Category: psychiatry

Real Experiences with Lamotrigine Combination Therapy

My experience with lamotrigine has been only positive. I have been on it for over two years, and it is the only psych med that actually worked for me. I continue to take a low dose of 50mg for depression, without any other psychiatric medications. Recently, I also discovered that I have chronic malabsorption, which causes chronic iron deficiency anemia alongside low B12 and low vitamin D. I ended up getting an iron infusion that raised my ferritin from 29 ug/l to over 60 ug/l, and my family doctor told me to keep taking an iron supplement every other day, plus B12 and vitamin D a few times a week.

Since lamotrigine is primarily a mood stabilizer for bipolar disorder, using it for unipolar depression is an off-label route. While taking it alone has worked well for me, many people end up needing a second psychiatric medication.

I analyzed 541 Reddit posts where people reported that lamotrigine helped their unipolar depression. Out of those, 141 mentioned taking a co-medication. However, 78 of those posts only mentioned the second drug in a negative or unclear light – either it was started recently with no verdict yet, it was unclear, or it explicitly made things worse. That leaves 63 posts where the person explicitly credited at least one co-medication with helping them.

Lamotrigine + Wellbutrin
The single most common pairing mentioned was lamotrigine + bupropion (Wellbutrin), showing up in 9 of those combination-therapy stories. I am not posting the full stories here as some of them are quite long, but here are the main relevant points from those stories:

Story 1 (note that this person has only been on this combination for 3 days)
Day three of consistently taking my lamotrigine/wellbutrin xl combo. here’s what i’ve noticed so far:
– Reduced appetite/food noise. I have always had a problem in which I binge/restrict which has resulted in fluctuating weight my entire life. I’m not thinking about food as much and not craving it as much, which is awesome for me.
– Reduced chronic emptiness. For about a month I’ve been in a depressive episode in which i’ve had little to no interest in anything (hobbies, music artists, etc). I find that emptiness has more transformed to a general numbness, and more willingness to get back into things I enjoy doing.

Story 2
I started lamictal two weeks ago and recently bumped up from 25mg to 50mg and things are going so much better for me. Before this I was doom cycling and experiencing panic attacks. I couldn’t really deal with life at the moment. Even during a stressful move and an incoming baby … I feel like I’m handling everything instead of just worrying and freezing over it.
I also started with 150mg xl wellbutrin which i’ve been on in the past. Although the wellbutrin helps – alone it motivated me but I would just get irritable and angry instead of depressed. I feel like the lamictal really smooths out the rough parts of wellburtin.

Story 3
I have been using lamictal for depression and anxiety (combined with wellbutrin) since 2021. It has helped my life so much. I was able to confidently make decisions to create the life I want.

Story 4
Wellbutrin + Lamictal
I recently started taking my full dose of Lamictal after a month of slowly upping the dosage. It’s been about two weeks on the full dosage, and I feel a little weird. As if I had taken a low dose of Xanax. I feel very relaxed, but I can still function just fine. Plus my depression and anxiety almost non-existent at this point. The only negative seems to be some brain fog.

Lamotrigine + Seroquel
The second most common positive combination was lamotrigine + quetiapine (Seroquel), coming up in 4 of the 63 posts where people credited a second medication with actually helping.

Story 1
After months of being extremely suicidal on various drugs, things drastically changed on the day I dropped all the SSRIs (on my own), was put on Seroquel (100mg, then 200mg), and the day I initiated Lamotrigine – which has been the key player – on my own as well (titrated extremely carefully, no rash).
The medical landscape in my country is really awful, I had to navigate all this alone to save my life, and I’ve successfully done that – 1 month without any symptoms.

Story 2
I’ve been on Lamotrigine and Seroquel for 3 months and I couldn’t be happier. I can’t believe how life changing these medications have been for me. I have zero depressive episodes anymore, I’m not obsessively thinking about certain things, my whole demeanor is very chill. I no longer have PMDD.
Doses – lamotrigine 150mg morning, Seroquel 150mg night.

Lamotrigine + SSRI
After quetiapine, the next most common positive pairings were lamotrigine + fluoxetine (Prozac) with 3 posts, and lamotrigine + sertraline (Zoloft) with another 3 posts. Both of these are SSRIs.

– I’m on fluoxetine and lamotrigine which helped me get to a state of only moderate to mild depression.

– I do feel quite better on it, and taking it off label since August (100mg) for depression along with prozac, after going through dozens of other meds.

– I am now on Zoloft 150mg and lamictal 100mg, both of which have finally helped me to control my emotions greatly. I have felt happier than I ever have before and I just feel fantastic!

