Anyone on Lamotrigine and/or Pramiprexol for Major Depression Disordee

@louisy Welcome to Mayo Clinic Connect.

I will say that I have not been on any of these medications you are talking about. But what I do know, is that often our bodies may "get used to" a regimen, and then no longer be as effective. And that can go for any medication. And if we are prescribed additional medications for other conditions, they might interact with something we are already taking.

Have you spoken to the prescribing doctor to let them know your thoughts, and see if there is some testing they can do? What do you do now to help you with your memory and critical thinking? Crossword puzzles? Learning new things?
Ginger

I was on Effexor for over twenty years, and for the last three of those it turned me suicidal, something no one, not even my psychiatrist, picked up on. She had kept me on Effexor after I was hospitalized a year-and-a-half ago. I quit it in a suicidal rage last winter genuinely wanting to wreck my life and, despite the wicked withdrawal symptoms (I do not advise doing what I did, it's miserable), within a few days the suicidal depression lifted. What happened to me has been shown to occur in rare occasions with antidepressants, and after finding NIH and BMJ articles about this, I refused to even consider going back on it.

I told my psychiatrist that while I was glad to be rid of the antidepressant and would not take any medication in that class again, I did feel like I'd stripped off my armor. She suggested Lamotrigine, and I decided to give it a go. This sequence of events occurred between late February and early March of last year. I started logging my moods on this program, which I can't recommend enough: https://www.moodtracker.com/. I have daily data going back to March 2.

My experience was twofold. My overall outlook improved almost immediately after quitting the Effexor, and I went from daily thoughts of suicide to absolutely zero since. So we know the Effexor was driving that. My mood also improved gradually as the Lamotrigine was introduced, a six week process for me, and I have been absolutely stable for roughly nine months now.

How much of this is thanks to getting off of Effexor and how much has to do with the Lamotrigine is something I cannot pinpoint since there's a mix there. But depression, which I've dealt with since childhood (I'm now 60) is flat gone. I was never particularly suicidal until the Effexor turned on me in 2021. There were three years there that I'm frankly thankful to have survived (it came scary close), and there's no way I'd upset the current balance to find out if it's primarily the Lamotrigine, primarily quitting the antidepressant, or a 50/50 mix of the two that got me where I am.

Kind of vague, but that's been my experience. I have not noticed any side effects of the Lamotrigine, but I haven't been taking it as long as you have and am not taking Pramiprexol, so I cannot speak to that part.

I hope this helps.

I am on lamotrigine for seizure prophylaxis. I am not having any issues but I was overmedicated by psychiatry for years. Not now. I do not support over prescribing in any way.

I was diagnosed (incorrectly, IMHO) with bipolar disorder in 2009 and placed on Lamotrigine and Zyprexa. I always had severe brain fog while on this combination even though my dosages were adjusted many times over the years. I also experienced other unpleasant side effects and finally had enough and titrated off of the Zyprexa in Spring '23. Although most of the sympto.s were relieved, I still had some thinking problems and decided to get off the Lamotrigine this last Spring. I've been L-free since early Summer '24 and feel great. My dog's lifted and nothing but blue skies for the past several months. I did this under a shrink's guidance.

Good luck!

My fog's lifted.

My dog has remained earthbound.
😁

Hi and thank you for your reply. I'm very curious about how you went off of lamotrigine. I have read that it is very difficult and must be done very slowly over a fairly long period of time. Was that true for you? I'm currently taking 150 mg twice a day. I don't know if that's a lot but the shrink told me she has people on much higher doses. I'm just wanting to try to get off of these meds at least one of them. I have no idea what I would feel like without meds. It's encouraging to hear that you're doing better Now that you've discontinued them but I agree that it's something that needs to be done under supervision. Scary stuff right? Our brains are such a mystery and there's so much they don't know but we all do our best. I would love to see what psychiatric care will be like 50 years from now! I figure they will look back on this and think "how barbaric "! Who knows? But again they are doing the best they can with what the research has been able to provide. Thanks again and I look forward to how your experience went.

From my (admittedly sketchy) records, my max dose of Lamotrigine over the 15 or so years I took it (Fall 2009-Spring 2024) was 400mg/day.
Started titrating down from 400mg/day in Fall 2023 as follows (with a few bumps along the way):
60 days@ 200mg/day
30 days@100mg/day
20 days@75mg/day
20 days@ 50mg/day
20 days @ 25mg/day
20 days @ 12.5 mg/day
My logs say my last dose of L was on April 14, 2024. I'd had a nasty itch-like condition that I suspected was L-related but my GP diagnosed it as dermatographia (unrelated to L) and put me on Cetirizine then switched to Fexofenadine, which controls it satisfactorily.
Be advised that I'm retired and a 12-year teetotaler and am no longer subjected to the extreme job stresses and alcohol abuse that I more and more suspect were the primary drivers of my chronic nutjobiness. Like I said before, I really don't think I'm bipolar.
Hope this can be of some help to you.