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Dr. Bob is Robert Hsiung, MD,
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Posted by Phillipa on May 17, 2005, at 18:12:20
In reply to Re: Paging Ed UK:Can Zoloft be taken with Wellbutrin? » stresser, posted by ed_uk on May 17, 2005, at 17:40:44
Stressor, I did take l50mg of trileptal and it didn't cause any wt gain. I thought l50mg was consided a low dose? It was supposed to help me sleep and improve my mood. I don't have a dx of bipolar that I'm aware of. Fondly, Phillipa
Posted by stresser on May 17, 2005, at 20:32:13
In reply to Re: Paging Ed UK:Can Zoloft be taken with Wellbutrin?, posted by Phillipa on May 17, 2005, at 18:12:20
Phillip,
Did it improve your mood? I'm a really nervous for her to start taking it, anything else. How do people deal with this for an entire life time? How long does it take to find the correct medication? -L
Posted by HappyGirl on May 18, 2005, at 0:25:43
In reply to Re: Paging Ed UK:Can Zoloft be taken with Wellbutrin?, posted by stresser on May 17, 2005, at 16:58:22
Hi:
>>> The nurse just called back, and the doctor has put her on 75mg of Trileptal as well as what she has been taking. How does that sound to all of you? <<<--- Recalling your daughter has 'irritability problem' in your previous post, ... in my 'good' guess, ... this/irritability is somehow related to 'bad-side hypomanic' side, not due to depression, ... for that reason she NEEDS more 'legitimate' mood-stabilizer, Trileptal. Also, I recall, she's on another M.S., Topamax, however this med. is NOT a truly mood-stabilizer. Rather, it's an 'add-on' mood-stabilizer to assist 'pure' form mood-stabilizer, such as Depakote, Lithium, and others. In this regard, ... hopefully your daughter gets a 'good' benefit from starting on Trileptal.
I read some of Bper's are quite content with this mood-stabilizer. As we all know, everyone reacts differently on various form of psycho.meds. In regard to 'weight-gain,' I rarely read 'terrible' weight issue attached to this M.S. Rather, some are quite happy about a good result with it. As for 'four' different meds., ... most of Bper's need this amount/# meds., believe or not, ... partly because of a complexity of this M.I. I, too have been on 'four' meds., ... it didn't happen overnite tho'. My competent pdoc. rx'ed one med. at a time over the years and my Bp symptoms/Bp II with rapid-cycler has been ALMOST 'remission,' not having the highs and lows I was years ago. Then, 'HOPE' is there.
Please keep us posted how she's doing on new med. regimen.
H.G.
Posted by Phillipa on May 18, 2005, at 0:31:59
In reply to Re: Paging Ed UK:Can Zoloft be taken with Wellbutrin? » stresser, posted by HappyGirl on May 18, 2005, at 0:25:43
Stressor, To be honest, I really don't know. I switched pdocs and he discontinued it after about a month. I still have a bottle in my drawer. I'll have to watch all of your posts and others. Right now I could use something to improve my mood. But I really think that is quite a low dose and she will probably not have any problems. Fondly, Phillipa
Posted by Nickengland on May 18, 2005, at 5:30:57
In reply to Re: Paging Ed UK:Can Zoloft be taken with Wellbutrin? » stresser, posted by HappyGirl on May 18, 2005, at 0:25:43
I agree with what happy girl said. The topamax is not a well established mood stabilier, I think even in epilepsy its a second line drug.
Its worth considering, putting lithium aside, all the other main mood stabiliers are drugs for epilepsy..and how well these drugs perform in epilepsy often reflect how well they treat bipolar.
Carbamazepine is considered one of the best drugs for epilepsy and theres hardly any difference between carbamazepine and oxcarbazepine/Trileptal.
Try not to worry about your daughter having yet another drug, because now she has a very good mood stabiliser on board.
75mg is as smallest dose as you can get. As in you can't make the tablets any smaller. The minium dose from epilepsy is 600mg.
I take 1 drug for my bipolar and I have 300mg of Trileptal - its the best mood stabiliser ive taken, and pretty much controls all my symptoms, and no weightgain.