Lamotrigine + SNRI
There were also 3 posts about lamotrigine + Effexor (venlafaxine), which is an SNRI medication.

– Lamictal is amazing. I don’t know about the negative reviews but I believe every case is different. I started with 25 twice a day and now on 50 twice a day. Honestly, it has changed my life for the past two months. I feel confident emotionally stable and I don’t know how and I don’t know how but it reduced my anxiety. I do take effexor as, I believe the combination worked well for me. I managed to travel by myself to places that would heighten my anxiety, and I even took the subway which I absolutely despise.

Mixed post with some positives, but also some increased anxiety:
– Im on day 10, 200mg (lamotrigine) with venlafaxine 225mg, not bipolar, no mania/
Im deff feeling better but i still have anxiety, sometimes im nervous but then im good. Then I’m anxious.

Positive lamotrigine stories for unipolar depression

The first psych med that I ever tried was mirtazapine back in 2015. I was quite hopeful because it was prescribed by a psychiatrist at a hospital, so I assumed that they must have selected it specifically for my case and that they knew it would help. I was not aware yet of how much trial and error there is in psychiatry.

When I was prescribed lamotrigine in 2024, I was not hopeful. It was just another medication that I was going to try, after more than a dozen that I have already tried, and none of them have been helpful.

It was spring when I started lamotrigine and I remember riding in the car, looking out of the window, and I suddenly noticed how beautiful the sunlight was. Maybe because the winter is over, I thought. But the way the sunlight fell on tree branches and the houses, it was very interesting, and made me want to capture it, to paint it. I realized then that I did not feel as dull as I did on the days previously and that I had a lot more interest in my surroundings.

I have since then continued to take a low dose of lamotrigine. Increasing the dose did not work out for me as it increased my intrusive thoughts and did not make me feel better. The low dose has definitely been helpful for my unipolar depression. What is interesting to me is that this medication has been so effective for me yet for some reason I have never heard of it until 2024 while I have tried all sorts of psych meds since 2015.

I assume that a lot of you who are being treated for depression have also not heard of lamotrigine. I want to bring more awareness about it. It’s quite an inexpensive medication and it is mostly used for controlling seizures and for treating depression in bipolar disorder. It is not often used as an anti-depressant in unipolar depression, even though several studies shows that it helped some individuals with treatment resistant depression.

I have collected some reviews of lamotrigine from online posts that I want to share here. I tried to filter out those posts that mentioned bipolar disorder, as I specifically wanted to look at experiences with lamotrigine of those individuals who were diagnosed with depression, not bipolar disorder. In this video I will be focusing on just the positive experiences.

Let’s get started.

# 1
Experience number one – young male treated for depression.
I’ve been on Lamictal for 4 years now. In these 4 years, my life changed drastically.
My depression is gone, and my suicidal ideations have stopped, nor I’m suicidal anymore. Risky behavior and deliberate exposure to life-threatening situations are gone. The feeling of emptiness is gone.
I have completely stopped drinking alcohol and stopped taking drugs (kind of – more on that later on).
My relationship with friends and family improved.
The state of my mind, and my well-being improved overall.
I work. I travel and I’m happy and satisfied with my life.
Side effects the person has been experiencing: low libido and erectile dysfunction.

# 2
Second experience has some positives and negatives. Personally I think playing around with the dose is important. This individual is taking 100 milligrams, I found that for me any dose over 50mg made me feel dull, as they describe, and also increased my intrusive thoughts.

I’ve been taking lamotrigine 100mg for my mood instability for about two years now following a very bad depressive episode I had after a breakup. I felt like life was nothing. Cried every day for months and thought the way I felt would never end and I couldn’t leave my bed. I was very self destructive and sabotaging to the point I was hurting those around me. I’ve never felt that way in my life and wish it on no one. After a series of trying several SSRIs and anti-anxiety medication, lamotrigine was the only thing that seemed to help clear up my head and make life more tolerable and that I had control over my actions, no impulse.

But I feel dull. I don’t know how to explain it. I feel extremely depressed even though I am not in that state I was in. No one would describe me as depressed. I laugh, I can be silly, I’m still who I am and it’s not entirely lost. I work on personal projects and I do well in school. I am in an extremely healthy relationship with someone I am considering to even marry one day, although I’m not done with college yet so that’s far in the future. I can shower, I get out of bed, I clean and I’m productive. Most of the time. I have bad days which is normal and never on the extreme.

But I feel like I am on autopilot mode almost. To the point I’m just going through motions and then I’ll randomly remember I’m a real person and I am actually doing things.

