Hi,

Here is a great question from Dana regarding medications.

Hi Julie,

I’m on the Lamictal starter pack and still taking 25 mg a day. I’ve been increasingly manic, irritable and aggressive. I have no tolerance for other people and haven’t been able to attend school.  Is this normal?  Will it be better at 100mg?

Dana

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Hi Dana,

First of all, it’s great that you’re aware of what’s going on. Sometimes side effects happen so subtly that people stay in a state of physical and mental agitation before they realize what’s happening.

Lamictal, like all drugs works in different doses for different people. For example, my mother gets a lot of help from 75mg and I’m on 500mg. If she goes above 75mg she gets the jaw clenching that comes with the drug. If I go under 500mg I get pretty bad withdrawal symptoms including bad twitching and super bad leg pain.

Your health care professional was really smart to start you on a small dose as going up slowly on Lamictal really helps minimize side effects.

It’s super important that you contact your doctor with your question. Any time a drug makes you feel manic, this is dangerous as it can lead to rapid cycling.

I have not heard of Lamictal causing mania and agitation, so that is new to me, but your health care professional will definitely know what do to. Here are questions you can ask yourself so that you can give your HCP the info needed:

Are you taking other meds that may be interacting with the Lamictal?

Did you stop a drug to go on this drug? IE, could you be having withdrawal from something else?
Have you had a trigger in your life that is messing with your sleep?

Speaking of sleep, the number one sign of mania is sleeping a lot less but not being tired. You may feel agitated and worn out, but not necessarily tired.

There are many things that could be happening, but it’s probably the drug. Only you and your HCP can work on dosage. Lamictal is notorious for withdrawal symptoms, so don’t do anything drastic. If you and your HCP decide to change the dose or the drug, do it slowly!

I hope this helps. Hang in there. It took me many, many years to find the right med at the right dose. It takes time, but you can find the same relief.

Julie

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Well, nine hours of sleep is so amazing for me I actually woke up and wanted to do a little jig. I’m what I call an undersleeper. I was actually talking with my friend Kristin yesterday- she’s the author of Bipolar and Pregnant, and we spent a long time talking about bipolar disorder and sleep. Here are all the ways it affected our sleep:

#1. Issues due to meds. Kristin talked about Topamax. She has no idea if it affects sleep- but she’s pretty sure it affects memory. Kristin uses Lunesta to sleep.

#2. When I’m depressed, I have agitated sleep which means my brain doesn’t shut down at night. Bother! I use Ativan to sleep when it gets bad.

#3. Of course, mania is the biggest problem. I rapid cycle almost daily, so on the nights I can actually fall asleep normally and get 7-8 hours of rest is pretty great!

#4 . Excessive tiredness from medications- especially some anti depressants. Whew, I used to get so tired my lips got numb and I slept 14 hours a day. No kidding!

 Many people in this industry say that regulating sleep is the #1 way to manage the illness. How is your sleep? I need to write a book on the topic!

 The buzz word these days is ’sleep hygeine” I am not even sure how to spell the word! Ah, here it is: hygiene!

Julie

Hello All! The computers were packed at my hotel, so this is my first time for a blog.

 I’m at the Depression, Bipolar Support Alliance in Norfolk, Virginia. It has been wonderful and very interesting - as well as stressful and sleep challenging!

 Here is some funny stuff: I have my seminar on family wellness on Friday. It went really, really well according to the crowd- there were about 150 people. When I got my evaluations, they were very positive. My first thought was:

 These are all fake! They are lying. No one can tell me the truth as they like me. This is quite funny, and it was funny at the time, but paranoia is not fun!

 I’m very used to paranoia. It’s hard to fight, but easy to recognize when you know the signs.

I’ve had trouble sleeping, even thought I took my own advice and switched over time zones. I went to be at 2:00 last night which puts me on  Portland time. I mention this a lot as a fun conference - with a lot of excellent conversation and my fun presentations is a recipe for disaster if I don’t get enough sleep!

I will write more tomorrow. I have so many stories and pictures. There was one woman who told a very funny joke- I have to find her to give her credit. Here is the joke.

 I go to DBSA support meetings and we discuss our meds and we’ve all determined that we all get fat from Krispy Kreme donuts!

 heehee. So, it’s not the Zyprexa!

Julie

Like everyone, I struggle with doing what’s right for myself versus doing what I want to do.

I’m paying the price. Sleep is always an issue and lately I haven’t been a good girl when it comes to getting to bed on time. In fact, I’m doing things that are counter intuitive. Eating way too close to bed. Eating foods I’m allergic to- which means body pain that makes it hard to sleep.

Drinking too much decaf- eating chocolate and drinking iced tea. They all have caffeine!

Watching TV really late- but that’s because of the Olympics!

I can make so many excuses. Managing sleep is one of the best ways to manage bipolar disorder. I get tired (no pun intended!) or having to monitor all that I do, but if I don’t I feel like I feel right now.

Tired!

Julie