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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Nickengland on June 29, 2005, at 10:23:21
..Went extreamly well :-)
Saw my psychiatrist today and had to explain I stoped taking Trileptal/Tegretol because of the kidney pains blah blah blah.. He asked the usual questions and that was that.
Then.lol.Hmmm..I told him I have been taking 900mg of Neurontin & 50mg of Topamax for the past few weeks. Without going into too much detail I didn't mention this on the board to people as I have been self prescribing this, simply due to the fact of the NHS waiting times, my GP being helpless in not being able to give me anything and these 2 meds being my only option left. I felt the risk was worth the benefits instead of waiting months upon months of waiting for something he may refuse anyway. I basically took 'drastic' action and i'm glad to say I have been responding excellently to both drugs so far..
I explained this to him in the best way possbile and even brought my mother along with me as a witness so she could confirm everything had gone alright with what I had done.
Well the expression on his face... Totally Flabbergasted!!! :-o He asked where I got them from, I explained, he then said what doses are you taking, I told him...(all the time he's writing this down) He said he has some knowlege of Gabapentin...but he has never used Topiramate before...how did I know this was used in bipolar?? - He's a Consultant Psychiatrist and I have to tell him?! I explained its more or less widely used in the US and the National Institute of Mental Health over there have been studing it for the past few years and doctors have been giving it to patients etc.. He then said what about the interaction with gabapentin..I then said from what I understand it can be safely combined and gabapentin can in fact be safely compined with most if not all anti epileptic drugs.. More questions were asked..and to my delight I was able to give the correct answers..
So to summarise, he didn't moan at me one bit for what I did at all and was understanding to some extent I think as to why I had to resort to such measures in the first place. He did try to basically say which one would you like to take, which is the best? (as in i'll prescribe 1) but I answered, well both. the gabapentin has killed my anxiety which was very bad and has been an issue from day 1. But the Gabapentin doesnt provide any mood stabilisation ~ Thats why the Topamax is needed because it appears so far to work very much like other mood stabilisers i've taken eg, like Triletpal, its keeping my moods in check with regards to preventing it going up and down..
No problem he said, I just need afew days to make sure the 2 drugs can be taken safely together, then you phone my secretary in afew days to see that its ok that they can...then you will have a letter to your G.P saying its ok to take both Topiramate and Gabapentin prescribed by him...
Quite an interesting appointment just to see the shock on his face!
Main thing is though i'm so reliefed, this combination seems to working perfectly with little side effects, its even better than when I was taking Trileptal and I thought that was great. Oh well, I know it may not last forever but I certainly feel like i've made some progress.
Nick 1 : Bipolar 0
^ I feel like I'm in control of winning this now
Thanks for taking the time to read..Kind regards
Nick
Posted by ed_uk on June 29, 2005, at 10:42:52
In reply to Todays Psychiatrist Appointment....., posted by Nickengland on June 29, 2005, at 10:23:21
Hi Nick!
>Totally Flabbergasted!!! :-o
HAHAHA!!!!
>he has never used Topiramate before...how did I know this was used in bipolar?? He's a Consultant Psychiatrist and I have to tell him?!
Oh.... our lovely NHS pdocs. Mine knows Prozac - that's about it.
>he didn't moan at me one bit for what I did........
:-)
>I just need afew days to make sure the 2 drugs can be taken safely together.....
No problem there :-) Best of luck getting your GP to prescribe it - I hope he's heard of Topamax. UK GPs prescribe a lot of Neurontin but not much Topamax. I think he'll probably have heard of it though.
Kind regards
~Ed
PS. Keep up the good progress :-)
Posted by Nickengland on June 29, 2005, at 15:10:15
In reply to Re: Todays Psychiatrist Appointment..... » Nickengland, posted by ed_uk on June 29, 2005, at 10:42:52
Hi Ed!
I always have a strange horrible feeling of disgust before I see the psychiatrist on the NHS here..lol thats the only way I can describe it...but today was a good result ~ if I wouldn't have done what I did though and just would have went along and asked theres not a chance he would of even considered giving me both...no way.
