Posted by SLS on July 22, 2016, at 16:02:54
In reply to lithium » porkpiehat, posted by porkpiehat on July 22, 2016, at 11:26:51
> Doc said hypomania add lithium at a low dose. Going back to the generic lamictal would leave my depression unaddressed.
1. Low-dosage lithium (300 mg/day) might not be enough to control mania. My guess is that it will take 900 mg/day to do it. So, that lithium doesn't help control mania at low dosages does not mean that it will not work at high dosages.
2. I happen to like the combination of Lamictal and Trileptal (oxcarbazine) in your situation based upon things I have read and having seen a few people do well on it for its anti-manic and mood-stabilization properties. I have tried Trileptal. It is a very clean drug with respect to side effects. It didn't help my depression, but I wouldn't pass this drug over for treating your hypomania. The only side effect that should be monitored for is the development of hyponatremia - low blood sodium. If Trileptal works well to address your mania, then any reduction in the sodium levels in your body can be corrected using water restriction, increased salt intake, or low dosages of diuretics.
3. There's Depakote, but you would have to reduce your dosage of Lamictal by 50% to compensate for the interaction between the two drugs. Depakote hinders the body's ability to eliminate Lamictal. I think glucuronidation is involved here. Depakote can cause weight-gain and minor depression. I have no statistics to characterize the incidence of these things happening. Personally, I find that Depakote takes care of my mania within hours. Lithium does not reduce my mania, regardless of dosage. The key to getting an immediate response to Depakote is to begin treatment using loading-doses. However, it doesn't sound like there is enough urgency in your condition to do this. My guess is that the average dosage necessary to treat mania or hypomania is 1000-1500 mg/day. There is great variability, with people doing well at dosages of 750-2000 mg/day. I'm pretty sure that there are blood tests that can be used as guidelines.
4. Zyprexa (olanzapine) can be used acutely if immediate relief is necessary. You might not ever need to use it, but it is good to know that this antipsychotic drug can squash mania in 12 hours at a dosage of 5 mg/day.
I hope you find an answer soon.
- 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
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