be the best for bipolar II, for rapid cycling, with the fewest side effects, and best for depressive episodes. So if I'm no longer getting the same level of relief from this wonder drug, what the hell else can I do? All of these other drugs seem to cause weight gain, bad side effects, would not be good considering the NSAID I already take for possible inflammatory arthritis/autoimmune issues. I am afraid of stopping Lamictal because it would take FOREVER to start back up again. But could I take Lithium in addition to Lamictal and Klonopin, has anyone done that? I don't know, I'm just so annoyed right now. I had not planned to go back to my pdoc until the first week of December (at my choice, since I'm having a hard time affording medical bills these days) but I think I will call to see if there is any chance of me getting in the first week of November, because I don't like the place I am in right now.

lostgirl40 10-22-2011 01:58 PM

Re: Lamictal causing increased mania?
 
being bipolar I understand I am on lamictal myself they upped my dosage from 1 to 2 mg its hard I don't have the mania but I sure have the depression if you need someone to talk to I am here

cri222 10-26-2011 06:31 AM

Re: Lamictal causing increased mania?
 
This is exactly how my mind is working at the minute i have also had all your symtoms and still do in ways,i was only diagnosed of bp2 rapid cycling in may and to find it hard to except that i have this horrible illness.My doc originaly put me on olanzapine but i gained alot of weight and wanted to come off it,he then put me on lamictal 150mg which worked brilliant for about 3 weeks!! My mind started to race like crazy i didnt want to be around anyone and was very snappy with my children and husband.Trying to talk to people was terrible as i would losse them mid conversation or zone out completely.I went back to see my pdoc on Monday he has put me on ablify and lustral supposedly because he thinks im having a depressive episode.I also experienced mania at the beginning of my illness were i went completely gaga luckily i came out of it myself but i scared the **** out of my husband and sister who were thankfully there but that was the beginning of my journey into this horrible illness.The irritability i had before i was diagnosed was so bad my family were afraid of what i would be like every time i came home from work or if something was in the wrong place or not done to my liking i would be like a banshee screaming at them when i think of some of the things ive done im so full of guilt but now realise it was this illness.Im suprised your still able to work ive been off since i was diagnosed as i think getting myself better first is more important and again the irritability etc would be enough to want to snap at someone
Defiantly go back to your pdoc as soon as there has to be meds out there that can help you.
Good to know theres someone out there that thinks like me and has the same symtoms,stay in touch and take care you will get there

Minerva78 10-27-2011 02:40 PM

Re: Lamictal causing increased mania?
 
Thank you. I managed to get an appointment with the psych nurse on Tuesday instead of having to wait to see her again in December, so I'm hoping she can help me figure out something.

Cri222, as far as work goes, I'm barely hanging on. I work because I have to, because my husband can't find work with his current degree so now he's in school full time again to get a tech degree, I have 2 young children, and I'm the only income. That alone puts so much stress upon me, which makes all of these symptoms worse. I can't concentrate well at work, which means that reports I write that should take a few days to complete end up taking a few weeks, I'm never on top of anything and always just barely get things done by the absolute deadline. It takes everything in me to just hold it together to keep from having a breakdown, because I can't afford to do that. I was on medical leave for 2 months over the summer, for physical health reasons NOT related to the bipolar - was having convulsions, joint inflammation and pain, inflammation and pain in my spine, anemia, fatigue. But no diagnosis other than worsening symptoms of some type of autoimmune problem that's been developing for years.

