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Dr. Vikas
Dr. Vikas, Psychiatrist
Category: Mental Health
Satisfied Customers: 2251
Experience:  MBBS ; M.D Psychiatry, MS. Health Informatics
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How long before trileptal poops out? And what about Lamictal?

Resolved Question:

How long before trileptal poops out? And what about Lamictal? Does lamictal generally poop out too?
Submitted: 4 years ago.
Category: Mental Health
Expert:  Dr. Vikas replied 4 years ago.
Hello

Some patient who have an initial response after starting trileptal may relapse even though while continuing treatment which is called as "poop out". There is no strict time duration and it may happen within weeks to months or even after a few years.

This can happen with any medicine including Lamictal.

In all such cases, the usual strategy is to either increase the dose if not already maximum or to augment the previous medicine with some other medicine with a different mechanism of action.

I hope this helps.

Please feel free to ask any other related query.

Regards

Vikas
Customer: replied 4 years ago.

Dr. Vikas, what percentage of people experience poop out with lamictal? 10 per cent? 50 per cent? Is there a reasonable chance that it may work for me for the rest of my life? And how effective is it for anxiety?

I was deeply disappointed when my trileptal pooped out on me after 4 months...? Does this make it more likely that I'm likely to experience poop out on lamictal too?

And are there other drugs similar to trileptal and lamictal that will be available to people like me in the near future?

Finally, I was hospitalized in 2003 with major depression, and I went through 8 or 9 treatments of ECT to recover from it...Thankfully, it worked!! It was a very scary and harrowing experience for me though...If my medications keep pooping out on me, would you recommend outpatient maintenance ECT? And have there been advances in ECT since 2003 that would make my experience less terrifying? Please advise...Thank you...!! John Boesky ( I will happily pay you as soon as you answer these questions for me...)

Customer: replied 4 years ago.
Relist: Incomplete answer.
Expert:  Dr. Vikas replied 4 years ago.
Hello John,

Please accept my apology for the delay in replying.

What percentage of people experience poop out with lamictal? 10 per cent? 50 per cent? Is there a reasonable chance that it may work for me for the rest of my life? And how effective is it for anxiety? -- As I mentioned earlier it is impossible to predict which patient will poop out but on the basis of our clinical experience roughly 10 -30 % may initially show response followed by "poop out". Again there is no guarantee that this medicine will work for life time (assuming that you will be needing a life long treatment which should not be the case as we usually stop treatment within 1-3 years if a patient is asymptomatic for a significant period of time). Lamictal is not very effective in controlling anxiety in my view. For controlling anxiety, antidepressants are a much better choice and antianxiety medicines such as Alprazolam / Clonazepam can be taken on as and when needed to provide quick relief.

And are there other drugs similar to trileptal and lamictal that will be available to people like me in the near future? - There are several medicines which are under trial and hopefully there may be an effective medicine very soon for treating depression. Until and unless they are in the market and have been used by patients in real life we can't say from when they will be available.

Finally, I was hospitalized in 2003 with major depression, and I went through 8 or 9 treatments of ECT to recover from it...Thankfully, it worked!! It was a very scary and harrowing experience for me though...If my medications keep pooping out on me, would you recommend outpatient maintenance ECT? And have there been advances in ECT since 2003 that would make my experience less terrifying? - We usually advice ECT only in severe cases of depression with suicidal ideas or depression which is not responding to medicine and psychotherapy, so, if you are not responding to medicines and getting benefit from ECT, maintenance ECT can be a good option in your case. I don't think there are any significant advances in the ECT treatment recently and it is the same as before.

If you have not tried before, you can also consider the option of trying Cognitive Behavior Therapy in addition to medicines.

What is Cognitive Behavioural Therapy?

Kind regards

Vikas
Customer: replied 4 years ago.

Dr. Vikas,

Thank you so much for your answers thus far...!! You've been very informative...

Fortuntately, the lamictal has been helping me feel more at ease and considerably less anxious, as did the trileptal before that...( The trileptal pooped out on me)...

I'm titrating down on the trileptal because its no longer effective...Is it possible that the Trileptal can benefit me again a few months after I've stopped taking it... If so, when? 3 months after discontuing it? a year? Perhaps I can use Trileptal then on an as needed basis in lieu of a benzodiazipine...Might this be possible?

Unfortunately, I've had debilitating major depression and anxiety on and off since I was an adolescent...I'm 40 years old now...I'm happy to take Lamictal for the rest of my life, since its likely that my depression and anxiety will return without medication...

This has always been the case...Therefore, discontinuing the medication after a year or two of relief makes no sense to me...

If roughly 10% to 30% of clients experience poop out, does this mean there's at lease a 50% chance that I may benefit from Lamictal for many years to come? Or for the rest of my life?

ps: I'm new to this site...I presume that I am to make my payment as soon as all of my questions have been answered, no? I just want to reassure you that I fully intend to pay you for your time and expertise as soon as my last few questions are answered...

Sincerely,

John

Expert:  Dr. Vikas replied 4 years ago.
Hello John,

If Trileptal is not effective now, you can again try this medicine may be after 6-8 months and see if it is effective or not but you can't use it on as and when need basis just like Benzodiazepines.

Yes, you may use Lamictal for long period if you find it useful. Some of our patients are taking this medicine for more than a year without noticing any decrease in its effects so may by you can also use it for a long time.

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