Posted by Mitch on May 31, 2001, at 11:05:00
In reply to Re: Tired of chronic BP II misery , posted by loosmrbls on May 31, 2001, at 9:29:56
1) If your Depakote blood level is stable and well into the therapeutic range-he probably will want to maintain your present dosage on it(at least for a while). I would go ahead and add *some* Neurontin (say 300mg/2-3xdaily). Just a personal note: I have found Neurontin works a *lot* better for depression than Depakote.
2) If that noticeably helps-especially with depression and grouchiness, *then* *consider* either reducing the Remeron (which probably won't help much), ditching AD's altogether (probably not a good idea), or switching to a different AD (i.e, some low-dose Serzone-something lower potency, mellow and not likely to set you off, say 25-50mg twice daily).
3)Just a thought, if you do have ADD along with the bipolar, a really sedating AD like Remeron might not be a good choice and could be the culprit setting off the irritability (for different reasons). My theory is that it *fogs* up your head and makes it tough to think clearly and you get frustrated easier-hence the grouchiness. Sometimes really sedating AD's create a "pseudo-depression". You are just so knocked out.
4) If you find a different AD that works for you, and you are on your Depakote/Neurontin combo. BUT, you are gaining weight like it is going out of style-talk with your doc about a *gradual* taperdown of the Depakote (leaving everything else the same) and see how you respond.
I have been on Dep. before and I gained about 20lbs. Remeron will do it to you too. About 20lbs there. Buy some new pants and hang in there! When you get past all of this you will be able to lose most of it back.
Keep me posted on how you are doing. I am curious how this all works out.
good luck,
Mitch> My pdoc did mention adding Neurontin to the Depakote. I truly hope so because the weight gain is becoming an issue. Hopefully, it will allow me to lower the depakote dose. I've read that antidepressants destabilize mood in BP II patients, but I seem to crash into horrible depressions if I'm not on one. So I'm not sure if multiple mood stabilizers or keeping the Remeron on board is better. If the irritability is still there after 4 weeks, I will stop it. I'll keep you informed of what happens. Thanks for your input, it helps alot.
poster:Mitch
thread:64595
URL: http://www.dr-bob.org/babble/20010530/msgs/64887.html