Being in so much pain and unable to do a lot of things sent my depression spiraling. Yet now I'm physically not feeling as bad, but my mental state is horrible, I cannot catch a break. And I'm stuck. Can't take leave from work, already only had about a month of sick leave when I went on leave so I went through a month of almost no pay, still trying to financially recover from that. The depression was bad, but now this irritability and on edge and mental racing feeling is mixed in. But I try hard to appear "normal", that's what I have to do at work. Which is bad because then it just means that after all day of pretending to be normal I go home and all of these things I've been holding back come out. And I'm snappy, and have no patience, and I just want to get up and walk away. I wish I didn't work because it's not fair that work makes me hold all of this in only to come and release it on people who love me. I feel like the worst mother in the world. And really my children are one of the only reasons why I want to get better. I want to be better for them, I don't want to screw them up because i'm an emotional wreck. They are only 2 and 4 and deserve better than what I am right now. I try to hold it together for them too, but it's so hard when I spend all day trying to hold it together at work, I can't hold on. I hate feeling so out of control. I think that's why I work so hard to control my feelings, my symptoms, pretend like they aren't there, act normal, and for a while it works, it does seem to. But it all comes crashing down. I can't control it, I can't control whatever this is, and I can't stand that. I need to be in control, and I'm not.

Another big problem for me is that all of my symptoms, of everything, the inflammatory flare ups and mental breakdowns, are worse during the 2nd half of my cycle, so lately I've been wondering if going on birth control pills would help? My hormones trigger too much for me, and on top of being chronically anemic, I'm just so tired of it all. I was thought to just have PMDD for years, continued on antidepressants, and thought that's all my mood swings were - but charting my moods showed that I went through mood swings throughout the month, it was just so much worse during the second part. That's also when I learned the antidepressants were triggering the mania, and all of those years I stopped taking antidepressants because I felt on top of the word, only to come crashing down again, and go on more antidepressants, and go through the same cycle for years and years, all of it could have been bipolar all along. It makes sense, but I still have a hard time coming to terms with it. It took me years to come to terms with regular depression, that it was not my fault and not because I was a weak person, but how do you even come to terms with being bipolar? How can I honestly tell myself that I'm not crazy when I feel crazy? Like really, my mind feels insane. I used to think just being depressed was bad, and it was, but not like this. I could still function as a depressed person, or as a person coping with personal losses. I could understand why I was depressed, I don't understand this. I really don't understand why all of this keeps getting worse over time. Still makes me wonder if it could be hormone related, I should do some research on that.

How are you doing on the abilify? Is that an antidepressant? I know I've heard of it, but I wasn't sure exactly what type of drug it was classified as. I don't think I've heard of lustral. I know I've been going on forever but I'm glad that you understand some of what I am going through too. Does your pdoc think the irritability you were describing was part of mania or think the irritability was a part of a depressive episode?

Minerva78 11-01-2011 05:37 PM

Re: Lamictal causing increased mania?
 
Cri222: my pdoc also prescribed me with Abilify today - starting just at 2 mg, and I'll see her in a month to see if I can stay at this or get moved up to 5 mg. This is in addition to the Lamictal and Klonopin I'm already taking. The past few weeks, during the second half of my cycle, have been pure hell, and I'm doing a bit better right now, but still nowhere near "normal", whatever that is. She felt like I was experiencing hypomania and a likely mixed episode that needs to get under control. Also said that if I didn't start reducing the stress in my life, I could end up in the hospital. Sigh. So I need to figure out something and take this more seriously.

Let me know how you're doing on the Abilify, I'd love to talk to you more about it since you're taking it now too.

cri222 11-03-2011 04:20 AM

Re: Lamictal causing increased mania?
 
hey minerva good to hear from you,

sounds to me that your defiantly in the middle of some sort of episode wheather thats mania or depression but somethin is goin on,i was like that last week were i didnt no if i was coming or going couldnt concentrate on what people were saying snapping at the kids and so on and the cycling was terrible... to my relief it passed and i defiantly think its the ablify that helped especially with the cycling,ive actually slept properly the last 3 nights for the first time in months which is a big improvement for me.im on 5mg of ablify so i would think you might need to up your dose especailly as your in such a bad place at the min your on lamictal are'nt you?
regards to the stress of work if its going to end with you in hospital which is my worst nightmare i would be doing some serious thinking and talking with your husband because you will defiantly be no use to anyone especially your kids if you get any worse than you already are,is there no help from the government for money etc so you can take some time off because by what you said your goin to end up having to take it anyway if you dont get better.
give the ablify a week or 2 to start working if you dont feel any different ask your pdoc to increase the dose,let me no how your doin
take care thinkin of you x

Minerva78 11-04-2011 08:58 PM

Re: Lamictal causing increased mania?
 
