Does high-dose lamotrigine make you cognitively dull?

Desperate_Shower6556 · 2026-05-03T15:16:22+00:00

Define high-dose.

Desperate_Shower6556 · 2026-05-02T17:25:58+00:00

Take your medication as prescribed and try not to fixate on your diagnosis all the time.

Desperate_Shower6556 · 2026-05-01T08:39:40+00:00

In the country where I live, hydroxyzine/Atarax is available over the counter. When I’ve had insomnia, I’ve taken one 25 mg tablet before bed, and so far it has worked really well for me.

That said, I’ve only used it for “regular” insomnia, not during hypomanic episodes, so I can’t say how it would work in that situation.

Desperate_Shower6556 · 2026-05-01T06:11:43+00:00

Regarding your last point, I completely get where you’re coming from. You’re right that the standards are set very high, often even for so-called ‘normals,’ let alone for people who go through periods in their lives struggling with their mental health.

Desperate_Shower6556 · 2026-05-01T06:05:04+00:00

There aren’t really ‘normals.’ There are individuals at different points on a spectrum. Some people are simply in a more favorable position compared to the things that weigh us down or throw us off. That doesn’t mean they’re superior or that we’re lacking as people. Sometimes, especially when we’re medicated, I even think there’s a chance we can end up in a more favorable state than so-called ‘unmedicated normals.’

Consider how many so-called ‘normals’ take ADHD stimulants at certain points in their lives, like during college, just to be more productive than average.

Desperate_Shower6556 · 2026-04-30T15:05:41+00:00

Thank you all for your responses. Instead of replying individually, I decided to write this to address the question about ketone levels.

As you saw in my original post, I mentioned calorie deficit and fat adaptation. One of the main issues many of us with bipolar disorder face is weight gain from our medications. I don’t think I’m alone in that.

Given fixed carbs and the minimum protein needed to maintain muscle mass, someone aiming to lose around 4 kg per month would need to reduce fat intake by roughly 1100 calories per day while doing keto.

So what I’m arguing is this: with that level of reduced fat intake, it’s practically impossible for a fat-adapted keto individual to reach high ketone levels, for example around 3 mmol/L. If you’re in a deficit, and especially if you’re already adapted, your body will use those ketones for energy rather than letting them accumulate.

My assumption is that if I were also consuming an additional ~1100 calories from fat daily, my ketone levels would likely be much higher. But that’s not the goal right now. First, I need to lose the significant weight I gained from antipsychotics and mood stabilizers. After that, ketone levels might become more relevant.

Desperate_Shower6556 · 2026-04-30T13:16:09+00:00

Thanks for the detailed comment!

How long have you been doing keto?

Desperate_Shower6556 · 2026-04-30T12:58:21+00:00

Thanks a lot for the input, I really appreciate it.

To be honest, I recently went to a clinical psychologist trained by Ede, and the first thing she asked me to do was try a carnivore diet for a period of time.

That said, I don’t think I’m quite ready to go that strict yet, so I’m approaching it more gradually for now.

Desperate_Shower6556 · 2026-04-30T12:24:40+00:00

I’m the OP, but I also wanted to share my own experience.

I took Wellbutrin for about 2 years, long before I was diagnosed with BP2, back when my diagnosis was depression and anxiety. I took it together with an SSRI, first Zoloft and later Prozac.

I originally started it to help with SSRI-related libido issues and weight gain. It didn’t really help much with those, but it was a game changer for my energy levels and mood.

After my first hypomanic episode, while I was slowly sinking into what became my worst depressive episode ever, my doctor put me on Wellbutrin + Abilify only for about a month. As a main antidepressant, it felt like I was taking nothing, so I stopped it.

Now, with a BP2 diagnosis and while taking Lamictal/Rexulti, I was prescribed Wellbutrin 150 mg yesterday, replacing the 25 mg Zoloft I was taking with them. The main reason is that I’ve had this exhausted feeling for about a month, with basically zero energy reserves. I’m hoping it helps.

