Is there a generic for lamictal

So, I’ve had two psychiatrists over the past like 7 ish years due to moving to a different location. My first one (who diagnosed me with MDD) I felt understood me best and I had the best relationship with her. After I moved, I was referred to a local psychiatrist. She was okay. Well, for one reason or another, she no longer works at the practice I have been going to so they gave me someone new. She seems like a nice lady. A little bit odd, but nice. Anyways, she thinks because of my family history (lots of bipolar, alcoholism, but also depression too) is in my family. She thinks I have bipolar. I am aware there are two types, but I just don’t think I have it. Generally speaking, I’m pretty consistently controlled or in low energy/tired moods. I sleep ALL of the time. I’m pretty sad most of the time. I don’t really have periods of “mania” I don’t think. I definitely do overspend, but I’m not sure that I would call that a manic episode. My brother definitely has bipolar, and would not sleep for days and that’s when I knew the onset was coming. He would get in trouble with the law all of the time. It was like it is hard for him not to. I also lived with someone who had bipolar and I just don’t think that I have it. I will say, at one point my first psychiatrist put me on generic abilify when I expressed that my Prozac wasn’t fully helping me anymore and I was worried that I could have bipolar at that time. Eventually that didn’t work for me and my newest psychiatrist has put me on lamictal I think it’s called? I honestly feel like it’s made me worse — but I’m not sure what to do from here. I’m meeting with my psychiatrist tomorrow.

EDIT: The main ones I am considering are fluoxetine (Prozac) and vortioxetine (Trintellix) because of their longer half life, but based on the Genesight results, I could also try desvenlafaxine (Pristiq), levomilnacipran (Fetzima), vilazodone (Viibryd), duloxetine (Cymbalta), or fluvoxamine (Luvox). Unless I want to try a tricyclic, which is tempting after seeing they’re used off-label for some of my physical chronic health issues! I need to check if I can get an updated list since mine is from 2021, though, and I know there are new meds not mentioned and possibly some no longer available. I’ve had much better luck with brand name meds also, so I know newer ones are less likely to have generics (my insurance will pay if no generic is available).
To preface, I am diagnosed with autism, adhd, and c-ptsd. I exhibit many OCD symptoms, but my doctors feel they’re better explained by my other conditions. I’ve more recently begun tackling treatment of my symptoms through an OCD lens because intrusive thoughts are one of my most debilitating symptoms, and the ADHD medication and autism diagnosis have practically eradicated my depression and anxiety. Yet issues that could fall under OCD still remained. I also have chronic health issues, like POTS, hEDS, and likely MCAS.
Currently, I take 150mg Zoloft and 15mg Dyanavel XR (amphetamine). It’s been working fantastically for nearly 2 years, with just some minor dosage adjustments as my tolerance increased. Unfortunately, while my intrusive thoughts are under control with Zoloft, at the current dosage my skin and nail picking has gotten out of control, as well as other things that I worry may be OCD-like symptoms or side effects. I have been getting “stuck” in what I’ve come to understand as compulsions much more frequently, and it’s really impacting my daily functioning. Also, my memory is even worse than usual, as well as my ability to manage my time or even conceptualize it, and I’ve become incredibly avoidant. I feel intense dread just trying to reply to a text, and it can take me a month or more to send a reply. I also feel like I have blinders on to everything that is bothering me or that I care about. I don’t feel numb, but more like it just isn’t processing. I know when these feelings are from autism or ADHD, and they play a role, but it feels different this time and has gotten worse without any typical triggers in the last 4-6 months, which is why I’m thinking medication.
I am wondering if I might have luck with something like Prozac or another medication that helps OCD symptoms? I’ve had pharmacogenetic testing, and nearly everything falls into the “moderate” list. I’ve taken Effexor, Wellbutrin, Seroquel, Buspar, Abilify, Lamictal, Tripleptal, trazodone, Strattera, Concerta and some others I’m forgetting. All either did nothing, had bad side effects, or stopped working after 6 months. I know from the genetic testing that I have the mutations that mean I produce serotonin but can’t seem to access any of it (I think it’s “reduced serotonin expression”), and I burn through dopamine faster than I can make it. I’ve also tried some OTC things, but they were either ineffective or couldn’t be tolerated. And I’ve done both neurofeedback and TMS treatments. Greatly benefited, but insurance would only pay for a certain amount.
I’m just so tired of this battle, and I don’t want to change meds if it’s going to make things worse, since it has taken almost a decade to find an adequate combo. But I’m scared of staying the same as well, because it’s impacting my job, caring for my health, my friendships, and staying on top of responsibilities.
I appreciate any advice or words of encouragement. I’m going to talk with my doctor soon, but I need help getting my thoughts in order and what I might want my next moves to be.

My psych really wants me to try an AP, either Latuda or Vraylar. We decided on Vraylar. I have two concerns, the #1 being the subject line:

1. I'm absolutely terrified of permanent TD. Like up there with losing my hearing or vision. Google claims the risk, even with SGAs, is around 25%-50% in people taking an AP. Is this true? Is there anything else to consider, such as most of those people get better after discontinuing the med? Are there any warning signs people get before suddenly being stuck with TD forever? I know he's not going to like it, but that high of TD risk is a deal breaker for me.
2. Unrelated to the subject but another potential deal breaker. I may have to be out of the US for a while, and even if Vraylar is available, it won't be covered by my insurance there. I can't afford to fly back and forth, and I've found that some countries make importing meds an absolute nightmare. Also there's no guarantee my insurance will cover a 90+ day supply. In this case, if you are pretty stable on just Lamictal already, would you postpone trying something like Vraylar?

With #2, very very respectfully, I know there are other generic APs that work well for others, but please let's not go off topic recommending that I look into those just because they have worked for some others here :)

i've already made a few other posts regarding medicaid, but since i'm approved and new to all this, i have dozens of questions lol
i'm currently prescribed lamictal, wellbutrin, & klonopin. my psych told me once i get approved for medicaid, i get the best of the best prescriptions including name brand. i know klonopin might be a little harder to get but id figure id try. i currently get Teva for those. i get solco for the wellbutrin (garbage imo) & i forget the lamictal. i was wondering if i have to request brand name? or what it look sus for asking
i know it's not 100% guaranteed but i'd really like to try. my current total from all of these for a 3 month supply is little over $70 and i know it doesn't sound that expensive for 3 months, it is for me. i would only pay that price honestly if i could get name brand. obviously i'm on medicaid for a reason but i'm not yet married to my fiancé so we have separate insurances so he helps me out when he can.
i'm looking into Blue Cross Complete- i think this is the name, and a lot of the medications i look up in their formerly glossary says they're "carved out" medications. and it says non preferred brands are available but the generic are usually the prescribed ones since lesser costs. anyways, am i able to request name brand when my psych sends out my script? he's really cool and would honestly probably try his best for me but is there even a chance?
sorry if wording is bad, i'm trying lol! any help or advice would be appreciated in advance , thank u! 😊