I hope the Abilify will help me, but my pdoc said that it may be likely that I have to go up to 5 mg. I haven't had any side effects yet, but the real test is going to be when I go through the second half of my cycle, because for whatever reason those hormones trigger so much for me, both my mood problems and autoimmune flare ups, everything in my body just goes insane. When I go back to see her in the first week of December, that should give enough time to find out if it has helped. I am on 200 mg of Lamictal and 1 mg of Klonopin, that I take at bedtime. I took the Abilify at bedtime on the first day, and felt fine, so I did the same on the second day, which was a big mistake. I fell asleep early and woke up at 2 a.m. and could not get back to sleep, I couldn't even sit still. But taking it during the day isn't bad, which is what my pdoc recommended anyhow. I did have a chance to talk to my husband about dividing up the household work more evenly, the problem is sticking to it. When he has a lot of school work to do, he's basically no help to me around the house, or with the kids, and I basically know it's going to be more of the same this weekend, so who knows how that will affect me. I've already gone from feeling on top of the world most of the day to crying this evening, I don't know what is going on with me. I think the pdoc said this could be a mixed episode, going through depression and hypomania at the same time, so I looked that up online and it just scared me, I didn't want to read anymore about it. I wish I could take time off of work, but I was on FMLA this summer, mainly because I was having the terrible widespread inflammation, pain, and seizure-like episodes, and used up all of my sick and vacation leave and I don't have enough built up yet to be able to take any time off. And then I wonder if these convulsions/seizures made everything worse for me mentally, if it affected something in my brain. I have no idea because they couldn't find anything specific, I probably wasn't having true seizures, but no one can explain what it was and why I was having them only when i had widespread pain and inflammation in my joints and the rest of my body. I have a lot of symptoms of Lupus and RA, but not enough to diagnose me, just enough to show it's likely I have some type of autoimmune illness, and I wonder if all of that is making me worse too. I was really depressed when I was dealing with so much pain for several months, and wasn't able to drive, but now that my pain and neurological problems are under control, I don't know where this latest episode came from. I feel like I should be able to control it, and I try to, but a lot of times I just can't. Even if I were able to go on disability, it wouldn't be enough to cover our bills, so that's not an option. I guess I just keep going until my body shuts down or something, I really don't know what to do. I want to go back to grad school in 2 years, once my husband is done with school and my oldest is in kindergarten, so less daycare bills, but I wonder how the heck I'd be able to do that. I hope that since I'd be studying something I enjoy, doing research instead of the boring clinical stuff I do now, but I have no idea. Sometimes I just hope that my husband will get a good job after he finishes his tech degree, and I could just work part time. I brought that up to him, and he honestly said he would be okay with it. The problem is just getting to that point. I just don't know. I just know I hate feeling like this. I know I need counseling on top of the meds, to help me deal with my stress and how to cope with my mood swings, but I can't afford it, I can barely afford to see the pdoc once a month and add another medicine to what I already take. I just wish I knew something to do, but other than making my husband do more of the cooking and cleaning than he does now, there really is nothing else I can change in my life. Just sucks, I suppose.

cri222 11-05-2011 11:22 AM

Re: Lamictal causing increased mania?
 
your really in a dark place at the min trying to deal with everything thats going on,you have to try stay positive and this episode IS going to pass its just about getting the meds right,the depression is the hardest and especially when your trying to deal with so many other things all you want to really do is lock yourself away and not have to worry about anything or anyone! im glad that your trying to fight this though and you will get it under control, i keep saying to myself that i wont let this illness beat me and although every day can be a battle we have to fight.you will get over this and when your feeling better the everyday stress's wont seem as bad and you'll be able to deal with them in a different way.there does seem to be light at the end of the tunnel with your husband hopefully gettin a better job after he finishes school and it would be great for you to go back to school it all just seems so far away at the minute thats all but it will happen.
stay positive you will get there x

Doveangel47 11-05-2011 07:04 PM

Re: Lamictal causing increased mania?
 
