Lamictal side-effect, bulimia???

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stella_blues
New Member


Date Joined Nov 2009
Total Posts : 6
   Posted 11/1/2009 4:38 AM (GMT -7)   
I have a diagnosis of BP II, Borderline Personality Disorder, with major depression and adult ADHD- have been hospitalized twice in the last year.  I have a history of restricting my eating when depressed.  I've always been a normal weight, often at the low end of the range for my age/height, so not actually anorexic. I've been on a therapeutic dose of Lamictal (200 mg) for a couple of weeks.  It took about 6 weeks to titrate up to this dose.  So, technically, I've been on Lamictal for somewhere around 2 months. 
 
At about the time I hit 200 mg, I was thrilled to see my severe depression and symptoms of BP absolutely disappear. (I'm also in DBT for the BPD)  I've gone through 7 drugs over the past year trying to find the right one- this is clearly it!  But about the eating issues... I've also noticed I have irrisistable cravings/urges to eat and eat AND EAT.  I've NEVER experienced this EVER.  As someone who has successfully talked herself into restricted eating off and on for some 25 years, you can imagine how strong these binge urges are!  It's so out of hand, I've begun purging after I eat.  I exercise more, but I just can't do enough to burn the awesome volume of calories I consume.  I've never purged, before.  It's actually HARD and miserable to do!  But it's the only thing I CAN do!  I eat WAY too much- and I know it sounds lame, but I JUST CAN'T HELP IT! 
 
I can only assume it's the Lamictal.  ???  ~OR~ is it b/c I feel so much better in my mood, that it's just ME? 
 
I don't want to add a new disorder to my already long list of problems- but bulimia is the only thing I see to remedy the binging.  I've told my doc that I've been binging (tho not about the purging), but she doesn't pay it any mind and hasn't given me any suggestions to deal with it. 
 
Help??? Please???

stkitt
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Date Joined Apr 2007
Total Posts : 32602
   Posted 11/1/2009 9:10 AM (GMT -7)   
Hello there and I am sorry to hear you are having issues with the eating which has led to purging.
 
You did not mentions any other medications you may be on and wondering if you would mind sharing info re any other meds?
 
Lamictal and Topamax seem to be the mood stabilizers least likely to cause weight gain. Of course whether or not they work for you is perhaps the biggest question. Your doctor should be able to give you the best feedback on the meds that might work and produce the least objectionable side effects.
 
Binge eating and purging is a disorder of it's own and I would you like to suggest you   talk to your  physician  about your binge-eating symptoms and feelings.
 
You have my support and prayers that you can find the cause of your binge eating and stop the purging.  You are a special person so please be gentle with yourself and take good care of you.
 
I wish you peace,
 
Kitt


 

~~ Kitt ~~
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*~* http://www.healingwell.com/donate *~*
"When you find peace within yourself, you become the kind of person who can live at peace with others."
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Post Edited (stkitt) : 11/1/2009 8:06:39 PM (GMT-7)


O Buddy Boy
Regular Member


Date Joined Oct 2009
Total Posts : 106
   Posted 11/1/2009 9:14 AM (GMT -7)   
This is simply from somebody else with BPII and takes Lamictal.

I feel like a new me. It's amazing. I'm happy and never knew that feeling before. Just incredible

Maybe the binge eating is the new you. If that's the case you may have to learn to resist. Drink water when the urge to eat strikes.

At night I have an urge to binge. But I take seroquel at night and think it is the culprit. And to combat that, I've started drinking water. It doesn't fight the urge completely, but it helps and keeps my hydrated.

OBB
55 yo
Dx:9/29/09
DRE: Susp
PSA: 3.5
Gleason: 3+4/7
6/12 Cores Positive; Sextants were 1%, 3%, 8%, 15%, 12%, 0%
RALP: 10/10/09
PATH:
Margins: Clear
Lymph Nodes: Clear
Seminal Vesicles: Clear
Gleason: No increase from biopsy 3+4/7
Some perineural and capsule invasion.
T2c,NO,MX


serafena
Veteran Member


Date Joined May 2007
Total Posts : 3715
   Posted 11/1/2009 6:58 PM (GMT -7)   
stella_blues,

Hello and welcome to HealingWell and the bipolar board. I'm so glad you've joined us.

As St.Kitt said, your Lamictal shouldn't be the culprit, but you never know. You absolutely have to have an honest talk with your doctor about this. Bulimia isn't a new disorder for you, it's just a new take on an old one: disordered eating. Binging and purging can have long-term physical effects, and it isn't something a doc should blow off. Who knows what the doctor was thinking, but perhaps she thought your version of binging is closer to healthy eating. If you've been restricted eating for a while, eating a little more than usual wouldn't necessarily mean a true "binge." But you sound like you know what you're talking about, so definitely let your counselor and your doctor know you're purging.

