Lamictal and Abilify: Back on Medication

Images from rxlist.com & drugs.com

After 2 years of not being on medication, I am back to a daily regimen of lamotrigine (Lamictal) and aripiprazole (Abilify) with lorazepam (Ativan) as needed.

Many of you may know, or may not know, what I decided to taper off of medication so that I could get pregnant. Well, that hasn’t happened. And my thoughts got to a point where it became life and death again. I didn’t want to go back to the psych hospital so I asked my psychiatrist for help.

My psychiatrist (God bless him) is a very conservative psychiatrist. He was the one who helped me off of medication 2 years ago, and he’s the one titrating my dosages up now. Lamotrigine is for long-term maintenance of the bipolar disorder, aripiprazole is for short-term maintenance of bipolar disorder and SAD (seasonal affective disorder), and lorazepam assists with severe anxiety as needed. I started taking the medication four weeks ago, and I’m only on 50 mg of lamotrigine and 5 mg of Abilify. There will be no increase on Abilify and I titrate up on lamotrigine every 2 weeks. My next big jump is 100 mg.

My psychiatrist expects me to come off of aripiprazole within the next few months (hopefully by December). If not, I will have to get regular blood sugar and cholesterol tests performed. He will adjust all medications as necessary in the event that I am pregnant. He’s a great psychiatrist; he’s willing to work with me based on my situation rather than him throwing drugs at me. He allows me to have complete control over my treatment regimen, which is something I like and respect.

In the past, I may have come off as anti-medication, but really, I’m not. I advocate for use of medication in a necessary, responsible manner. In 2010, 253 million prescriptions were written for antidepressants.¹ (Keep in mind that the U.S. is estimated to have 307 million people in the country.² That’s about 82.4% of the population taking antidepressants.) This is not responsible; this is too much. In the comments, people have rightly corrected me in the assumption that 1 person can get multiple prescriptions in a year; I failed to remember that.

Let’s assume a person is on 1 antidepressant (the majority of people take 1). Beginning in January, that person gets 5 refills for 30 days. By May, the person will need another 5 refills. Then another prescription is dispensed in October. That’s 3 prescriptions per person. Of course, this can vary depending on how often the doctor will see a patient so let’s generalize and say 5 prescriptions per person per year. My calculations for prescriptions per American mean that nearly 20 percent (about 17%) of the population is on antidepressants. Sure, it’s not my original ridiculous number of 82.4%, but I still think this is pretty high. (By the way, feel free to correct my stats in the comments if necessary; I don’t claim to be a math wizard.)

While I am not on an antidepressant, I am one of the millions of Americans who is on medication for mental illness. For 2 years, honestly, I’d forgotten I had anything relating to mental illness. It was nice to wake up and be myself without thinking about me plus bipolar disorder. Every morning and every evening, it’s now me plus bipolar disorder plus SAD plus anxiety. These are all real symptoms that need to be managed. I don’t want to be dependent on this medication forever, but I may have to. If it helps me manage my suicidal thoughts and function with people in life, then it’s worth it.

Your turn: What do you think about taking psychotropic medication? Do the symptoms outweigh the risks for you? What’s been your experience in taking (or not taking) psych meds?

Notes:

1. Shirley S. Wang, “Antidepressants Given More Widely,” The Wall Street Journal. Published on August 4, 2011. Available at: http://online.wsj.com/article/SB10001424053111903885604576486294087849246.html. Accessed October 20, 2011.
2. Google Public Data Explorer. Population in the U.S. Last updated: July 28, 2011. Available at: http://www.google.com/publicdata/explore?ds=kf7tgg1uo9ude_&met_y=population&tdim=true&dl=en&hl=en&q=us+population. Accessed October 20, 2011.

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19 Comments

  1. Rick said,

    October 20, 2011 at 10:44 am

    It’s good to know you’re taking care of it the way you and your doctor feel is the best for you. There are unhealthy points at either end of the spectrum: Being unmedicated when it’s needed, and being medicated when it’s not.

    The combination you list here is actually a familiar one at my house, where we had a family member using it for a few years.

    • Kassi said,

      October 21, 2011 at 6:26 am

      Thanks, Rick. :)

  2. James Claims said,

    October 20, 2011 at 11:54 am

    I’m on a similar cocktail of lamictal, abilify, klonopin, and xanax. I’ve had decent success with lamictal, though now I’m reevaluating its potency, but abilify has done wonders for me. In general, having BP1 means that I have a deadly disease, one that I’ve found that I cannot fight on my own. An considering that it worsens as I get older, I need to stay in the fight against it early. So in terms of taking the risks versus the rewards, while I balance the symptoms, I’ve definitely taken a riskier approach and been very aggressive with finding new medications to take and CBT approaches to manage my symptoms.

