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Re: Neurontin as a mood stabilizer-max. dose? » Wendy B.

Posted by Mitch on October 17, 2001, at 23:59:42

In reply to Re: Neurontin as a mood stabilizer-max. dose? » Mitch, posted by Wendy B. on October 17, 2001, at 23:22:40

> > > ** Would anyone recommend depakote or lithium over the constant pill-popping on the neurontin? (It looks like I'm going to have to get a new watch that I can set to beep an alarm every 3 hours...)
> > > Anybody with info, or responses, or ideas?? I would appreciate hearing about anyone's experience with this topic...
> > >
> > > Thank you very much for input, in advance,
> > >
> > > Wendy
> >
> > Hi Wendy,
> >
> > I don't know if any of my experience is that applicable: I am BPII rapid cycling with atypical depression, etc. However, I have got a couple of ideas. I am on Neurontin as a sole mood stabilizer at just 400mg/day. The highest I went to was 1800mg/day. I understand what you mean about having to cart meds around with you all the time. I have found either Depakote or Lithium works well as an adjunct to the Neurontin. I don't understand why your pdoc doesn't want to allow the Depakote (i.e.) to be added on(?) Especially if it makes it easier for you to comply with your Neurontin dosage regimen (say 2x or 3x a day instead of 4+!) FWIW, I responded well in the past to 900mg Neurontin + 500mg Depakote per day in that ratio.
> >
> > Mitch
>
>
> Thank you for responding, Mitch:
>
> I will keep on doing what the pdoc says, I guess, for a while. I wonder if she has ever popped 7 pills a day of the same med... Having to do it every 3 hours, means I took it today at 7am, 10am, 1pm, 4pm, 7pm, 10 pm, and I'll take 1 more at bedtime. God, it's weird. It may even have to be upped from the 4200.
>

Wendy, that is just absurd to be expected to maintain that type of drug regimen! Most statistical studies on med compliance that have ever been done show at BEST 75% compliance with taking medications twice daily! And that percentage falls off rapidly with increased dosage timings. Geez, you are a human being not a lab rat!

> I really feel like an invalid, sort of connected to this drug like it should be hooked up in an IV in a pouch on my hip! I wonder if the pdoc wants me to feel this? Like, it's part of the therapy, to admit that I *am* limited in what I can do? Or that I am really sick. (The pdoc is also the therapist).
>
> I don't know, I feel so frustrated I want to cry. I envy you, that you only ever had to take it 2 or 3 times a day. I thought the pdoc would give me a positive response when I asked about depakote or Li. I hear Li isn't as hard on the body as it's made out to be. I take it you were never on it, Mitch?

Oh, no I have been all sorts of mood stabilizers over decades including Lithium for probably 18 years or so. When I was in my mid-twenties I had my lithium dose pushed to 1800mg/day in combination with 150mg of Sinequan, 25mg of Thorazine, and 10mg of Valium every day!

>
> I suppose she doesn't want me to have to suffer from the depakote side-effects, or the lithium blood tests... What else would it be? I have an appointment Friday, so I'll be sure to ask. I'm afraid I'm going to get angry with her.

Well, one thing you have to think about is have I taken this med before? If not, then you don't know if you are going to suffer all those horrible things, right?
>
> I also wonder why Parke-Davis doesn't figure out how to pack an extended release into 1 or 2 pills a day. It makes me upset, why don't they care what the patient is going through?

I understand they are working on a refined version of gabapentin (pregabilin) which may be able to be taken less frequently, etc.

>
> Arrgh. You are a sweetie to talk to me about this. I hope others respond, too, so I can bounce some ideas off them, too, get the reality check.
>
> Many many thanks,
>
> Wendy

No problem, there are MANY others here that can tell you that Neurontin doesn't work that well by itself for most people as a mood stabilizer. Also, there reaches a dose level in some where Neurontin can either quit working or it begins to *lose* some of its effectiveness (a therapeutic "window" of sorts-if you will). In fact I felt I needed to take 125mg of Depakote today with my Neurontin because I can tell I am getting too high and agitated.

I would just tell your pdoc something like this: 1) The frequency of the dosing is too strenuous to comply with (Neurontin).
2) I need an adjunct to it that will allow me to take the Neurontin a *reasonable* number of times during the day.

hope this helps,

Mitch


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