It'll be ok if he hasnt heard of Topamax though won't it?...doesn't he just type "Topamax" on his computer and can print off the prescription from there?....how do you mean best of luck...Ed LOL your worrying me!.. can he refuse to give it to me?! :-0
Kind regards
Nick
Ps HAPPY 21ST BIRTHDAY!!!!!!!!!!!!!!!!!!!!!!!!!!!
Posted by Phillipa on June 29, 2005, at 18:48:06
In reply to Re: Todays Psychiatrist Appointment....., posted by Nickengland on June 29, 2005, at 15:10:15
Ed, Is it your birthday? I'll have to check social. Fondly PJOOXX
Posted by Maxime on June 29, 2005, at 20:52:20
In reply to Todays Psychiatrist Appointment....., posted by Nickengland on June 29, 2005, at 10:23:21
*snif* I love happy endings. :)
Maxime
> ..Went extreamly well :-)
>
Posted by ed_uk on June 29, 2005, at 21:28:22
In reply to Re: Todays Psychiatrist Appointment....., posted by Nickengland on June 29, 2005, at 15:10:15
Hi Nick :-)
>I always have a strange horrible feeling of disgust before I see the psychiatrist on the NHS here..
Hehe, you're not the only one!!!
>It'll be ok if he hasnt heard of Topamax though won't it?...
Yeah I think so :-) He'll find it on the computer and print you a script. He'll probably look it up in the BNF as say 'Isn't this drug for epilepsy?'
>can he refuse to give it to me?! :-0
It should be fine...........when he gets your pdocs letter :-) I don't think you've got anything to worry about.
Kind regards
~Ed
Posted by Nickengland on June 30, 2005, at 10:17:13
In reply to Re: Todays Psychiatrist Appointment....., posted by Maxime on June 29, 2005, at 20:52:20
LOL Thanks Maxine :-)
Hows the Provigil going by the way?...I'm interested how this stimulant will suit you (I think and hope it will work well) I've just been in a book shop and was reading about this in the use of bipolar and to me it seems the best stimulant to try....as hopefully you should avoid the crashes..
Let me know how it goes :-)
Kind regards
Nick
Ps I also read it was a kinda "smart drug" - good for keeping you intelligent so it said in the newspaper ;-)
Posted by Nickengland on June 30, 2005, at 13:39:45
In reply to Re: Todays Psychiatrist Appointment..... » Maxime, posted by Nickengland on June 30, 2005, at 10:17:13
Hi Maxime
Sorry I always spell your name with an 'n' Maxine-Maxime near the end....just the way I think of it being said in my head?!
I'll try not to do it again :-0 lol
Nick :-)
Posted by Nickengland on June 30, 2005, at 13:58:26
In reply to Re: Todays Psychiatrist Appointment..... » Nickengland, posted by Nickengland on June 30, 2005, at 13:39:45
Posted by Jakeman on June 30, 2005, at 19:19:46
In reply to Todays Psychiatrist Appointment....., posted by Nickengland on June 29, 2005, at 10:23:21
Nick,
Thanks for that report, excellent. Somehow moving from a passive to an active role in our treatment is in itself very therapeutic. Ideally I want a doctor there for advice and oversight, but too frequently: I can't afford a doctor, or I can't get an appointment, or the doctor is not knowledgable or is extremely biased. So like many people (especially those without insurance in the US) there are times that I've resorted to ordering medications myself.
I was wondering what effect the Gabapentin has had, if any, on the quality of your sleep? I posted this question on separate thread but no one has responded. Also, have you tried Lyrica (UK name maybe different?).
good luck ~Jake
Posted by ed_uk on June 30, 2005, at 20:32:52
In reply to Re: Todays Psychiatrist Appointment..... » Nickengland, posted by Jakeman on June 30, 2005, at 19:19:46
>Also, have you tried Lyrica (UK name maybe different?).