I've been on 400-500 Lamictal for about 3 years now and over the last year new mania has been poking through. I was given Lamictal because at the time I was mainly depressed with just one psychotic manic episode.

The last 2 years I've been battling mixed episodes which include all your symptoms! The rage, distractibility, racing thoughts... The usual plus so much more and magnified by 10. Last week I had another episode and it was so severe that my family called 911. I just spent 6 days on the psych ward and I think it's due to to the Lamictal tweaks.

My doc took me off of it and now I'm depressed! :( Life sucks again. With the Lamictal, I always felt like I was on "go". Always speedy, like I had a fire burning constantly. Now I'm flat and hate life again. I haven't been depressed in over 2 years, so I guess the depression cycle begins again...

Minerva78 11-07-2011 12:03 PM

Re: Lamictal causing increased mania?
 
Wow, 400 - 500 mg of Lamictal seems like a whole lot. I thought they only gave doses that high for people who have seizures. So your doc took you off of the Lamictal completely? How come they didn't just try you on a lower dose? If you aren't taking any Lamictal at all, no wonder you feel depressed. Since Lamictal is used a lot for Bipolar II, when there is more depression and less mania/hypomania, getting off of it completely may not have been the best thing. But if you ended up in the hospital, I suppose they did what they thought was best at the time, I'm sorry. :( It is odd, but the past 2 years does sound like you were going through a lot of mania/hypomania/mixed episodes. And if I was starting to feel some of it at 200 mg, I can't imagine what it must have been like at 500 mg.

I still don't know if mine was a coincidence or not, because the past week I haven't been as bad on the Lamictal and Abilify, although I've seemed to have more depression, which seems to be worse at night once my mind and body have a chance to rest, very weird. I'm either extremely tired or wired and can't sleep, but I'm still a bit depressed. But I know my depression has not been as bad since I increased the Lamictal from 150 mg to 200 mg - maybe something around 200 mg would be good for you? What are you taking instead of the Lamictal? If stopping the Lamictal no longer made you manic, it's still not good if it increased depression. Sigh. It seems so hard to find the right balance of these meds, it's very frustrating. But it is interesting you had some of the same problems I did with the increased Lamictal. I would definitely talk to your pdoc about this and I hope someone is able to help you get back on track soon.

gemini89 11-07-2011 06:22 PM

Re: Lamictal causing increased mania?
 
I have been on Lamictal for the past week, and I have gone nuts! It seems to be working at times but, most of the times my mind is racing! I have been reading a lot on the internet about bipolar 2 or mixed moods as I call it, and the mood swings are so rapid that I don't know if it will quit. I feel just like y'all. I am angry, irritated, depressed and manic. I got two hours of sleep last night and I took ambien. I have a lot of issues and I am going to a counselor and a psychiatrist about it. I have a major problem with expressing how I really feel. The only feeling I have is anger and I am trying to control that. I am at the point though that I have to start expressing my emotions, even if they are bad. I am in the same boat as you all. I am so irritable. Keep me posted if it works for you.

Doveangel47 11-08-2011 03:22 PM

Re: Lamictal causing increased mania?
 
Hi. You know, I was thinking about this whole mess again today (Lamictal has basically acted as a an amnesiac for me) and I was up to 600 mgs at one point. Geez.

Anyhow, these episodes were definitely mixed (dysphoric mania). My doc put me on wellbutrin and I still have the Tegretol as my backup. Last month I insisted I give Tegretol a shot. It was the only MS that I hadn't been on yet and I wanted it because it is supposed to help with mixed episodes and anger and hostility. So, I'm just on those two for now. I've been battling MI for 17 years, so my body is no stranger to all the psych meds, but this Lamictal discovery has been such a letdown.