    I hope to hear that a similar cocktail works for you, SAD is nasty, but thankfully predictable.

  3. Laura said,

    October 20, 2011 at 4:03 pm

    I think it’s worth noting that each prescription written doesn’t represent an individual on antidepressants. My psychiatrist is in the habit of writing prescriptions that only come with two refills–that way patients have to check in often and stay connected with her. I got six prescriptions in the last year. That’s six write ups for one person. I think a lot of MDs work this way.

    I also think it’s worth noting that a lot of people get prescriptions for antidepressants and then never fill them. Or they fill them and then never take them. And nobody knows how many of the Rx are being written for off label use (i.e. Cymbalta is frequently prescribed for fibromyalgia.) It’s so hard to figure out exactly how many folks are a on given medication at a time.

    Good for you for doing the right thing for you! I think you are such a good example of making informed and self-aware choices. It sounds like your psychiatrist is a gem :)

  4. ANN T LYES said,

    October 20, 2011 at 7:56 pm

    Regardless of belief a psychiatrist actually helps the anyone with an instability, theres the reality of which is the ‘helping you ‘believe’ youre in need of chemicals/toxins/synthetics/animaldna to ‘treat’ an ‘illness’ that you are told you have.

    I do not mean you are not with problems, i do not know how severe, nor why you are unhappy/anxious/unstable, its not my place to know.
    Id be happy to know you were happy of course, i never wish any harm nor sadness on the anyone.

    I do have a lot of experience of medicinal science both as a person still attempting to withdraw from Venlafaxine Hydrochloride xl/Efexor XR, after ten yrs on, and also as i am now a ‘medicinal reaction researcher’ to which has only opened my eyes to pHARMa agendas/clinical evidence -altering trial results/failing to disclose full adverse reaction data (pre and post market, to which only if and when a fatality/seriously harmful rate reaches a ‘media noted problem, will the truth trickle out by force ).

    Even if you feel the chemicals work for you? Thats the placebo effect anyway, you ‘feel’ they work because youre told they will help and you believe you need them.

    No one needs chemicals no one needs drugging of their brain, drugs ‘will’ eventually destroy the natural neurotransmitters, pump way too much synthetic alien created defective serotonin into the most delicate and complex part of the entire body, and that of what makes you who you are, personality/character/emotion and the entirety of the self.

    The brain confuses what messages it is sending out (hence abnormal reactions that are side effects to which may or may not be recognized as connected to drug? But the worsening fact is those reactions will become brain stuck to ever repeat even when drug is no longer ingested.

    Medicinal science is not so advanced as its always claiming to be, its not at all in an understanding of brain mechanisms, there is no solid physical evidence to support any brain directing drug nor illness to medicate.

    The potenial harm and mental deterioration is tenfold to any long term theraputic value, its not hard to see this, considering drugs are drugs regardless of prescriptive legality.

    Furthermore mental illness/disorder/dysfunction/disease etc is a big lie, what is mental disorder? Some say anxiety or depression but these are emotions that we all face, maybe one person can cope better than another? Maybe a person is luckier to have a big loving supportive family? Whatever the maybe? The facts are we all face losing heart, utter despair/self loathing/rage/ enoughs enough etc etc,

    the drugs are both the cause of and continuation of much of the damage we see today, Autism, downs syndrome, its easy to recognise the thalidimide damage but mental generation damage is easier to disguise via the unseeable damage in an infant.

    Drugs given, whether 100yrs, 50yrs, 10yrs ago, that were are injected as vaccines or vitimin supplements in any bloodstream effects both sperm and ovum, the child may be damaged instantly or develop a ‘condition’ later in life? However the result? The drugging throughout school life and mmrs/flu jabs etc wll only cause the all known yet unatural cancers people die of said to be from smoking or genetic.

    Cancer is being grown with each drug that is toxic to an otherwise healthy immune system, the evidence is widespread but no one sees nor wants to see the medicinal killing/defecting/damaging reality. Those Drs and Biochemists who speak out in concern or provide evidence of drug abuse via pharma patient creating, get derogatorized, severely bullied, get demoted lose job and are hounded, brutally enforced to retract any statements and even driven to nervous breakdowns themselves. The industry thrives on patients, so any Dr to jepordise a patient to earn from is an enemy.

    a patient cured wold be a loss of good profit

    my aim in life is to spread the truth that is there to both see and evidently reason any of todays claims to new illness .

