Sunday, July 31, 2011

Lamictal Day 23: Lamictal, Mood and Delayed Sleep Phase

Daily Irony Supplement: Staying up until 2 am reading John McManamy's Living Well With Depression and Bipolar Disorder. Sigh.

Since titrating up to 50 mgs of lamictal, my mood has definitely been better.  I'm not experiencing as many mood dips as I was even last week.  I had one day (Day 17) where my mood was low to neutral.  I had a low day a few days after starting lamictal too (Day 5), so maybe there's something about getting used to the dose that causes a temporary slip in mood.

On Friday, I noticed that my late-afternoon mood shift has gone in an agitated direction.  This is a change from baseline -- my tendency over the last few years experience a trough of some kind around 4 or 5 pm.  When I'm doing well, this is just slight sleepiness or trouble concentrating.  When I'm not doing well, I'm into The Pit.

I'm also beginning to get concerned about what this med is doing to my sleep.  I'm used to going to bed around midnight, taking an Ativan, and reading until I get tired -- usually 12:30 or 1 am.  After half an hour, I'm asleep, and ready to start my day at 9:30 or 10.

Since starting lamictal, I'm having a hell of a time falling asleep before 3.  I'll do my reading-in-bed thing, glance at the clock, and realize that it's 2 or 2:30.  It takes me an hour to fall asleep.  I often awake at 9, fall back to sleep, and awaken for good when my alarm goes off at 10.  I'm tired when I wake up, but don't have particular trouble waking, and the Vyvanse I take for my ADHD (as well as the lamictal, possibly) keep me from feeling tired during the day.  But I look tired; I have dark circles under my eyes.  And in spite of not feeling tired during the day, I can feel the lack of sleep.

I need to find a way to wind down at the end of the day.  My mind tends to become active as my body slows down.  As I get ready for bed, all of the things I'd been thinking about throughout the day will percolate to the surface, usually all at once.  A few weeks ago, well after midnight, I asked my husband (who's a network engineer) why we were could enable the Voyager spacecraft to transmit data wirelessly in 1977, but it only became standard in personal computers in the early 2000s.  (His answer: "Mff.  Sleep now.")

At first I wondered if this was a side effect of lamictal.  Then I remembered the time my mother was kissing me good night and I asked her why WWI had happened.  Her answer, sighing: "Why do you always ask questions like this at bedtime?" I had trouble winding down at night as a kid, too.

So we appear to have an inborn trait that is exacerbated by lamictal.  I'm not sure what to do here -- give up my nightly ritual of reading before sleep?  Try some yoga for insomnia before bed?  Make sure I'm off the computer by 11 pm, or even by 10, and see what that does to wind my brain down?  All of the above?


  1. I also get a late-afternoon shift around 4-5 o'clock... or a bit later. Not every day, but more often than not. I haven't been able to figure it out, but glad to hear that it's not just me.

    I wrote about this phenomena on a blog post at

  2. I'm also glad to know it's not just me! Thanks for sharing that link.


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