“Lamictal Bipolar I”

Thank you for your patience, many times medications take a while to start working correctly for a state of equilibrium. However, sometimes medications can cause more side effects with specific types and when in combination with each other. It may be too much and may be efficacious to back off one of two or reduce the frequency of taking the medications in some way without affecting the therapeutic treatment aspect, or replacement of one or more of the medications thus changing it's continuity and the effectiveness of the medications either positively or negatively, discretion from your doctor or health provider will help in this case. Lamictal is often prescribed with other medications for treatment of depression as a mood stabilizer, Klonopin is for reduction in anxiety 'attacks', Trazadone is also many times prescribed for a 'sedative' type antidepressant to help people sleep often prescribed at night, Levothyroxine is used for treatment of hypothyroidism (Low amounts of the thyroid hormone) which need to be monitored and has some adverse side effects and if taken with additional medications could cause potential adverse biophysical consequences which should always be managed by your medical doctor as well as with your psychiatrist and any other related health provider in the management of your health conditions. This all depends on what is being treated medically and physically in the body as well as psychological, anything additional taken internally such as supplements, coffee or street drugs including marijuana could potentially cause adverse side effects. Some careful maneuvering on titrations of specific or all of the medications could be beneficial depending on all health and mental health conditions being treated. There is a moderate risk with the medications Levothyroxine and absorption with other foods, time taken, fluctuations with blood levels which may alter effects and this medication can cause nervousness and may increase anxiety with other medications as well so blood levels for this medication alone also need to be monitored, a moderate risk and interaction with Trazadone and foods absorption and may impair cognitive alertness and may cause dizziness and or drowsiness in which case tasks requiring full attentiveness may want to be avoided (use discretion), same with Lamotrigine and Clonazepam. With Clonazepam and Trazadone combination the central nervous system can be affected so mindfulness in this area will help with management from your health professionals. Lastly, there is a body of evidence that may suggest that ingesting Levothyroxine with Trazadone can potentiate the antidepressant actions of Trazadone which isn't fully understood why. Clinical advice in this scenario would be cessation of any caffeine, alcohol or drugs or any supplements that may cause an increase in nervousness and a reduction or changing the medication dosages of Lamictal (could elevate nervousness), Trazadone( Could elevate nervousness) Klonopin and Levothyroxine ( Could elevate nervousness) especially with the combinations present. Wishing you well,

Sincerely,

Dr Ryan Koryciak

Consultation with your prescribing provider is recommended. If you would like a psychological evaluation for diagnostic clarification and specific support and treatment recommendations that would be helpful for you, seek out a psychologist. We provide these evaluations at my office.

This is a question for a Psychiatrist, not a Psychologist. Psychologists do not prescribe medication (with a few exceptions). I would recommend you talk to your prescribing physician about whether this medication is appropriate for you.

You can have your medication reevaluated. There are other medications that could have positive outcome. I recommend you combine medication with cognitive-behavior therapy.

Who is prescribing the medication and knows your history they should be the one to address the medication If you have anxiety then can’t would be a good starting pointv

There are many different medications used to treat bi-polar disorder (if you have it). I would suggest contacting your prescribing doctor, telling him/her about your side effects and asking about alternatives. I am also curious about why you doubt the diagnosis.

Sorry to hear you are struggling! You should definitely check back in with your prescriber so that you can share your concerns.

Greetings,

You probably need a more formal neuropsychiatric evaluation with psychological testing to parse out the differential diagnosis and determine the appropriate pharmacological and nonpharmacological interventions. Do you have a provider you could approach for this purpose? Where are you located?

Hi - it is scary to take a med for the first time. You dont say how long you have been taking it - some side effects decrease after a couple of weeks. I recommend you speak to the doc who prescribed it - if they arent a Neuropsych person or a psychiatrist, go to a consultant associated with a teaching hospital if possible. Zoom is fine for that kind of consult. Let an expert weigh in on the diagnosis and medication. Glad you asked! Peace, Marian (Dr) Marian K Shapiro Licensed Psychologist