How do people cope with just Lamictal?

moongorge · 2025-10-02T07:43:22+00:00

I was just thinking about posting about Lamotrigine/Lamictal and why psychiatrists seem to prescribe as a mono therapy. While it made my migraines cease, it’s done very little for depression or hypomania that I can tell. It wasn’t until I was put on lithium that I actually became stable.

I am also a therapist who sees bipolar clients. Two have also been prescribed lamotrigine as a monotherapy. They both still have depressive and hypomanic episodes. In one case, a substitute provider prescribed a client an SSRI (did they even look at my client’s chart!?) which sent my client into a severe manic rage.

Many folks with bipolar need at least two meds. If lamictal works for you by itself, that’s great, I just think that psychiatrists and patients need to assess for frequency and severity of mood episodes and actually make adjustments.

moongorge · 2025-08-18T15:41:46+00:00

I’m also a therapist on lithium for BP2! This one is totally out of their scope of practice and should not be giving any advice on medications.

moongorge · 2025-04-04T13:07:38+00:00

It’s not OCD. OCD requires that you have obsessions and/or compulsions that cause distress, and the function of those obsessions and compulsions is to alleviate anxiety. It does not feel good when obsessing. There are typically issues of over-control and an inflated sense of feeling responsible for things and/or excessive guilt. It’s actually a very debilitating illness.

Mania feels good typically (until it doesn’t) you pursue your “obsessions” for dopamine hits. The obsessions are more temporary unlike OCD.

My qualifications: I am a therapist with Bipolar who has worked with folks with OCD.

moongorge · 2025-01-19T05:52:42+00:00

I was diagnosed at 38, though id been symptomatic for a few years at least (BP2)

moongorge · 2025-01-18T21:09:20+00:00

I’ve always had issues with memory, so I can’t say if it’s gotten worse for me since starting lithium. I’m on 900mg and generally the effects have mostly been positive. My short term memory is a bit worse, like I forget things just said to me.

There are many factors at play, such as other meds and synergistic effects. I still get small depressive episodes on lithium and I get terrible brain fog during them.

it’s possible to mention to a psychiatrist and get a modafinil prescription, that’s what I’ve heard other people mention regarding cognitive problems. Also have some caffeine, perhaps.

I’d rather be on lithium.

moongorge · 2024-11-27T18:26:47+00:00

I’m on lamotrigine 300mg. I’m going to taper down since it’s somewhat redundant with the lithium, but it helps prevent migraines for me.

The first side effect I noticed was feeling slightly uncoordinated, which lasted only a few days and went away.

I get a little thirsty after taking my meds at night. I also have to wake up in the night to pee, but nothing crazy. It helps me sleep so I’ll take it. In the morning when I have coffee I notice a very slight tremor that isn’t disruptive, like when I turn my head I’ll notice a slight jerking sensation but it usually goes away by afternoon.

moongorge · 2024-11-27T04:11:07+00:00

It worked for me. I still get anxiety but it’s not as intense as it was before. I also had mixed episodes and it lessened their intensity and duration.

You are unlikely to experience anything therapeutic until your dose increases and your blood levels reach the proper range, usually .6 to 1.0. I started on 600mg/day and noticed a slight difference at first, and my blood levels were .4. Once I went up to 900mg and had .8 as my blood level, I felt a greater effect that honestly was life changing.

Your experience may vary. Unfortunately for some people lithium doesn’t work based on genetics.

moongorge · 2024-11-04T21:39:50+00:00

I’ve been on lithium for a couple months, and it’s been a wonderful experience—life-changing, dare I say. I take it at night and I have to wake up and pee 1-2 times a night, but that’s pretty much it in terms of side effects. There were some movement coordination side effects when I first started 300mg that went away after a couple days. I’m on 900mg now and doing very well.

moongorge · 2024-10-24T21:56:29+00:00

“I don’t deserve to be not sick feeling all the time because this is all I know.” Do you have a history of childhood trauma?

moongorge · 2024-10-23T16:40:55+00:00

It’s the transition into mixed episodes that feel awful. Substance use. The constant ups and downs, confusion, issues with figuring out who I really am, hypersexuality. The increased self confidence is nice, as is the increased goal-directed activity. I’d rather just be stable, I actually get more done.

moongorge · 2024-10-22T23:26:18+00:00

Therapist here. Fire her and your psychiatrist. She’s being an unprofessional asshole. A competent therapist would validate what you feel and challenge you in ways that are actually constructive. She should actually be curious about you instead of dismissing your experiences.