    Swine flu, bird flu, sars, mrsa, even aids are lab created, note they start elsewhere and spread slowly across western countries, retrace the original steps of any such disease from the initial reaction in UK/USA and youl have a third world country visitor or ‘mandatory jab’ its a tactic that only reveals itself alot later so unless youre looking you wont find.

    Sorry i hate to go on just desperate to get the truth out, its a cruel evil industry that even takes its name from Greek ‘Pharmakos’ to mean ‘witchery’ ‘deceptive perception’ ‘ its the alchemic wisdom as also in Egyptians PHARoh whom loved alchemic potions/hallucinagens etc.
    Please go find this out for yourself, go deep into archives a freedom of information is a right delve into the corners within the deep web databases via ‘infomine’ ‘complete planet deep web search’ go find out about the drug/s you have in you.

    And me, i wil always have a hope anyone anywhere is healthy happy and always

  5. October 21, 2011 at 11:07 am

    I’m not exactly sure how I feel. I had anti-depressants once but now I try to stick to more natural remedies like working out, eating right, magnesium, 5-htp, light therapy, etc. When I came off of the anti-depressants, I had very vivid and violent dreams. I wasn’t one to have nightmares at all. Now I have them every now and then and it’s really frustrating. :(

  6. Daniel B said,

    October 21, 2011 at 1:55 pm

    I’m quite happy with my current medication for Bipolar I disorder. It flattens out my moods, so that my extremes aren’t quite as bad. I have a few side-effects, the main one being that my memory is a little shaky and I have trouble recognizing faces, but it’s worth it not to be blowing up on people in bookstores.

    I’m currently using valproic acid, which is the one I’m happy with. I was on lithium before, but I didn’t like the side-effects, so I asked about switching and I did. They seem to work about the same.

    I have had a terrible experience with anti-depressants, though. Aside from Wellbutrin, every single one of them had some kind of terrible reaction for me.

    Of course, that’s just me. Everyone responds to different medications differently, but I’m happy with my current meds.

  7. Rick said,

    October 21, 2011 at 9:32 pm

    Ann, you’re commenting on a blogger whose research into psychopharmaceuticals rivals that of many medical professionals. From your comment, it’s obvious that you haven’t gone back to read her 5+ years worth of content on the subject. I think you owe her at least that much before posting such a long, baseless response.

  8. Cicely said,

    October 23, 2011 at 2:45 pm

    I’ve been on Lamictal for about a year now and it is the best decision I ever made. I’m worried right now because I’m starting to have symptoms and have capped off at the highest dosage. I do not want to take anything else because I have no side effects from Lamictal and that is a blessing.

  9. manveri said,

    October 29, 2011 at 2:19 pm

    I’ve stumbled on your blog recently and find it very interesting, and thought-provoking. I’m currently on a cocktail of less-potent drugs for depression and anxiety–Wellbutrin, Zoloft and Xanax, with a supply of Remeron on the side for as-needed use (mostly because of its side-effect of increasing the appetite–I tend to react to stress by losing my appetite and have trouble maintaining a healthy body weight.) I was on Cymbalta at one time, but it suppressed my appetite and also made me feel mentally “fuzzy,” for lack of a better word–I felt considerably less anxious but also completely unmotivated and unfocused on anything. Anti-anxiety meds in general seem to do that to me–Zoloft also had a similar effect when I was on a higher dosage. For that reason I resisted taking a tranquilizer like Xanax for a long time, but a new psychiatrist convinced me to give it a try and to my surprise, it’s had almost the opposite effect; not only do I feel much less anxious than I did before, my productivity has skyrocketed. (Could still be better, but part of that is re-forming lost work habits.) I now hope to gradually wean myself off Zoloft altogether–I’m already at a low dosage–but it’s tricky because I’ve just moved to another country for a year and so I’m not currently in consultation with any doctors, and I’m not sure adjusting to a long-distance move is the best time to mess with anything anyway. Still, it feels redundant with the Xanax and I hate to be on a medication that’s unneeded. (Any thoughts?)

    In answer to the original question, going on the medications was probably one of the best decisions I ever made. Severe depression, anxiety, bipolar disorder and various related problems run in my family on both sides, and I probably should have started on antidepressants in high school, but I resisted until well into college for similar reasons to those you mentioned above; I didn’t want to confront the fact, every morning, that I was now officially no longer “normal” and was now someone with a “disorder.” After a number of nervous breakdowns my mother basically twisted my arm into going to at least talk to a psychiatrist, and I’m now very grateful to her for it. It was a struggle for a long time, though, because the very fact of being on meds was indeed a major blow to the self-esteem even while it became clear that I functioned much better with them as long as I could forget I was taking them.

