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Author Topic: Latuda as monotherapy or adjunct, gotta love the merry-go-round  (Read 497 times)

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Online dannysmiles19

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So Latuda, any insight on this medication? Anti depressant therapy since 2012 for an undiagnosed bipolar, mood stabilizer Lamictal introduced to my treatment to control mood episodes, but I am in need of better maintenance therapy.

Maybe anti depressants aren't the drug of choice for my illness or maybe they are a key component, but latuda? what can Latuda do for me if I use it alone as monotherapy? and if I add it to an anti depressant, could my bipolar go into a remitted state? I need something for mixed states and lamictal isn't cutting the mustard for it. I know I'm mixed because I feel both ends of the spectrum to a degree.

Abilify IMO wasn't used to it's full potential when I was on it because of dosing. but maybe I need multiple mood stabilizing agents. Lamictal and Latuda? I just want my happiness

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Re: Latuda as monotherapy or adjunct, gotta love the merry-go-round
« Reply #1 on: July 15, 2014, 06:03:09 PM »
Maybe anti depressants aren't the drug of choice for my illness or maybe they are a key component, but latuda? what can Latuda do for me if I use it alone as monotherapy? and if I add it to an anti depressant, could my bipolar go into a remitted state? I need something for mixed states and lamictal isn't cutting the mustard for it. I know I'm mixed because I feel both ends of the spectrum to a degree.

I don't think Latuda will cut it on its own, but you might do better on it in combination with an antidepressant than with Lamictal. However, the only way to find out is to try it.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Online dannysmiles19

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Re: Latuda as monotherapy or adjunct, gotta love the merry-go-round
« Reply #2 on: July 17, 2014, 07:14:20 PM »
Does bipolar disorder have a true remission from symptoms?

I'm cycling in-between mixed, okay and depressed mood. Lamictal has the anti depressant properties right? and mood stabilizing properties but I guess the problem is either dosing or the effectiveness for my particular case.

I was on the phone with my psychiatrist and he said that Latuda is a powerful medication and lamictal is better than latuda. But I don't get it, so many love latuda but yet so many love lamictal. I'm continuing to suffer and Latuda has great reviews from so many people. I need something that is going to work on the depression end of the supposed bipolar and something that stabilizes me so I don't enter dangerous mixed states or a reckless hypomanic state. Latuda is an atypical antipsychotic right? Lamictal seems to be promoting hypomanic states as well...

I think I need a medication adjustment...and my doctor is what I call crappy in the sense that he isn't putting me on a good bipolar regiment to try. Lamictal just isn't cutting it because of the SSRI/SNRI mixed states and different moods.
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Re: Latuda as monotherapy or adjunct, gotta love the merry-go-round
« Reply #3 on: July 17, 2014, 08:09:25 PM »
Does bipolar disorder have a true remission from symptoms?

Bipolar can be very hard to treat because its two main expressions are polar opposites.

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I'm cycling in-between mixed, okay and depressed mood. Lamictal has the anti depressant properties right?

It can have, but not for everyone. It seems to help a subset of depressed patients, so much so that some doctors call it Lamactil Depression.

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I was on the phone with my psychiatrist and he said that Latuda is a powerful medication and lamictal is better than latuda. But I don't get it, so many love latuda but yet so many love lamictal.

Doctors are as much creatures of habit and subject to confirmation bias as the rest of us. They tend to stick with what they've most often had success with in the past, or at least what they think they've had success with.

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Latuda is an atypical antipsychotic right? Lamictal seems to be promoting hypomanic states as well...

Latuda is indeed an antipsychotic and Lamactil an anti seizure drug. While the labels may be interesting, they don't mean much. One may be better than the other in your case, but the labels won't tell you which. The only way to know is to try them.

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Lamictal just isn't cutting it because of the SSRI/SNRI mixed states and different moods.

If a med isn't working for you then there seems little point in taking it and it's time to try something else.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Online dannysmiles19

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Re: Latuda as monotherapy or adjunct, gotta love the merry-go-round
« Reply #4 on: July 19, 2014, 11:25:23 PM »
well you know what? it seems the pills I am on now are treating the underlying condition to a degree where I am surviving. I'm not living the life, I'm surviving the condition. And to me that is a miracle in itself. The lamictal has derailed the anger to an exceptional degree. The mania is controlled considerably, but not in contrast to what I said about it inducing hypomania. I have cycled despite lamictal. But the MDD portion of the bipolar has receded substantially. It hasn't been in a critical point for quite some time.