Same name :-)
~Ed
Posted by Jakeman on June 30, 2005, at 21:26:08
In reply to Re: Todays Psychiatrist Appointment..... » Jakeman, posted by ed_uk on June 30, 2005, at 20:32:52
Posted by Nickengland on July 1, 2005, at 7:58:49
In reply to Re: Todays Psychiatrist Appointment..... » Nickengland, posted by Jakeman on June 30, 2005, at 19:19:46
Hello Jake :-)
I completely understand the frustrations you have with getting a doctor who can be there for you to give advice and insight. I have never had this ever thoughtout the past 5 years of my experience with psychiatrists. Although it can be highly risky to take matters into your own hands so to speak and "play doctor" to treat yourself..I think postively if done responsibly and seen as a means to an end, you can over-ride the misfortunates of not having the support of a doctor and achieve a great sense of satisfaction knowing that you are persoanlly taking such an active role in getting your health better..I certainly don't advocate this sort of treatment, but when forced into this kind of situation what other choice do you have..
Overall Gabapentin has had a positive effect on my sleep as it tends to be sedating....certainly not activating anyway.
To gain the best results for sleep, I would recommend taking the last 2 doses of the day very close to before you go to bed i.e. Have the actual last dose definately within 3 hours before sleeping and if possible even 2 or 1 hours before sleeping.
I'm still experiementing with the best timing of the 3 doses I have (300mg x 3 = 900mg a day) So far I quite like having the first dose a couple iof hours after waking. This seems to do well for anxiety during the day. Come around 5pm taking the second dose. Then about 2 hours before I go to bed I have the final dose.
I've found that if I take all the doses too early through the day, I'm more drowsy during the day... then my sleep is not so good at night (not that its too bad) but the more evenly there spaced out and the nearer the last 2 doses are to bedtime is better for sleep and this actually avoids any drowsyness thoughout the day so that you can be more "switched on"
I haven't tried Lyrica ~ I am fairly happy with the Neurontin right now and topamax and really I want to take this for as long as possible now to gain as much long-term stableness as I can. That said...Lyrica is always at the back of my mind as a back-up and i'm sure in time to come I will try it, simply out of curosity if anything! Right now though everything seems to work fine, so I'm just going to leave things as they are..
Hope that helps..
Are you planning to try Neurontin or are you taking it at the moment?
Kind regards
Nick
Ps If you're wanting to try Gabapentin and your seeking more information, theres a thread below with some more stuff about dosages of Neurontin and usage etc you may find helpful too...
Posted by Jakeman on July 1, 2005, at 20:53:12
In reply to Re: Todays Psychiatrist Appointment..... » Jakeman, posted by Nickengland on July 1, 2005, at 7:58:49
Hi Nick,
Thanks for telling about your experience including dosages. I haven't tried it yet but I've been thinking about adding Neurontin to hopefully provide a bit of a mind calming and sedative effect and to help with sleep. I go back to the sleep doctor in about two weeks. He did recommend gabitril initially which I took but it only seemed to work for about two weeks and then faded. I didn't think about it at the time, but now I'm wondering if adding a precursor nutrient like GABA might alleviate some of the poop-out effects that many people have reported from the GABA enhancing drugs.
Like you I'm considering Lyrica as a back-up alternative, but I don't think it's available yet in the US. I'm glad you've have gotten some good results with your regimen.
best regards ~Jake
Posted by Jakeman on July 1, 2005, at 20:55:49
In reply to Re: Todays Psychiatrist Appointment....., posted by Jakeman on July 1, 2005, at 20:53:12
Meant to direct above posting to Nick. Of course all comments are encouraged.
> Hi Nick,
>
> Thanks for telling about your experience including dosages. I haven't tried it yet but I've been thinking about adding Neurontin to hopefully provide a bit of a mind calming and sedative effect and to help with sleep. I go back to the sleep doctor in about two weeks. He did recommend gabitril initially which I took but it only seemed to work for about two weeks and then faded. I didn't think about it at the time, but now I'm wondering if adding a precursor nutrient like GABA might alleviate some of the poop-out effects that many people have reported from the GABA enhancing drugs.
>
> Like you I'm considering Lyrica as a back-up alternative, but I don't think it's available yet in the US. I'm glad you've have gotten some good results with your regimen.
>
> best regards ~Jake
This is the end of the thread.
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