I am 30 female with my major maladies being sporadic high bp and sporadic high heart rate, adhd panic disorder and ocd taking Prozac, Lamictal, propanolol and Adderall. Despite financial difficulties, overall in general good spirits!
Being 29 at the time but 30 now I honestly didn't get taken seriously by at least two or three of them....So we originally thought I was getting some arthiritis or carpal tunnel from dog grooming for so long and not properly stretching or taking care my wrists. We tried two separate rounds of cortisone injections, mri, and xrays-and no dice. I have since left grooming and I'm now working in a chemistry lab but it's still flares up pretty regularly.
The problem is the sharp pain changes location and the throbbing constant ache is usually in a couple hot spots. The sharp pains are usually in the meat of the right hand thumb in those muscles and then radiates down through my wrist along the radius. But on worse days like today it feels like the actual triquetrum bone on my left hand is sensitive to the touch and the upper portion of the ulnar. (especially resting arms on my desk) but then I'll have aching radiating from the upper ulna through the nerve of my palm and down the ulnar side of the left arm. Occasionally it'll occur on the right but not as frequently. The right hand is always the thumb connecting points and pain radiating in the wrist and down to my elbow. Either way I will have some throbbing going up through my fingers and tingling but not a lot of tingling. Oh and I've also done a good amount of physical therapy and acupuncture type treatment to no avail and I do ice and heat on painful days. Oh and let me tell you I feel the need to roll and crack my wrists all the time . It's quite frustrating
Does any of this sound familiar or ring a bell? I know realistically it's probably just a generic nerve damage and nothing I can do about it but I just feel like but maybe there's something I can do as I'm getting older to slow the inevitable arthritis in my future.
Thank you!!

I've taken lamictal for one week at 25 mg with the plan of titrating up to 50 by the second. I've seen many people here discuss trouble with word recall, episodic & working memory, and brain fog. It's frankly concerning to me that this is not listed as a possible side effect by most online resources.
Could people who have experienced this share when you first noticed symptoms, what dosage you were on at the time, and (if applicable) what dosage you take now? Has anyone experienced an improvement along any of these metrics instead? Also what diagnoses you have if you feel comfortable disclosing that information.
I am using this medication as a monotherapy for unipolar depression, have been clinically diagnosed with OCD, & exhibit some symptoms of ADHD (many of these could just as easily be attributed to depression; hard to tell). Pristiq (generic desvenlafaxine) was extremely effective for me & I would be interested to know if anyone taking lamictal for depression or bipolar 2 here has found success with traditional antidepressants in place of mood stabilizers or as an adjunct therapy.
I apologize for the lengthiness of this post & appreciate the candor of people here. Since everyone obviously have a vested interest in their medication being as safe & beneficial a treatment as possible, I think there's a lot of denialism & minimizing of other people's side effects on other forums dedicated to the discussion of psychiatric medication if it is not considered an "official" side effect of the drug.

TW - discussion of pregnancy loss and blood
I can't get my post to work in the Miscarriage sub, so I'm posting here because I'm really wanting some input. I'm pretty sure I'm currently dealing with a chemical pregnancy (second loss), and I'm so sad. Aside from the fact that my life has been a total mess for the past month for a variety of reasons, this was the cherry on top.
For context, husband and I weren't exactly "trying" again for our second baby, but we were also not being too careful because we were planning on actually "trying" over the next month or two. I also have luteal phase defect, so I always start spotting around 7-8 DPO, and my period usually starts around 11 DPO. With my two prior pregnancies (one was an MMC due to trisomy 2), the spotting stopped around 11 DPO from what I remember. Well, my spotting this month started right on schedule very briefly, but then it stopped at ~8 DPO this time, and I had some light twinging and cramping. Knowing how this happened before, I took a generic (red dye) pregnancy test last night (8 DPO) and got a faint but clear positive, like you didn't have to squint or angle the test in the light a certain way to see it - it was pink and it was there. It was a private label test that said "compare to Clearblue" with a sensitivity of 10 mIU/mL, and I took it after holding pee for a couple hours, though I realized I was WAY dehydrated after seeing the color of my urine in the cup, so it was pretty concentrated. Of course, husband and I were excited, but having been through a loss before, we were cautious with our feelings. I took an FRER this morning after holding all night and not over-hydrating, and it was very clearly negative. I was gutted. I had told myself not to get too excited in the first place, and this is why. I took another FRER after holding for 3-4 hours today just to be sure and again, clearly negative. I won't be taking any more now since I'm pretty sure I have my answer. Ugh. It really sucks. I know I only caught it early because I tested early, but I needed to know ASAP because per my psychiatrist, I need to take high-dose folic acid during pregnancy since I take Lamictal every day. Hooray bipolar II. Had I not tested, I definitely would've chalked the stopping of the spotting up to pure stress from my life as of late, but I'm fairly certain I caught the VERY brief end of a chemical. This is my first experience with this kind of loss, and I've just been crying off and on all day. My husband is so supportive and helpful, and it means a lot. Nonetheless, this is rough. The emotional whiplash of a clear positive at night to a negative in the morning stings.
My question is, when I can possibly expect to start bleeding? I'm not expecting it to be too heavy this this loss is incredibly early. To be clear, I'm NOT asking for medical advice. Today is 10 DPO, and still no spotting or discharge, so I'm just waiting for the shoe to drop at this point. I told my husband I just want to get it over with and start the bleed so I can be done. I felt this way with my first pregnancy (MMC). I waited in this terrible limbo for over a month until I had to have a D&C. I know that's very different than my current situation, but it's the waiting that kills me. I called off work in advance tomorrow and will be spending it trying to relax and grieve.
Very few times in my life have I actually WANTED to bleed, and this is one of them.

