Lamitrogine or lithium? Please help!

[Nalanoo]

:-) hello! I have recently been diagnosed as 'somewhere on the bipolar spectrum' probably bipolar 2. I have been on anti-ds since I was 18 (now 33). Many ups and downs along the way! My specialist would like to try me on mood stabilisers now and is gearing more towards the lithium option. I have heard lots of scary things about lithium but also good things. I had another doctor tell me I should start on lamotragine. I wanted to know if any of you lovely people had any advice on which medicine I should try?
Thanks in advance xx

[Mentalpsychiatrist]

For bipolar 2 with predominantly depressive presentation I would go with lamotrigine.

Lithium scares a lot of people but it's not too bad. The only side effect I have is a tremor but you have to be very aware of your salt and fluid intake and you need to have regular blood tests.

[Nalanoo]

Thankyou for your advice x

[Mitchy1nge]

I've had zero problems really with lithium, but was extremely mentally and physically uncomfortable on lamictal and ended up taking so much extra antipsychotic (a useless one) to even it out that it was a bit pointless really. But if you have been able to take antidepressants all this time without anything awful happening it should be ok?

Someone was just saying the other day that nobody really prescribes it anymore now the patent has expired, it had such a clever and glossy advertising campaign even my ancient lithium-and-chlorpromazine consultant was seduced.

[fortifiedwithtea]

I have epilepsy, migraine, anxiety.

This year I have reduced Lamotrigine to strengthen effect of Topiramate. This reduced the frequency of my migraines and lessened the effect of flash photography.

Co-incidentally having reduced Lamotrigine, I am less anxious and have reduced Citalopram.

I do need annual blood tests, not sure whether this because of the Lamotrigine or Topiramate.

Only possible rare dangerous side effect I know of for lamotrigine is a rash, report asap to your doctor.

[idiuntno57]

Lithium works a treat for me. Has done for last 20 odd years. I have regular blood tests but that is the only real issue. Takes a while to get the dose right and you can't BF on.

What works for someone is less good for the next person so I'd be guided by your doctor and your own experiences.

[KittyandTeal]

I am bipolar 2 within mainly depressive episodes. I was medicated on lamotrogine for years. I still hold it was the magic medicine for me!

I'm now med free and pretty stable.

I would definitely go for it over lithium. Lithium is some hardcore stuff with some nasty side effects. If the the lamotrogine doesn't work then you can try lithium.

It worked wonders for me though.

[KittyandTeal]

Oh and yes you need annual (or bi annual) blood tests on lamotrogine.

[joanofarchitrave]

The right meds are really really personal. DH was on lithium for some years when his diagnosis was bipolar II, but is now on lamotrigine along with increasing numbers of others, with a different diagnosis, and it's been fine. The drug that makes the single greatest difference for him is sulpiride [makes 'I heart sulpiride' t-shirt]

[Ivytheterrible]

I've tried lithium and valproate and found they both caused massive weight gain so discontinued use. Doctor hasn't suggested lamotrogine yet but I think it could be what I try next.

[dontrunwithscissors]

I'm bipolar 2, 95% of my problems are with depression. My problems started when I was prescribed AD's after DD2 and I went manic (I was 34, no MI before that point).

Just my experiences:

• Lithium (at a blood level of 0.5):
  

Physical side effects: made me sick 3-4 times a day, I had an unquenchable thirst and drank water compulsively (think 10 pints a day), I had a tremor in my left hand/arm that was so bad I couldn't pick things up, each evening after I took it, I would lose my sense of balance and stagger around.
Impact on mood: I was mentally very clear in terms of concentration, but I lost every hint of emotion. I felt nothing. My DD's would hurt themselves and I felt nothing. I kept walking out in front of cars and nearly getting run down as I didn't feel that 'oh crap, I better get out of the way' feeling.

Lamotrigine:
Physical side effects: none, so long as I don't go above 225mg. Above that, it affects my word-finding abilities (enough so that I can't work as I'm a lecturer.)
Mood: I worked the dose up very slowly from 25mg, increasing by 25mg every 6 weeks. Each increase would throw me into a terrible, agitated, suicidal depression for 6 days. After that, it would clear and my mood would improve. It took me a while before I realised that those crashes were related to the Lamotrigine increase. In the long-term, it's been a really good medication for me and really helps the lows.

However, Lamotrigine is not enough to keep the depression away. I also take Quetiapine (an antipsychotic) and Agomelatine (an antidepressant.) The real 'magic' is the Quetiapine, but I' definitely need all 3 to keep me reasonably well (although I still relapse at least once a year.)

[KeemaNaanAndCurryOn]

I have bipolar 2. I take a combination of lamotrigine and quetiapine. Once the lamotrigine dose is fully titrated, I find it side effect free. I'm on 125mg twice a day. It's made a huge difference in levelling out my moods.

The quetiapine helps stop the terrible lows, but I find it more problematic as it's very sedating. Depending on my current health, I take anywhere between 150 and 600mg per day.