HealthTalkie

Talk About Health and Its related Topics

 

Lamictal And Inattention

by Erasmus777
I've been depressed most of my life. I've also suffered from severe inattention. I tried stimulants for a while and they really worked, but I quickly built a tolerance to all of them. I'm on 450mg Wellbutrin and it takes the edge off the depression but has not totally gotten rid of it. But the inattention is what bothers me most. My life is a series of unfinished projects, books, and endeavors. I'm sick of it. I desperately want to actualize my potential.

After consulting with a psychiatrist, I think I'm likely Bipolar II. Whether or not this is comorbid with ADHD, I don't know. Honestly, I don't really care what the source of the inattention is--I just want it to go away.

Do Bipolar medications such as Lamictal help with inattention or will that have to be dealt with separately?

Thanks,

e

  • lamictal can help with inattention if it is related to depression, not ADHD though.
    - Matt S., 6 years ago
  • lamictal can help with inattention if it is related to depression, not ADHD though.
    Is there any qualitative differene between the two types of inattentiveness? Is depressive inattention caused by perseveration or preoccupation with negative thoughts, or is it similar to ADHD in being characterized by easy distractability, mind wandering, etc?
    - Erasmus777, 6 years ago
  • When Im depressed I find it harder to concentrate because my energy level is lower, my interest in whatever Im thinking about is alot lower than normal and its not as important to me. Negative thoughts aren't a big problem (they can be, but only usually come when I have nothing Im doing, ie sleeping which is a real pain) I just have a real lack or interest and energy, but thats just me.
    - The_Colossus, 6 years ago
  • Um...well here's the deal, speaking for someone who has Inattentive ADD & Bipolar II , has been on Lamictal over a year, and Adderall.


    First, they are not going to treat you with stimulants to start with. Or rather they better not. You will need to get balanced out on the Lamictal for a couple of months....then look into your options for treating ADD? If you choose a stimulant, you will need to ease into it and be very very aware of your cycles. Meaning , you need to journal ...well you should any way....but more often with any med changes.

    I can tell you, after being on the Lamictal a few months, I felt MORE ADD...
    My doc explained that Lamictal causes some Coginitive dulling....this is acceptable in just BP patients,,,um can cause some issues for us.
    The Adderall helped with that for me. I just watch my cycles and when I feel a hypomanic upswing coming on, or if I go through something that I know will trigger one I pull myself off the Adderall until it passes. I have full permission to do so from my doctor. I bascially cut my normal dose of Adderall XR in half compared to what I took prior to my diagnoses..I went from 40mg XR down to 20mg....and I keep a very very close eye on myself....The combo has worked well for me.
    - justhope, 6 years ago
  • It is standard operating procedure to stabilize the mood disorder, then take on the ADHD. That is not the way things happened for me? But that is what my doctor told me he would generally do. In my case and my daughter's the BPII was obscured by the ADHD phenomenen of hyperspeech.

    I agree with what Hope said: Lamictal made me feel more "duuuuuh" at first, requiring an adjustment in my stimulant medication (dexedrine). I spent a lot of time titrating up on Lamictal though (25 mgs in the starter pack, all the way up to the 300 mgs I am at now), and have not had to increase my stimulant all that much, to be honest. Unlike Hope, I do NOT decrease my stimulant when I sense a cycle (I am a SEVERE Inattentive, a possible danger to others while driving and so forth), a decrease for me does nothing. I take a tiny dose of an atypical antipsychotic, which will knock the hypomania right back down again.

    For me, Lamictal mainly attacks depression and I am happy to say, it does so with a vengeance! I felt a mild lifting of my own constant companion, depression, a few days after I started on the 25 mgs. (Not what I eventually needed, but a distinct lack of a continual wish to be dead).

    I couldn't begin to tell you about qualitative differences between inattention as it manifests in depression vs. ADHD, simply because I do not know and have not noticed any marked degree of inattention after beginning dexedrine, because I started Lamictal very soon afterwards.
    - Crazy~Feet, 6 years ago
  • I am only on 150 mg of Lamictal but I take anywhere from 90-120 mg of dexedrine and yeah I am feeling a little on the cycling side.