I wrote this in an attempt to get it published but mostly I just want to put it out there. I'm thinking people on this sub will hopefully have an appreciation for it. Please share/spread it if you want to.
The streets are crowded and chaotic with pedestrians, bicyclists, mail and garbage trucks, all embracing the opportunity to move about the city now that the ice storm is receding. I sit in my delivery van on the side of the road, smoldering with rage nearly to the point of tears.
A ruminating thought occurs over and over again. Just give me one easy day universe! I was snowed in all week, I’m broke, I’m off my meds, and I wasn’t even hired to do this here! I was supposed to be on a rural route. The cyclical thoughts don’t do me any good but if I was good at stopping the cycle I wouldn’t be in this situation.
I’m annoyed at life pulling a bait and switch. I don’t do well in winter, crowds, traffic, or when trying to find somewhere to park. The sense of being trapped because I need the income becomes almost too much to bear. My flight instinct is telling me to take the van back to the warehouse and just quit, but I know that my family needs the money. I have to override the stress response, something I’ve been accustomed to since long before I understood my illness.
Closing my eyes I take slow deep breaths just like I’ve practiced so many times before. I inhale through my nose slowly and exhale through my mouth. After a few moments I’ve regained some composure and I get out of the van to have a cigarette. I know that I shouldn’t be smoking them, but unlike the psych meds the tobacco was available for purchase.
In fairness I had really tried to get my mood stabilizer, a simple 50 milligram daily dose of lamictal that had made all the difference for the last few years. I’d sent in the request for a refill and called the doctors office. Multiple times even. I could see the frustration on the face of the pharmacist when for the third time I checked and the doctor's office had still not responded to the request in the four days since it had been sent.
I went so far as to contact a former nurse practitioner to ask if she might be able to write the prescription but I was quickly informed that I owed her money from appointments my prior insurance hadn’t covered.
Mood stabilizers do what the name implies, and sudden withdrawals can range from uncomfortable to outright deadly depending on the situation. I knew from prior experience that my first two days without it had already been the worst, but that I was still in for a white knuckle January.
Withdrawal from lamictal was the most awful feeling of my life. It consisted of an intense and utter despair that remained for more than a week. A prior prescription snafu and hold up had resulted in me quitting a job in a crowded brewery when my mood started to spiral out of control during a shift.
“I’m not going to take my mood stabilizer any more, or any psych meds for that matter.” My wife nodded her head in understanding. Her lack of reaction said it all. If anyone understood how important the meds were to my day to day it was her.
For years I would rise each morning, tired, sore, filled with hopelessness, and methodically push myself to the medicine cabinet, popping pills into my mouth one at a time before swallowing them all with a giant gulp of water, and then waiting desperately for their effects to take hold.
“I get it.” Was all she said. She’d witnessed first hand the bureaucratic battle I’d been waging to try and maintain my medications while no longer being able to afford health insurance.
I carried on spilling out my inner thoughts. “I need it, my mood is everywhere, but I can’t face these withdrawals again. I just can’t do it. The anxiety over whether or not the prescription will be refilled on time, or at all, is just too much. It outweighs any benefit I get from the meds at this point.”
That was three weeks ago. Today, in the van on the side of the road it all comes back. The overwhelming day has pushed me to that point of despair, of wanting to flee, of simmering anger at being expected to survive like this. I wish I could at least go home.
I’d previously been on private long term disability but it was canceled after two years because the condition isn’t physical. Similarly I’d been denied social security. With no assistance coming and a family to support I re entered the workforce hoping I’d have enough refills on medicines to get me through until my new insurance activated. Had the company not closed the location a mere two months into my employment I would have made it. I quickly found another job, but the clock started over.
If this is the fight that I go through as someone who wants to take his cheap and “available in generic” medications then I cannot imagine the struggle for those who don’t even want to take them.
I’m fortunate that I’m able to hold it together, but that doesn’t mean it doesn’t come at a cost. In the past the anger became self directed and manifested in an addiction to self harm. The thought crosses my mind again this afternoon but I shove it aside.
While the doctors have let me down I’ve at least been paying attention in therapy. I know what I’m up against now. I know that the worst of it will pass and that for me, I just have to keep moving. I’m lucky in that this job doesn’t require me to socially interact with anyone while in such a state.
A few hours later I’ll pull into my driveway, the twelve hours of chaos and frustration behind me, but another day already looming on the horizon. I’ll spend several minutes sobbing before I go inside to try and avoid exposing my family to my mood.
For the remainder of my evening I’ll see flashes of busy streets and crowds and face fits of despair and rage. I’ll hold it inside as much as possible but I won’t be very successful. I’ve held in too much already and my limits are bursting.
Mental illness doesn’t cooperate with making a living, or paying bills. It doesn’t care what your family needs or whether you're just trying to survive the work week. What help there is always comes at a cost. Which leads one to wonder, is there really any help at all?
It’s an isolating battle, made worse by the judgment and stigmas attached. It’s not something I can discuss with my employer and it’s not something that people find pleasant to talk about or easy to understand.
In order to survive my safest bet is to suffer in lonely silence, but I’m tired of suffering, tired of loneliness, and tired of the silence. We hear people say that we need talk about mental illness, but we’re way past that, it’s time to actually do something about it.

