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.

Thank you for posting. Hoping you can relate to my issue and suggest a helpful direction for me to begin the healing process. Going just type the points.
I was a successful sales executive. Yes, I lived life in the fast lane for years, but always produced at work and showed up.
Played baseball till age 24. College grad. At age 35, my back began severely degenerative processes. My issue-my back was killing by age 44, couldn't sit still. WELL, I'm at a primary care dr follow up for flu symptoms and I was fidgeting do to back nerve pain. Dr aid, "I think you'll be more comfortable if you take these "calming" medications". I'd have tried anything, this was before surgeries started. My "primary care dr" prescribed me Lamictal and citalopram. WTF, now that I'm 54. My life via mental health was a free-fall downhill from there. I was manic or bipolar,. I was simply miserably in pain and looked agitated because I Frick'n was-WITH PAIN! That dr new that because he regularly gave me steroids shots for pain. I finally had mri's, many pain blocks, surgeries gone wrong bla, bla, bla. I survived the opiate prescription years with benzo's. I never had a manic issue, or bipolar thoughts until prescribed mental meds. I felt like I was in a nonchalant fog after mental prescriptions. Then I started seeing a psychologist 3 years after starting Lamictal, I didn't feel like myself. Well they put me on benzo's. Then 2 years later they switched me from Lamictal and citalopram to effexor and mirtazapine, propranolol, vistoril-because I just couldn't explain how I felt...I wasn’t myself. I was awarded SSDI around 46 because of back, hip condition and many surgeries. Then I'm prescribed ass lia@ds of opiates for years and was almost off them/on my own doing and strenuous efforts. Only to have another dr prescribe Frick'n Suboxone. Whoa! That was ridiculous now that I'm older and had to wean myself off of Suboxone because Dr would say at appt, "how do you fell)? Me-"I guess OK and normal ". BS!!! U can't think and feel anything on Suboxone. People might argue that statement, but everyone will just let life roll of their shoulders and don't realize that. Then it's 10 years later and they wonder where did years of my life go.
Side note: I've been included in 5 insurance and prescription overcharge fees, 3 over prescribed class action, 3 opiate class action and 4 Suboxone class action law suites....all based of my insurance and prescription records. Thus far, I've received a total of $2100.....lawyers-$3 billion!!!! I had perfect chronological records for everything at THAT RIDICULOUS!
Before I make my point, I neverhad mental health issues until being prescribed those types of meds. I had to wean myself off Suboxone 1mg at a time for 3 years and when down to .05 mgs every 4 days...every time I quit and made it to day 8-10, I'd end up in the ER thinking I was having a massive heart attack...and I'm in great damn shape. The 3rd time, I did have a heart attack. My CNS had literally given up and was mis-firing..for lack of better words. My ICU dr friend said they've never been trained on how to care for Suboxone pt's, nor is there any written protocol to titrate off the med if no longer applicable to pt. Frick!
I stopped AGAIN, on my own-didn't sleep for 3 weeks...HORRIBLE! But I pushed through knowing that my brain chemistry would heal itself-my degree is in chemistry. You can't take medication for years and expect a return to normal in a few days or weeks. It's been 8 months since last taking Sand I still have triggers of not feeling whole. So that's the back story
Ok...yes, I have drank 2 x's a week and used cocaine 4x's a month AFTER start mental meds. Both made feel normal..thinking and resolute while on all that damn medication.
Chemically speaking g, if you don't need serotonin and dopamine reuptake inhibitors and Dr's prescribe them...then you use illegal dopamine and serotonin increasering drugs seeking a feeling of normalcy...your screwed, not by drugs, but by incorrect prescribed medications.
I haven't dated, rarely leave the house, I've missed paying bills just shrugging all responsibilities off because of Lamictal, Citalopram, Effexor, Mirtazapune, all benzos and opiates/Suboxone that'd been prescribed to me...incorrectly I feel. I don't do the illegal stuff anymore and I feel more helpless.
So much so, I felt so aloof on my prescribed mental meds, I went to ER 3 years ago and because I needed help so bad and I was sick of not being cared for with back pain flare ups because the hospitals automatically flag you as a drug addict because ur prescribed certain meds by no fault of ur own...I checked into ER and then went into bathroom and made 2 harmless suits in wrists so that I'd get the mental health I so desperately needed. This happened at year 4 of Lamictal and citalopram and again w/no drama like that at 3 years of Effexor and mirtazapune. Me, Frick'n checking myself in a mental emergency mental rehab hospital. My friends and family are still shocked, "you, how did this happen"? Well I explained above.

Question for public, has anyone been initially been prescribed mental meds later in life, only to realize they were misdiagnosed and now are medication free and doing MUCH better???

Help! Hoping someone can relate to my dissertation. Sorry so long winded
TCB

So sorry to hear about your troubles. I've had back problems before, but nowhere close to what you describe. I did have a short-lived bout of idiopathic peripheral neuropathy five years ago that were treated with opioids and, luckily, I experienced no negative side effects. I'm not a doctor and definitely not a psychiatrist and I found your description of your health history fragmented and hard to follow. But, I can't understand why you would be prescribed Lamictal as a pain remedy.
I was stuck on a combination of Zyprexa and Lamictal from Fall of 2009 until winter of 2022-2023. Throughout this period I suffered from many severe side effects, including massive weight gain, blood sugar control problems, extreme mood dysphoria (which, paradoxically, the drugs were supposedly treating), paranoia, loss of physical coordination, intellectual retardation (no genius to begin with, so this really hurt), memory attenuation, etc., and came to the conclusion that the drugs were making my overall health much worse. They never really ameliorated my mental problems which, IMHO, didn't match the qualifying symptoms for Bipolar, which I had been diagnosed with by virtue of a 20 minute conversation with a doctor in Iowa in August 2009. I'd previously been diagnosed with ADHD in 2004 and I'd been a world champion drinker since my Navy days, which never helps.
I weaned off of Zyprexa in fits and starts over about a one year period and titrated off of Lamictal over the first four or five months of 2024. I have since regained much of my mental and physical health and will NEVER take any psychiatric drugs again. I've come to look upon the mental health field with great suspicion and generally do not trust shrinks, especially the APNPs.
But, that's just me and I still recommend that you avail yourself of professional guidance if you decide to kick the Lamictal habit. If you try to do the detox on your own you're assuming all the risk which justifiably should be shared with the folks who prescribed the crap to you in the 1st place.
Hope this helps and, again, my sympathies for your travails. I've been there and know how much it sux. Courage!

Thanks for sharing your experience. Can you tell me what dosage of Lamotrigine you were on? Also how did it work with getting off of it? How much did you reduce by and how often did you adjust down? How long did it take? I've heard it's really hard to stop it and it takes months. I'd really like to titrate off but I'm fearful of having a relapse of severe depression. I tried reducing the dose by 25 mg once and kind of crashed mentally. I had been in 150 mg twice a day. Still on that dose. Of course I did this all under supervision of my shrink and would do the same if I decide to give it another try. Thanks so much.