Lamictal side-effect, bulimia???

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???

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

Hi OBB-  Thanks 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???

 

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)

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. 

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.

Very interesting! Have you talked to your doc about this?

serafena