My neighbor and friend needs help. He is unable to self advocate due to the inabiity to correctly articulate his problems, and his doctor of two years isn't listening or asking the right questions.
Age- 51
Sex- Male
5'8" 220 - 250lbs (I don't know but its all in his stomach)
BiPolar (I haven't ever seen him manic, but he is definitely depressed) and most likely some other problems but hasn't been diagnosed.
Drinks beer daily (purchases a case about twice to three times a week through Walmart Delivery) Smokes weed daily but only about an oz every 5 - 7 days or so (I have to drive him to the weed shop). He rarely appears inebriated.
HIS DOCTOR IS AWARE OF HIS DRINKING AND DRUG USE
Meds Prescribed: ALL GENERIC when available
divalproex sodium - 500mg TD
Prinivil (lisinopril) 20mg OD
quetiapine 400mg TD
trazodone 500mg TD
venlafaxine 75mg OD
Since knowing him he has been prone to violent outbursts when something goes wrong (I can hear him yell very loudly (Yelling at the top of his voice "GOD DAMMIT" or "FUCK!" and then I can hear him hit something or slam a door from two doors down, as well as his hiting various appliances or his compter when upset). He has never been physically violent towards me though. However he is very quick to anger. It's either hes sedated and confused or having a violent outburst but it's a very rare day when he's clear headed.
Within the past year he has been getting a lot of large bruises that he canot explain where he got them. One day I came over and he had a gash on his forhead and major bruising on his arms and legs but no idea how it happened. He has bruising on multiple areas all the time now.
He tells me in an offhand way that he must be falling down but that he doesn't remember. They are the kind of bruises that are very VERY large like 3-5" diameter. With around 3 - 6 at a time.
One night he had a gash on his forhead just below the hairline that was not actively bleeding but it wasn't bandanged. He didn't even mention and I didn't see it right away. He offhanded said that he had cut himself but he didn't know how it happened. He didn't know where he got it.
Oh and he had gout last year.
Because I live next door to him, I can confirm that he is not drinking more than beer, and he isn't driving, and he has no access to drugs beyond the little bit of weed he takes. He also says that the weed helps him keep up his appetite or keeps from vomiting. He says that he is thowing up his morning doses even if he eats, but that he often doesn't take his full dosing because he feels too sleepy after taking them.
He is often unable to understand conversations. He THINKS he understands but it's like he doesn't get what I am saying and thinks I am saying something else - Sometimes it's like he hears a totally different question or comment I made because he answers it in a way that only vaguely resembles an answer appropriate. It's hard to explain but it's not word salad. The best I can say is when this happens I ask him "What the hell has that got to do with what I just said?" Not quite non-sequiters but it's more like he heard some of the things and thought I said or meant something else.
There are times when he comes to watch tv with me but ends up needing to go home because hes so sedated. He has stumbled and almost passed out. I have had nights where i am begging to take him to the ER because of the mystery bruising and his stumbling, incoherance, and weakness. He just says that he'll be better in the morning and I should just let him sleep.
He is absolutely not medically compliant because he often throws up after taking his morning medications due to nausea, he compains that he isn't sleeping well that he wakes up fully around 3 or three in the morning, but he takes his evening meds at night. He has been skipping doeses or taking the, unregularly due to the side effects, or forgetting or intentional skipping or lowering the doses.
There have been nights that I have seen him go to bed and I would be worried he wouldn't wake up. He insists that if he thought he needed to go to the hopspital that he would tell me, but short of my admitting him under 5150 I can't do anything. He doesn't have skitzophrenia (sorry about the spelling)/. I feel he would benefit from some inpatient time to get him stabilized and to check on his dosing and the effects to figure out what is wrong.
I personally have a DX of Bi-Polar Disorder and take brand name only Seroquel 25mg night, Lamictal 200mg night, Buspirone 15mg TD and generic Metoprpolol 50 OD, however i am fully medically compliant, sober and basically symtom free.
I have been helping him to get his doctor (the same one I have - he is in the same HMO and the same plan and we share the same doctors) to prescribe him brand names but until today I wasn't aware of how high his doses were. Seriously - 1000mg Depakote (generic) 300 Trazodone, 800mg Seroquel PLUS the rest!
I am worried for him. Is this a brand name vs. generic problem (he's taking generic), is this a drug interaction problem or is this a drug dosing problem? Is this a non-compiance problem? What is the first step he can take to become compliant when he's going through all of this?
His inability to articulate his side effects, what he goes through, to his doctor, and his doctor's inability to really ask questions is killing me. I am scheduled at the appintment either before or after him since we come together. When I tried to talk to her about it she refused to discuss anything with me, but when she talks to him it's like everything he was supposed to say ends up not being said and she rushes through the session.
Mysterious and large bruising on arms and legs along with random gashes and cuts from falling but not knowing (or admitting) to falling,frequent stumbling, confusion, throwing up after taking morning doses, not being able to sleep, violent outbursts, sedated behavior, and a stomach that is very large, round and hard. Pain in his legs at night.
I am already attempting to get him on brand names since he responded very well to a 200mg Seroquel brand name (I had a lot of 100mg left over when I went to 25mg).
What can I do? Is it necessary for me to call the hospital or have him go into care? He has Medicare/Medical HMO and the cost of inpatient treatment is not a concern. He is just not getting the care he needs because he is not being asked the right questions, and if he says he's having trouble sleeping or something they just increase his doses.
Sorry for the long rant. I just saw his med doses and checked the interactions on Drugs dot com. and am totally pissed because this is just wrong.
EDIT: SPelling

In Bipolar II. I’ve been on Lamictal for 20 years. I’ve tried every other medication out there and this is the only one that works.
A few things:
I can only take brand name - generic has zero effect on me. My biggest issue has always been fighting with insurance companies but I always win in the end. Because of this - I always keep a 3 month supply on top of my day to day meds.
It controls my ups and downs and minimizes them. I also take welbutrin for depression.
My Lamictal dose varies based on weight. While the medication is weight neutral, other life factors affect me. I will periodically adjust my dose by 25 up or down depending on how I’m doing (I don’t recommend anyone else do this without a doctors input). I’m on 150 now and have been for a while.
Now the side effects:
Mostly minimal or at least manageable…
Mild OCD- I count my toes at night - this doesn’t happen at lower doses or when I’m not on it.
Hypersexuality - I’ve just accepted this is the way I am and my wife keeps me in check.
About 10 years into Lamictal I started to develop acute pancreatitis. It puts me in the hospital for 3 days at a time and happens once every three years. It’s not guaranteed the Lamictal is the cause but it’s a documented side effect, (1 in 100,000) and physiologically there is nothing wrong with me.
All in all, I couldn’t survive without it.
AMA

In the past, I have been prescribed Lamictal or generic lamotrigine. It helped so much with mood regulation but eventually I developed a rash. Since lamotrigine has a black box warning for skin rash, SJS, & TEN, the psychiatrist I was seeing at the time discontinued that med for me. This occurred almost 10 years ago.
The psychiatrist I got established with this past year asked what my skin rash was like years back during an appointment when we were exploring medication options. I told him I don’t remember what the rash looked like or how bad it was. He said let’s try starting it again with a slow titration & see if rash will re-occur. I was reluctant but agreed to give it a shot.
25mg was fine. 50mg my neck developed a rash. 75mg the rash spread from my neck to my chest & arms. 100mg my whole body developed a red hot itchy rash.
I informed my psychiatrist of the side effects. He advised me to discontinue lamotrigine until my body was fully cleared of the rash, then to restart it & keep the dose at 25mg. I was furious at this recommendation considering the black box warning & that there is no way to predict when a rash will ever turn into TEN or SJS. I even questioned if 25mg can even have any therapeutic effect in stabilizing mood. He said yes.
Despite my personal feelings, I still followed his instructions & restarted at 25mg once my rash was cleared up. I am currently still on a 25mg daily dose.
Since then, I have learned that one of the inactive ingredients in lamotrigine is lactose. I have lactose intolerance. So now I suspect perhaps my rash on higher doses might be due to the lactose in the pill formulation.
What I want to know is if there is a lactose-free formulation of lamotrigine on the market? If so, what is the name for that Rx? I wonder if I can take a higher dose successfully if there is a lactose-free formula available & would really like to try that if possible.

I am petite and can’t seem to gain weight on any medication. There is potential for weight loss but that can be a health risk for me. Any suggestions? I’ve been on Topamax, Keppra (brand and generic), Lamictal (brand and generic), and citalopram.

How do you guys go about getting a 90-day supply for meds while moving around every few months? I use generics and can be really sensitive to manufacturer changes, so I’m worried about consistently changing manufacturers when filling in different countries, not to mention cheap garbage that might be prescribed instead of my actual script that will mess me up.
Is there a reliable way to keep up medication supply?
Edit: Medications are lamictal, strattera, zoloft, and buspar. 90-day supply because it makes it easier to not have to deal with getting a prescription in a different country every month. And it’s a safety thing for me too. It’s really important I keep my regimen consistent otherwise everything gets thrown off balance and it takes weeks to recover.