    Is there any qualitative differene between the two types of inattentiveness? Is depressive inattention caused by perseveration or preoccupation with negative thoughts, or is it similar to ADHD in being characterized by easy distractability, mind wandering, etc?
    It can be part of the depression in both respects, there is a brain chemical change that goes on when a person is depressed.
    - Matt S., 6 years ago
  • You sound just like me Erasmus777!
    - PraizeHim, 6 years ago
  • I don't believe Lamictal significantly affects my ADD one way or the other. Well, I guess maybe indirectly because when I'm not stable my ADD symptoms are worse. Everything is worse.
    Even if Lamictal did make my ADD a little worse, it's a side effect I'd be willing to accept and I feel it can be counteracted with ADD meds and a little extra personal effort. I'm unable to get my ADD under control at all without having my BP under control first.
    Personally, Lamictal is essential to my well being. That's just how it is.

    I'm on 400mg of Lamictal and 10-30mg of Dexedrine right now (still working out the right dex dose for me and my needs seem to change from day to day... should be able to stabilize that a bit more once school starts and I'm on a more set schedule).
    I feel good about this combination for me.
    - meriellyn, 6 years ago
  • I'm now on 150mg of Lamictal. It's pretty amazing as far as the depression goes. Wow!

    It has a helped a little bit with attention. I don't feel as agitated all the time. I play fewer video games (no TV, computer is my electronic entertainment) and read a lot more. That's been really great as I love reading when I can focus. It takes a lot of effort though--a lot of redirecting my attention back to the page.

    Because I have a history of alcohol abuse, my pdoc plans to put me on Vyvanse. I'm trying to remain skeptical as I want it to work so badly. I don't want to be really disappointed again.
    - Erasmus777, 6 years ago
  • I am currently taking 200 mg of Lamictal a day, and have been for the past 2.5 years. I have been mildly depressed for as long as I can remember, and in my highschool years exhibited what could be considered symptoms of bipolar disorder, as well as ADD. I have a large family history of mental disorders, especially bipolar disorder, as both my sister and two of my cousins have it, two of them diagnosed with bipolar disorder and ADD. However, my "mania" experiences were not so intense or grandiose to warrant the need for medication. In my second year of college, I fell into a severe depression with suicidal ideations. After self-medicating with marijuana (I am not advocating this, but I must make note of it since it is possible that contributed greatly to worsening ADD, although I quit a year ago), and trying antidepressants that caused mania, my doctor put me on a mood stabilizer. Lamictal lifted me out of the abyss, and for about a year, I was doing well. I was either so glad not to feel suicidal that I didn't notice any adverse affects, or the negative side effects emerged later on. When I first sought help from my psychiatrist for severe depression and anxiety, he told was sure I had ADD. I shrugged it off, not really "believing" in ADD (naively), and he didn't bring it up until about 7 months ago, when I agreed to try a stimulant. He put me on Adderall and it helped greatly with my focus. Unfortunately, it stopped working and the medication I am on now, Concerta, only makes me anxious and more social, but still incapable of focusing.

    To answer your question, however (sorry for the long background), Lamictal certainly does exacerbate ADD. Of course, side effects vary greatly from person to person, although I've read many patient boards and there are many who have had the same experience of cognitive dysfunction. I believe I was undiagnosed in high school because I did well enough despite it, as I suppose (or believe) I am lucky to have a high enough level of intelligence to compensate for procrastination and lack of proper study skills. Last semester, I noticed difficulty finding the word I was looking for, constantly, which is strange since I am a writer and have always excelled in english and vocabulary. I have an absolutely horrible memory, and couldn't even tell you what I did yesterday. I basically display every symptom of adult ADD inattentive type, but without the proper stimulant medication, Lamictal stabilizes my mood to the point where mild depression is normal and I can't ask for anything more than freedom from suicidal thoughts. Adderall certinaly helped counter the problems Lamictal intensified. It is possible that the only reason I notice this is because I am in college, and constantly fail classes or fall behind, though I get A's and B's when I can actually get to class or finish papers. Lamictal exacerbated my ADD, and my ADD exacerbates my depression and anxiety because of my inability to get things done.

    Overall, Lamictal works for me because it all but obliterates my memory, not allowing me to analyze every single thing or remain angry or more than ten minutes. If you have ADD, adding a mood stabilizer like Lamictal definately has the potential to worsen ADD, but you have to weigh the benefits and detriments. It saddens me-and would anger me if I wasn't so apathetic about everything-that in my case, being dulled down, more inattentive, and without my former creativity is what I have to sacrifice for sanity. It is unfortunate I must trade cognitive function for freedom from suicidal thoughts, but the latter is the one I simply can not handle on my own.

