Lamictal or Duloxetine

[Andyroo66]

Hi I have long qt so can't take many meds.

Took anitriptyline for years but had to come off

I also have migraine aura and nerve disturbances. Neurologist reckons it's sodium channels.

A short trial on gabapentin low dose worsened my depression. At least I got a little sleep though.

So now I have insomnia low mood lots of anxiety due to my situation and feel in a bind.

In the past could not tolerate ssris far too stimulatory for me.

Which one is best on balance Lamictal or Duloxetime.

[Hidden]

Hey there,

I hate to be the bearer of bad news, but based on what I know about both these meds, neither are very good for sleep. Now, that said, everyone differs on medications. What works for me, may not for you. Personally speaking, I have only tried the duloxetine (Cymbalta) and had trouble getting deep rested sleep. I awoke every morning feeling like absolute crap. SSRI/SNRI medications can have an impact on the ability for the brain to enter REM sleep which in turn can lead to moodiness and feeling sleepy all day. My doctor paired it with hydroxyzine (either HCl or pamoate....though with your heart issue, I believe this isn't a good medicine for you) and I slept better, but still not great. Lamictal I have never taken, but I am aware that it can also cause insomnia. It is technically an anticonvulsant, so it may work differently and perhaps give you a better night's sleep.

Given my having tried most SSRIs/SNRIs paired with most of them giving me issues with sleep, I would probably try the Lamictal first. If it doesn't help you, you can always give the Cymbalta a try. Again, different folks, different results. I'm sorry you're having the issues you're having and that medication is a little more difficult. I'm not sure if there's a solution, but maybe your doctor can find a sleep aid that doesn't interact with the heart issues. Melatonin is an OTC supplement (I'm sure you know already) that could be tried. He/she would be the one best suited to ask knowing your complete medical background. I wish I had some better answers, but I hope this helped. Best of luck and I hope one of the medications is able to help you with both your mental health issues as well as a better night's rest....a better night of rest might help the other issue. Let me know if I can help with any other questions, take care!

[Ragdoll15 in reply to Hidden]

Mirtizapine helps me with sleep and depression

[Yumyum12]

the Dulox is better; I have been on both....

[Andyroo66 in reply to Yumyum12]

thanks could I ask how the side effects are ramping up? I know everyone is different

[Yumyum12 in reply to Andyroo66]

dry mouth mostly

[Andyroo66 in reply to Yumyum12]

thanks, was that omce on it, whats it like to get onto?

[Mabelx]

Hi there! In situations like yours, Lamictal (Lamotrigine) has always been a great option for me. It stabilizes mood without being overly stimulating, which is crucial if SSRIs have been too activating for you. Unlike Duloxetine, which can have a more energizing and noradrenergic effect, Lamictal works by modulating glutamate and stabilizing sodium channels—something that aligns well with your neurologist’s suspicion about your condition. It’s also known for having fewer cardiac risks compared to many antidepressants, making it a safer choice given your Long QT.

While Duloxetine could help with nerve disturbances, its effects on norepinephrine might increase anxiety, which seems to be a major issue for you. Lamictal, on the other hand, is gentler, helps with mood stabilization, and can also improve sleep over time. If I were in your position, I’d go for Lamictal—it’s been a lifesaver for me in managing mood without the overstimulation or worsening anxiety that can come with other options.

[Andyroo66 in reply to Mabelx]

Thanks, I'm struggling to find anybody that will prescribe it to me. I believe I have MCAS and ive read somewhere Lamictal can trigger that?Thanks