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Ask Dr. Kaushik Your Own Question

Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 3997
Experience:  MD Psychiatry
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Re Lamictal

Customer Question

I have been taking lamictal for 8 months now. Initially, I sufferered from dizziness and anxiety with dose increases. I then seemed okay once I reached my therapeutic dose of 200mg. However, 2 months ago I developed stiffness in my neck and it hurt to turn my head to the right. I thought this may be due to sleeping in an awkward position and paid little attention to it. This symptom has become progressively worse over the past 5-6 weeks and my left shoulder and upper arm feel sore. These muscle aches and pains have spread to my upper back and between the shoulder blades. Infact, my whole body now feels tense. I have seen a chiropracter for some manipulation and massage which gives some temporary relief and am waiting to see a physio. I am also feeling irritible and exhausted and have been having crying spells. Saw my psychiatrist today and he wants to start duloxetine to help with the pain; he also thinks i am depressed. Could these symptoms be caused by the lamictal? Please help me.
Submitted: 5 years ago via Patientsville.
Category: Mental Health
Expert:  Dr. Kaushik replied 5 years ago.

Hi there,

 

Welcome to Just Answer !

 

Well, it must really have been a struggling period for you to endure , with the muscle aches , irritability , intemporate crying spells, and exhaustion , taking a toll on your health and routine lifestyle. I do not understand, the fact that why the doctors have refuted or neglected your symptoms when , these present symptoms of yours can very much be the result of Side effects of Lamictal ( lamotrigine) as well as lamictal being Ineffective , which has lead to depression ( as evident from intemporate crying spells, irritabilty , exhaustion, etc), as correctly pointed out by your doctor.

 

You see, lamictal 's common side effcts include muscle aches, generalized body aches, fatigue, irritability , dizziness, insomnia, cognitive and memory problems, etc and the fact that you have been placed on this drug since quite a long time , it makes a lot of sense to have such side effects as well as the drug becoming ineffective due to development of resistance of body against the lamictal , which is quite commonly seen in cases of mood stabilizers , as you must have experienced earlier , in case of depakote . You being a case of bipolar disorder , are more likely to end up being depressed , if the mood stabilizers such as lamictal is not working to the best of its ability and hence what we have currently is a depressed state . So, although i do not appreciate your doctor neglecting the typical side effects of lamictal , but , i agree with him that you are in a state of depression and also that duloxetine ,a fairly good anti depressant would be a good option for you. And , besides starting you on Duloxetine , i would suggest that Lamictal should be stopped and instead of it, you should be started with other tried and tested mood stabilizers such as Lithium or Valproate , and let me also mention here that addition of these mood stabilizers becomes essential in a diagnoses of bipolar disorder to prevent any future episode of Hypomania , which may get precipitated on its own , or due to the use of anti depressant , thus making mood stabilizers a mainstay of the treatment for Bipolar disorder.

 

So, i would suggest that you ask your doctor to replace Lamictal as soon as possible with another good mood stabilizer such as Lithium or Valproate and along with this change , also start you on Duloxetine ,which would take care of the depressive mood.

I am quite sure that his new combination would take care of your symptoms and would alleviate your mucle aches once for and all.

 

I wish you rapid recovery to the best of health.

 

I hope my answer serves your query according to your satisfaction .

 

Regards...

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