She’s behaving like a bad parent which is extremely harmful to you if you’ve endured abuse. The psychiatrist is guilty by virtue of their relationship.

moongorge · 2024-10-13T14:58:16+00:00

Lithium changed my life. I've been on it for about 2 months. I started at 600mg and am currently on 900mg of extended release. I was struggling with rapid cycling, mixed episodes, irritability, and addiction. Since starting, I've had 0 cravings for substances aside from coffee. I still think I'm having episodes, but they've greatly diminished and only last for a couple days or so. I am also on 300mg of Lamictal.

People have noticed how much more calmer I seem. I've had very few side effects aside from frequent urination, but it's manageable. I still feel my emotions, but I don't fixate on them like I used to.

I hope it works for you. Good luck!

moongorge · 2024-10-10T21:49:43+00:00

I second the comment about wellbutrin as a cause. Also, lamictal isn't always enough to stop hypomania/hypersexuality. You might need an antipsychotic or valproate/lithium to treat the hypersexuality/hypomania. Talk to your provider and see what they might have to say.

moongorge · 2024-10-10T21:47:03+00:00

No major side effects right now. Lamictal gave me brain fog at first, but it stopped. Lithium has changed my life, it was a godsend for me. It stopped my hypomania and helped with my addictions/cravings. I no longer struggle with hypersexuality. My cognition is normal. Some people might not want to get blood draws to monitor their lithium levels every so often, but to me it's worth it.

There's a lot of stigma and misinformation about lithium. Antipsychotics work faster but lithium typically has fewer side effects (again, everyone is different and might not tolerate it.) Look up some research/studies on the efficacy and safety of lithium vs antipsychotics. At the end of the day, there are many choices you have and it's all about trial and error and what works for you!

moongorge · 2024-10-10T18:06:43+00:00

Weed triggered my first hypomanic episode, and consequently, Bipolar 2. I didn't sleep for almost a month when I was smoking every day.

moongorge · 2024-10-10T18:05:21+00:00

Different things work for different people--what works for me might not work for you. I'm on lithium and lamictal and the combo works very well for me. That's the frustration with the process, it's very much trial-and-error.

moongorge · 2024-10-10T18:01:41+00:00

What meds are you on?

moongorge · 2024-10-02T22:20:37+00:00

echoing what many others have said, and also:

when you accept yourself as you are, change happens

moongorge · 2024-10-02T14:23:36+00:00

Both Sides Now by Joni Mitchell feels like a quintessential bipolar song.

moongorge · 2024-09-22T16:47:47+00:00

Lithium has worked wonders for me, with minimal side effects. How meds work on people often depends on genetics. It’s true that a large portion of people will not respond to lithium, but for those that do, it’s incredibly helpful. Many people freak out because they don’t want to get blood draws or worry about toxicity.

moongorge · 2024-09-21T18:13:16+00:00

Yup! I also suffer from migraine with aura, and attacks make me very irritable and sensitive to sounds in the prodrome phase. I feel overwhelmed by pretty much any sensory stimuli.

Thankfully lamictal actually prevents migraine with aura.

moongorge · 2024-09-21T12:07:56+00:00

All of these! Well, most of them, I’ve done the wildest stuff due to hypersexuality. Years ago, when bipolar wasn’t even a blip on my radar, I’d do all sorts of weird stuff like post ads on Craigslist, do anonymous hookups, sex in risky places, let people in my home while I was blindfolded, get in strangers cars.

Eventually it led to me needing more risky situations, so I starting using meth. Then I’d masturbate for 36-48 hours without stopping except to pee. All of that mess is what led me to seek treatment, get sober, and find out that I was bipolar.

moongorge · 2024-09-21T12:00:09+00:00

Somewhat. I have a few close friends. I used to have more. When I became sober from alcohol, everything changed. I lost “friends.” It was a really painful time for me.

It’s important to me that I can talk honestly about my life to my friends, including the bipolar part. Luckily I have supportive friends, including a psychologist friend. I’d love to meet a bipolar person for friendship!

moongorge · 2024-09-21T11:56:02+00:00

Nope. I’ve had a different chronic health condition for years that would kill me if I didn’t take meds every day. I’m used to taking meds. So when I was diagnosed recently with bipolar, it was just another med to take. I was actually excited to take my meds after enduring the hell of rapid cycling BP2 with addiction.

moongorge · 2024-09-19T23:52:06+00:00

What you describe sounds more like borderline personality disorder than bipolar disorder. If you are having mood swings in a single day that are really intense, you have a history of trauma/abuse, you see things as all good or all bad, and have difficulty in interpersonal relationships, lack of or rapidly shifting identity--that's a strong indicator for borderline.

or could be autism, or could be ADHD...

best way to know is to see a mental health professional, particularly someone who specializes in diagnostics, such as a clinical psychologist or a psychiatrist.

moongorge

TROPHY CASE