I have regained some pep/speed since I was discharged Thursday. I feel productive and only moderately flat, but I don't have that negative energy which turns into rage for me. only time will tell, I guess.

How are you doing??

cri222 11-11-2011 02:51 PM

Re: Lamictal causing increased mania?
 
hi minerva,
just wondering how your gettin on with the ablify,i havent been sleeping properly the last 3 nights mad dreams and waking up in a sweat dont no if its from the ablify or just one of them things what you think? good to hear your feeling a bit better with the ablify and lamictal would you not ask your doc to put you on an anti depressant aswell they did for me and seem to be working well together, except for this sleeping thing!

cri222 11-11-2011 03:01 PM

Re: Lamictal causing increased mania?
 
hi gemini
lamictal DOES work believe me i was just the same when i started it but when it has time to get into your system it does work and the rapid cycling will slow down and everything else that comes with it its also about getting the dose right so if your on it longer than 2 weeks and still no better get it upped a little bit i did and it started to work
good luck cri

Minerva78 11-18-2011 08:05 AM

Re: Lamictal causing increased mania?
 
Cri222: Sorry I'm just getting back to you. I haven't felt like talking much lately (translation: depressed) so it's just been one of those times. I'm really not sure what to think about the abilify. I haven't had any bad side effects from what I can tell, as long as I take it during the day. My pdoc told me to take it in the morning, as opposed to the Lamictal and Klonopin I take at night. When I accidently took it at night, it gave me terrible insomnia and I could not sit still, I wonder if that might be what's going on with you? If you take it at night I would definitely try first thing in the morning to see if that helps. I can tell my hypomania hasn't been quite as bad as it was a month ago - I'm not standing at the window, wondering what it would feel like to jump out, so that's good. I haven't gotten in my car and almost drove away from my family, so that's good. But my temper has still been bad, I'm very agitated, and I still feel like I want to punch someone sometimes. I feel bad when I yell at my kids, but I've been able to have a few more positive, good moments too. But I have clearly slipped into a depressive episode, and I have no idea if that is due to the Abilify or I was going to slip into one anyway? Who knows. I know I try my best to hold it together, and then a minor stressor comes along, and I lose it - not just crying, but extreme anger, going back and forth, so maybe I'm still a bit in a mixed episode? I don't know, it's draining to even try to figure this out. I go back to the pdoc on the 5th, so I'd imagine she'd probably up my dose to 5 mg, or at least I'm going to ask her if she thinks that would help. I don't know what to do about the depression though. I know Lamictal is supposed to help prevent depressive episodes, but it doesn't seem to be treating mine right now.

I'm not sure about an antidepressant - I think with my history, both me and my pdoc would be a bit nervous about prescribing an antidepressant. Because it wasn't until I was in therapy that I realized I had been prescribed one antidepressant after another to treat depression, for over ten years, and they were triggering manic and hypomanic episodes, then I would stop because I felt on the top of the world, and come crashing down again, then the whole cycle would repeat. It was fascinating yet scary to know that I could have actually been bipolar all along. So because of that I'm a bit nervous about adding an antidepressant, and honestly I have been on nearly every antidepressant in existence other than the recent ones: Prozac, Zoloft, Wellbutrin, Effexor, Cymbalta, Lexapro, and about 2 or 3 others I can't remember - all gave me the same overall effect. Sigh. I don't know. I do know that it is very depressing just reading about rapid cycling and mixed episodes, because they seem so hard to treat. I dealt with hard to treat depression for the longest time, I don't like being in yet another hard to treat category. But I guess the depression is better than the terrible hypomania I was experiencing last month - it's just sad that's all I can say. Depression shouldn't be the "better" option, because it still sucks, especially when I still have some of the hypomanic symptoms, just not as severe.

Have your sleep gotten any better on the Abilify? Noticed any improvements for you?


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