    Ultimately I think that’s where counseling comes in–different doctors have all told me that psychiatric patients generally don’t recover enough to go off medication _unless_ the meds are accompanied by good counseling. Ultimately they really do only manage the symptoms, not the underlying problems. Sometimes, like with physical disorders like diabetes, managing the symptoms is the best you can hope for, but why stop there when there’s more you can at least try out? I went to a few different counselors before I found a good one, but meeting with her has helped me reach a point where I’m now, at least, okay with myself as I am, even on meds, and I’ve started to deal with several other long-term issues that were affecting how I think. I’m very optimistic that within the next few years I may be able to go off the meds altogether. Maybe this optimism is misplaced, but then again, maybe not.

  10. November 1, 2011 at 11:20 am

    Why can’t it be what works for you, as an individual. Maybe they are over-prescribed, and that’s not a statistical inaccuracy, but if I feel better, more myself, without my mental illness, then that’s up to me. It’s also up to me if I decide, like you did, that taking them right now isn’t a good idea.

    I have to say that it wasn’t until I was actually diagnosed and prescribed anti-depressants that I learned to cope effectively. It worked for me.

  11. Amtheyst said,

    November 4, 2011 at 4:19 am

    I cant live without my medication. I did try stopping once but became suidal

  12. Meghan said,

    November 6, 2011 at 5:09 pm

    I spent a very, very long time avoiding medication. As I look back on it, a lot of it was based on the same self-punishing thinking that drove my depression: I was smart and living a pretty good life and should have been able to pull myself out of the darkness without meds. I now find myself reminding people in similar situations that it’s virtually impossible to fix your brain when the problem is in your brain.

    I recently started taking Celexa for depression. My partner has bipolar disorder and has spent a number of years adjusting his meds to find a combination that alleviates symptoms without interfering with his life and personality. I still don’t think that medication is necessarily the first line of defense, but I do think it’s an incredibly powerful weapon that shouldn’t be rejected out of hand.

    It seems like there’s a new stigma in mental health: if it’s not judgment from “healthy” people it’s judgment within the community about treatment. Some things will work well for some people and not for others, and I really think that we’re all better served by expanding our tolerance to allow each person to find the treatment that gets them where they need to be. Brains are incredibly complex and weird and poorly understood. There are probably as many treatments that work as there are brains that need tweaking.

  13. CT said,

    November 7, 2011 at 11:45 am

    I’m new to this blog. This may have already been talked about elsewhere, excuse me for the repeat if so. I have been diagnosed with Bipolar 2 and placed on 400mg of Lamictal. I am planning to come off of the drug and I was never confident enough to do that in the past, but I’m now eating a “diet” that I think helps lessen the mood swings. My husband and I are eating Paleo (meats, vegetables, and fruits, no preservatives or gluten) and I’ve already started feeling a lot better (I would still have minor mood shifts even on the Lamictal). Has anyone else on here tried or looked into changing how they eat? That could be a cause in the increase of medications being prescribed. Just a thought.

  14. November 12, 2011 at 9:06 am

    My 17 year old son has just been recently diagnosed w/major depression. It explains headaches, stomache aches, isolation, and not taking part in things he used to enjoy. Until now, I didn’t know that it can also cause irritability and aggression. He is bigger and stronger than me and he scared me earlier today. I was in tears after he stormed upstairs and started punching and throwing things. All because I asked him to get off of a computer game. My husband had to come home from work early because I didn’t feel safe. I guess it’s time to taper up to 100 mg. of Zoloft. If it doesn’t work I don’t know what else to do……….

  15. burnouter said,

    November 21, 2011 at 11:42 am

    hi. i just found your blog via google. i’ve been diagnosed the burnout syndrome a couple of weeks ago and started writing an online diary about it: http://burning-noticed.blogspot.com. the more i deal with this illness the more i feel like actually being depressed. now my doctor asked me at the very beginning if i wanted medication and i said no but i didn’t really know anything about it. now i can’t stop wondering if it would help me with my fears and sadness? do you feel it is helping you?
    thanks for your honesty btw…

    • Kassi said,

      November 21, 2011 at 1:06 pm

      Personally, I believe the medication is helping me. But it is different for every individual. I have found that other medications have an adverse effect on me. If you are having trouble, you should probably consult your doctor.

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  17. June 27, 2014 at 8:06 am

    […] postpartum hormonal changes with Xanax (alprazolam) as needed to target the intense panic attacks. Abilify (aripiprazole) and Lamictal (lamotrigine) are mood stabilizers for my bipolar disorder to help prevent the excessive mood swings I […]


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