    Long story short, Lamictal has a significant impact on my cognitive function, exacerbating symptoms of ADD, creating an apathetic and passive mood which makes achievement demonstrating my true capabilities and aspirations nearly impossible.

    However, it is apparent that many people do not have this sort of response to Lamictal, but I am curious how many of these people have jobs that require intense cognitive tasks or are attempting to get through college.
    - Sarah JD, 6 years ago
  • I have been taking Lamictal for about 3 months and have only managed to titrate up to 75mg. It took me several weeks to adjust to even 25 mg. as it caused severe inattention and anxiety (despite the fact that I take 90-100mg. of adderall a day- it relieves both & doesn't exacerbate my cycling). Every time I increase the dose, these side effects reappear. I also have severe problems with word recall and working memory. I am a dogwalker and my day involves a tremendous amount of organization which is extremely difficult for me even medicated. When I increase my Lamictal, I have to carry pen and paper with me and immediately write down whatever I need to remember, or it will vanish within 15 seconds. I also text message it to myself and ask my clients to leave reminder post-its. Even then, I space out in the middle of doing something and frantically try to figure out what I'm doing. Total disaster. I write a lot as well and it definitely causes problems with word recall. I awoke one morning with the words "alacrity" and "paroxysm" as my first thoughts. I spent the entire morning meditating upon their significance. Later that afternoon, I tried to recall them. No matter what I did, I couldn't, I made an exhaustive list of every word beginning with "a" and "p" that popped into my mind because I figured I would recognize the words if I saw them. Nothing. The next day, I was thinking of the previous morning and the words flashed into my mind. However, had I tried to recall them, I doubt I would have been able to. I wrote them down immediately and haven't lost them since. Weird.

    My psychiatrist and I are still trying with the Lamictal, I probably would have titrated up more by now, but I spring mania started setting in after a psychotic episode at the end of March. In a flash of manic wisdom, I decided my life was boring on meds and stopped taking them. I was on Seroquel as well, but it caused hyperprolactinemia so I had to stop taking all but small quantities. I work outside, no matter the weather and it poses a significant risk for heatstroke so it would be too risky for me too take in summer months.

    I'm back on meds now as the mania still rockets onward and it devolved into severe agitation, irritibility, hostility and paralyzing anxiety. I came dangerously close to harming myself or others and barely managed to avoid the psych ward.

    I have experienced rare and intolerable side effects from a bunch of meds, and can't take any atypical antipsychotics at all. Seroquel was great-- I didn't gain any weight, was focused, organized and could remember things easily. However, at 500mg., it did not stabilize my mood. I am now taking Depakote, Lamictal, Seroquel (50-100mg), Adderall and Xanax (I hate it-- gives me "pockets of amnesia"). Unfortunately, I can't tell I take anything at all and I haven't slept more than 2-3 hrs. a night all week- courtesy of seroquel & xanax combo). I'm going to the psychiatrist again tomorrow to see what other options I have.

    My moods follow an exact cyclical pattern (to the week- scary), every year for the past 10 years that I've kept a journal. I think my bipolar started in elementary school as I was severely suicidal in 5th grade and most of my childhood was a big, long mixed episode). The inability to function and the psychotic episodes did not start until I was 19. I am 31 and was diagnosed about a year ago. I managed to survive all these years, barely, but did lots of crazy things along the way. Sadly, I was a top student in high school, went to William&Mary, dropped out, went to UC Berkely, then Columbia University (so, so many medical withdrawals) and never finished even though I had a 3.7 GPA. I would like to go back and complete the year I have left, but I can barely handle the stress of existing and with the added pressure of school, I will lose it completely, yet again.

    I don't truly know what it's like to be stable since I never have been. However, I would not be willing to sacrifice my intellect and creative/artistic abilities in the process. Although I have been severely suicidal, I have never spent more than a month or so feeling that way, so I can't truly understand your predicament. I don't know if you've tried any other medications, but I would talk to your psychiatrist and see if he/she would be willing to help you find another combination that wouldn't force you to live in a mildly depressed fog.

    My psychiatrist is wonderful-- he fully understands that I would not want to feel flattened and appreciates my desire to not quash my creative capacities. He seems to possess a profound understanding of a person's desire not to want to sacrifice their talents for stability. We had a long, manic discussion about "One Flew Over the Cuckoo's Nest" last week. While I'm unlucky with meds (this is true of non-psychotropic ones as well), at least I have a talented psychiatrist helping me. (my previous one was so, so awful. I despised him.)