Three nights ago I started lithium. 300mg. Currently taking alongside 100mg of lamictal because my new psych wanted to keep mood stabilizing but my god my mood is not stable!
Background: I’ve been on lamictal 100mg and zoloft 100mg (but generic) for about eight years, since I was first diagnosed. I’m 26 now. I moved to Brazil in December of 2021, so I’ve spent the last year and a half taking care of a lot of health issues since there’s free healthcare here. A big one that I’m tackling now is I sleep 12+ hours a night and have sleep inertia and frequently take naps on top of that. I’ve been this way my whole life, and it’s fucking annoying. I thought I would grow out of it but nope. I work from home with a set your own schedule type of job for now, but it’s annoying when I travel, when family is over, when my partner wants to get up early to do things we both enjoy, etc. Plus I have a master’s degree in museum studies that I would like to actually use at an in-person job eventually. The worst part is my sleep is very light too, so even though I sleep a lot and easily, I’m constantly waking up to literally anything.
I’ve done blood work and hormone checks and no issues there. My thyroid is picture perfect even though my mom has such bad thyroid issues she had to have hers removed. I get mine checked regularly, especially since thyroid issues can cause bipolar like symptoms but nope, mine’s beautiful and healthy. Now before free healthcare in Brazil would put me to see a neurologist to test for anything neurological causing sleepiness, I had to see a new psychiatrist. He was great and wants me to transition to just lithium. I quit zoloft cold turkey and now here I am. I go back in October for a check up and next steps.
The first two days were okay. I was tired and dizzy, but I always get dizzy when I stop zoloft. Then last night it took me forever to get to sleep and I am SWEATING. The fan is on (no A/C) but even lying on my back my stomach and chest are soaked. Then this makes me feel cold. Then I cover up and sweat some more. Then this morning I have to take some paperwork to the health post to do a process to get the lithium for free since my city doesn’t supply it. I didn’t even fuck up this process, I just didn’t scan and print copy of my documents the most effectively, and my partner asks me why I didn’t do it a certain way that was easier and I just lost it. Sobbing so hard it’s making me feel sick.
Will this pass? How is my mood suddenly unstable? I’m a sensitive person but Jesus Christ. I assume it’s because of shit sleep but I’ve been looking around the sub and it seems like lithium night sweats are not a transient symptom. I can deal with the dizziness. I can deal with the thirst and urination, I already drank a lot of water and peed a lot anyway. I’m emetophobic but so far no issues there. But I did this to sleep better, not worse, and I do not want to be unstable again. It’s only been a few days, though. Does it pass? Any advice?

inspired by my own recent experience with kicking Nardil back into gear after months of ineffectiveness, as well as some similarly-themed questions that have come up recently on the sub about Nardil pooping out, i drafted up this guide including all of the anecdotal knowledge/tips about poop out that i've absorbed from being on this sub for 2.5 years or so.
was hoping to get feedback on any places where additional info or tweaks to what's here is warranted. i'm not super well-versed on the technical chemistry/biology aspects of MAOIs, so that's an example of where detail might be useful.
beyond that - mods if you think this is useful (and the information seems generally accurate enough and faithful to consensus without overstating anything), could be a good resource to add to the side bar.
​
Techniques for Making Nardil Work Again (in the case of "Poop Out")
Nardil (phenelzine) is a potent antidepressant for treating both depressive and anxious symptoms. however, users have found occasionally that it stops working over time or "poops out".
this is a brief guide of things to consider and strategies to try if Nardil poops out on you.
IMPORTANT NOTE #1: none of these techniques are scientifically validated or officially endorsed by a psychiatrist or MAOI expert. they are merely tips and tricks passed along anecdotally among users, via trial & error and information sharing on this subreddit.
IMPORTANT NOTE #2: the recommendation to try these techniques rests on the assumption that you have already worked with your prescribing doctor to find an appropriate dose of Nardil. note that it's often possible to get stronger effects and additional symptom relief by simply increasing your dose, as tolerated vis a vis any side effects.
for additional information on Nardil, and to get a more "official" POV from psychiatrists and experts, please consult the MAOI Prescribers' Guide compiled by Dr. Ken Gillman and associates: The prescribers' guide to classic MAO inhibitors (phenelzine, tranylcypromine, isocarboxazid) for treatment-resistant depression
there are no apparent significant downsides to any of these techniques, but as with any adjustment made to your MAOI regimen, use caution and consult your doctor before making any nontrivial changes.
PROPER STORAGE
some varieties of Nardil (like Neon) are explicitly intended to be refrigerated. however, users have discovered that all varieties can potentially degrade under poor conditions (in particular heat, humidity, or condensation). the following are tips to prevent degradation.

1. ask your pharmacy to give you sealed original bottles (rather than opening them and putting them in a generic pharmacy bottle)
   
2. once you receive the bottles, keep them cool and dry until you get them home
   
3. if your home is consistently at a temperature between 20-25° C (68-77° F) and has average or low humidity, refrigeration is likely not necessary (see caveat above for Neon Nardil)
   
4. if your home has unstable temperatures, is consistently hot, or has consistently high humidity, you should considering storing your bottles in the fridge, including your "active" bottle (the one you currently have open)
   
5. If you store your pills in the fridge in anything but the original bottle, inspect the pills to make sure no condensation is collecting inadvertently. if it is, you can prevent moisture by putting the bottle in a ziploc bag with desiccant packets (can be purchased cheaply on Amazon)
   
6. in addition to the techniques enumerated above, make sure to read carefully and follow any storage instructions that come with your medication (either on the bottle or on a separate printout)
   

DOSE TIMING
Nardil's effects do vary somewhat depending on how much of it goes through your system at any given time, so you can try adjusting the allocation and timing of your doses.

1. for example, if you normally split your total daily intake into two doses, try taking it all at once in the morning
   
2. conversely, you can try splitting into a greater number of doses - e.g., moving from two doses to three
   
3. you can also try shifting the timing without changing how many doses you take. for example, if you normally take your entire daily intake in one dose in the morning, try taking it before bed
   
4. give any shifts in dose timing 7-10 days to have an effect before making a final evaluation
   

DIGESTION & ABSORPTION
it's been speculated that Nardil can be incompletely or improperly absorbed in some users, causing less of the active ingredient to reach your nervous system. there are several proposed techniques to try to improve absorption.

1. take your dose with a reverse sugar (e.g., honey)
   
2. take your dose with a few drops of ethanol (e.g. vodka or another clear spirit)
   
3. take your dose with bioperine (can be purchased fairly cheaply on Amazon)
   
4. take your dose on an empty stomach
   
5. use coated enteric capsules (can be purchased in bulk from Amazon). in theory, an enteric capsule slows down degradation in the stomach so more of the medicine can reach your intestines. so, the strategy is to put the pill inside an enteric capsule before ingesting. note that, depending on the size of the capsule, you may need to split the pill into halves or quarters to fit it inside.
   