Have a read of:
http://www.psycheducation.org/depression/meds/moodstabilizers.htm
Its a psychiatrists point of view of mood the different mood stabiliers(you can click the link for each one) that will give you some information of how well they perform
Posted by stresser on May 18, 2005, at 12:27:20
In reply to Re: Paging Ed UK:Can Zoloft be taken with Wellbutrin?, posted by Nickengland on May 18, 2005, at 5:30:57
I wonder why Topamax and Zoloft are working so well for me? If Topomax is an add-on stabilizer, then why am I responding to it? -L
Posted by Phillipa on May 18, 2005, at 17:50:27
In reply to Re: Paging Ed UK:Can Zoloft be taken with Wellbutrin?, posted by stresser on May 18, 2005, at 12:27:20
Nickengland, So does this mean that the old pdoc lied to me? He never diagnosed me as bipolar. Just said the trileptal would help my mood and with sleep. Fondly, Phillipa
Posted by HappyGirl on May 18, 2005, at 18:27:37
In reply to Re: Paging Ed UK:Can Zoloft be taken with Wellbutrin?, posted by stresser on May 18, 2005, at 12:27:20
Hi:
>>> I wonder why Topamax and Zoloft are working so well for me? If Topomax is an add-on stabilizer, then why am I responding to it? -L <<<--- My 'best' guess is that your Bipolar is a VERY milder form, and more close to 'depression'/unipolar with miniscule hypomania.
However, on the otherhand, your daughter is most likely a true nature of Bipolar, called Bipolar II. It's not serious but still she needs Bipolar med. regimen that includes a mood-stabilizer, anti-depressant and plus ADD brought on by a depressive side of her Bipolar(very commmon among Bper's).
As for Mom of a 17-year High-school kid, you must be quite disappointed to read/hear this. However, unlike 'old' days, in the 70' and 80', with a modern med. regimen along with necessary psycho-therapy, your daughter will be back to 'old' self soon.
H.G.
Posted by Nickengland on May 19, 2005, at 7:13:31
In reply to Re: Paging Ed UK:Can Zoloft be taken with Wellbutrin?, posted by Phillipa on May 18, 2005, at 17:50:27
Hello Phillipa
When you say why did the pdoc lie to you, do you mean why did he give you a mood stabiliser which is used for bipolar - if you not bipolar?
If you were having sleeping problems at that time and perhaps your mood was such that things needed to be balanced out, i can only guess that for those reasons he thought the Trileptal may help - As I doubt he was giving it to you to prevent mania.
It makes sense in some ways as Trileptal deifnately does help with sleep..
Kind regards
Nick
Posted by stresser on May 19, 2005, at 13:36:35
In reply to Re: Paging Ed UK:Can Zoloft be taken with Wellbutrin? » stresser, posted by HappyGirl on May 18, 2005, at 18:27:37
I am actually relieved to have a diagnosis as to what is wrong with her. She had been seeing a psychologist for about a year and one half, and not getting any better. I had asked him if he thought she was bipolar, and he said no. After some time, we decided to find someone else, because her father and I couldn't stand her anymore. She was unhappy, and her grades were falling. She had gone from an A student to a C student, within one year. She couldn't handle the smallest situation, and was using food as a self-medication. I did endless amount of research and new there was something else other than depression going on with her. I went to her old pdoc and asked for the Topamax myself, and that's how she got started on it to begin with. I had to ask for the Adderall several times, (her new pdoc) before he would give it to her. It helped emmediatly, and I wish he had given it to her months ago. I hope this is making sense, because I am in a hurry. Thanks for your help. -L
Posted by Nickengland on May 19, 2005, at 14:33:50
In reply to Re: Paging Ed UK:Can Zoloft be taken with Wellbutrin? » HappyGirl, posted by stresser on May 19, 2005, at 13:36:35
Hello there,
Just out of curosity, what were the symptoms of your daughters hypomania/mania to get a diagnosis of manic depression?
Kind regards
Nick
Posted by Phillipa on May 19, 2005, at 19:10:57
In reply to stresser, posted by Nickengland on May 19, 2005, at 14:33:50
So, you think he just wanted to give me the trileptal to help augment my other sleep meds? Fondly, Phillipa
Posted by stresser on May 19, 2005, at 20:40:03
In reply to Re: stresser » Nickengland, posted by Phillipa on May 19, 2005, at 19:10:57
She was continuing to be intollerable, and everything that happened was a drama. Getting up and going to school was an event in itself. When she comes home, I never know who is coming through that door. It's as if she's angry at everyone, and can't find any humor in anything anymore. Do you consider that symptoms for needing Trileptal? Please give me you opinion. -L
Posted by Phillipa on May 19, 2005, at 20:49:48
In reply to Re:Symptoms for Trileptal, posted by stresser on May 19, 2005, at 20:40:03
Stressor, How much of it do you suppose could be due to being that age and all the hormone surges? Fondly, Phillipa
Posted by HappyGirl on May 20, 2005, at 0:31:03
In reply to Re:Symptoms for Trileptal, posted by stresser on May 19, 2005, at 20:40:03
Hi:
In my 'good' guess is that your daughter at 17, she has a lot going on in her mind, ... school work, peer-pressure, clothes-wearing, boy-friend and much more and plus, an added-problem, Bipolar.Has she been on any sorts of therapy, or counselling to get through all of this? Most of cases, those with newly dx'ed Bipolar need definitely some sort of 'counselling.' Because, talking 'inner' pressure, ... 'stress' does NOT resolve on medications-therapy alone. As we all knows, 'Stress' is #1 enemy once coming to M.I. I got a VERY good one in the beginning and recalling that the lady with a good knowledge of M.I. helped me tremendously, although I was in my early 20's, then. Because, talk with the close members is NOT enough. Needs a professional help. At least this was my view through the experience.