# 3
This person was clearly doing better on lamotrigine and for some reason they decided to taper down and got worse. I think if you find a med that is finally working for you, please stay on it!

One full month in, I quit smoking weed and was able to step into a bus again, my depression was actually not as bad even though I rly did go through a shitty couple things back then, and was able to reason with myself a lot better and put things in perspective in a way I hadn’t been able to do. I was working on myself, feeling better, but also feeling less. Every emotion seemed to be observed from helicopter view, I felt it, I stepped away and analysed it instead of feeling it and then rationalised it and waited it out. But I feel like I wasn’t necessarily processing them. They just went away?

Either way, I was doing better, only had one relapse with my weed use those 8 months and it was all great, except for my robotic way of handling stuff.

My therapy ended, am now working on getting my BPD diagnosis removed and would start working again. Worked out 5 days a week, was on a good healthy diet, walked a lot, didn’t smoke (weed/cigs), drink or binge eat anymore, was very social, could handle stimuli, etc.

As I wanted to just gap a bridge with these meds, until I felt secure to do it myself, I started decreasing them. I went from 150mg to 25mg and already had my final consult with the prescribing psychiatrist a while back.

Since building off, I’ve noticed a big increase in insecurity, irritability, impulsiveness, depression and anxiety instantly.

# 4
This person tried lamotrigine once and it did not work, but had a very positive experience the second time they tried it.

TL;DR — lamotrigine did nothing except give me insomnia while titrating up to 75mg. I tried it again 6 months later, taking it in the morning, and after jumping from 50 to 100mg, it started working amazingly well for my mood instability, depressive episodes (probably cyclothymia), and general pointlessness. Huge win!

I’ve heard lamotrigine being described as a ‘rope’ you can grab onto that helps keep you from falling and lets you climb back up, and I couldn’t agree more, honestly. I’ve had virtually no side effects, and taking it in the morning seems to energise me, if anything. I’ve not had another downswing since. It’s been 2 weeks since I started 100mg, and it really has been fantastic.

# 5
This person had a positive experience with a combination of lamotrigine and vyvanse.

My doctor currently has me on lamotrigine and vyvanse. The former seems to stabilize my mood well and the latter helps significantly with motivation and getting things done. More importantly, the medications have allowed me to start forming habits to help me thrive and not just survive.

Like I said earlier, I’ve tried dozens of medications. Adderall and Ritalin simply didn’t work for various reasons. I tried every depression medication with horrible side effects and even attempted abilify but it caused awful restlessness.

I’m typing this up to try and show there is hope. It took me years to find something but there is relief out there. Don’t give up on your search. I got my butt kicked by brain zaps, quelled an adderall dependence and fought through a disease that almost killed me. Please do not stop fighting and seeking. The relief could be right around the next corner.

I can actually be a husband and dad again. Life is finally showing color again. No, things aren’t perfect. There are setbacks. But now setbacks are short term hurdles that don’t seem impossible to conquer.

It has been almost a full year on these two medications and I can finally say my life is truly worth living again. I can’t stress this enough… I know the true hell that a lot of you experience on a daily basis. It can be brutally debilitating and inconceivable. BUT there might truly be hope for you. Don’t give up. Life can be worth living again even if you can’t find a reason for it right now.

Noticed that my job has been causing me brain fog due to high workload.

I have had brain fog on and off since early 20s, currently I am close to 40. Recently I have received several treatments such as starting lamotrigine two years ago and getting an iron infusion this year due to anemia. I also quit drinking coffee and lowered my caffeine consumption. I also started to consistently take vitamin D, even in the summer, and occasionally B12.

These changes have reduced my brain fog significantly. I have had many days without any brain fog at all.

I have been having an increasing workload and I noticed that the more emails, messages, and meetings I have in a day, the more likely I will experience brain fog. I have a senior position and a pretty good salary, no complaints. Unfortunately I will have to look for another job because feeling well is more important to me.

I’m glad that as I am now older, I have a much easier time accepting that I can’t handle a certain job. When I was younger I would have felt very ashamed that I couldn’t handle the workload. And I used to believe that life had to progress linearly. From undergrad you had to get your masters. That wasn’t enough though, so I went for a PhD.

Now I am much more nihilistic in a positive way. We have to accept that sometimes a specific job or educational program is too stressful, even if other people can handle it. Turns out that personally I don’t tolerate high workload and especially constant emails and messages from co-workers / managers asking me whether XYZ has been completed.

Now I have a much easier time accepting this, that it’s just my neurobiology, and I can’t change it. Time to look for another job, and that’s ok. Health is more important.