Posted by SLS on August 9, 2015, at 6:47:56
In reply to Geodon add on?, posted by Sheilac on August 8, 2015, at 9:14:14
> > I was experiencing some irritability mania from taking Tramadol. My pdoc pushed my Geodon from 120mg to 160mg.
>
> Both tramadol and Geodon act somewhat like Effexor. Both drugs together might be pushing too much serotonin for you, and is producing mania. Since it is imperative that you continue to take an anti-manic drug like antipsychotics, you might do best to discontinue the tramadol in favor of another opioid or Lyrica. I still like Trileptal for you - or perhaps the newer sister drug, Aptiom (eslicarbazepine) to control your irritability and mania. I know it leaves you feeling somewhat depressed, but you can work on that separately.It occurs to me that adding Lamictal to either Trileptal or Aptiom would help with the depression. I have seen this combination work well for mixed-states. You could also add Wellbutrin. Some people do experience more anger, irritability, and anxiety with Wellbutrin, but it is often a good antidepressant for bipolar disorder. It is less likely than SRIs to trigger mania.
Believe it or not, Topamax can effectively treat hypomanic mixed-states. Of course, this drug is known for producing memory and cognitive side effects. However, starting at a very low dosage and titrating very gradually can often prevent this from happening. Having done this myself, I found that my memory and cognition were not affected at all.
I don't think that anyone posting here on Psycho-Babble is a practicing psychiatrist. There should be an understanding that recommendations made by posters are really just suggestions meant for one to discuss with their doctor. I personally believe that taking combinations of drugs is perfectly safe and acceptable when administered properly, and is often absolutely necessary for people to feel better and build a life for themselves. High blood pressure and diabetes each often take more than one drug to treat effectively - why not psychiatric disorders? To take the stance that there is no place for polypharmacy in psychiatry is illogical.
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1081174
URL: http://www.dr-bob.org/babble/20150806/msgs/1081205.html