BP2 - flat & stupid on Lithium + Lamotrigine

[Georgia324]

Hi everyone, I have bipolar and got very unwell after having my son, who just turned 2. I was hypomanic (without realising) for 4 months, then mixed and PND for 10 months. I’ve been well for 8 months now on Lamotrigine 150 and Lithium 800, BUT I feel meh and stupid in a way I didn’t on just Lamotrigine alone. It could be my brain recovering from the episode, or it could be lithium, or it could be taking both together? I’m very tempted to reduce the lithium to 600mg. I’ve already gone down from 250>150mg lamotrigine and that hasn’t helped. Thanks so much!

Hi @Georgia324, I know I’ve chatted to you on the other thread but just saw this post. I feel the same about feeling stupid! That’s part of the reason I stopped taking medication for a bit. I did see some information that showed cognitive ability declined each time someone with bipolar has an episode ☹️

I see you’re on 150mg Lamotrigine - if you didn’t feel flat on just this, could you increase the dose? For me, the therapeutic dose was 200mg, when I went below I had episodes. Maybe then you wouldn’t need the lithium too? However, I also think I saw that lithium can protect the brain from this cognitive decline. So confusing. Sorry I don’t have links to the studies/books as it was a while ago when I was reading up on it. I’ll try and look through the books I have and let you know.

I’ve been trying to accept that this version of me (not as ‘quick’) might be it now, but it’s so frustrating. Hope you find a solution with your meds x

Hi @Rose5678 thank you so much for replying here too, and in so much detail too. It means a lot.

Do you mind my asking how you felt off meds vs on them?

How have the cognitive effects/general medicated feelings been on lithium vs lamotrigine?

What you say about the 200mg therapeutic dose is also v helpful - I think if we TTC for a second then I’ll come off lithium and increase to 200 lamotrigine to help cover me.

How are you feeling now on the 600 lithium and when do you drop to 400? Are they wanting you to be on 200 lamotrigine before going below therapeutic on lithium?

sheesh it’s so complicated….
I def think the slowness is partly caused by the illness, and partly by the meds. X

Hi @Georgia324, I’ll PM you if that’s ok?

I was diagnosed bipolar after a post partum psychotic illness and took lithium for some years. I had been mentally unwell since my teens, resulting in much unhappiness and frustration, so I was pleased at least to have a diagnosis. I tolerated the lithium reasonably well, though it knocked out my thyroid function. I decided to stop it after a few years because my life had stabilised and I was able to manage without.
Later in life I realised - largely because my DD had similar problems - that in fact it was not a bipolar condition I had, but extreme PMT/PMDD. The right type of hormonal contraception and later, HRT, has kept me well since.
I mention this because I believe that others are wrongly diagnosed as well.

Absolutely @Rose5678 - thank you!

Hi @borntobequiet , it’s great to hear you are doing much better. The impact of hormones on our moods outside of simply our menstrual cycle is so underplayed. I do wonder about women getting diagnosed with bipolar so late (ie is it really bipolar).

Hi @Georgia324

Don’t be put off by the name, this is Professor John Studd, an eminent gynaecologist. The first link is to his biography, the second to a page on his website about PMS/bipolar disorder, which is very interesting. It’s a bit (well, a lot) out of date now but was what changed my DD’s life when we found it, because she saw him privately and was treated properly. I myself continue to attend the NHS clinic he founded to deal with menopause. It’s possibly worth a read. In any case, I wish you the very best.

https://www.studd.co.uk/biography.php
https://www.studd.co.uk/biography.php

Oops copy fail on second link, sorry

https://www.studd.co.uk/pmsbipolar.php

Thank you so much!