Brand Name Lamictal and Generic Lamotrigine …2015 Update

generic medications bipolar disorderI regularly receive questions about the brand name drug Lamictal.  It’s one of the best medications around for treating bipolar disorder depression. It works as an anti depressant without as many concerns about mania.  It saved my life.  It’s the only drug I’ve ever been able to use long term. I was on it for five years. My bipolar disorder is under control these days and I’m not taking it regularly, but at one time I was on 750 mg a day and it kept my suicidal depression from getting too severe.  Lamictal (lamotrigine) has one of the highest treatment effectiveness ranges. The therapeutic dose is around 200 mg, but many people need a higher dose.

The brand name of the drug is Lamictal and the generic is called lamotrigine. When the generic came out seven years ago, it wasn’t very trustworthy. You can read about my experiences with the original generic lamotrigine on this blog- these posts are from the first week it came out as a generic- it wasn’t a stable drug at the time and I had to use the brand name for awhile as the generic literally would not enter my system. (My posts on generic bipolar disorder medications explains why this can happen even though the active ingredients in the brand name and generic are the same.)

Despite this improvement in generic lamotrigine, there are still some people who do not do well with generics and still want to use the brand name drugs. I just received a comment from Robin on this topic.  Here is my answer:

“ Hello Robin, It’s always a dilemma when the generic version does not work. Brand Lamictal is one of the most expensive drugs on the market, but you can petition your insurance company and prove that the generic version does not work and sometimes they will approve the brand name. This was because when generic Lamictal (lamotrigine) came out, there were some concerns about the make-up of the generics. Now, that the generic version has been perfected and works for most people, insurance companies are not as likely to allow you to switch to the brand-name option. This is why you have to prove that it doesn’t work for you. I should note here that if the generics didn’t work for you in the past, there is a chance they might work for you now. If you have determined that the lamotrigine does not work for you and you do not have insurance, you can contact Glaxo Smith Kline and ask them about their medication discount program, but it can still be quite expensive. Another route is to ask if your healthcare professional can obtain some samples, but this is not a long-term solution. Another option is to look for authentic drugs from Canada, but you have to be very careful and make sure that the quantity is clear. Sometimes, you find that the drugs are a lot cheaper, but it turns out to be for only half the amount. Good luck! 

I want to stress that once generics have been used for a few years they can get a lot better-  in the bipolar disorder medication world almost all of the drugs used are generic. All of the work I do with my parents and partner coaching clients is about bipolar disorder medications. I’m lucky that my coauthor Dr. John Preston has been my advisor and teacher on the topic for ten years.  I don’t give medical advice, but it’s essential that anyone associated with bipolar disorder knows what each medication does and the typical dosage ranges.

You can read one of my posts from 2012 below to see how generic lamotrigine worked at the beginning. It wasn’t as well manufactured as it is now!



Hi Everyone,

Thanks for the great comments you leave on the blog. Here is some information on Glaxo’s prescription program. They make Lamictal- it’s now available in generic, but if you qualify, this may be cheaper. For those of you new to Lamictal- it’s an anti convulsant used to treat bipolar depression.  It has helped so many people, but it’s expensive.


Most major drug companies have programs to help low income people with bipolar disorder get prescription help.  Here is a link for GlaxoSmithKline, the makers of Lamictal.

I have to ask this- where is the help for the middle class ?!!!


Can you Create Happy Holidays When You Have Bipolar Disorder? Of course!











Do  you have plans for the Festive Season? Do you have plans for New Year’s Eve? There is still time to work out who you will see and where you will be.  We are social creatures- as seen by the Santa mob below.  If you have a tendency to isolate and not take care of your needs during the holidays, what can you do differently this year? If you usually get overwhelmed and burn out during the holiday seasons, what can you do to voice your absolutely right to say NO to what you can’t or simply don’t want to do? My goal is for all of us to glide through the next few weeks with ease.




Seasonal Affective Disorder and Bipolar Disorder

Oh yes, the dark weather has started here in Portland, Oregon.  It’s easy to experience seasonal affective disorder symptoms when it gets dark at 4:00 PM. I have found that prevention is the best treatment for SAD.  The first step is to determine your worst time of the day. When do you feel the most down?  It’s around 4-6 PM for me.

Here are some tips for how I manage and prevent seasonal affective disorder :

1. I get natural light in my eyes if there is sun in the morning. Look up at the sky and let the light get into your retina so it can tell your brain to switch on your serotonin.  You want to look at blue sky whenever possible- this is the blue light that helps depression. Light boxes can cause mania in people with bipolar disorder. I recommend a full spectrum alarm clock if you want to use a light box treatment.

2. I have coffee with a friend during the dark times. A quick visit with someone when it gets dark early takes your mind off the gloom outside.   I’ve found that going to a movie helps as well.  Yes, the theater is dark, but seeing a comedy is often a great antidote to the outside darkness.

3. Exercise during your worst hours.  If 4- 6 PM is my tough time, it makes sense to battle the problem directly and make sure I’m as active as possible during these times.  If you work on a schedule and can’t exactly jump up and exercise for an hour at 4:00, at least stand up,  stretch and mentally remind yourself that you feel down because of the weather, not because there is anything wrong with your life. Take a walk right after work is possible.  Gyms have very bright lights and that helps.  It’s hard to remember to do these activities when you feel down- scheduling in advance works the best.