    Sorry for long, unedited post. I can't stop writing (or talking) when I'm like this. Before this, I just wrote a 1,000 word letter about something unrelated in only 45 minutes. I look over it tomorrow and see if it's coherent.
    - adhdogwalker, 6 years ago
  • I have been taking Lamictal for about 3 months and have only managed to titrate up to 75mg. It took me several weeks to adjust to even 25 mg. as it caused severe inattention and anxiety (despite the fact that I take 90-100mg. of adderall a day- it relieves both & doesn't exacerbate my cycling). Every time I increase the dose, these side effects reappear. I also have severe problems with word recall and working memory. I am a dogwalker and my day involves a tremendous amount of organization which is extremely difficult for me even medicated. When I increase my Lamictal, I have to carry pen and paper with me and immediately write down whatever I need to remember, or it will vanish within 15 seconds. I also text message it to myself and ask my clients to leave reminder post-its. Even then, I space out in the middle of doing something and frantically try to figure out what I'm doing. Total disaster. I write a lot as well and it definitely causes problems with word recall. I awoke one morning with the words "alacrity" and "paroxysm" as my first thoughts. I spent the entire morning meditating upon their significance. Later that afternoon, I tried to recall them. No matter what I did, I couldn't, I made an exhaustive list of every word beginning with "a" and "p" that popped into my mind because I figured I would recognize the words if I saw them. Nothing. The next day, I was thinking of the previous morning and the words flashed into my mind. However, had I tried to recall them, I doubt I would have been able to. I wrote them down immediately and haven't lost them since. Weird.

    My psychiatrist and I are still trying with the Lamictal, I probably would have titrated up more by now, but I spring mania started setting in after a psychotic episode at the end of March. In a flash of manic wisdom, I decided my life was boring on meds and stopped taking them. I was on Seroquel as well, but it caused hyperprolactinemia so I had to stop taking all but small quantities. I work outside, no matter the weather and it poses a significant risk for heatstroke so it would be too risky for me too take in summer months.

    I'm back on meds now as the mania still rockets onward and it devolved into severe agitation, irritibility, hostility and paralyzing anxiety. I came dangerously close to harming myself or others and barely managed to avoid the psych ward.

    I have experienced rare and intolerable side effects from a bunch of meds, and can't take any atypical antipsychotics at all. Seroquel was great-- I didn't gain any weight, was focused, organized and could remember things easily. However, at 500mg., it did not stabilize my mood. I am now taking Depakote, Lamictal, Seroquel (50-100mg), Adderall and Xanax (I hate it-- gives me "pockets of amnesia"). Unfortunately, I can't tell I take anything at all and I haven't slept more than 2-3 hrs. a night all week- courtesy of seroquel & xanax combo). I'm going to the psychiatrist again tomorrow to see what other options I have.

    My moods follow an exact cyclical pattern (to the week- scary), every year for the past 10 years that I've kept a journal. I think my bipolar started in elementary school as I was severely suicidal in 5th grade and most of my childhood was a big, long mixed episode). The inability to function and the psychotic episodes did not start until I was 19. I am 31 and was diagnosed about a year ago. I managed to survive all these years, barely, but did lots of crazy things along the way. Sadly, I was a top student in high school, went to William&Mary, dropped out, went to UC Berkely, then Columbia University (so, so many medical withdrawals) and never finished even though I had a 3.7 GPA. I would like to go back and complete the year I have left, but I can barely handle the stress of existing and with the added pressure of school, I will lose it completely, yet again.

    I don't truly know what it's like to be stable since I never have been. However, I would not be willing to sacrifice my intellect and creative/artistic abilities in the process. Although I have been severely suicidal, I have never spent more than a month or so feeling that way, so I can't truly understand your predicament. I don't know if you've tried any other medications, but I would talk to your psychiatrist and see if he/she would be willing to help you find another combination that wouldn't force you to live in a mildly depressed fog.

    My psychiatrist is wonderful-- he fully understands that I would not want to feel flattened and appreciates my desire to not quash my creative capacities. He seems to possess a profound understanding of a person's desire not to want to sacrifice their talents for stability. We had a long, manic discussion about "One Flew Over the Cuckoo's Nest" last week. While I'm unlucky with meds (this is true of non-psychotropic ones as well), at least I have a talented psychiatrist helping me. (my previous one was so, so awful. I despised him.)

