Switching lamictal to lamotrigine

Hi there, I usually take 250 mg of lamotrigine extended release, but the last few days have had to switch to 200mg of instant release (borrowed from my partner who coincidentally takes the same med for epilepsy.) while I wait for my new pharmacy to fill the prescription.
I find that I feel similarly to when I first started taking lamotrigine a couple years ago with the instant release - very activated for the first half of the day, 100000 thoughts and ideas and restlessness to do crafts and clean and work etc., very social and kind of buzzing.
I do love that feeling and feel so productive but on the ER at my normal dose I kind of feel like... nothing? Just fairly level the whole day, leaning a little fatigued sometimes.
I haven't had a psychiatrist for almost two years now after an insurance change and haven't been able to find a new one so my PCP has just been prescribing me my last psychiatrist's recommendation.
Has anyone experienced this kind of thing switching back to instant release? Or even tapering down your dose in general? I kind of want to try it officially again but worried it might make my moods too elevated.

I’m currently taking: Lamictal/lamotrigine, Lithium, Zyprexa/olanzapine, and as-needed only Klonopin/clonazepam.
My psychiatrist REALLY wants to get me off of the Zyprexa because of extreme weight gain. I’m hesitant because it really does work well. But I agree that my obesity is leading to health problems and poor self-image. (I did try the Lybalvi version and it didn’t help).
In February we tried Vraylar, but I had several severe negative effects and had to stop.
At the appointment when we stopped, he asked if I have ever tried Geodon. I have not.
But after some searching, it looks like Geodon must be taken with 500+ calories of food, twice a day. That just will not work in my brain. I have an eating disorder.
I was previously on Latuda, and didn’t like the 350 calories rule once a day.
How am I supposed to lose weight if I have to eat so much with my meds? And the Latuda made me drowsy so I couldn’t drive after taking it…so if I was out to an event until midnight, I had to eat 350 calories at midnight even if I wasn’t hungry. So stupid.
I have tried literally every other atypical antipsychotic there is.
Should I just stick with the Zyprexa, that works, and not mess with it?
Should I try Geodon?
Any other suggestions?
(I am already on Metformin for my pre-diabetes. It never helped with weight)
(I do have a diagnosed eating disorder. I am starting outpatient treatment for that in May. Maybe that’s the real answer?)

I'm using Lamictal 100mg/day. I got great relief. Over the years I gave so many chances to all SSRIs and Benzo, but failed every time. Now doing great for 4 weeks. Hopeful that more of Lamotrigine's good effects will come.

My name is Jean, I’m a young teen, I have severe depression, severe anxiety, insomnia, severe ptsd, and big symptoms of bipolar personality disorder because both my paternal and maternal grandma’s had it. I have attempted suicide twice now, both with overdosing. I have drank, smoked, binged, purged, cut, and punched myself. I am in therapy but it doesn’t do much. With my meds I’m on lamictal, bursar, trazadone, and Prozac. I have been switched my meds, dosages, gotten new ones, everything. But they don’t do shit. I have pretended to take them for about two weeks. It felt so freeing. For the first time in months I just felt sad. Not confused. Not angry. None of that. I have told my mom countless times have wanted to get off the meds but no. I just get more and more. It’s so fucking exhausting. I feel physically unable to cut anymore. Which I want to. I feel like I’m fucking crazy or that I’m doing it all for attention at times. But would I really go this far? I just want to get worse. More depressed to be specific. Medications only makes me confused. Nobody gets what I mean by this. I genuinely don’t know what the fuck I am feeling at times, and it’s not a numb sensation either. I’ve told my therapist about this, all she said was “confused is a feeling” I just wish I never existed. Everybody around me is genuinely a narcissist. My parents, cousins, grandparents, aunts, uncles, just everyone. I just want to sink into a pit of depression and not have to worry about life. I really do want to get worse. I’m so fucking stupid for feeling this way.

Hi. There's someone who was undiagnosed with bipolar then used antidepressants and switch to mania and get their diagnosis? My pdoc up my dosage of Zoloft to 150 mg and Lamictal to 200 mg and I'm scared. I've been on 100 mg of Zoloft and Lamictal 200 mg about a year and a half, things get really good but I told her (my pdoc) that I have sporadic moments of breathing deeply and slow with no hope; sometimes for a thought but this months for no reason and stay looking around like everything is gray and indifferent, never gonna' have a lover one at my 25's and last time that I had a date was 2 months after start with Sertraline... 😞🍁🍂🩶 Thanks, sorry for vent.

