Interesting, as well as....revdoc said:
Back in 1999(?), my psychopharmacologist added Lamictal to my combo of Klonopin, Celexa and Nortriptyline. I'm also 24/7 chronic DP/DR for over 30 years. No let-up, not even in my dreams. I'm also very anxious, and when stressed the DP gets BAD.nemesis said:
My doctor's goal, before I stopped seeing him (I moved out of state), was to push the Lamictal and subsequently take me off of my other meds. But I have been afraid to touch the entire combo until recently, as it has been the most effective -- no cure though -- and I started with meds at age 15. (Call me Guinea Pig). (I've also gone through several extremely stressful years involving separation from my husband, a move, the death of my mother, etc.)
I am now decreasing the Nortriptyline VERY slowly, (everything will go VERY slowly -- still no bad effects as I see), and will decrease the Celexa slightly, then the Klonopin somewhat. This may take a year if not longer, probably two. I am still afraid of removing the Klonopin which really saved my rump back in 1987 and has kept me afloat since.
But after eliminating the Nortrip, and lowering the Klonopin, I may INCREASE the Lamictal which I haven't been able to do.... over 200mg I become very sleepy. (But this is attributed to the fact that I'm on the other meds -- the combo undoubtedly contributes to the sleepiness when the Lamictal is increased.)
The effect of Lamictal for me at 200mg/day added to my other meds (particularly the Celexa) has been very subtle yet very important. It lessens the "fear" of the DP/DR. It's almost impossible to articulate. And what really worked miracles for me, and has never stopped working is 6mg/Klonopin ... the first med to significantly decrease the DP/DR -- no other benzo did ANYTHING for me. They all did NOTHING ... didn't even help my anxiety.
I also believe, for me, Lamctal is most effective with the Celexa (or SOME SRI for others), but I may be wrong about that. But, I need to say that, as it is possible some failed attemps here with Lamictal alone might have been more effective with an SSRI.
AND Very interesting about the Bipolar connection:
1. I believe over the years I was misdiagnosed -- or a significant part of my makeup was not recognized properly. I have certain Borderline characteristics which may actually be on the Bi-polar spectrum. I would say I have what they are now calling "mood dysregulation" vs. full blown Borderline. I am also almost certain my mother was high functioning "Borderline". Note: I do not self-harm, cut, etc. and neither did she -- she was also a psychiatrist, but she had what may have been brief episodes of paranoia on and off. :? (A lovely combo there.)
2. So many years of experimenting with meds, I found that I am also very resistant to the effects of many meds and frequently need higher doses of things to feel any effect positive or negative. I don't get many negative side-effects from my meds. But I also need higher doses to feel any positive effect. (Hence the 6mg/Klonopin I've been on for years.)
Bottom line, Lamictal may be an excellent med to try for those who have mood dysregulation/Bi-polar. I've said this numerous times, that my psychiatrist back in LA at UCLA had great success eliminating serious chronic DP in some patients with bipolar disorders ... using Lamictal alone.
So there seems to me to be a subgroup of people who have Bipolar, or what is now an antiquated term I believe -- Borderline, with DP who might respond well to Lamictal.
I was on a number of other "mood stabilizing" meds... Depakote, Tegratol, etc. They did nothing for me... good or bad.
Lamictal helped me significantly with both mood fluctuations AND the DP/DR -- both in extremely subtle ways, but in hindsight, I see the effect as being rather dramatic.
Also, individual psychotherapy and most significantly group Dialectical Behavioral Therapy (the latter geared towards mood regulation) have helped significantly. I was in DBT for four months 12/2004-3/2005. It was then that I have finally begun putting the puzzle of my illness together.
I have a long way to go, as I had a truly dysfunctional upbringing which would have caused all manner of psychological problems anyway. I have no doubt I probably inherited mood problems and anxiety/depression from both parents.
This all goes back to Andy's original DP Board where the "Klono-Combo" was stumbled upon. There may be somethng to be said for this or the "Lamictal-Combo" (either combined w/an SSRI) for those of us with mood problems that are accompanied by DP.
We are all unique. Each are VERY individual cases here, despite what we all have in common re: the DP experience, and THAT varies as well though we all understand each other -- we can all connect w/DP Hell.
Best,
D
[Edited for the last time I hope.]