Lastly, ... if her 'intense' irritability keeps on, then you need to call her pdoc. to get 'further' evaluation. Most likely, she may need another form of med. In my case, Zyprexa is a good answer for this, ... but if you're worrying about weight issue, then other similar A.Ps., Geodon or Abilify might be a good choice. But, this is just my 'personal' view. You need to talk to her pdoc., if she doesn't show 'any'improvement next few more days.
H.G.
Posted by Nickengland on May 20, 2005, at 5:22:49
In reply to Re: stresser » Nickengland, posted by Phillipa on May 19, 2005, at 19:10:57
Generally the main use of Trileptal in mood disorders will be given to prevent mania, even that use is "off license" Seeing as its so similar to Tegretol it makes sense to use it for a mood stabiliser/anti manic though.
If you have no problems with your mood going "up" then there would be no need really to use this med.
However you use benzo's for sleep? Because of the risks they can have with regards to loosing their effectiveness...possibly meaning they are not working so well for sleep as they should - Taking the trileptal although its not a sleeping tablet, it sure does promote sleep. So maybe he gave it to you for like a safety barrier measure against if your benzos were to reduce in effectiveness?
I have read somewhere aswell that carbamazepine/tegretol is sometimes used when trying to come off of benzos, to help with withdrawal symptoms. So there seems to be a link somewhere there.
If you found that the oxcarbazepine/trilepal didnt work so well for sleep and you still feel you need something........I defiantely suggest you try Tegretol/carbamazepine as ive tried both and found the tegretol seems to have more power..i.e it will be like 10x better with regards to sleep.
Its kind of like Marlborough and Marlborough Lights....with trileptal being the light version you know? lol
Hope that makes sense :-)
Kind regards
Nick
Posted by SLS on May 20, 2005, at 7:23:01
In reply to Re:Symptoms for Trileptal » stresser, posted by HappyGirl on May 20, 2005, at 0:31:03
> Hi:
> In my 'good' guess is that your daughter at 17, she has a lot going on in her mind, ... school work, peer-pressure, clothes-wearing, boy-friend and much more and plus, an added-problem, Bipolar.
>
> Has she been on any sorts of therapy, or counselling to get through all of this? Most of cases, those with newly dx'ed Bipolar need definitely some sort of 'counselling.' Because, talking 'inner' pressure, ... 'stress' does NOT resolve on medications-therapy alone. As we all knows, 'Stress' is #1 enemy once coming to M.I. I got a VERY good one in the beginning and recalling that the lady with a good knowledge of M.I. helped me tremendously, although I was in my early 20's, then. Because, talk with the close members is NOT enough. Needs a professional help. At least this was my view through the experience.
>
> Lastly, ... if her 'intense' irritability keeps on, then you need to call her pdoc. to get 'further' evaluation. Most likely, she may need another form of med. In my case, Zyprexa is a good answer for this, ... but if you're worrying about weight issue, then other similar A.Ps., Geodon or Abilify might be a good choice. But, this is just my 'personal' view. You need to talk to her pdoc., if she doesn't show 'any'improvement next few more days.
> H.G.
I agree that a thorough evaluation should be performed by a psychiatrist to look for things like MDD (major depressive disorder), bipolar disorder, and BPD (borderline personality disorder), and even AD/HD (attention disorder/hyperactivity disorder). If these things can be ruled-out, then psychotherapy might be the best choice. For BPD and conduct disorders, Tegretol and Trileptal and Zyprexa seem to work well. I would go with the Trileptal first, though. It eliminates the need for the frequent blood tests that the use of Tegretol requires. It also avoids the potential for weight-gain and diabetes that Zyprexa carries.Even if medication is warranted because a true psychiatric disorder is present, psychotherapy would still be a good idea, especially with a borderliner, for which specialists are available. They sometimes require a form of therapy known as DBT (dialectical behavioral therapy).
- Scott
Posted by Nickengland on May 20, 2005, at 7:47:42
In reply to Re:Symptoms for Trileptal, posted by stresser on May 19, 2005, at 20:40:03
Trileptal, very much seems to help with anxiety, agitation, being irritable and sleep problems.
It will help to keep the mood from going "up" too as in hypomania/mania as this is its main use.
Tegretol which is very similar to Trileptal/oxcarbazepine acts very much the same way, with the differemce being Tegretol/carbamzepine is slightly stronger, which is turn does slightly have more side effects.
On the other hand, i've read that topamax can "cause" agitation, sleep problems and anxiety. Is possbily the topamax doing her more harm than good?
