Today is my last day on 150 mgs of lamictal. I've been at this dosage for a month, and tomorrow I'll be going up to 200 mgs. This month has been difficult for several reasons -- life stress, mood stress, and side effect stress. I guess I hit the trifecta. Lucky me.
Being on 150 mgs has definitely improved my mood, but my mood suffered with the shift into autumn, so I started using my sunlamp. In spite of this, during my third week on this dosage, I experienced more 4 to 8 pm troughs than I had in the previous two weeks. The fourth week was much better. What was different during the fourth week? I had my period.
Yeah, I know that's not the stereotypical way for things to go. And strictly speaking I don't have periods because I'm on hormonal birth control. But this past week has been my "off week". For some reason, hormonal birth control (this includes both The Pill and the NuvaRing, which is awesome) interferes with lamictal. When you take your "off" week you have more of the med in your system.
Anyhoo. My mood has not been high enough or stable enough for me to stay at 150 mgs. It suffered with the waning light, it suffers when it's cloudy, and today, gods help me, it's raining. The light will continue to wane, and my mood along with it. When daylight savings time ends, it will suddenly be getting dark an hour earlier, and that's the point at which I started to crash last year. In light of that (haha!), I'll be asking my doctor if I can ultimately go up to 300 mgs. I just don't want to take any chances.
But the most remarkable thing about titrating up to 150 mgs has been the side effects. Whooboy, the side effects.
Lamictal continues to interfere with my sleep. Actually, my sleep has just been all kinds of messed up for a lot of reasons. After sleeping a little better on 100 mgs, the bump up to 150 mgs delayed my sleep phase again. I was sleeping from about 3 am until about 11 am. Then I started using my sun lamp, and started waking up on my own at 9:30 am. Unfortunately, I still can't fall asleep until 2 am at the earliest.
Part of the problem with my sleep is dry mouth. Especially since starting the sun lamp, my mouth has been dry as the Sahara. Therefore I'm drinking a few gallons of water a day (seriously, I counted). And the end product of water is pee. I have to pee ALL THE TIME. This is a pain in the ass when you're trying to fall asleep. When I finally do drift off, I have to get up a few more times. Sometimes I have to get up again around 5 am. Sometimes I have to get up AGAIN around 7 or 7:30.
My appetite has been normalizing in the last week or so, which is good, because it's time for me to take up my exercise program again. Who knows whether this will continue as I titrate up to 200 mgs. Other side effects which continue in mild or intermittent forms are dermatitis, balance problems, and word-finding.
The brand-new side effect I've experienced has been some serious GI issues. Holy crap (ha, see what I did there?). I have never experienced digestive problems on this scale, from a medication or otherwise. I escaped the nausea, but was gifted with truly MAJOR gas, bloating, and constipation. There were times when I was hungry and couldn't eat because my stomach hurt that badly. I swear, there were times I've been so constipated I couldn't pee.
The gas has abated somewhat over the last week, but the constipation, not so much. I've been eating prunes, and they've done a bit to help, but it's still an issue. I hope to gods this doesn't get any worse on 200 mgs.
Wow, you're going up to 300! That's what finally freed me from my sadness and troughs. It threw me into hypomania for a little while (three weeks), but it wasn't that bad. Felt kinda good. Except for waking up at 3am, ready to go for the day, then crashing later. But never mind that, don't worry -- I bet it'll help you. Just try to stick it out, GI-wise, I bet that'll go away, on it's own sweet time. Sleeping .. well, you'll have to watch out for that one. Have you been given any sleep aids?
ReplyDeleteThanks for the encouragement. It really helps.
ReplyDeleteAs for sleep aids, I've been given ativan. Originally it was for "occasional" sleeplessness, and I could usually get away with half a tablet (0.5 mgs). When the psychosis hit last winter, I decided not to play around with my sleep, and I started taking 1 mg every night. I was also placed on Abilify at this time, which interfered with my sleep.
1 mg of ativan is no longer working for me. I can feel it taking the edge off, but it no longer helps me sleep. I need to talk to my pdoc about the wisdom of taking more -- I'm already concerned that I'll have a hard time weaning myself off it when the time comes, and upping the dosage won't help.