Question: I need to determine if I am going to keep Lamictal in my regimen. Been on it 14 years...it was added to celexa when celexa started to give me a driving urge to drink and take drugs. The immediate effect was one of motivation, less social anxiety, interpersonal confidence, and more self-agency.

Eventually I recognized the drug was increasing racy ruminations, like a constant background "narration" of what I was seeing, experiencing, feeling, deciding, thinking. Cognitively it created a lot of problems, and the racing ruminations interfered with intimate and sexual relationships. It made sleep difficult, produced headache, neck and esophageal spasms.

Over time the ruminations became extremely negative and paranoid, and the cognitive problems worsened shortly after I took me lamictal dose. I would lash out in hypercritical ways of everything I saw and/or turn inwards and make me feel persecuted and unwelcome. I was getting yearly rashes that resembled scabies. When I switched from the generic to brand name lamictal, I felt quite manic, chatty, almost inappropriate. Physical problems would return also.

A doctor took me off the celexa altogether several years ago. My brain raced a lot less and became more calm, but depression, lack of motivation, and social anxiety returned bad after discontinuation. The lamictal did help with the depression, but that background ruminating feeling of being persecuted and unwelcome on planet earth were less pronounced but didn't go away, nor did the cognitive problems. My thoughts felt increasingly fractured and strange.

Trying to wean off Lamictal would create depressive symptoms and WORSEN the cognition.

Since then I returned to antidepressants (effexor with stimulant, and later all three MAOIs) with somewhat similar effects from the lamictal. I'm not sure if the paranoid ruminations are an effect of increased dopamine, serotonin, or NE, or in some combination with the Lamictal. They did get worse during this time. During my break between effexor and MAOIs the free-floating paranoia lessened, especially when I am alone. They became constant again during the MAOIs. Trileptal and gabapentin helped and made me feel more open, but really impaired cognition. Throughout all this I am still taking Lamictal.

In weaning off the Nardil now, my morning dose is 15-30 mgs of nardil, 50mgs Modafinil, and 100 mgs of Lamictal. The combo helps the worsening morning depression but really creates zoney confusion until I take .125mgs of klonopin. Then I crash after lunch and need ritalin for the sedation, mood drop, and apathy.

Today I staggered the morning pills to find what is responsible for the zoned out cognitive state. The modafinil and nardil (taken at once) improved mood but I had a total lack of confidence with clients until I took the Lamictal...THEN I got zoned and confused...until taking the klonopin. I was left with the a big spike in motivation until lunch. I did start ruminating out in public, judging my actions and the intentions, thoughts of everyone around me.

In the last two days I have stopped taking an afternoon dose of Lamictal (25-50mgs) and the Unsettled paranoid feeling didn't kick in so much.

I'm not looking for you to solve ALL of my mental problems in this post, I just want to explore the role of Lamictal, how it is working with the other drugs, and how it works on the glutamate systems in case I add tianeptine or lyrica or low-dose naltrexone. The tianeptine increased the scary, zoned out feeling yesterday.

Additionally, can the the positive effects of motivation and confidence be replicated with another med without the side effects?

Thanks again.