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Can Ritalin be taken to reduce intrusive negative thoughts while on Lamictal?

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Posted on Wed, 16 Dec 2015
Question: I'm not sure if you can see our chat history but you were helpful this summer.

I've been having problems with a lot of intrusive suicidal thoughts combined with lack of motivation, low energy, irritability. It almost always comes about two hours after I take my morning meds (celexa 15mgs and lamictal 100 mgs)

I find on my current dose of lamictal this happens more frequently. It also tends to abate when I eat a full meal or drink a good amount of coffee, although I have a healthy diet and don't suffer low blood sugar.

Anyway, I found that the intrusive thoughts and lack of motivation, irritability, etc. disappears when I take a small amount of ritalin, like 5mgs of the extended release. I know some people are very anti-stimulant, but the amount is small. Also the side effects are a lot better than if I increased my SSRI or Lamictal.

Is this a workable solution in your opinion? I have never found myself abusing stimulants despite having perscription for them for years. I don't like the racy effect, although this dose I described is not racy.

Cheers
doctor
Answered by Dr. Seikhoo Bishnoi (11 hours later)
Brief Answer:
Low dose of stimulants are better options but don't increase the doses.

Detailed Answer:
Hello thanks for asking again, please excuse me for late reply

I can understand your doubts. People are not really against stimulants but as the stimulants cause subjective sense of well being and pleasure so they tend to increase the dose of the drug progressively. This results in dependence with time. Individuals also develop tolerance to the effects of stimulants like Ritalin.

But at the same time the drugs like Ritalin are very useful especially in increasing energy levels. So as long as you take the low doses of the drug then its fine. Try not to increase the dose please. Yes its a workable solution, this can even ameliorate the need to increase the dose of the drug.

Thanks, Still have more doubts or need clarifications please ask again.

Take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Seikhoo Bishnoi (9 hours later)
thank you very much for the opinion on ritalin. I will use it carefully and wisely.

Do you know why this lability may be happening? The depressive thoughts lasted all day yesterday until I had a high-carb meal and then ameliorated for a few hours and then came back. It seems to occur with any change in lamictal dosage if memory serves.

Just two weeks ago I worried that I was manic because I was having trouble keeping my thoughts to myself and felt a little euphoric. Now the depressive part. In the past month I have increased my celexa to 15mgs and changed the manufacturer of generic lamictal. I don't remember every having this kind of lability before taking the lamictal, which I have been on for 10 years now.

There is a lot of bipolar in my family but I've never been diagnosed.
doctor
Answered by Dr. Seikhoo Bishnoi (11 hours later)
Brief Answer:
Depressive disorders might also result in mood swings.

Detailed Answer:
Hello again and thanks for asking again

Mood swings are commonly observed in depressive disorders or in any mood disorder. Individuals mood might remain depressed and after some time they might feel euphoric. So this is occurring due to psychopathological process of depressive disorders. I don't think its bipolar disorder. Lamictal helps in mood stabilisation and is not the reason for these changes.

High carbohydrate meal results in mood improvement because carbohydrates are rich source of glucose and this helps in transport of amino acids in brain especially of tryptophan. Tryptophan is precursor of serotonin and improved serotonergic neurotransmission results in reduction of depressive symptoms. This is the reason you are feeling good with high carb meal. Basically high carbohydrate and high protein meal is best for depression.

Thanks, hope this helps. Please don't hesitate to ask more for more doubts.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Seikhoo Bishnoi

Psychiatrist

Practicing since :2007

Answered : 5187 Questions

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Can Ritalin be taken to reduce intrusive negative thoughts while on Lamictal?

Brief Answer: Low dose of stimulants are better options but don't increase the doses. Detailed Answer: Hello thanks for asking again, please excuse me for late reply I can understand your doubts. People are not really against stimulants but as the stimulants cause subjective sense of well being and pleasure so they tend to increase the dose of the drug progressively. This results in dependence with time. Individuals also develop tolerance to the effects of stimulants like Ritalin. But at the same time the drugs like Ritalin are very useful especially in increasing energy levels. So as long as you take the low doses of the drug then its fine. Try not to increase the dose please. Yes its a workable solution, this can even ameliorate the need to increase the dose of the drug. Thanks, Still have more doubts or need clarifications please ask again. Take care