u/Brodeany

TL;DR: Mild L4/L5 and L5/S1 disc bulges diagnosed four years ago with no nerve compression on MRI. After tapering lamotrigine and lowering my SSRI dose, my back has become much more sensitive, with increased myofascial pain. Exercises that used to help now often cause flare-ups, while nerve glides seem better tolerated. Looking for others with similar experiences and how they adapted their rehab.

I'm a 30 year old male looking for other people's experiences with L4/L5 and L5/S1 disc injuries.

What kind of pain?
My symptoms have changed over time. I experience lower back pain with episodes of nerve pain, and more recently a lot of myofascial (muscle) pain around the injury. During flare-ups my back becomes much more sensitive, and certain movements can significantly increase my pain. While tapering off lamotrigine and lowering my SSRI dose, I've noticed the muscle pain around the injury has become much more noticeable, and my overall pain sensitivity seems higher, at least temporarily.

How long have you had it?
Around 4 years.

Mechanism of injury?
Repeated heavy pulling/lifting in physical work (last incident was pulling 200kg where I felt it ‘give’).

What have I tried?
I've seen my GP, a spine specialist, and multiple physiotherapists. I've consistently done the exercises and stretches my physiotherapists have recommended over the past couple of years. I was also taking medication that without knowing dulled my nerve pain, which meant I often didn't realize I was overdoing things until I had a significant flare-up.

Recently I've noticed that many of the strengthening and stretching exercises that used to be part of my routine now seem to aggravate my symptoms, especially while my back is more sensitive. Gentler nerve-focused exercises, such as nerve glides, seem to irritate things much less. Because of that I've reduced my activity, but I feel like I need a new exercise program that matches where I'm currently at.

What makes it worse?
Heavy lifting, heavy pulling, overdoing physical activity, and some strengthening or stretching exercises seem to trigger flare-ups.

What makes it better?
Rest, pacing myself, and gentler nerve-focused exercises seem to be better tolerated than some of the exercises I used to do.

Imaging
My MRI (from about two years ago) showed mild L4/L5 and L5/S1 disc bulges with small annular fissures but no nerve compression. But I understand symptoms don’t always match MRI findings. My neurological examination was normal, and the spine specialist wasn't concerned or recommending surgery. They advised physiotherapy, strengthening, cardiovascular exercise, and gradually increasing activity. Since that MRI is now about two years old, I'm aware things may have changed.

How has it affected my life?
Before this I was much more confident being active. Now I spend a lot more time thinking about whether an activity will trigger a flare-up. I work in a physically demanding warehouse job, so finding the right balance between staying active and not aggravating my back has been difficult.

I'm mainly interested in hearing from people with similar injuries. Did your symptoms change over time even if your MRI/Xray initially looked relatively mild? Did anyone find that traditional strengthening exercises started aggravating things while nerve-focused exercises were easier to tolerate? If so, how did you rebuild your activity and exercise routine without constantly flaring your symptoms?

TL;DR: Lamotrigine left me feeling dissociated, mentally foggy, and stuck in my own head. Tapering has been rough, especially the drop to 75mg, but I’m slowly starting to feel more connected again, with more vivid perception and enjoyment of hobbies returning.

I wanted to share my experience with lamotrigine and see if anyone else has gone through something similar.

I was originally prescribed stimulants for suspected ADHD, but they didn’t work well for me and caused significant overstimulation. Lamotrigine was later added in an attempt to help manage some of those issues.

I also previously tapered off venlafaxine completely, but that didn’t work out well for me. I ended up going back onto 75mg, which I personally find more helpful and tolerable than lamotrigine.

I’ve been on lamotrigine for about 8 months and am now close to being fully off it.

Unfortunately, lamotrigine ended up being one of the most difficult medications I’ve taken.

The biggest problem was a persistent sense of dissociation. I felt disconnected from myself, other people, and the world around me. It developed gradually, so I didn’t fully notice it at first, but over time I became less and less present in my own life.

One thing I want to clarify is that I didn’t experience dissociation immediately after starting lamotrigine. The stimulants were actually the worst offender when it came to that disconnected feeling. However, even after stopping them, that sense of dissociation didn’t fully go away. Looking back, I feel like lamotrigine may have prolonged that state and made it harder to reconnect with myself and the world around me.

I also experienced confusion, brain fog, and a general feeling that my thinking wasn’t as clear as it used to be. I’ve always been prone to rumination, but it became significantly worse on lamotrigine. Because I felt so disconnected from the world around me, I seemed to get stuck in my own head more often, constantly analyzing and replaying thoughts.

I’m currently tapering off lamotrigine, and the process has been much more difficult than I expected. I’ve experienced anxiety, insomnia, restlessness, and a general sense that my nervous system is struggling to settle. These symptoms feel tied to the taper itself and are still pretty challenging.

I’m currently at 75mg, and this has been the hardest and most noticeable dose reduction so far. The effects hit me harder than expected, especially since I had only been on 100mg for about a week before dropping again. Because of that, I’m planning to stay at each dose for roughly 2 to 4 weeks depending on how I feel before making further reductions.

Despite the difficulties, I’ve also started noticing some positive changes. The dissociation has begun to lift, and the world feels more vivid again, especially visually and sometimes even in sound. I’m enjoying hobbies and interests that had become dull or uninteresting, and I feel more connected to my surroundings than I have in a long time.

The rumination is still there, and to be fair it’s something I’ve dealt with throughout much of my life, but it feels less intense than it did on higher doses of lamotrigine.

I know lamotrigine helps many people, and I’m not suggesting others will have the same experience. This is just my personal experience.

Has anyone else experienced dissociation, cognitive fog, increased rumination, or a difficult taper while coming off lamotrigine?