No psychiatrist up until the current one recognized the elusive bipolar II. They all said anxiety which led me to register on this site. I have researched mental illness since 2012, and I have learned that anti psychotic drugs are a key part of many people's treatment if anti seizure drugs aren't quite doing it. Am I right? Don't anti psychotic drugs treat the depressive part of the illness and have mood stabilizing properties that treat acute mania and prevent future episodes? Latuda sounds so promising to me, but so has every other medication... lol I do think that I need another or replacement mood stabilizing drug...that actually curtails the entire depressive end of the illness and eliminates mixed moods as well. "Remission" is what I am aiming at.

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Re: Latuda as monotherapy or adjunct, gotta love the merry-go-round
« Reply #5 on: August 13, 2014, 02:35:07 PM »
Insights, I've been given Latuda 20 milligrams. I've read (I know, reading too much into side effects is no good) that akathisia is a common side effect, which is quite serious. Akathisia has been associated with homicides and violent behavior.

So, he is tapering me off of cymbalta, no more anti depressants in the SSRI or SNRI class. Latuda is now the antidepressant and lamictal is serving as the stabilizer for hypomania. Latuda treats mixed moods as well, correct? And the withdrawals from cymbalta is going to be tough, he said 60 every other day and so on... so... any insight?
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Re: Latuda as monotherapy or adjunct, gotta love the merry-go-round
« Reply #6 on: August 13, 2014, 06:45:41 PM »
I've read (I know, reading too much into side effects is no good) that akathisia is a common side effect, which is quite serious.

In trials the latuda groups developed akathisia at twice the rate of the placebo groups. It is a potential side-effect but not a common one.

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Latuda is now the antidepressant and lamictal is serving as the stabilizer for hypomania. Latuda treats mixed moods as well, correct?

Yes, to some extent.

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And the withdrawals from cymbalta is going to be tough, he said 60 every other day and so on... so... any insight?

They can be. I'm not convinced that alternate days doses is the best way of doing it. It might be better to dissolve the med in a measured quantity of fruit juice (not grapefruit) and cut the dose this way. This is what the highly respected psychiatrist Steven M. Stahl recommends in his Essential Psychopharmacology: The Prescriber's Guide (4th ed.) which many consider to be the psych drug bible (see p 61) for the SNRI Pristiq which has the same issues as Cymbalta.As this will negate the slow release function, it would be better to divide the daily dose taking half about 12 hours apart.

Ian

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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Online dannysmiles19

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Re: Latuda as monotherapy or adjunct, gotta love the merry-go-round
« Reply #7 on: August 13, 2014, 10:16:05 PM »
So for bipolar patients, a cocktail is basically a given, right? So the Latuda being an atypical antipsychotic, treats bipolar depression but is it anti manic as well? You said Lamictal delays onsets of mood phases, but I hear that Lamictal is a prophylactic drug insofar that it keeps episodes from happening in contrast to lithium or klonopin etc. that treat acute mania.

I think it's great that I am now going to be on an anti-convulsion and antipsychotic because from what I have researched, it seems to be a more bipolar type combination. And from my personal experiences for the past two years, serotonin re-uptake drugs aggravate bipolar. I'm kinda putting in all of my hopes into latuda only because it is marketed for bipolar depression, even as monotherapy which is impressive...because bipolar really is an adjunct type of illness for many people.
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Re: Latuda as monotherapy or adjunct, gotta love the merry-go-round
« Reply #8 on: August 14, 2014, 02:12:09 AM »
So the Latuda being an atypical antipsychotic, treats bipolar depression but is it anti manic as well?

Maybe. There is good evidence that it works well for the depressive phase, but the data is less convincing for mania.

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You said Lamictal delays onsets of mood phases, but I hear that Lamictal is a prophylactic drug insofar that it keeps episodes from happening

It may or may not. Only trying it will determine how well you react to it.

Ian

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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Online dannysmiles19

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Re: Latuda as monotherapy or adjunct, gotta love the merry-go-round
« Reply #9 on: August 14, 2014, 07:15:53 PM »
Well thank you, how do you know so much about clinical trials? lol you're very insightful as I have said before. Is klonopin a good idea for long term hypomania treatment? or are the atypical AP's/anti seizure meds a better route? I have anger and mixed mood issues as I've mentioned. Klonopin works for anger?
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Re: Latuda as monotherapy or adjunct, gotta love the merry-go-round
« Reply #10 on: August 14, 2014, 08:08:36 PM »
how do you know so much about clinical trials?

