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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by sheilac on June 21, 2011, at 7:05:03
I was taking 450mg of Lithium with a blood level of .4 My doc wanted me up to 600mg with a higher blood level, but I just couldn't tolerate that. I was gaining weight rapidly and losing my hair (actually I started losing my hair on 450mg of Lithium!)
I am now doing a trial of Trileptal. Supposed to take 150mg at night. I have only been taking 75mg along with 1.5mg of Klonopin and it does make me feel mellow and fall asleep. During the night I sweat and get restless. Then the next morning I just feel drugged, even after coffee and Adderall.
I have had to increase my Adderall.
I am thinking that Trileptal is not the drug for me? It seems a lot stronger than Lithium.
If I have to increase my Adderall to function on Trileptal, possibly this is not the med for me?
This is crazy. I am considered soft bipolar II. I am not depressed. I just get irritable.
Maybe I am looking at the wrong class of meds. I just don't know anymore.
Would a low dose of Lithium along with Klonopin curb the irritability without making me fat and bald? Maybe I don't need a .8 blood level for soft BPII? I mean if I'm just trying to curb the irritabiity?
Posted by SLS on June 21, 2011, at 7:42:58
In reply to Trileptal kicking my butt!, posted by sheilac on June 21, 2011, at 7:05:03
> I was taking 450mg of Lithium with a blood level of .4 My doc wanted me up to 600mg with a higher blood level, but I just couldn't tolerate that. I was gaining weight rapidly and losing my hair (actually I started losing my hair on 450mg of Lithium!)
>
> I am now doing a trial of Trileptal. Supposed to take 150mg at night. I have only been taking 75mg along with 1.5mg of Klonopin and it does make me feel mellow and fall asleep. During the night I sweat and get restless. Then the next morning I just feel drugged, even after coffee and Adderall.
>
> I have had to increase my Adderall.
>
> I am thinking that Trileptal is not the drug for me? It seems a lot stronger than Lithium.
>
> If I have to increase my Adderall to function on Trileptal, possibly this is not the med for me?
>
> This is crazy. I am considered soft bipolar II. I am not depressed. I just get irritable.
>
> Maybe I am looking at the wrong class of meds. I just don't know anymore.
>
> Would a low dose of Lithium along with Klonopin curb the irritability without making me fat and bald? Maybe I don't need a .8 blood level for soft BPII? I mean if I'm just trying to curb the irritabiity?
It is sometimes worth being patient with the startup effects of drugs in that they often mitigate over time. I would consider not self-medicating based upon how you feel hour-by-hour.
- Scott
Posted by sheilac on June 21, 2011, at 8:05:30
In reply to Re: Trileptal kicking my butt! » sheilac, posted by SLS on June 21, 2011, at 7:42:58
So, you think stick with the Trileptal and see what happens?
At this point I don't know if Lithium or Trileptal is the med to counter the irritability.
Posted by SLS on June 21, 2011, at 9:40:00
In reply to SLS -Re: Trileptal kicking my butt!, posted by sheilac on June 21, 2011, at 8:05:30
> So, you think stick with the Trileptal and see what happens?
>
> At this point I don't know if Lithium or Trileptal is the med to counter the irritability.
>
>
As I am sure you know, Trileptal is a cousin of Tegretol. Both drugs have shown efficacy in treating aggression and hostility. Trileptal also helps manage mixed states. I have seen Topamax work well with mixed states as well at dosages of 100-200mg.
- Scott
Posted by Christ_empowered on June 21, 2011, at 11:07:29
In reply to Re: SLS -Re: Trileptal kicking my butt! » sheilac, posted by SLS on June 21, 2011, at 9:40:00
I'd personally take trileptal over lithium, but trileptal made me pretty stupid over the long haul. Not only was my thinking impaired, when I talked I sounded like a stoner.
Posted by floatingbridge on June 21, 2011, at 11:11:22
In reply to Re: SLS -Re: Trileptal kicking my butt!, posted by Christ_empowered on June 21, 2011, at 11:07:29
Hang in there Sheila. I agree w/giving it a fair trial.
One question: did your doc push up the lithium because of symptom control or to hit the chart? Just curious.
Good luck!