I'm really glad the lamictal is working for you otherwise.

Keep us up to date with this,
serafena
Serafena
Co-Moderator, Bipolar Forum
Bipolar II

"Bipolar disorder can be a great teacher. It's a challenge, but it can set you up to be able to do almost anything else in your life." - CARRIE FISHER


stella_blues
New Member


Date Joined Nov 2009
Total Posts : 6
   Posted 11/3/2009 2:21 AM (GMT -7)   
Hi OBBThanks for sharing your experience with Lamictal. 

"Maybe the binge eating is the new you. If that's the case you may have to learn to resist. Drink water when the urge to eat strikes."

The problem is my attempts to resist fail- over and over and over.  I've tried drinking water and decaf coffee (which I love) as a substitute for binge eating.  I just never works.  The urge is SO powerful-  unlike anything I've ever experienced.  It's almost like it takes over my body.  I realize how that sounds- melodramatic- but it's just that strong.  And this is coming from someone with years of experience starving herself.  One thing I've always been able to do well is starve myserlf.  I NEVER imagined being in this position.
 
My binge urges also come in the evening.  I can actually eat very little up until mid afternoon.  And then it starts.
 
 
 
 
Hi Kitt and Serafina - Thanks for your words of encouragement.  I'm not taking any other Rx meds, other than Ativan, which I've had on board for years as a PRN for anxiety.  I very rarely take it and I am certain it's not a contributor to the bulimia behaviors.  I take melatonin before bed - but i don't see that as a contributor, either.   
 
I definitely see the severity of the situation and feel like I need help- like this is much bigger and stronger than am I.  I feel like it could take over my life - in the blink of an eye.  I'm already a pretty obsessive person- I get "stuck" on a thought or behavior very easily. 

The problem is that I'm so ashamed and embarrassed of the vomitting behavior.  I can't explain how powerful this shame is.  I hate everything about it- the ridiculous pep talk I need to give myself to vomit, the dread and discomfort of the act, the awful sound of purging, the headache, shakes and fatigue I need to hide after I purge.  Nothing about it is "fun."  I feel like anyone who knew would just judge me.  Think - "You need to be stronger - just resist the binge eating and simply stop purging."   As if it's that easy.  I've endorsed that judgement and put it myself- I  feel like it's a sign of great weakness that I can't stop the binging.  And then a failure after I binge.  The purging is the only way to regain a feeling of balance- but it's such a pathetic act.  I feel like my Doc would just think it's attention seeking behavior, b/c it's so new for me.  I don't think she would believe me.
 
I've NEVER been a binge eater.  I'm 36 years old.  My ED up til now has been restricted eating.  I've been the master of starving myself off and on all my life.  Of ignoring intense hunger.  Of staying on a 600 cal./day diet for weeks- no matter how weak or hungry I got.  I MISS those days!  Why can't I DO that, anymore - at least enough to curb the binge eating???  What happened to that well honed ability to NOT eat???  Where did that go???
  confused
 
I don't know how to ask for help from my Doc.   I've already expressed my despair over intense urges and binge eating and she doesn't seem to give it any thought.  She's never offered suggestions.  I feel like the purging is the only recourse.  I don't want to go off the Lamictal- and I know she would be incredibly frustrated if I said I wanted to b/c it's taken SO long to find a "good" drug for me.
 
How do I ignore my shame so that I can talk to someone???? 

Post Edited (stella_blues) : 11/3/2009 2:26:28 AM (GMT-7)


serafena
Veteran Member


Date Joined May 2007
Total Posts : 3715
   Posted 11/3/2009 11:31 AM (GMT -7)   
Hi stella_blues,

I have so little experience with eating disorders, I would like to refer you to The Joy Project and Something Fishy.

Please try to remember, and I know it's not this easy, that most medical professionals want to help, not to judge. If you don't trust your gp, talk to your psych, or vice versa.

serafena
Serafena
Co-Moderator, Bipolar Forum
Bipolar II

"Bipolar disorder can be a great teacher. It's a challenge, but it can set you up to be able to do almost anything else in your life." - CARRIE FISHER


stella_blues
New Member


Date Joined Nov 2009
Total Posts : 6
   Posted 11/4/2009 2:37 PM (GMT -7)   
I have some positive news.  Today I had a regular appt. scheduled with my psych doc.  (I see her about every three weeks to touch base regarding my medications.)  I came out to my DBT group last night regarding my ED (very scary and hard but I did it!) and that was the stepping stone I really needed to take the leap and tell her about all of this mess.  She's the one person I really trust to be fair and not judge me too harshly.  Still, it was so hard to actually speak the words.  I totally struggled and tripped over myself- I changed my mind a hundred times in the span of a few moments on whether or not to actaully say the words outloud- it was ridiculous.  But I did finally admit it.  She was kind about it, of course.  I don't know how else I thought she'd respond. 
 
