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Q: Physician administered drugs
asked by: DoctorQuestion on February 7th, 2009
I went to see a new psychiatrist a couple of months ago and he said that he thinks I am on too much medication and put me on lamictal which I built up to 100 mgs at night. He wants me to try and get off the clonazepam and the stilnox eventually but I can't seem to do it. It is very very hard!!
I cannot get to sleep if I do not take stilnox and then my pain the next day is really bad.
I ran out of the prescription for lamictal and I havent taken it now for 2 weeks. I'm not sure if I feel more depressed than usual or if its because of not taking lamictal.
I really do not know what to do whether to go back on the lamictal or not.
I dont know if it helped in any way. What is your professional advice about this medication? Do you think I need it?

Thanking you in anticipation,

Sue


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Dr. Goce Aleksovski , MD
replied on February 9th, 2009
General Q and A Answer A5707


Diagnosis that has been suggested: fibromyalgia and depression
Current medical status: pain in hips and tight muscles around shoulder blades and neck
Current medical treatment: 75 mgs. lyrica at night, 2 mg clonazepam 1 or 2 stilnox cr at night, 20 mgs prozac in morning


Clonazepam is a medication of the benzodiazepine group. Stilnox (generic name: zolpidem) is gamma-aminobutyric acid (GABA) mediated nonbenzodiazepine hypnotic. Lamictal (generic name: lamotrigine) is antiepileptic medication of the phenyltriazine class.


All of these three medications have different mechanisms of action and can not be replaced with each other without a doctor’s recommendation. The dosage should be strictly as the doctor recommended and no changes are allowed.


Ceasing to take lamotrigin can worsen the symptoms due to the up-regulation of the supposed receptors.
The treatment should be decided only by a doctor that knows, follows and evaluates the symptoms.




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