Posted by Phillipa on June 21, 2011, at 11:25:05
In reply to Re: SLS -Re: Trileptal kicking my butt!, posted by floatingbridge on June 21, 2011, at 11:11:22
I took trileptal and not bipolar just supposed to help an an ad and felt absolutely nothing at all. How could this be it was also 150mg low dose was told. Phillipa
Posted by sheilac on June 21, 2011, at 14:27:58
In reply to Re: SLS -Re: Trileptal kicking my butt!, posted by Christ_empowered on June 21, 2011, at 11:07:29
> I'd personally take trileptal over lithium, but trileptal made me pretty stupid over the long haul. Not only was my thinking impaired, when I talked I sounded like a stoner.
>
>Yea, it does make me feel stoned! But at least I'm not mean! I just hope it doesn't make me fat!
I did have to take more Adderall just wake up and make it through the day.
I don't like the night sweats - hopefully that will pass.
Posted by sheilac on June 21, 2011, at 14:31:36
In reply to Re: SLS -Re: Trileptal kicking my butt!, posted by floatingbridge on June 21, 2011, at 11:11:22
> Hang in there Sheila. I agree w/giving it a fair trial.
>
> One question: did your doc push up the lithium because of symptom control or to hit the chart? Just curious.
>
> Good luck!FB - My doc didn't think the .4 level with Lithium was high enough. She wanted to get me up to .6, which is why she pushed me up to 600mg. But I just couldn't take walking around bloated (no matter how much I drank) and I started gaining weight fast at 600mg.
Posted by floatingbridge on June 21, 2011, at 14:50:49
In reply to FB - Re: Trileptal kicking my butt!, posted by sheilac on June 21, 2011, at 14:31:36
Were you still symptomatic at the lower blood level?
Posted by floatingbridge on June 21, 2011, at 14:58:14
In reply to FB - Re: Trileptal kicking my butt!, posted by sheilac on June 21, 2011, at 14:31:36
I don't necessarily have an opinion on which is best. Just the idea that maybe , you could get by on less lithium. Also I believe your body will acclimate to the sx of trileptil (sp), and if that hits the irritation, well, yay :-)
The sweats sound yucky. Night sweats?
Do you ever do Chinese medicine or other herbs? It could be alot for your
liver to handle, hence the sweating (just my thoughts). There is some good liver support formulas out there.Good luck with this.
fb
Posted by sheilac on June 21, 2011, at 15:53:49
In reply to Re: FB - Re: Trileptal kicking my butt! » sheilac, posted by floatingbridge on June 21, 2011, at 14:50:49
> Were you still symptomatic at the lower blood level?
>
>No. In fact I thought I could get away with 300mg.
Posted by sheilac on June 21, 2011, at 15:55:59
In reply to Re: FB - Re: Trileptal kicking my butt!, posted by floatingbridge on June 21, 2011, at 14:58:14
> I don't necessarily have an opinion on which is best. Just the idea that maybe , you could get by on less lithium. Also I believe your body will acclimate to the sx of trileptil (sp), and if that hits the irritation, well, yay :-)
>
> The sweats sound yucky. Night sweats?
>
> Do you ever do Chinese medicine or other herbs? It could be alot for your
> liver to handle, hence the sweating (just my thoughts). There is some good liver support formulas out there.
>
> Good luck with this.
>
> fbYea, the sweats are a pain in the butt. Plus, I'm only on 75mg of Trileptal and I feel stoned most of the morning. I never felt stoned on Lithium. I did get depressed after a while on Lithium - even on a "sub-theraputic" dose!
Posted by Christ_empowered on June 21, 2011, at 21:45:51
In reply to FB - Re: Trileptal kicking my butt!, posted by sheilac on June 21, 2011, at 15:55:59
I don't know what to tell you. I took a lot more trileptal (900-1200mgs), but that stoned feeling never really goes away. Plus it kinda made me dulled out and stupid over time.
Have you tried an alternative doc? I mean, OK, they're obviously not mainstream, but it seems like you've tried all the mainstream stuff and the side effects outweigh the benefits for many/most of these meds (except for the adderall). Supplements are cheaper and sometimes beneficial to your body and mind.
Just a thought.