4. Try not to complain too much about the weather.  Portland, Oregon here on the west coast of the United States is funny.  The weather is terrible many months of the year. It has always been this way and yet we still complain.  It was the same when I lived in Seattle, Washington. We would have gloomy weather and rain all the way into the spring.  I’m not sure why I used to get so upset and complain so much. I’m the one who chooses to live in these areas!

5. Hang out with positive people. This helps all around.

You can manage seasonal affective disorder!



BP Magazine Blog: Are Cortisone Shots Safe for Bipolar Disorder?

I’m on a cortisone awareness crusade! It’s essential that all people with bipolar disorder and the family, friends and health care professionals who care for those with bipolar disorder understand the facts behind the shots! 



You would not believe the horror stories I’ve heard from people with bipolar disorder who had cortisone shots. This is also a common theme I hear from my family member and partner coaching clients.

  • Full blown euphoric manic episodes.
  • Aggressive dysphoric manic episodes that lead to jail.
  • Suicidal depression and hospitalization.

…. one series of shots can cause severe mood swings even if a person has been stable for years.  Prednisone for swelling due to a head injury or asthma and the ever present testosterone treatments for ‘men over 50′ have the same risks as cortisone shots.

This is why I am so adamant that those with bipolar try everything to treat an injury, before they take the risky move of getting a cortisone shot.

Please click here to go to my BP Magazine blog for the remainder of the newsletter. I wanted to put this on the BP Magazine blog so that everyone can leave comments. I think you will find this information very timely, important and interesting.


Bipolar Disorder and Thanksgiving Part One…………..


Let’s Make Thanksgiving Great This Year!



There is a commercial on the radio where I live here in Portland, Oregon that always makes me laugh. It says… ‘Beware of the holiday horrors! Buy all of your holiday presents now, the day after Thanksgiving and save yourself the stress of waiting until the last minute!”    Oh, it sounds like torture to me! When did Thanksgiving become so much about Black Friday sales? In case you didn’t know, Black Friday is a sales day after the Thursday Thanksgiving. It’s called Black Friday because it’s a day businesses can make enough money to balance the books instead of being in the red!


As a person with bipolar disorder or a person who cares about someone with the illness, there’s a good chance you have had some difficult holidays.

I hear people laughing all the way to the Starbucks where I am sitting in Portland, Oregon.

For those outside the US, our Thanksgiving is a family holiday based around a traditional dinner  held in honor of the dinner served between the people who ‘founded’ the US and the people who found the country way before any British showed up- the Native Americans. The food usually includes the following: Turkey, stuffing or dressing, sweet potatoes, mashed potatoes, pies such as pecan or pumpkin pie and cranberry sauce. Many families have a Thanksgiving dish they remember growing up. For me, it was my grandmother’s homemade corn bread dressing.  I had many wonderful Thanksgiving holidays while growing up – mostly in Alabama.

As I got older, the holidays became a fun time with friends.

And then…. they just became too much.

Is it the same for you? Maybe you don’t want to cook, don’t have the $200 to spend on a dinner for eight. It might be you don’t like your family! And finally, the hardest is when you don’t have anywhere to go. It doesn’t mean you don’t have friends- it might just happen they are all with their families and yours is out of town.

And finally, it may be that your family is here, but the atmosphere is stressful. I’ve seen a few snarky faces at Thanksgiving. It’s hard to have to be happy and united for a day.

It’s a lot of pressure.   To lighten the mood, check out this turkey. Yes….

It’s a turkey wrapped in bacon!


PS:  Thanksgiving can be wonderful, but it’s usually challenging when bipolar disorder is an unwanted guest.   That’s why we have to plan ahead! Part two of this post is below.

Bipolar Disorder and Thanksgiving part two…….

Continued from Thanksgiving part one…..

My friend Margery who has bipolar disorder just called and told me that her sister has decided to come down to Portland instead of staying in Seattle.  Margery said, “I cooked her dinner a few years ago, Julie. I’m not spending days cooking for something that is gone in a few hours. It’s too stressful!” I agree. Margery just reserved a full Thanksgiving dinner from Whole foods.  She picks it up Thanksgiving  morning! She said it was so cheap when everyone went in on it.  These stores have great and inexpensive salad bars as well.

Good idea:  Say no to cooking if it’s too much for you. Let others do it or buy dinner from a store and bring it home.  Or, eat out!

I’d like to say I’m immune to the whole Thanksgiving thing- but I’m not. I have to make sure I have something to do that day or I know I will get depressed and lonely.  It’s my nature. The concept of Thanksgiving has been burned into my American brain.  My dinners were so wonderful as a child- that is what I remember.

Here are some tips if Thanksgiving is important to you:

1. Plan now. Where do you want to be? Start hinting to the people you know that you would be a good addition to the party.

2. Send out an email to friends saying you are looking for a fun dinner. You will get replies.

3. Volunteer for the day. Many people do this and you meet new friends.

4.Crash a party!

5. Go to Target to check out the Black Friday specials. Oh – this just sounds terrible…  but people love it! Buy a TV the next day! ;) I’m joking.

6. Go to the movies with a friend. Pay for one and then sneak into the others…hehe

7. If you are going to order a dinner from a place such as Whole Foods, do so ahead of time. They do sell out.

Or… you can be like me.

5. Watch football!

If you’re someone who doesn’t have firm plans yet, start making them today. It’s hard to be lonely on the holidays when you have bipolar disorder.

There is a place for everyone.


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