u/BUTTERSBRAIN

I'm starting Caplyta at an ultra-low dose next week hoping to really only get the 5ht-2a antagonism so as to offset some of the agitation, apathy, and obsessive thinking, and sexual side effects I get from my Celexa/Lamictal combo.

I hope to do this by taking half a 10.5 mg capsule to start. In my thinking that should largely leave the D2 receptors alone. I'm also hoping that it's impact on glutamatergic tone might offset my obsessive side effects from Lamical.

I have a ton of diagnosis' that have been tossed around, including MDD/anxiety, ADD, BPII, BPD, PTSD, etc. The newest is OCDPD and my therapist said people tend to respond to low-dose atypicals well. Rigidity in thinking, extreme distress with uncertainty, and shutdown of all emotion except irritability.

I've been noticing more and more how Lamictal, in me at least, creates rapid obsessive thinking loops and criticality. It also dampens deeper vulnerability and presence in favor of executive function, motivation, and boldness.

I have read that the improval of NMDA signaling by Caplyta might help offset the Lamictal obsessiveness and rigid thinking.

Can any psych/pharma nerds tell me if my thinking is close to correct here? Thanks.

I’ve been on Lamictal for 20 years and it took me some time to realize it definitely increases my ruminations and hypervigilence, among other things. As soon as I pop in the shower, the knives come out and I obsess about all my faults and actions, and get hypercritical of everything in the outside world, planning for upcoming battles and slights.

I don’t know if this is the default mode network or not. But I think it’s funny we are trying to tamp down the DMN with ketamine and then I take my lamictal which does the opposite.

Obviously lamictal has its own antidepressant qualities and it sometimes turns up my motivation. It also makes me feel less traumatized and hyper vulnerable dealing with groups and people. I’ve become useless and suicidal the two times I tried to come off it completely.

So I’m wondering how other people taking ketamine experience Lamictal. Cheers.