Straight Talk on Managing Bipolar Disorder

Here is a great question from a reader – Amy- regarding Lamictal (Lamotrigine) side effects.

My 18 year old son with BP, anxiety, depression, OCD, ADD tried Lamictal from March to June of this year and once he got above the 100 mg. mark he developed facial tics (squeezing his eyelids shut and mouth grimaces). We went off Lamictal gradually for about one month, and the facial tics disappeared. He had about 3 weeks completely off, then on the advice of Dr. Papolos (author of The Bipolar Child), we started up again and he is on 25 mg./day. So far, so good. But that dose is really equivalent to 50 mg/day because he takes 1500 mg. Depakote as well, and Depakote intensifies the Lamictal in the blood.

Has anyone else experienced facial tics with Lamictal? Dr. Papolos as well as my son’s current pdoc had never heard of that, but a friend who researched drug interactions/side effects on line did come up with 5 cases that have been reported.

Hi Amy,

I love questions that I can answer from personal experience.

I’ve been on Lamictal since 2005. It has saved my life numerous times. I call it my wonder drug- but this doesn’t mean it’s side effect free!

You can definitely have tics with Lamictal. I have them all of the time. Sometimes they are so bad they’re comical. I can practically jerk and twitch myself out of a chair. As awful as it can be, it can really make my mom laugh!

I even have one that makes me tap my cheek a few times after my body has jerked around. That one is weird.

Lamictal is an anti- epileptic drug. It’s powerful and it affects our brains. It makes sense it would have physical side effects such as controlling our muscle movement.

Dr. Papolos was completely correct about dosage. I only have these tics when my dosage is not correct. I’m the opposite from your son. I get the tics- I call them twitching- when my dose is too low. I always know if I’ve made a mistake with my meds when I start to twitch all over the place.  Messing with my meds can also cause some serious leg pain similar to restless leg syndrome.

I take 500 mg of Lamictal – 200 mg in the morning and 300mg at night. I have to put them in dated pill boxes as missing a dose is really painful for me mentally and physically.

I believe in the comprehensive treatment of bipolar disorder- I use my Health Cards and my Lamictal to have a functioning life. It’s a fact of life that these strong meds come with side effects- I try to minimize them as much as possible.

In terms of five cases being reported- this is not uncommon. Thousands and thousands can have Lamictal side effects that go unreported- as there is no place to report them unless we are in a study.

Your son is lucky to have you Amy! I hope he does really well on the new dose.

Julie

Hi,

 I really like answering reader questions- unfortunately, I’m limited by time, the illness itself and my darn hurt thumbs, but I will get to as many as I can. If you go down two entries, you will see a reader comment about my teenagers with bipolar disorder entry. I answered the question half way and will do the rest later tonight!

 If you have read all of the entries and want some more information on my work, please visit www.juliefast.com

Talk with you later tonight!

Julie

Wow, I am getting so many comments regarding teenagers and bipolar disorder. It’s a topic that is NEVER talked about- maybe that is because it’s so complicated. If you have not read my blog entries on the topic, you can go to the right and click on the teenager category to read them. I am following up with the topic through a reader question- here is a good one that captures the fear and confusion so many of us feel when someone we love has bipolar disorder that isn’t being treated effectively.

This reader comment is from ‘Mom from a 19 year old with bipolar disorder.’

Julie,

I have two bipolar daughters and a bipolar ex-husband. My heart is hurting now for my teenage daughter. She’s not well right now and she seems only to become involved in destructive relationships with guys who have criminal records, drug issues, no job etc. How can I help her see that her own moods and health are affected by her choices and that I’m not just being a critical Mom who doesn’t like her boyfriends? (I do like them, they are just NOT good for her) She is also in counseling, on medication but the constant DRAMA in her life would cause anyone to feel like they’re living life on a roller coaster. How can I better help her help herself?

Also Julie, I so appreciate you devoting your life to helping others with this disease and sharing so openly your own experiences. You are helping many.

Hello Mom!

First of all, you daughter is lucky to have you. I say that to all parents who try to learn about this illness even when it breaks their heart to see what it does to their children.

It’s a dangerous and rotten illness, but it absolutely can be managed. It may take many years as it did with me, but it can get better.

When I was particularly sick and didn’t know how to control my mood swings, I made very bad decisions with men. This is just what happens when a person is manic/depressed/psychotic/anxious and unhappy! Going for a relationships- especially one that involves sex is how many people try to cope. It doesn’t work unless the person is also willing to do the work needed to make sure they pick the right person- which is pretty hard to do when you’re sick.

Also, a 19 year old doesn’t have the maturity to be forward thinking- that is one of the main problems of bipolar disorder in teens.

There are many things you can do to make it easier on yourself- because as you have seen, she is going to do her own thing until SHE decides she wants a joyful, stable and fulfilling life instead of one filled with mood swings, men who aren’t right for her and a strained relationship with the people who care about her.

I will give tips on the next blog. I don’t want this one to turn into a novel!

Julie