New medication help

[Music]

My psychiatrist recently started on Lamictal, I'm already taking 1200mg of Lithium a day, 1000mg of Tegretol a day, and 1mg of Ativan whenever I need it (which ends up being 1 or 2 every couple weeks). I'm also taking Azathioprine for an Immune disorder.
For this medication she's had me decide my own dosage and titration as she believes I know more about it than her. However, I know that Lamictal and Tegretol interfere with eachother's metabolism and I'm not sure how this affects dosage. I'm fairly certain I need to double up on the Lamictal but for some reason I'm unsure if I'm supposed to lower the Tegretol or not.
She was going to put me on Zeldox but decided I don't eat enough. Then Invega but my intestinal tract is narrowed which is apparently contraindicted. According to her Lamictal is the last medication I can try so I really want to make this work.

[Bibliophile]

Hey there :]

I'm on Lamictal, too, and I have been for a while now, so if you have any questions about the drug in general just drop me a message! As for the Tegretol, your dosage of Lamictal is likely to have to be higher. However Lamictal needs to be increased incredibly slowly because of the numerous lovely adverse reactions - so the best way to go about it is to get to around 200mg (maybe higher, maybe lower) then take a break from increasing it to see how that goes, and increase as and when needed.

I know this isn't particularly helpful!

Take good care.

[Dr.Bobby]

Wait. And this is something you should take with that grain of salt of yours.

What exactly does your psychiatrist mean by your deciding what the dosage of these meds should be? Is she asking for feedback on how you feel on them and then using that to properly adjust the dose, or is she really telling you to take what you feel is correct? Clarify this, b/c if she's actually telling you the latter, find yourself a new psychiatrist who actually knows what they're supposed to be doing here, Rick.

Psychiatrists are supposed to know enough about how these meds work, and in what dosages..and then apply that knowledge to the patient they're assessing. If they cannot do that, if they do not have the necessary experience, then you should not take this responsibility on yourself (even if given to you), but rather find a new, more experienced psychiatrist to work with.

[Music]

It doesn't really work like that here Bobby. Psychiatrists are concidered specialists and specialists you need a referral to. I tried to get a referral to a Bipolar Clinic here but my psychiatrist needs to do it and she either doesn't want to, doesn't know how, or keeps forgetting. Even if I got a referral for there the wait list was around 15 months last time I checked so I still need help with this question now regardless.

[Music]

I'm going to stop taking the Lamictal, the side effects are stupid. I haven't been able to walk since yesterday, I keep falling over or bumping into things which isn't really good for my job.
Back to the drawing board.

[Bibliophile]

What dose were you on? Perhaps try with a lower dose and ease it up slower? If it were me I'd try and stick it out, but I've never had THAT extreme side effects from it (but I'm clumsy anyway)!

[Music]

I was on 25mg. My friend suggested I try cutting them in half before I stopped taking them but they're far too small.