6. similarly, use a quality food shellac as an enteric coating. food shellac comes in spray form, and though it's typically used as an aesthetic coating for baked goods, has properties that may make it a suitable enteric coating. the technique is as follows: spread your pills out on a baking sheet lined with parchment paper (the shellac is sticky, so the paper will allow you to manipulate the pills easier once sprayed). the pills should be slightly spread out and not touching each other. spray one coating on, being careful not to overdo it - it should only take about 10-15 seconds to spray a sufficient coating on all 60 pills in a bottle. wait 1 hour to dry, flip the pills to the opposing side, and repeat. allow 1 more hour to fully dry.
   

VITAMIN B6
although the influence seems to vary greatly across users, regular Nardil use has the potential to deplete the body of adequate amounts of vitamin B6.

1. a simple blood test can measure your vitamin B levels, which can detect whether you have a vitamin B6 deficiency
   
2. if you do have a shortage and decide to supplement, be aware that excessive amounts of B6 can cause other health issues, including headaches and numbness in the extremities. what’s “excessive” varies from person to person, but something like 100 mg per day is probably too much.
   
3. note that many users recommend P5P, a form of B6 that may be superior to other varieties
   
4. it’s often suggested that B vitamins absorb more effectively in a B-Complex type combination supplement. a typical formulation includes varieties of B6 + B9 + B12.
   

ADJUNCTS
adding other medications to Nardil can often help enhance its antidepressant and anxiolytic properties, and may also kick it back into gear after poop-out.
IMPORTANT NOTE: Nardil and other MAOIs have very dangerous and potentially deadly interactions with certain types of medications, especially any medication with serotonin reuptake inhibitor properties (SRIs). always consult your prescribing doctor before adding or changing your medication regimen in any way.
the list below reflects several commonly used adjuncts, but it is not exhaustive. there may be other possible adjuncts that could enhance Nardil's effects for you, depending on your symptom profile.
many of these, as indicated by asterisks (*), are mentioned by Dr. Ken Gillman in the MAOI Prescriber's Guide: The prescribers' guide to classic MAO inhibitors (phenelzine, tranylcypromine, isocarboxazid) for treatment-resistant depression. the parentheticals reflect common trade names (in the United States) for each medication, simply for reference.

1. lithium*
   
2. divalproex sodium (Depakote)
   
3. lamotrigine (Lamictal)
   
4. methylphenidate* (Ritalin, Concerta)
   
5. modafinil* (Provigil)
   
6. armodafinil (Nuvigil)
   
7. bupropion* (Wellbutrin)
   
8. reboxetine*
   
9. triiodothyronine* (T3)
   
10. thyroxine (T4)
    
11. antipsychotics (e.g., quetiapine/Seroquel, olanzapine/Zyprexa, aripiprazole/Abilify) - note that aripiprazole/Abilify is asserted, at least anecdotally, to have significantly different effects at lower doses (<=2.5 mg) vs. the typical therapeutic dose range (10-20 mg), in particular acting more significantly as a dopamine agonist
    
12. pramipexole* (Mirapex)
    
13. agomelatine*
    
14. TCAs* (other than imipramine and clomipramine, due to SRI activity)
    
15. mirtazapine (Remeron)
    
16. trazodone
    
17. gabapentinoids (i.e., gabapentin/Neurontin & pregabalin/Lyrica)
    
18. benzodiazepines (e.g., lorazepam/Ativan, clonazepam/Klonopin, diazepam/Valium)
    

EFFICACY-NEGATING MEDICATION INTERACTIONS
although there aren’t any definitive, widely-accepted medications that are contraindicated with Nardil specifically due to their potential to negate Nardil’s effects via some sort of interaction, users have found anecdotally that concurrent use of some medications has coincided with reduced Nardil effectiveness.

1. omeprazole (Prilosec) - a PPI anti-reflux medication, omeprazole may interfere with Nardi’s action. this could (speculatively) be due to both medications use the same CYP450 enzymes.

DOSE RESET (REDUCE + INCREASE)
some users have successfully kicked Nardil back into gear by quickly reducing and then increasing their dose.
IMPORTANT NOTE: be warned that, for other users, this strategy has actually yielded negative results - i.e., returning to their original dose resulted in Nardil being even less effective than it was previously. be extremely cautious in attempting, and as always consult your prescribing doctor before undertaking this technique.
there's not a canonical "best practice" approach to this strategy. some variation examples that have been cited as effective for individual users are as follows. your mileage may vary for all of the details included here.

1. reduce to a subtherapeutic dose for 1 week, and then return to baseline dose (e.g., 60 mg baseline effective dose -> 30 mg 1 week -> resume 60 mg)
   
2. reduce to zero for only a few days and then return to baseline dose (e.g., 60 mg baseline effective dose -> 0 mg for 3-5 days -> resume 60 mg)
   
3. reduce dose "dynamically" when life circumstances dictate (less stress, more stability, etc.) and resume original baseline dose as needed (e.g., career changes, relationship changes, family emergencies, etc.)
   
4. with any of these approaches, you may want to use a bridging agent to minimize symptom return and/or withdrawal during the time you are reducing your dose. for example, a benzodiazepine taken regularly for a short time may help to reduce anxiety.
   

Could not have said it better! We literally celebrate morons as if they are heroes. We call poisoning people justice, and there are notable and obvious facts and evidence to show when researching the FDA, CDC, WHO, WEH, and Rockefeller Foundation. They purposely put poison in all the Big Pharma meds and vaccines. This is on their websites. It's not made up. Luciferase is in the covid jabs. Talked to my doctor, asked her if it's true that there's remnants of crushed animal bones and human hair purposely put in Geodon/Ziprasidone? She paused, and I showed her what ingredients are listed in the medicine 💊. She couldn't deny it at all. Not long after, she told me I needed to find another phychiatrist, and she said our conversations about medicine made her uncomfortable, lol imagine that. She knows she is hurting people and is getting paid to not talk about that, If parents knew what they are doing to thier kids. It's why kids have so many health issues at a young age, the immunizations and vaccines they are forced to take to go to public school, and so much more.
The ingredients in Geodon/Ziprasidone are listed on the OSHA safety guidelines as; ("HAZARDOUS") PEOPLE ARE SO HYPNOTIZED AND DEMORALIZED, THEY RATIONALIZE THAT WE NEED TO BE POISONED.
By the way Geodon is not a generic name for Ziprasidone. They are two separate drugs/poisons. And the info you will find when you search each compound and all the fancy scientific terms, then define those also will leave you horrified. Kids are made to take this evil, satanic, poison. Somehow, a school nurse with no PHD has the authority to say your kid needs to be on medicine. Tell that satanic jezebel to take her meds first.
Also, look into lithium, the mood stabilizer, zoloft for anxiety, Adderall also, ridilin, Depakote, Lamictal/lamitrogine, not generic names at all. They are also channeling words for power of the occult over you.
Pharmacopeia/pharmacia/pharma Greek translation from the Holy Bible; Sorcery and witchcraft. Your merchants/traveling doctors were your world's trusted peoples by their sorceries were all nations lead astray. When you take these meds, it gives the occult power over your mind, telepathy is real, astral projection, and hex Magick is real. Lucerferionism is real, cabalism is real. The ingredients in the pills/vaccines are like that they put in potions, used to bend the will, mind, and body of the person's who digest the ingredients. They, at times, will sacrifice a child, adult, virgin, animals, to make a deal with Baal, Maloch, or others to have you fall ill or taken out of the way for good. Drive you mad, to have you hospitalized, and deemed crazy, diagnosed, so you're now labeled, and no one will listen to you. Don't believe me, that's fine, just don't say I didn't warn you!!! Do your own research before you reply in ignorance, please.

