Quote:
Originally Posted by SylvieM
My SFN came on last year in a wave of profound depression. I'm sensitive to SSRIs and SNRIs (Cymbalta is the latter; is said to be good for pain, but I couldn't tolerate it). I finally recently agreed to my neuropsychiatrist 's suggestion of lamotigine (Lactimal). It's an anticonvulsant...a sodium channel blocker that works very differently than SS or SNRIs.
It is used off -label for neuropathic pain, bipolar disorder, and unipolar depression (I'm unipolar).
It changed my life in the last month. It is a stabilizing drug, calming hyperactivity in neural channels, inhibiting glutamate. I titrated up from 25 to 100 mgs in six weeks and started feeling markedly better two weeks ago. The usual therapeutic dose is considerably higher...but I'll stay here for a while. It does not do a lot for my pain, which fortunately is tolerable. It's my dysautonomia that is bad.
Like all drugs that work on neural pathways, it is "dirty," and can have many side effects. One is Steven-Johnson's syndrome, a sometimes lifethreatening- rash.
However, all side effects are reduced if you slowly titrate up. I did have antidepressant effects immediately -- unlike conventional antidepressants. I can only suggest you read up on anything you are given. I have no side effects at all now..and I'm also sleeping better. Most importantly, my energy is up and I'm laughing a lot...in spite of having both autonomic and sensory neuropathy. The addition of depression had me thinking I would be an invalid for life.
It's really working for me, and my neurologist said just two days ago, it's a particularly good choice for SFN, for it apparently calms neuro-inflammation, which may be a cause of both SFN and depression. (Written with the caveat that autoimmune disorders might cause neuro-inflammation).
I hope the Cymbals works for you....don't give up hope if it doesn't...and go off very slowly if you change meds.
Best,
Sylvie
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Hi Sylvie,
Its interesting you say this. I managed to get on relatively well with SSRI's years ago. I stopped for a number of years. (After I had my child my SFN hit and it went hand in hand with depression / severe anxiety at exactly the same time. I am convinced there is a physiological inflammatory cause behind feelings of depression.) I tried SSRI's again and I have now become hyper hyper sensitive since SFN hit. To the extent that after only one tablet on one day I vowed never to try it again. I was almost shaking under my duvet in bed in fear all day - it was bizarre. I'm therefore very cautious about any type of anti depressant but am desperate for something to help me through this. I feel alot of the depression is because of what has happened to me physically and I therefore feel like there is no point even trying to address the depression medically - but I have got to try something even if it is just a sticking plaster. If it helps numb the emotional anguish, I will try it.
I am going to look into Lactimal. I havent heard of this. My neuro and I both feel my SFN is inflammatory, if this affects neuro inflammation to some extent then this is worth considering. Thankyou for the reply, it is so helpful. :-)
I relate to what you said about being an invalid for life. I now actually recognise that the depression is becoming a significant beast in its own right and may be contributing more to my feelings of debilitation than I realised.