So you are still feeling irritable and agitated?
That is unfortunate, I still think it is the Lamictal causing the irritability and agitation, since that was the newest medication added before these symptoms started. You can increase the Wellbutrin to see if it helps with the irritability and agitation.
You can go as high as 300mg of the Wellbutrin, but I would suggest going to 200mg to start with and see if that makes a difference.
You can go to 300mg with those tablets. You cannot split the extended release tablets as that harms the efficacy of the extended release function in them. This should help lower your agitation and irritability within a couple weeks.
300mg is typically the target dosage for depression
Also I just want to ask because I do not believe I asked last time we spoke, but are you drinking alcohol at all?
Wellbutrin will help with anxiety that is associated with your depressive symptoms. Anxiety and depression are commonly seen together, so Wellbutrin can be effective in this regard.
Okay, well that is not enough to cause this long term feeling agitation and irritability you have been having. But alcohol and wellbutrin mixed together do cause some adverse effects, like agitation, so I just want you t be aware of that.
Thats true it definitely does not help with depression, but I also wanted you to know that it does not mix well with the Wellbutrin too.
But once or twice a month does not account for your symptoms, I just wanted to make sure
No, I would advise not to drink at all while on the Wellbutrin. In addition to the agitation symptoms, these other side effects can happen if taking alcohol while using Wellbutrin; seizures, hallucinations, delusions, paranoia, mood and behavioral changes, depression, suicidal thoughts, anxiety, and panic attacks.
Wellbutrin can be sensitive to alcohol use, if you must drink though, I would say no more than one drink once or twice a month.
I would leave the Lamictal as it is right now, but if the increase of Wellbutrin has no effect in at most 4 weeks, then you may have to reduce the Lamictal to 200mg, which should lower any agitation or irritability, but may effect your resistant depressive symptoms too. This is why lets see what increasing the Wellbutrin would do first because I do not want to lower the Lamictal as that is an effective medication for resistant depression.
You also told me that you would see your primary care doctor in 2 weeks last time we spoke, has that happened yet or not?
I remembered you having that conversation with him and I agreed that agitation is not usually a symptom with it, but it can be a very rare adverse effect.
Oh wow, October 3rd, that is a while away. But there is anecdotal information out there of increased agitation associated with Lamictal at higher doses, so this has occurred to other people as well. I am hoping the Wellbutrin can lower it for you.
I think raising the Lamictal does help with depressive symptoms a lot, but I think it may increase your agitation and irritability as well. Now there is a possibility that this irritability and agitation is associated with your depression, as these are symptoms of depression, but I do not think so because you have no other depressive symptoms that you have told me about. Also increasing the Wellbutrin first is a safer route then the Lamictal because the Lamictal is a stronger medication with more serious side effects.
Low energy is definitely a symptom of depression as well, so these symptoms may be caused by your resistant depression and increasing the Lamictal may help. But I would still go with the increased Wellbutrin first to see if this helps as this is a more conservative route, with less chance of side effects.
Well the biggest concern is always with the skin rashes associated with the lamictal and this risk increases as you increase the dosage. But also irritability is a side effect that can occur as well at increased dosages, although this is not as common. Here are a list of all the known side effects of the Lamictal.
That is really good and you probably will tolerate an increase in Lamictal. But since I am not your primary care doctor, I think you should only increase your medication with your primary care doctor's knowledge as I said this is a strong medication, so that is why I would wait until Oct. 3rd if your symptoms of agitation or irritability have not been resolved yet to discuss increasing the Lamictal.
Since agitation is not a well known side effect of Lamictal, there really is not timeline. I just remember you telling me that your agitation increased when you increased the dosage of the Lamictal and you were concerned about the increase of the combination with the Wellbutrin
So usually since your agitation started as you increased your Lamictal, that is suggesting that the Lamictal caused this
The increase in Wellbutrin should also help with the depressive symptoms as well, so if this irritability and agitation is associated with your depression then the increase in Wellbutrin should have an impact either way.
Anytime, I am always happy to help. I hope it all works out well for you. My goal is to provide you with excellent service, so if you ever have any further questions or concerns please do not hesitate to contact me at anytime.