Could not have said it better! We literally celebrate morons as if they are heroes. We call poisoning people justice, there are notable and obvious facts and evidence to show when researching the FDA, CDC, WHO, WEH, and Rockefeller foundation. They purposely put poison in all the Big Pharma meds and vaccines. This is on their websites, it's not made up. Luciferase is in the covid jabs. Talked to my doctor, asked her if it's true that there's remnants of crushed animal bones and human hair purposely put in Geodon/Ziprasidone? She paused, I showed her what ingredients are listed in the medicine 💊. She couldn't deny it at all. Not long after she told me I need to find another phychiatrist, said our conversations about medicine made her uncomfortable, lol imagine that. She knows she is hurting people, and is getting paid to not talk about that, If parents knew what they are doing to thier kids. It's why kids have so many health issues at a young age, the immunizations and vaccines they are forced to take to go to public school and so much more.
The ingredients in Geodon/Ziprasidone are listed on the OSHA safety guidelines as; ("HAZARDOUS") PEOPLE ARE SO HYPNOTIZED AND DEMORALIZED, THEY RATIONALIZE THAT WE NEED TO BE POISONED.
By the way Geodon is not a generic name for Ziprasidone, they are two seperate drugs/poisons. And the info you will find when you search each compound, and all the fancy scientific terms, then define those also will leave you horrified. Kids are made to take this evil, satanic, poison. Some how a school nurse with no PHD has the authority to say your kid needs to be on medicine. Tell that satanic jezebel to take her meds first.
Also look into, lithium the mood stabilizer, zoloft for anxiety, Adderall also, ridilin, Depakote, Lamictal/lamitrogine not generic names at all. They are also channeling words for power of the occult over you.
Pharmacopeia/pharmacia/pharma Greek translation from the Holy Bible; Sorcery and witchcraft. Your merchants/traveling doctors were your world's trusted peoples by thier sorceries were all nations lead astray. When you take these meds, it gives the occult power over your mind, telepathy is real, astral projection and hex Magick is real. Lucerferionism is real, cabalism is real. The ingredients in the pills/vaccines are like that they put in potions, used to bend the will, mind and body of the person's who digest the ingredients. They at times will sacrifice a child, adult, virgin, animals, to make a deal with Baal, Maloch, or others to have you fall ill, or taken out of the way for good. Drive you mad, to have you hospitalized, and deemed crazy, diagnosed, so your now labeled and no one will listen to you. Don't believe me, that's fine, just don't say I didn't warn you!!! Do your own research before you reply in ignorance please.

I had an appointment with my epilepsy specialist today. I told her that my fiancé and I are trying for a baby. She was kind of stern with me. She was very no-nonsense about it, and explained that while the possibility of birth defects with Lamictal was virtually nonexistent (less than one percent), Zonegran was riskier, and there was no information about Briviact (its only been in the market for ten years-there isn’t even a generic for it). I have an appointment with an OB/GYN in two weeks, and I took a (blood) pregnancy test in addition to getting levels. She also wants me and my fiancé to see her PA in four weeks. She said something about changing me to Kepra, but my former neurologist (I changed to my current epilepsy doctor after seeking a second opinion) wasn’t keen on me being on it (I have a history of mental health problems and Kepra can exacerbate them), and I told her that. She said that was a little narrow-minded.
Update: Pregnancy test is negative. I have an appointment with my epilepsy specialist’s PA in October (soonest I could get in). I’ll let you know what happens.
Update 2: I’m starting on Kepra in the morning. I’ll let you know what happens.

I'm writing this for my sister since she is completely out of it from medications and how scared she is and I want some reassurance that she is getting better and not worse.
About a month ago, my sister (early 20's, no history of seizures and no family history of epilepsy afaik) was switching to a new antidepressant (I forgot the name of it). Her doctor did not really taper her off the last medication properly, and to boot my sister wasn't sleeping, or eating enough and still going to work. Long story short, she had a seizure, fell and got hurt pretty bad and had to go the ER. (She is still waiting to see a neurologist)
They put her on depakote XR for a week or two but she noticed it was making her hungry 24/7 so she asked to be put on something else. So they switched her to lamictal 25mg, she took that for about 2 weeks, then I believe the 3rd week she was told to double her dose from 25mg to 50mg. A few days later, She had begun having an on and off fever, a bit of dry cough, and what we thought was basically a cold or something. A few days passed and this progressed into a very mild rash on her face, and slightly swollen lymph nodes, still a light cough and intermittent fever. I told her to report to her doctor that she might be having an allergic reaction but her doctor had gone on vacation. I told her to be more aggressive with them and they eventually forwarded her message to the doctor at which point he said stop taking the medication immediately. For some reason, I guess out of fear of having a seizure, my sister took one 25mg pill before she stopped for good, I guess she assumed if she went back down to the dose she was on prior to symptoms appearing that she'd be fine. She stopped completely after that. I began researching lamictal and learning about Stevens-Johnsons Syndrome. Meanwhile, her face and arms became now visibly quite red (but thankfully not itchy, peeling or blistering) I became very scared understandably and kept emphasizing to her she needed to urgent care or an ER immediately before anything more serious happens. She did not have any blisters, any vision issues, or any of that type of thing at this point thankfully.
She takes a benadryl for the rash earlier that evenibf... but finally she goes to the ER that night as her face is visibly red and slightly swollen. I fear the potential seriousness wasn't revealed because of the benadryl but I digress. I didn't get to go with her so I don't know the exact treatment they gave her there, they told her she may have Stevens-Johnsons syndrome, then she was told if her symptoms became worse she would need to go directly to a burn clinic. However, as her symptoms were quite mild relative to example photos, they told her they had sent worse cases than hers to the burn clinic and they had been denied entry. She was given a prescription of Zyrtec, Prednisone, Banophen (generic benadryl), and Keppra.
That was yesterday. Her rash has greatly improved in terms of color and swelling (to my eyes it looked like it was gone entirely), though she says she has new symptoms today, namely 2 small blisters on her lower lip and itching in her vaginal area. The rash she had on her body and face looks like it's gone (at least in terms of redness) but she showed me she had a bunch of unraised tiny red dots where her rash had been. They're small like flea bites so I don't think they're blisters . She still has a little cough and she had a fever this morning but otherwise has been having less fevers.
I know this probably means she is recovering and just metabolizing what's left of the lamictal out of her system but she is very agitated from the prednisone so I want to calm her down and reassure her she is simply healing. Of course, I have no experience with this so I'm reaching out.
TL;DR Sister had a bad reaction to lamictal 50mg, possibly a mild case of Stevens-Johnsons. Off and on fever, very mild dry cough, chills, rash (without hives/blisters), slightly swollen face. No vision issues and no blisters. Her psych's on vacation but tells her to stop the medication immediately. Out of some fear, she takes one 25mg lamictal and takes an OTC benadryl for the rash, then later that night goes to the ER as the rash has begun to look worse and she's been having some high fevers.
There she's prescribed prednisone, generic benadryl, keppra, and zyrtec. The next day she takes them, then today (the day after) she had a lower fever in the morning but afaik hasn't had any more fever the rest of the day. Her skin is no longer red but she has some tiny unraised red dots where the rashes had been (maybe remnants from the rash she had yesterday?), along with two new symptoms: two quite small blisters on her lower lip, and is complaining of vaginal itching.
I assume this is just the last of the lamictal leaving her system, but I just want to ask to be safe. Should we be concerned?
Thank you.
​

