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Re:Q for Mitch » Ritch

Posted by Chloe on May 30, 2003, at 22:00:59

In reply to Re:Q for Mitch » Chloe, posted by Ritch on May 29, 2003, at 23:39:59

> Zonegran and Keppra.... Well, they are the newest anticonvulsants that have been approved (for epilepsy). Of course, pdocs are trying them off-label for bipolar in some of their patients. I have heard little that is positive. I definitely got very irritable on the Zonegran-no doubt. Keppra was very tolerable (physically), and I noticed decreased pain, better sleep, less GI disturbance (which I definitely liked!), but it seemed to slowly make me more and more depressed. That's the trouble with many AED's-they can aggravate or cause psychosis and depression. However, Lamictal (another AED), has a track record for helping bipolar depression specifically. Folks with epilepsy like it because they feel more "normal" or "like themselves" (fewer behavioural side effects). Lamictal is in Phase III trials for an FDA indication for bipolar depression. IOW, it's got the empirical science going for it, it is just the potential rash issues that freak people out (including me). It seems like Lamictal by itself may not be a very good antimanic and probably does little for psychotic symptoms (like lithium can). So it often combined with lithium or Depakote. I am interested in Lamictal as a possible means of getting through my bipolar depressions without needing AD's or not needing to increase the dose of the AD I currently take for anxiety(Effexor) to the point where it aggravates cycling. You might look into Abilify. It has some troubles with insomnia, akathisia, and some irritability in some-so I don't know how it would set with you. The nice thing is that it seems to have little dystonia-and I think that is one thing you have a lot of trouble with AP's---Mitch

Hi Mitch,
What you talk about is fascinating...Most of the AED's I have tried make me feel irritable and blah at the same time. I think that "mixed" kinda state is what lead me to ECT. Thank god for Li in my case. It is interesting though that lamictal is being tried for BP depression. If I remember right, Lamictal had a lot of physical things I really hated, like feeling so achy and uncomfortable in my body. I think it gave me headaches too, and this was all before I reached therapuetic dose! That was hard for me, titrating up so slowly. But you don't want to get that rash. If you do try it, I really hope it's beneficial to you...
Thanks, my pdoc mention abilify to me. But when I did a smallest amount of research, I say the side effects you mentioned. Irritability is one of my biggest problems. I have an extremely short fuse. And so I don't want to try a med that might work like gasoline. I also fear insomnia. Some days are so hard and so long, the thought of not being able to sleep through part of it is terrifying. But so are these tongue and jaw problems. I wish I knew if it's ok to even take Seroquel if it exacerbates my movements. Is there any way to know if the movements will get worse? They don't seem to be worse than when I was on Thorazine/Mellaril. The movements kinda stopped at the level where I d/c'd those typical AP's. Oh, back when Clozaril first came out I was put on that. It worked so great, no tongue stuff, no chronic suicidal thoughts. But I got the dreaded agranularcytosis. Go figure.
Well, I guess I am just rambling. I hope you like Lamictal-if you go for it.
Take care
Chloe


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