Nervous about taking Lamotrigine for anxiety.

I saw a psychiatrist recently who suggested that I could take Lamotrigine to help with anxiety. He said that anxiety, migraine, depression and digestive problems are all connected due to a problem with glutamate in the brain. Glutamate is an excitatory neurotransmitter which is normally in balance with GABA which has the opposite effect. He said that he has had some success with people who have anxiety that hasn’t responded to other treatments and that have some of these other problems. You start on a very low dose and then gradually build up. It takes a few months before you notice any positive effects. The only snag is that Lamotrigine can potentially have very serious side effects, i.e. something called Stevens-Johnson syndrome which can be fatal. So I’ve been looking at other alternative ways to improve the balance between glutamate and GABA in the brain. One possibility is following the ketogenic diet.

The ketogenic diet is a low carbohydrate high-fat diet. Basically you are eating a combination of protein from meat and vegetable sources, fat from things like coconut oil or cheese, vegetables which I guess give you the recommended 50 g of carbohydrate per day. Strangely fruit is not part of the diet. This is because fruit has got a lot of sugar in it which is a big source of carbohydrate. So essentially the ketogenic diet is a low carbohydrate high-fat and zero sugar diet. Sometimes people call it a paleo diet, which implies that it is similar to the diet of hunter gatherers. I can see how the potatoes, bread and rice that we eat would not have been part of the hunter gatherer diet and may possibly be harmful to us, but the hunter gatherers would have been gathering fruit which of course is an important source of vitamins. This diet is better known as being a way to lose weight but it is also gaining popularity as a way of treating neurological conditions and mental health problems.

The ketogenic diet is a diet has been used for decades as a treatment for treatment resistant epilepsy. Lamotrigine was originally used as a treatment for epilepsy as well. However like Lamotrigine the ketogenic diet also has drawbacks. I don’t think I would feel confident trying it without being guided by an experienced dietician. In the meantime I’m trying to find ways to deal with my sensitivity to noise as an alternative way to reduce anxiety because I think this may be one of the root causes of my anxiety. Apparently there is a kind of sound therapy which uses either white or pink noise to reduce sensitivity to sound. I think I would rather try this first then try either the Lamotrigine or the ketogenic diet.

Am I phonophobic?

A number of years ago I saw an audiologist and explained my problem with being troubled by noise when I am trying to speak in a pub or other busy places. She said that I was phonophobic. I now think that the root of my problem of speaking in noisy environments is not primarily caused by sensitivity to noise or phonophobia but a loss of voice projection that has made me sensitive a noise. This is because I have learnt to associate the noise with finding it difficult to express myself. When I look back I was not sensitive to noise in pubs (for example) and then found it hard to speak. I found it hard to speak and then became sensitive to noise. I am still not sure why I have lost my ability to project my voice, whether it is because of reflux or over/misuse or anxiety and what I can do about this. I am taking medication for reflux now. I think the solution must lie in tackling the loss of projection  and dealing with the phonophobia.

I have noticed that it is possible to learn to like certain sounds that you initially dislike. Therefore it seems likely that it is possible to learn to dislike certain sounds as well that you initially did not dislike. For example, there are some songs that I do not like but when I have played learnt them I have grown to like them, maybe because I begin to associate the song with pleasant feelings of self-expression and learning.