Hi everyone and thank you for this group.
I've got twin boys, they are 13. After their mom and I divorced they lived with her. Now, because of behavior, one is with me. He has extremely explosive tendencies. Doors ripped off of hinges, holes in walls etc. The slightest thing can trigger him. Especially if someone says anything about his mother. He absolutely hates me. At least that is how it seems and how I feel. Regardless of what upsets him, I am the punching bag. I literally needed his permission to sleep last night because I was afraid he was going to leave the house at 1am. He finally told me I could sleep because he wasn't going to leave. He is no longer allowed at moms because of his behaviors. I completely understand and he has accepted that and has no animosity toward her. He worships mom, which he should do. However, I am the one he lives with. I feed him, console him, love him daily. Always tell him how special he is and how much I love him, yet he hates me. What am I doing wrong? It's horrible when I am so exhausted that I pull over in store parking lots to power nap for 10 minutes just to keep going. I'm tired of crying, tired of fearing the destruction of our home and never knowing what each passing minute will bring. He is also epileptic, on keppra and also on lamictal( lamotrigine).
Thank you for reading my blathering

I am still in the middle of the agonizingly slow ramp-up of Lamictal. My epileptologist warned me that while I might feel some small improvements pretty quickly, until I'm at my goal dose I should expect things to still be difficult, still have some auras on top of the side effects, etc. He said it could take as long as 6 months for things to stabilize, and as frustrating as that is, I do appreciate the reality check.
He also doubled my Briviact dose 3 weeks ago, and I think I'm pretty much over the adjustment hump from that (not really having the rage spikes and horrific misophonia anymore, at least).
I had two solid AMAZING days earlier this week. Just stellar. Went from dozens of auras a day to basically nothing. Slept deeply and woke up feeling rested for the first time basically ever. Fantastic mood, tons of energy, actually had some feelings of hope.
Thennnn yesterday the auras came roaring back ... stomach dropping over and over, black spots blooming in my vision, smelling old moldy coffee where there was none, feelings of certainty that I am GOING to die RIGHT NOW and the need to run, somewhere, anywhere, just run. I also bit the living hell out of my tongue and cheek last night and my jaw hurts like a motha, so I assume I had yet another seizure while I was sleeping.
But ...
I had two incredible days. Two! Probably the best two days of well-being in my entire life. I'm only halfway through my lamictal ramp-up and I had two full days of feeling fantastic. Even though today I'm right back to feeling the way I did before, I have to see this as improvement. It's a process rather than flipping a switch. I know feeling good is possible now, even on a fraction of the dose I'm supposed to be on.
Just gotta hang on.

Hi, I need some advice on what to do next - all the Drs I have met with are stumped and really have no ideas of what to do! I am desperate for help figuring this out.
Primary complaint: Left foot considerably swollen for about 3 months from an unknown cause.
Demographics: 42F, 5'8", 220 lbs, White, recently started smoking again (Ugh! Plans to quit again soon tho) after being quit for a long time - this issue started prior to smoking, do not drink or use recreational drugs ever. Meds - I am on a lot, but there have not been any recent changes for at least a year. Checked with PCP & Psychiatrist, they think only possible ones connected would be lamotrigine (Lamictal) and Gabapentin. But I have been on both of those for 5+ years, so it seems strange that a side effect would happen suddenly now, and that the swelling would happen only on one side of my body.
Existing Medical Issues: Diabetes 2, Chronic pain in low back, hips & ribs, sciatica, unknown nerve problem in legs - waiting to see neurosurgeon for more testing, benign tumors all over my body including one inside ear canal and softball sized one in my liver, anemia which required iron infusions every few months. Had gastric sleeve surgery 2018 (lost 130 lbs), abdominoplasty Aug 2023 - complications of splitting at horizontal & vertical intersections and creating a hole with tunneling requiring being on a wound vac for 5 months. Blood work doesn't show much of concern besides iron, and a chronically moderately elevated WBC.
More details on issue:
I have already talked with my pcp, a vascular surgeon / General surgeon, a specialized vascular surgeon, a wound care nurse / General practitioner, several other nurses, & podiatrist. I also went to the ER twice. All of them are stumped and have no ideas of what to do next.
My left foot has been very swollen for a few months. I have very minor varicose veins on the outside of my left calf that hurt, throb, and "fizz". The top of that foot has also been numb to sensation (not pressure) for many years for an unknown cause. I do have sciatica which has been the main guess for now as to the numbness. I am diabetic but it's well controlled and was ruled out as the cause for that. No idea if that has any connection to this issue or not.
My right leg and foot are fine.
Nothing seems to help the foot swelling and leg pain. I wear compression socks every day, use an electric leg compression device daily, elevate any time I am sitting, eat inflammatory foods and take some supplements. Also tried: diuretics, low sodium diet, ice, heat, anti-inflammatory creams, anti-inflammatory meds (like aleve etc), massage, varying levels of activity, and a couple other things that I'm blanking on at the moment. Nothing seems to make much difference. Some days it's much less swollen than other days, but it's always swollen to some degree. I'm not sure really what makes it worse or better, there doesn't seem to be consistent patterns.
Generally I exercise every day, tho I am not a super active person. I also have chronic pain in my back which worsens if I get more than about 8k steps a day for a few days in a row, and also worsens if I get less than 6k for a few days In a row. So I usually stay in that range tho I do cardio exercise for around 20 to 30 mins every day plus 30 mins of yoga, plus normal daily household stuff moving around.
I have tried being on the higher end of that activity for a week (not sure if it has a direct correlation or not, but the swelling did seem worse with more activity). I also tried being much more sedentary. Didn't seem to make a difference, maybe a bit better than being more active.
I have been scanned for DVT twice, have had a pelvic CT scan, and an ultrasound vein mapping (tho they said this would take 2 hours and it took 1 and I'm a bit suspicious it may not have been super thorough, but the Dr said it was ..). All of those tests came back negative for any problems.
I had an abdominoplasty in August from which I had complications (it split at the horizontal and vertical intersections). Was on a wound vac for a while and only recently has it basically fully healed. However there are lumpy and hard spots around my abdomen which could be scar tissue or maybe pockets of lymphomas which I'm told should clear on their own eventually. Not sure if any of that could affect my leg.
what kind of Dr am I looking for? I live in a rural area with limited services, so local Dr's have less resources and less broad knowledge with few specialists. I have traveled to two larger city areas, and those Drs also were stumped.
Thank you so much for any insight as to what MIGHT be going on any any possible directions to go in next.