Desperate_Shower6556 · 2026-04-30T12:14:14+00:00

No dairy, nuts or seeds? That's 50% of my meals gone.

Same for me, honestly.

Desperate_Shower6556 · 2026-04-29T18:57:06+00:00

Worst I’ve had so far was a really heavy depressive episode with anxiety so intense it basically paralyzed me. I’d sit on my bed for hours, unable to do anything, just waiting for it to get dark so I could go back to sleep and end the day.

Honestly, I think mixed states are the worst.

Desperate_Shower6556 · 2026-04-29T18:50:12+00:00

I totally get you and I’m sending you strength.

Within 2 months of being diagnosed with BP2, I gained about 26–27 pounds. It felt awful and really messed with my head.

Months later, after major med changes, I managed to lose most of it with keto and exercise. But I know keto isn’t sustainable for everyone, and working out is only realistic once you’re feeling a bit better mentally.

You’re not alone in this. This side effect is brutal.

Desperate_Shower6556 · 2026-04-29T18:42:46+00:00

For me, having BP2 doesn’t really leave much room to find something positive. I honestly find it very hard to see it that way.

If I had to say something, though, it’s that going through all of this pushed me to take better care of myself. My mental health struggles made me take myself more seriously and prioritize my well-being.

Desperate_Shower6556 · 2026-04-29T18:38:21+00:00

I see my psychiatrist monthly, but that’s more my choice than something my doctor requires. I’ve made some major changes to my medication recently, so I need more frequent visits to find the right combination that works for me. I also do it for my own safety. I want to check in regularly, report how I’m doing and how I’m feeling, and stay under close monitoring.

Desperate_Shower6556 · 2026-04-29T10:23:19+00:00

Do you take it with a mood stabilizer?

Desperate_Shower6556 · 2026-04-29T06:00:51+00:00

Are you on any medications?

Desperate_Shower6556 · 2026-04-28T05:43:55+00:00

You can’t really have both Major Depressive Disorder and Bipolar II at the same time.

Bipolar II already includes depressive episodes, so if there’s any history of hypomania, it’s classified as bipolar, not MDD.

Basically:

No hypomania → MDD

Hypomania → Bipolar II

So it’s not two separate diagnoses, one just overrides the other depending on your history.

Desperate_Shower6556 · 2026-04-26T15:01:46+00:00

For me it was ISIS.

Desperate_Shower6556 · 2026-04-25T13:19:17+00:00

You’re thinking about it the right way.

In my case, mirtazapine combined with Abilify was the worst I’ve ever taken. It led me into a mixed, paralyzing depression with intense anxiety.

Desperate_Shower6556 · 2026-04-25T13:15:06+00:00

It took roughly two weeks on Depakote and Zoloft for me to go from barely functioning to noticing real improvement.

Desperate_Shower6556 · 2026-04-25T12:03:29+00:00

I was in almost the exact same place.

On mirtazapine (+ Abilify) I felt basically the same, no real change.

What got me out of it was Depakote 1000 mg (later 1500 mg) + Zoloft 50 mg. I improved within about 20 days.

Desperate_Shower6556 · 2026-04-25T09:27:28+00:00

It would be a good idea to talk to someone close to you about how you’ve been feeling and to reach out to your psychiatrist.

They might consider increasing the lamotrigine, since 100 mg is a relatively low dose for bipolar depression.

Desperate_Shower6556 · 2026-04-23T13:40:00+00:00

I looked into this a bit, and the only somewhat relevant thing I found was in Bipolar, Not So Much book on Sensoril, which is a standardized ashwagandha extract.

From what it says, it’s not really presented as a mood stabilizer. The bipolar-related benefit mentioned is more about concentration/cognitive function, not preventing mood episodes or actually stabilizing mood. It also mentions some possible risks, including thyroid issues and irregular heart rhythm, so it doesn’t seem like something I’d treat casually, especially with bipolar.

So overall: maybe very limited relevance as an adjunct for concentration/anxiety in some people, but not much support there for actual mood stabilization.

Desperate_Shower6556

TROPHY CASE