I have emphysema. I have been a smoker for 45+ years. I was diagnosed with Bipolar I in 2007 and have been taking two 200 mg of Lamictal. I've been concerned that Lamictal makes my breathing worse so I decreased my dose to 1 1/2 tablets and then to only 1 tablet (200mg). I've been trying to quit smoking and feel very guilty and discouraged because I haven't been successful and almost think I don't care. So I'm thinking that decreasing my dose has created this negative thinking. I'm having problems with my son about this and I haven't seen him in 5 months nor have I seen my granddaughter. It seems like I just don't care anymore. I can't really say my breathing is better but at times it seems so. I'm thinking there isn't a definite pattern of breathing when you have about emphysema so it's be hard to tell if it's the Lamictal. I'm reluctant to increase my dose again. Quitting smoking would probably be the decisive factor for this dilemma but I'm still smoking. Any insight on this?