Hi everyone! 👋🏼 I am glad I found this Reddit group, I have not received an official PMDD diagnosis (mostly because I have a bad gyno lol— if anyone has any good gyno’s they see in the Boston MA area, let me know— I am looking for a new one!), but my psychiatrist is fairly confident I have it, and after reading into it, I think I do as well.
My psych encouraged me to ask for my gyno to put me on Yaz, but I ended up on the generic version, Nikki. I started it in October last year, and just finished my pack last week. It definitely helped with the PMDD symptoms, like the incessant crying, worrying, and depression, but it wasn’t as profound as I thought it’d be. Note that I also got on Nikki to deal with the hormonal acne I have, but I’m using a topical hormone blocker, Winlevi, which has really helped.
I decided to not start a new pack of my b/c for a couple reasons— 1. Not sexually active right now so don’t need contraception; 2. My periods have become freakishly short- I’m talking barely any bleeding and it lasts for a day, maybe 2 days if I’m lucky (or not haha). 3. I think it’s caused weight gain, or at least it’s making it difficult to lose weight. 4. My mom had blood clots from b/c when she was younger and ended up with breast cancer so all of that scares me especially when thinking about taking b/c long term.
I haven’t decided for sure if I’m off b/c for a while particularly because I fear my hormonal acne getting worse (it’s just been starting to get better), and the mood swings. So I’m not currently taking it but could get back on it if I want, I just had it filled.
Anyway— I’m inclined to get off Nikki and try to work with this from a more holistic standpoint. Is there any supplement, lifestyle change, etc that has been helpful for you? I am thinking of going back to acupuncture for help with the hormone regulation, as well as maybe finding a good supplement I can take. I have diagnosed OCD so I take both an SSRI and a mood stabilizer (Lamictal) which I started around the same time as the b/c. I also take Gabapentin as needed, and I’m considering just using that (after discussing with my psych) to deal with the PMDD mood symptoms, because I find that Gabapentin really does help me when I’m more moody/on edge.
Any thoughts and advice would be appreciated!

I've never posted here before, but I just got my prior auth for another year of rx, and I was just thinking that I'd share my cocktail in case in helps anyone. Background Bipolar NOS (also ADHD... maybe one manic episode, mostly hypomanic ones when they were in that range. Most of the disorder has been mixed depression, but I was always medicated with something, so i truly don't know how my natural state is.
400 mg Lamictal XR + Aplenzin 174 + Synthroid .112 (hypothyroidism for many years) + Buspirone 20 mg (x 3 times/day) + Propranolol 40 mg (x 3 times/day; first dose is 50 mg)
I can't take IR lamictal because it wears off too quickly and I cycle rapidly. I can't take generic lamictal ER because the product itself is so bad that it hits me all at once (it even looks like a totally different pill). Can't take generic buproprion hcl because I need the HBR.
If not for the majorly good insurance (Cigna, from husband's job), I wouldn't be able to take these medications. This is like... 20 grand a year worth of meds. Lamictal XR is insanely expensive, plus it's 60 pills/month so it's double the regular cost of a 30 day supply.
My only complaint is that I like to joke that I'm a fucking idiot. I say the wrong word A LOT. I don't tell stories well because I forget where I'm going, etc. I don't give a shit. It doesn't impact my large-scale cognition. I'm just... slower. This is the hand I'm dealt and it's better than the illness. I doubt most people who have never dealt with this shit would be okay living with the side effects I have, but we all know what the devil looks like and we know that these are NOTHING compared to the depths of hell of bipolar disorder.
Looking back at it, I was very sick. I actually had a job, though I couldn't really keep the same one for long. I'm married. I managed to keep myself out of the hospital (though frankly I should have been put there a couple of times). And I know it's just because I'm lucky and have social supports and good insurance and access to the best doctors, not because the illness was mild. I don't deserve that any more or less than anyone else, and I'm grateful.
I only got out of bed in the morning everyday because I knew there were more medications to try, so odds were that I'd eventually get better. I did, but I really think I have PTSD now from 7+ years of hell. I'm just recovering from severe DP/DR going back to the first manic episodes.
Hope that helps someone. I hope you all get to the day where you just forget you even have this shit and have more relevant things to consume your mind. I'd forgotten what it was like to think of ANYTHING else.

I (32m) WFH and am currently looking for a second job, so as long as I reach my goals and send out enough applications, it's not crippling. But it is the worst case of hypersomnia I've ever heard of, let along experienced, so it's a huge bummer. I used to love writing novels, drawing, generally being creative, but now I'm tired 24/7 and have no interest in any of those hobbies. For example, because it's a holiday and my boss is off, I slept from 2 AM to 6 PM today. If I limit myself to 8 hours of sleep in bed, I'll get up and immediately fall asleep in my desk chair. The worst part is going to sleep feels amazing, even just the thought of it, but when I see how long I've slept on waking up, I hate myself.
This started with my last monthlong stint in grippy sock jail in March, which is where I built up the habit of sleeping that much: Lights out lasted 12 hours, 8 PM to 8 AM, then I'd nap for an additional several hours because there wasn't much else to do there, but I thought I'd be able to break that habit on leaving. I guess not.
They also changed up my meds: Before, I was just taking Lamictal and Wellbutrin, but they switched me to Lamictal (100 mg), Depakote (1000 mg), Haldol (10 mg), buspar (10 mg) and I recently started taking 27 mg Concerta for my ADHD, but it hasn't changed the sleeping problem. (All generics.) I don't know if they have anything to do with it, since I was told multiple times that Depakote has the side effect of knocking you out.
I know I need to see a sleep doctor, but my insurance will only cover half of it, so I'm reticent to eat that bill.