I have been having some difficulty adjusting to Lamotrigine (off-label for MDD & Anxiety). I had an immediate ++ response that disappeared while still in the 1st introduction phase. Titrating up has been normal (I know not to expect much until I'm at a therapeutic dose). However, I had been at 100mg IR dose and my Doctor and I agreed that it would be good to bump it up again. However, what she did was move me to 100mg ER for 6 weeks, and said that it would be LIKE a bump up because my body would metabolize it differently. Problems:
1. Since switching to the ER, I crashed. My depression & anxiety swallowed me up. Modiness is okay, so that is a continuing improvement, but the desire for isolation, loss of motivation, and overall sad affect have really become noticeable.
2. I am on a birth control pill that is a mix of the one that starts with an E (not estrogen but more synthetic-sounding) and Progesterone. I did some internet research and was uncomfortable to see studies indicating that birth control pills can reduce the levels of L. in the system by as much as 50%. I emailed Doc with this concern, and she said that it might have some effect on the efficacy of the birth control (so I should use a back-up method) but she really didn't see that 50% reduction happening, carry on... blahblah.
I don't want to be one of those "internet patients trying to be doctors," yet I'm seeing this mentioned in scientific reports, in forums, and elsewhere. Are these studies so small and insignificant that MDs don't take them seriously?
Also, has anyone heard of the LOSS of positive effect when switching from immediate release to XR/ER?
For what it's worth, a study I read found that L. serum levels were found to NORMAL for women taking one unique hormone, which is in the brand injectable Depo-Provera. There are pills, Depo, and some kind of sticks that can be implanted in the inner arm that last 3 (4?) years.
One final note: I know this sounds really strange, but I take birth control pills not for actual birth control, but to keep from having menses, as that hormonal craziness induces a terrible cystic-type acne. If you know anything on the subject matter that might be helpful, please let me know what other medical options short of hysterectomy there might be to keep menses away. Depo worked like an absolute dream for me for many years of my adult life, yet it leeched calcium from my bones and made them brittle.