Posted by SLS on January 17, 2009, at 7:46:18
In reply to Re: Ideas on female hormonal dilemma?, posted by Cady on January 16, 2009, at 20:44:11
Hi Cady.
> (Scott, do you happen to know how long Trileptal can take to work?)
I am going to take the easy way out and say that it is variable depending on the person and the degree of non-menstrual, classic rapid cyclicity. Without rapid-cyclicity, you might feel some amelioration of rage as soon as your first menstrual cycle. I can't imagine that it would take anything longer than 3 months, however, I am only guessing. I was on Trileptal for a few months. I did feel slightly better within 2 weeks. For non-menstrual rapid-cyclicity, it often takes 2 or more mood stabilizers and 6 or more months before the treatment penetrates the cycle.
I know I am not being terribly helpful here. You are in relatively uncharted territory when it comes to making treatment choices with confidence. For instance, I have seen Trileptal and Lamictal help penetrate a rapid cycle in bipolar disorder, yet the Lamictal might be counterproductive in PMDD if the few reports I read reflect a majority. I don't know that they do. You still might want to give it a trial for yourself if you haven't already.
If you take Trileptal, and it doesn't seem to be helping or hurting, I would leave it in place and then perhaps add Topamax. If 2 is better than 1, you will never discover this by taking 1 at a time. With Topamax, if you begin low and titrate very gradually, you can often avoid the cognitive side effects it is notorious for producing. I had no problem with it. I have seen Topamax monotherapy treat very effectively mixed-mania with rage. Topamax is underestimated, I think.
I think using an AP is a good idea. Have you tried Seroquel?
- Scott
poster:SLS
thread:874289
URL: http://www.dr-bob.org/babble/20090104/msgs/874481.html