Hello all, 22F with epilepsy diagnosed about 2 years ago, had 2 tonic clonics before put on 500 MG keppra twice a day. I haven't had a seizure since.
Over the past year I have had some odd sleep experiences, waking up confused, panic, really not able to understand what's going on. Although me and my neuro were both unsure if this was epilepsy related or not we decided to switch me from keppra to lamictal. I also had a 2 hour sleep deprived eeg which came back normal.
Ig my question and worry is, does anyone think it's worth it to switch to lamictal when I've been doing good on keppra otherwise? I dont have keppra rage, I do think it makes me kind of foggy, and ofc if the sleep experiences are epilepsy related but likely they aren't. I start them tomorrow and I'm getting nervous that I shouldn't mess with something that's working. I am also hesitant about the "mood stabalizing" effects. I don't wanna seem different. My mom is a psychiatric nurse and prescribes it for bipolar so she too is hesitant about me starting this.
Looking for anyone's opinions/ experiences about switching: why? What happened? Are you glad you did?
Really any advice Thanks :)

Hi, so i just started Lamictal + Escitalopram for cyclothymia and anxiety disorder. Its a very low dose (started at 25mg lamotrigine and 5mg escitalopram) and will gradually increase but Today i’ve had bad hand tremors and shakes (like my hands are shaking non stop) and kind of a brain fog idk how to explain just dizziness and feeling my head heavy and foggy. Is it normal ? I got scared please if anyone knows let me know (also i’m taking a low low dose of amitriptylline for neuropathic pain bc of sciatica and seroquel 25-50mg at night to sleep) .

I’m super sensitive with medications and I first felt this want to jump out of my skin bc I’m so restless when my psych had me try lamictal. I took it for 2 days, 2 doses and I immediately felt off. I had other side effects from the lamictal like lock jaw and headache. So from what I’ve read from the posts on here, once you experience akathisia, you are more likely to experience it again and with any other medication? I went off the lamictal. Tried Geodon and had a weird interaction. Not I’m on caplyta. The first week of taking it, I was actually tired all day. But not I’m starting to have akathisia symptoms from this Caplyta medication instead. It that even possible this far into taking caplyta? I’m on week 2. I had a headache the first day that went away. I’m worried that I will have this issue with every antipsychotic even the atypical ones. I’ll be weirdly tired during the day and awkwardly at night I’ll be like purposefully switching and scratching and moving my body around to deal with the insane feeling of restlessness inside.
Is it even possible for akathisia to only affect a person at night? I hope this will eventually go away but not I’m reading from other people experiences that even tapering off a med can cause this feeling. Btw from these 3 meds I’ve tried, they have all been at the lowest dose.
What supplements might help with akathisia that actually work for ppl. I don’t want to be on yet another medication with this trial and error. I feel like im an experiment. Lol

Does anyone have experience taking Seroquel/quetiapene at night and modafinil in the morning? I had no trouble falling asleep before Seroquel; I take that, lamictal/lamotrigine for mental health, and ropinerole/requip for suspected RLS (all at night), but Seroquel makes it much more difficult to wake up in the morning. I'm about to try modafinil, but I'm worried that the Seroquel's half-life will cancel out its effect.