I lead a dull, colourless and exceedingly boring life, so read a lot.  :winking0008:

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Is klonopin a good idea for long term hypomania treatment? or are the atypical AP's/anti seizure meds a better route?

Depends on how frequent and long-lived the hypo mania episodes are. If they occur infrequently and don't last for more than a couple of weeks then Klonopin would be as good as anything else and with fewer potential side-effects. But if they occur frequently or last longer then the other options may be better.

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Klonopin works for anger?

Maybe. It isn't a specific property, but it may help by lowering stress levels. If anger is a significant issue then the mood stabilizers would be better, though anger management training might be the best solution.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Online dannysmiles19

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Re: Latuda as monotherapy or adjunct, gotta love the merry-go-round
« Reply #11 on: August 17, 2014, 12:19:19 AM »
Ian, psychiatrists just don't serve me well. I have had some crap luck. I have to just stop believing labels. The doctor I had an intake with today didn't think I was bipolar and suspects just unipolar depression... this is so annoying. I thought I was bipolar...now I have to have the mentality that I'm unipolar.

I worry about it because of the treatment differences...but this doctor explained that lamictal and lithium and latuda can treat regular depression. But I'm so lost... I swear I experienced some kind of manic switching...i just don't know anymore. I guess from this point on I'm just gonna have the regular depression mentality again.

So this post wasn't all about that though lol He prescribed Brintellix and instructed me how to wean off cymbalta. brintellix isn't to be started until I get off cymbalta. he is keeping lamictal and said to take latuda at night... so what can I expect during this period possibly? any input? Weaning off cymbalta and simultaneously starting latuda... do you think I could still feel better during this period? I just want this to all be over 
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Re: Latuda as monotherapy or adjunct, gotta love the merry-go-round
« Reply #12 on: August 17, 2014, 02:40:46 AM »
I worry about it because of the treatment differences...but this doctor explained that lamictal and lithium and latuda can treat regular depression.

Sure, but this doesn't mean they are the best option. Because of their side-effects profile  they should, IMHO, only be considered if there is no response to antidepressants.

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Weaning off cymbalta and simultaneously starting latuda... do you think I could still feel better during this period?

Perhaps, but I wouldn't count on it. People don't often feel better when either starting or stopping meds and doing both at the same time just adds to the potential issues. IMHO, changing two meds at once is not a good idea except in emergencies because if there is a problem it can be very difficult working out which med is causing it.

As for the Brintellix this is just another SSRI, but with the addition of a Buspar like compound. I think taking both a SSRI and Buspar is a better option because it is possible to fine tune the ratios instead of being stuck with the drug companies best guess. But it may be worth a shot.

Apart from Cymbalta have you taken any other non SSRIs as mono therapy? If so, what was the outcome?

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

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Re: Latuda as monotherapy or adjunct, gotta love the merry-go-round
« Reply #13 on: August 24, 2014, 02:18:16 AM »
Any non ssri's as monotherapy? No. It has been quite a journey with medications in such a short span of time. Here's the list:

Lexapro as monotherapy in january 2012. Mood swings to begin with and overall lethargic tired feeling most of the time.
Prozac given as monotherapy with leftover Benzo drugs for anxiety.
Wellbutrin, seroquil. remeron.
Lexapro again with Abilify
Viibryd as monotherapy
Cymbalta with Lamictal because of mood instability or lack of response
Now Lamictal and Latuda; tapering off of cymbalta and going to Vortioxetine

Latuda must be taken with 350 calories correct? I think that i need adjunct treatment or augmentation therapy. so latuda or lamictal or both seems like a good call. But maybe both isn't the right move.

So far, to be honest, cymbalta withdrawal so far has been a breeze compared to the horror stories. I am just having some head symptoms and that's it. cognitive shifts, yes, but overall im okay.

So... as of right now I truly believe I need depression medication because when I go off of these meds, my cognition and functionality plummet within months. How long does Latuda take again to do anything? and how will I know what pill I don't need?
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Re: Latuda as monotherapy or adjunct, gotta love the merry-go-round
« Reply #14 on: August 24, 2014, 02:20:39 AM »
and I think I like the anti depressants with a buspar like chemical because my response seemed to be good when I was feeling good. and my private area was functioning better (sorry if it's graphic). So maybe brintellix will work for me.
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