Posted by med_empowered on July 28, 2005, at 15:36:18
In reply to Re: Whats up with Trileptal?? med enpowered!!, posted by woolav on July 28, 2005, at 9:03:20
I used to take Trileptal with a cocktail of other meds at nite--not lamictal, but serqoeul sometimes, ambien, klonopin, neurontin, celexa, that kind of thing. Anyway, I did find that there were "synergistic" effects...basically, sometimes I could take something that was more or less non-drowsy with the Trileptal, and *BAM*, I got hit with the usual Trileptal sedation and a little extra. Weird. So, yeah, combining lamictal and trileptal could very well be part of the problem. Some people do 3X dosing...I imagine if you did something like a 300-150-150 split things might get better. How helpful is the lamictal? I'm just curious...I thought about it, but apparently the Trileptal induces liver enzymes that metabolize Lamictal over-efficiently...end result: you need bigger lamictal doses to get the same effect, which would presumably also cause side effect problems. You could lower your trileptal dose overall....you'd have less overall sedation, which would presumably help at nite. Then again you might also have more mood-swings, anxiety, etc. Its really a gamble. It could also be an "adjustment" phase...if this is the case, temporary adjunctive medication could help. Some docs will temporarily RX stimulants (Ritalin, Dexedrine, Adderall) to patients who find themselves over-sedated by needed medications. My own preference here would be for Provigil, or a stimulating Antidepressant such as Wellbutrin XL at a moderate-to-high dose in the AM. Good luck!
poster:med_empowered
thread:534139
URL: http://www.dr-bob.org/babble/20050728/msgs/534833.html