Anyway, she wants me to talk about it withy my individual DBT therapist.  She says obsessive compulsive stuff is complex and therapy is very important.  She also gave me an Rx for 10 mg of Prozac, which I've started today.  She says it can help settle the compulsive urges. 
 
I feel a huge weight lifted, having reached out for help like this.  I still have the compulsions but at least I don't have the panic feeling of dealing with it all by myself. 
 
I'm interested to see how the Prozac helps.  I'm still on the fence about talking with my DBT therapist.  I don't trust her like I do my psych doc. 
 
PS  Thanks for the links, Serafena.  I've stumbled upon Something Fishy several times- but have never heard of The Joy Project. 

serafena
Veteran Member


Date Joined May 2007
Total Posts : 3715
   Posted 11/4/2009 5:09 PM (GMT -7)   
Congratulations! I'm soooo glad you found the courage for this and that your psych responded positively. You really needed that. I hope the Prozac helps. Don't forget it takes a while to kick in, so go easy on yourself.

serafena
Serafena
Co-Moderator, Bipolar Forum
Bipolar II

"Bipolar disorder can be a great teacher. It's a challenge, but it can set you up to be able to do almost anything else in your life." - CARRIE FISHER


stella_blues
New Member


Date Joined Nov 2009
Total Posts : 6
   Posted 11/6/2009 8:16 AM (GMT -7)   
Thanks, Serafena. I did need it, you're right. I'll be patient with the Prozac. I have my fingers crossed.

I have to confess that I have a new fear. I've put my dirty little secret out there in asking for help, but I'm still bingeing and purging. I think I had this notion that if I asked for help, it would all end- that it would somehow be all better. But it's not. I'm still battling the urges. I've already purged this morning. I didn't even know why I wanted to purge- but that's just how it is. I really thought asking for help would HELP me. But it doesn't seem to have. :(

My psych doc suggested I tell my DBT therapist. I did tell her and she asked if I've considered an inpatient ED clinic. I hadn't thought about it- I honestly never thought I was "bad off" enough to go to a clinic. And I still don't think I'm that bad. I feel like I'm not that deep in it- that I'll get it under control, eventually. But then I don't know if that's just the disorder talking. ??? It's so confusing- so hard to gain perspective. Plus it would require telling EVERYONE about it and there's just no way I'm ready for that.

stella_blues
New Member


Date Joined Nov 2009
Total Posts : 6
   Posted 11/9/2009 6:49 AM (GMT -7)   
I recently found this article that describes how bulimia can be related to a biochemical problem!  This means my notion that my bulimia was caused by the Lamictal might not be so far fetched, afterall!  Since this drug would affect my hormone and seratonin levels- it makes perfect sense!   Lamictal in particular is well known to throw female hormones all out of whack.  Why is it my doctor didn't seem to think this made sense???  ....
 
An eating disorder can be caused by such things like obsessive compulsive disorder, depression or in the case of bulimia patients abnormally low serotonin levels.

Patients with severe obsessive compulsive disorder, depression or bulimia patients were all found to have abnormally low serotonin levels. Neurotransmitters such as serotonin, dopamine and norepinephrine are secreted by the intestines and central nervous system during digestion.

Researchers have also found low cholecystokinin levels in bulimics. Cholecystokinin is a hormone that causes one to feel full and decreases eating. Low levels of this hormone are likely to cause a lack of satiative feedback when eating, which can lead to overeating. Another explanation researchers found for overeating is abnormalities in the neuromodulator peptides, neuropeptide Y and peptide YY. Both of these peptides increase eating and work with another peptide called leptin. Leptin is released by fat cells and is known to decrease eating. Research found the majority of people who overate produced normal amounts of leptin but they might have complications with the blood-brain barrier preventing an optimal amount to reach the brain.

Cortisol is a hormone released by the adrenal cortex which promotes blood sugar and increases metabolism . High levels of cortisol were found in people with eating disorders. This imbalance may be caused by a problem in or around the hypothalamus. A study in London at Maudsley Hospital found that anorexics were found to have a large variation of serotonin receptors and a high level of serotonin.

Many of these chemicals and hormones are associated with the hypothalamus in the brain .Damage to the hypothalamus can result in abnormalities in temperature regulation, eating, drinking, sexual behavior, fighting, and activity level.


serafena
Veteran Member


Date Joined May 2007
Total Posts : 3715
   Posted 11/9/2009 9:49 AM (GMT -7)   
Very interesting! Have you talked to your doc about this?

serafena
Serafena
Co-Moderator, Bipolar Forum
Bipolar II

"Bipolar disorder can be a great teacher. It's a challenge, but it can set you up to be able to do almost anything else in your life." - CARRIE FISHER

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