Posted by floatingbridge on June 21, 2011, at 22:28:50
In reply to Re: FB - Re: Trileptal kicking my butt!, posted by Christ_empowered on June 21, 2011, at 21:45:51
Or convince the doc to lower the lithium? It's not bad stuff to be on in the 300 range.
More food for thought. But my advice is that whatever med is trialed, it's best to allow as full a time as possible to gather info and, well, it helps to keep away those 'what if' questions.
Posted by sheilac on June 22, 2011, at 7:16:33
In reply to Re: FB - Re: Trileptal kicking my butt! » Christ_empowered, posted by floatingbridge on June 21, 2011, at 22:28:50
Over many years will 300mg of Lithium hurt my kidneys like a higher dose would? Even if I am super med sensitive?
Posted by floatingbridge on June 22, 2011, at 7:26:37
In reply to 300mg Lith - Re: Trileptal kicking my butt!, posted by sheilac on June 22, 2011, at 7:16:33
That's best answered maybe by SLS, but I was told no. Just a neurogenic. I think about adding to whatever I may come up w/ for treatment, up to 300!mg.
Until someone else more knowledgeable weighs in,
Candace
Posted by SLS on June 22, 2011, at 8:20:53
In reply to 300mg Lith - Re: Trileptal kicking my butt!, posted by sheilac on June 22, 2011, at 7:16:33
> Over many years will 300mg of Lithium hurt my kidneys like a higher dose would? Even if I am super med sensitive?
>
>
Nephrotoxicity (kidneys) and thyrotoxicity (thyroid) are both dosage dependent with lithium. The lower the dosage, the less chance there is of inducing damage. 300mg might be the ideal dosage for you. It seems to be for me. However, it serves more as an antidepressant augmenter than an anti-manic at the lower dosages. At 300mg, my blood level is 0.2 mmol/L. At 150mg, I lose the therapeutic effect.Give Trileptal a chance. You can always stop it anytime you want, so you don't have to feel locked into a long trial. Take it one day at a time and report your experiences.
Good luck.
- Scott
Posted by sheilac on June 22, 2011, at 9:13:27
In reply to Re: 300mg Lith - Re: Trileptal kicking my butt! » sheilac, posted by SLS on June 22, 2011, at 8:20:53
I already take Synthroid for a bum thyroid. So I wonder if in time I would have to take more Synthroid even on just 300mg of Lithium.
The only bad thing about Trileptal is that it makes me hot and sweaty and dumb.
Maybe there is another drug in that same class that wouldn't cause those problems. My sleep really get interrupted from a sweaty bed!
Posted by SLS on June 22, 2011, at 9:27:56
In reply to Re: 300mg Lith - Re: Trileptal kicking my butt!, posted by sheilac on June 22, 2011, at 9:13:27
> I already take Synthroid for a bum thyroid. So I wonder if in time I would have to take more Synthroid even on just 300mg of Lithium.
>
> The only bad thing about Trileptal is that it makes me hot and sweaty and dumb.
>
> Maybe there is another drug in that same class that wouldn't cause those problems. My sleep really get interrupted from a sweaty bed!
I mentioned Topamax in a previous post. I have seen it work wonders for someone in a very hostile mixed state. Topamax has a reputation for producing cognitive side effects. However, if you start at 25mg and work up very gradually to 100-200mg, these can be avoided. Kidney stones are a possible side effect, but these tend to occur at higher dosages.
Topiramate Dosing InformationUsual Adult Dose for Migraine Prophylaxis:
Initial dose: 25 mg once a day in the evening.
In the second week, the dose may be titrated up to 25 mg twice a day, in the morning and in the evening.
In the third week, the dose may be titrated up to 25 mg in the morning and 50 mg in the evening.
In the fourth week, the dose may be titrated up to 50 mg in the morning and 50 mg in the evening.
The dose and titration should be guided by clinical outcome.
Longer intervals between dose adjustment may be used as needed.
Posted by floatingbridge on June 22, 2011, at 10:03:03
In reply to Re: 300mg Lith - Re: Trileptal kicking my butt!, posted by SLS on June 22, 2011, at 9:27:56
You guys have it covered. I wanted to add that I have thyroid issues, and while taking li I only checked my tsh levels more often. I actually cannot report an adverse affect on my thyroid.
Good luck Sheila.
fb
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