So I was on Zoloft for 12 years, weaned myself off and then realised I needed it. Tried to take it and had the worst side effects. Switched to Lexapro which was also bad for me. So my psychiatrist added Mirtazapine. The combination of Mirtazapine (30mg) and now Lexapro (7.5mg) still results in me being depressed but also very wired with lots of adrenaline. My psychiatrist is thinking I might be cyclothynic. She suggested Lamictal. Anyone on Mirtazapine and Lamictal? Or a combination with Lexapro? I want something that will calm me and my thoughts. Will Lamictal do this? Thanks

UPDATE I switched to night time dosing. I took it at 7pm. I slept from 11pm until 10am. I feel less tired than when I was taking it in the morning.
I'm up to 100mg of lamictal and have been for a couple days. I take my dose in the morning. I have noticed that I'm really tired during the day and I feel like just walking around the block is exhausting now. Is this normal? How long does it take to get better? Should I switch to taking it before bed?

Blurgh. I’ve been on Lexapro for 15 years and have put up with the sexual side effects as best I can. Arousal is no problem, but climaxing is a huge amount of work. It sucks.
Now I’m switching to a mood stabilizer (lamictal) after reassessing my diagnosis, and after I titrate that up I’m going to wean off Lexapro.
I’m pretty excited to move on. Lexapro has helped me tremendously but hasn’t handled some other important things. And I’m excited to potentially improve my sex life.
Has anyone gone off Lexapro after 10-15 years and seen side effects go away?

I've been medicated for BP2 for about a year now and i'm very stable moodwise (a little too stable tbh, very flat alot of the time).
I first started seroquel at 300mg because of mixed episodes and it did help, although my moods were still very unstable until i began lamotrigine at 200mg, then both my hypomanic and depressive episodes completely stopped. Never noticed any side effects from the lamotrigine either, it's like taking a sugar pill that balances me out.
My concern is the seroquel though, when i first started it i didn't notice the side effects very much, maybe because my brain chemistry was different when unmedicated/new to medication.
But now i seem to just sleep all the time, it's weird, it dosen't sedate me at night, just gives me really low blood pressure so i'm forced to go lay down, but the sedative effects for me kick in during the next day, i wake up hungover as hell and often miss alarms, and any opportunity my body gets to doze off it will take it, during movies, on the bus etc.
My boss even commented saying i'd been out of character lately, seeming zombified. I've also gained just over 50lb on seroquel, despite working a physical job, training 6 days a week at the gym and regularly doing cardio and maintaining 10-15k steps. If i don't work my ass off i start piling on the pounds.
My main question is, has anyone tapered off seroquel and/or tried lamictal alone for BP2? I should mention i'm far more of the depressive polarity, hypomania was much more rare for me.

Hi everyone. I have bipolar type 2 and I’m really struggling to find the right meds. I mainly struggle with major depression and I actually didn’t find out I was bipolar until being put on antidepressants.
I take klonopin once a day and I used to take a half a tablet of Zoloft. I did this for 5 years and looking back, I had some “highs” but nothing too noticeable (I think bc the klonopin kept hypomania at bay and the Zoloft was such a low dose that it didn’t effect me too much). My depression got severe and my doctor switched me to Prozac. That’s when our theory of bipolar came true (had a pretty severe hypomanic episode).
It’s hard because I am usually fine accept for the couple times a year that I want to walk into traffic lol. Anyways, because my symptoms aren’t too crazy, it’s been hard for me to justify taking bipolar meds.
Right now I take seroquel at night, and a tiny amount of Prozac in the day. This has worked for keeping the depression at bay, no hypomania, and sleep has been good. However, I don’t want to be on antipsychotics long term.
Then there’s lithium. I’ve read great things but I know it can be rough on the body. I think, overall, it’s better than an antipsychotic as it doesn’t cause brain atrophy over time- but the impact on the body can be a lot.
Anyways long story short, I met someone with bipolar who only takes lithium intermittently. He used to take it everyday and now he just takes it if he begins to feel an episode coming on. I’m wondering if anyone else does this and if it’s effective?
I’m also curious- if I did something like this, could I continue to take my Prozac without going hypomanic. For instance, maybe I take half a Prozac daily, and lithium 2x a week.
I know that no one can give me an answer, so I guess I’m looking for people who are on a similar medication routine (or who have tried this before) and how it works for them. Also, has anyone tried an extremely low dose of lithium for bipolar type 2? And does it work?
I’ll also add I’ve tried Lamictal twice and both times I got a major rash and was pulled off (so that’s not an option anymore).