    Sorry for long, unedited post. I can't stop writing (or talking) when I'm like this. Before this, I just wrote a 1,000 word letter about something unrelated in only 45 minutes. I look over it tomorrow and see if it's coherent.

    I've taken Lamictal for around 3 or 4 year for epilepsy (275 2x a day, I prob stared at 200 or so), about a year and a half ago I was diagnoesed with ADHD and they added stimulants and to a certian extent they have helped where as the Lamictal didn't (even as it went from 200mg to 275mg over the years.)

    One other problem I have always had I have just decided to live with is memory trouble. It came up last week at my psycatrsit and he pointed out to me that Lamictal can cause major memory trouble and I might wana talk to my nuroligist about that -- could your memeory have anything to do with your attention?
    - Dhda88, 5 years ago
  • I quit Lamictal after a couple of years. I think it was pooping out on me but the side effects weren't. I'm on Abilify now and my mind is MUCH clearer!
    - notmADD, 5 years ago
  • Lamictal causes some Cognitive dulling....this is acceptable in just BP patients,,,um can cause some issues for us.

    I've taken Lamital for about 9 months now, and I have seen major improvements. I used to drink a lot, but I was not a traditional alcoholic. I was familar with drugs, but that went away after having kids. I drank rarely, used it as a coping mechanism, and to self medicate to "slow my mind down." But it was a problem. When I started drinking I could not stop, and sometimes found my self at a poker table at 4 am wondering how the hell I got there. Needless to say, my wife was not thrilled about this nor was I. Apparently, I'm *slightly* bi-polar, whatever that means. Regardless, the craving and impulsive behavior has nearly vanished, so I'm reluctant to stop the medication. But my "cognitive dulling" has become a serious issue.

    I'm preparing for graduate school, and while I was an excellent student in undergrad, I've been struggling cognitively. I suspected it was the lamical since nothing in my life had change. In fact, one would assume you get smarter with age.

    I was recently prescribed adderall, and it has basically changed my life thus far. I am performing at a level I expect of myself, but I rarely sleep. I've been told this subsides with time.

    Anyhow, I asked my doctor about the "cognitive dulling" before I'd ever read any forum like this, and he referred to it as "very minor," but I'm in total disagreement. I have noted a drastic change. My mind is, for lack of a better description, "my pride and joy."

    Could you point me in the direction to academic articles or empirical studies back up the claim of "cognitive dulling"?

    Thanks
    - mdbutler71, 5 years ago
  • Anything? It would be best to PM me, since I'm not adept at finding each thread.
    - mdbutler71, 5 years ago
  • I went thru a severe cognitive crisis over a period of months: I think it was the result of beng on too many meds, and heavy ones, which counter-acted each other. One of them was Welbutrin/Buproprion which I insisted they find an aternative for. (Apparently, it can cause cognitive issues in a small number of people. ) Luckily, I met someone at the pharmacist's who went out on a limb while I was asking questions and admitted that he, too, had experienced this with Welbutrin. I would forgot things in 15-20 seconds. While I can be a little forgetful; during this time, I would lose info completely and be unable to "retrieve" it. I stopped retaining info; my brain flat-lined and became very dull and linear.

    Next, it was Lamictal (for cyclothymia). My psychiatrist never acknowledged that cognitive issues were a possibility with that either. I complained about cognitive issues for several months to no avail. During this time, she kept upping my dosage. After tons of research, trying alternative solutions, changing psychiatrists, a neurological evaluation and a brain biopsy: Finally, I am down to 50 mg of Lamictal and the difference since the titration has been tremendous. The worst of it is over but there is still a glitch or . two. I have uncovered so much about Lamictal and cognitive issues; issues that I have never heard addressed by physicians or psychiatrists. Most of this info, I discovered online. I take tons of Omega-3 to boost my brain and, when I can afford to, I see an herbalist and purchase teas that he makes for me.

    If I could find an alternative to the Lamictal I would. I recently started Vyvanse for the AD/HD (inattentive) and hope it works.
    - clinicallyari, 5 years ago
  • I cannot point you to academic articles/empirical studies but I can tell you that I experienced the same thing and it was severe. I am down to 50 mg of Lamictal (down from about 150-175 mg. I refused to go higher). The cognitive dulling, intellectual flat-lining, memory loss triad is not your imagination. If you must take Lamictal - I also experienced problems with Welbutrin/Buproprion - then be sure to take lots of Omega-3 and a daily vitamin.
    - clinicallyari, 5 years ago

Comment