Either way it looks like your on the right tracks with using trileptal.
Sometimes when I read on this board people are taking a medication, but then symtoms are still persisting they often add another med, which dont get me wrong in some respects that makes sense.
Perhaps it could be that for her, the Topamax is causing more harm than good - if thats the case "adding" something to that doesn't make sense. I would think "replacing" it would be better. That way its one less problem, less side effects and overall less medication which adding more seems to make things more complicating with knowing which med is helping what?/and more importantly not helping what - and if thats the case making things worse?
As obviously someone with bipolar goes through the very extream down depressive side..I was just curious about her hypomania with regards to the oppisite side of depression
Has she had the typical symtoms of feeling extream happniess, lots of energy, full of confidence..resulting in reckless behaviour etc for a sustained pererd of time like a couple of weeks, or months?.
Posted by stresser on May 20, 2005, at 13:30:15
In reply to Re:Symptoms for Trileptal stresser, posted by Nickengland on May 20, 2005, at 7:47:42
To answer all of your questions, she IS seeing a psychologist, and has taken an MMPI test. Therefore; she is seeking therapy, and it has helped so far. It took us two years to find the correct doctor so that we could get the correct diagnosis to begin with.
She tried going off the Topomax, and that resulted in meltdown that took months to get back to where she is right now. It also brought back the binge eating disorder somewhat.
She does not have the manic type symptoms that are typical of Bipolar I, because she's not BPI. Not reckless, or over confident etc. She threw her psychiatrist off quite a bit with that, that's why it took so long to diagnose. She has just a bit of BDP, (Tiny).
She also has had her thyroid tested TWO times, (not cheap) and now we know it's not hormonal.
It may seem as if she isn't getting proper medical attention or therapy, but being the aggressive mother that I am, she is.-L
Posted by Minnie-Haha on May 20, 2005, at 15:10:29
In reply to Re: Paging Ed UK:Can Zoloft be taken with Wellbutrin?, posted by stresser on May 17, 2005, at 16:58:22
> The nurse just called back, and the doctor has put her on 75mg of Trileptal as well as what she has been taking. How does that sound to all of you? Will that cause weight gain? I really hate the fact that she is taking four medications, because that seems to be quite a bit for a 17 year old. -L
FWIW: I have NOT had a problem with weight gain on Trileptal. (Depakote was the one that did THAT to me.)
Posted by Minnie-Haha on May 20, 2005, at 15:13:22
In reply to Re:Symptoms for Trileptal, posted by stresser on May 19, 2005, at 20:40:03
> She was continuing to be intollerable, and everything that happened was a drama. Getting up and going to school was an event in itself. When she comes home, I never know who is coming through that door. It's as if she's angry at everyone, and can't find any humor in anything anymore. Do you consider that symptoms for needing Trileptal? Please give me you opinion...
Anger and irritability can be a part of the manic phase of bipolar disorder. I got a little agitated when I added Wellbutrin to my Cymbalta, so I upped my Trileptal a smidge and that helped. (I'm BP2 and Trilep is my mood stabilzer.)
Posted by stresser on May 20, 2005, at 22:37:58
In reply to Re:Symptoms for Trileptal, posted by Minnie-Haha on May 20, 2005, at 15:13:22
That's exactly what I was told by the nurse, so you just confirmed it! The wellbutrin may not be a good thing, I just don't know why he keeps her on it. Do you still take it? -L
Posted by Minnie-Haha on May 21, 2005, at 12:41:12
In reply to Re:Symptoms for Trileptal, posted by stresser on May 20, 2005, at 22:37:58
> That's exactly what I was told by the nurse, so you just confirmed it! The wellbutrin may not be a good thing, I just don't know why he keeps her on it. Do you still take it? -L
Yes, I do, but I had to up my mood stabilizer a bit to counteract the slightly increased agitation. He might be keeping her on it for the same reasons I'm on it: to help increase energy/motivation, and to try to prevent weight gain. Have you asked?
Posted by stresser on May 21, 2005, at 17:22:17
In reply to Re:Symptoms for Trileptal, posted by Minnie-Haha on May 21, 2005, at 12:41:12
No, I haven't had the chance to yet, but I will next week when I go in with her. I do think the Trileptal is helping already, and it's only been five days. The nurse told me that I would see a difference in a matter of days, and it's true. (even at 75mg) She's not a time-bomb, ready to explode so much today, and yesterday. I hope it continues. -L
Posted by Phillipa on May 21, 2005, at 17:48:24
In reply to Re:Symptoms for Trileptal » Minnie-Haha, posted by stresser on May 21, 2005, at 17:22:17
Keep us posted Stressor. I still have that bottle of trileptal in my drawer. Do you think it helps with negativity? Fondly, Phillipa
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