Will try to keep this quick. I started slynd progestin only pill 3 weeks ago. Switched from the mini pill. One week in, for about 5 minutes I was getting a weird sharp pain on the lower left side ovary area. Since it passed I didn’t think anything of it and didn’t consider birth control.
Saturday night I woke up at 1 am with twinges of sharp pain in the same area. And then Sunday and Monday the pain continued on. Not unbearable or excruciating, but definitely annoying and concerned enough for me to go to urgent care. They sent me for ultrasound and CT scan. Both were clean. STD screen and blood work all good.
Now I’m wondering ….. could it be Slynd ?!?? Apparently online it says pelvic pain is a rare side effect.
Caveat: I have had lower left side pain in the past and clear ultrasound and doctor has suspected endometriosis, but I haven’t had surgery to diagnosis. This pain hasn’t occurred in a year while I was on the mini pill. I feel like it’s very curious that it’s happening and potentially even worse when I switched BC.
Please help!!
30F 120 lb non smoker Other conditions : depression anxiety ocd Med: Lamictal 150 Lexapro 15 Klonopin 1 mg as needed and slynd

Has anyone here gone off lamictal/lamotrigine and started on Lithium instead? I am curious about your experience/why that was decided etc. (I'm obviously gonna read into this more but I just want to send out the question to all the nice and caring ppl in here).
My new Dr recommends it. I've been on lamotrigine for 10years now and I still get really depressed way too often to be a functional human person in society. I've been thinking about Lithium for all these years but have always heard Drs saying there's too many side effects and it's "the old medicine" and blabla. But yeah, obviously lamotrigine does not seem to help for my depressions, only for some hypomanic symptoms (yes I've tried different dosaging, combo with other meds etc)
I've been depressed for a couple of months now since a burnout from masters studies and this one is pretty bad. I feel so sad about the thought of my life as a big long depression. So tired of this. And the process of switching meds feels really scary and exhausting. Thanks<3

I’ve been on Vyvanse for a few months for ADHD. It helps with focus, motivation, and even a little with depression, RSD, and social anxiety when it first kicks in.
It doesn’t last very long for the depression, RSD, and social anxiety. As soon as it starts to wear off, these all come back pretty overwhelmingly.
It’s a real double edged sword. I have trouble getting out of bed in the morning without it. I have tried combining it with some AD’s. So far the ones I’ve tried made it even worse. Wellbutrin and Lamictal. Many others in past years with little to no positive effect.
I’m wondering if others here with ADHD and RSD can relate to this. Did you switch to non-stimulant ADHD meds and feel any better? I’ve heard these can work for some better than the stimulant options. I just don’t know if I would be able to try a switch due to the motivation aspect.
Believe it or not I’ve worked as a telesales rep for many years. Every single day is torturous. No idea how I’ve managed for so long. I have zero energy by the end of the day and feel broken. I never feel comfortable in conversations. In person, by phone, or otherwise. It is basically the number one expectation of my employer, behind sales numbers of course.
I’ve been remote for almost 3 years now and the isolation has made it far worse I think. My income has dropped considerably which intensifies my anxiety. The heightened anxiety then exacerbates the depression and RSD. Such an awful trapped feeling. I can’t really leave since I have a family to support and can’t fathom having to start all over somewhere. I don’t possess any necessary skills to make a career change either.
If anyone else can relate to some or all of this, please let me know how you’ve been able to manage it and make life even a little more tolerable. Maybe even enjoyable at times. It seems like every time I do something most people get enjoyment out of, I can’t wait for it to end. And then I wish I would’ve enjoyed myself more without all the anxiety, but I don’t know how.

Hi all!! Sadly, I had the rash side effect to lamictal and was told by my dr. to quit cold turkey. She said she'll consider an alternative once this clears in 2 weeks.
I am already on lithium and she added lamictal because 1. I did well with it in the past and 2. To help with the depressive mood states that weren't quite fixed by lithium. Yes, I'm at a therapeutic blood level of lithium. I'm also on 25 seroquel at night.
That said, I'm wondering about alternatives that aren't SSRIs so when I talk to her next I'm aware of her suggestions.
Has anyone switched from lamictal to something else that helped you? Thanks!

I am wondering if anyone has had problems with being really tired all the time on Lamotrigine (Lamictal). I mean, it is great for stability, but I am ALWAYS exhausted, to the point where it affects me earning a income. I also get anxiety very quickly.