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Re: Micromedex Warning on Aptiom But With Benefit » LouisianaSportsman

Posted by klein on May 6, 2014, at 20:11:17

In reply to Micromedex Warning on Aptiom But With Benefit, posted by LouisianaSportsman on May 5, 2014, at 23:46:19

> Eslicarbazepine is a CYP34A inducer so it would reduce my Latuda requiring me to up the dosage--
>
> Based on this study:
>
> RESULTS: ESL significantly decreased the systemic exposure to both ethinylestradiol and levonorgestrel. GMR (90%CI) for AUC0-24 of ethinylestradiol were 68% (64%; 71%) following 1200mg ESL and 75% (71%; 79%) following 800mg ESL. GMR (90%CI) for AUC0-24 of levonorgestrel were 76% (68%; 86%) following 1200mg ESL and 89% (82%; 97%) following 800mg ESL.
>
> I would need about ~25% increase of Latuda which would be 75mg., so there are 80mg. tablets which I have handled perfectly fine in the past. No biggie.
>
> But, Aptiom is a CYP2C19 inhibitor which means it would increase my Brintellix, which is perfectly fine with me, as I was thinking about moving up my dose anyway, this sounds like a perfect way to do it. -- this is the Benefit as discussed in the Subject.

Hi L.

Eslicarbazepine (never heard of it before) sounds like a good choice for mood issues. Any chance that some of these issues are due to minor withdrawal?

Also: gabapentin and lamictal are usually anxiolytic, are you sure you're tolerating the Desoxyn well? Maybe lowering the dosage could make you feel less edgy. (no personal experience there)

You know that I'm going to recommend Saphris. Here's my experience: it's highly sedating for a few hours, promoting really good sleep (6 hours). Then when I wake up, I feel really motivated and clear-headed (no hangover). I love the stuff because the effect is pretty much immediate, whereas with most AAPs you need to wait for a few days til you notice an effect.

Geodon is a good second choice, it works within a few days, but the results, IME, are nowhere near as dramatic as with Saphris. If you stick to a low dose it should be mildly activating (be weary of akathisia though!). The only major issue with Geodon is having to take it with food (at least 500 calories) twice daily.

Switching to Ativan is an excellent choice, as you won't have to worry about eslicarbazepine lowering its level or Luvox (never tried it) raising the blood levels.

OK, hope this helps :)


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