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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by judy1 on January 26, 2001, at 16:25:15
I keep throwing up i think depakote? 1500mg usually over 100 blood level. On 100 mg lamictal and 3mg risperdal and 6mg klonopin. Called pdoc but he is not there. Can you help? Thank you- judy
Posted by SalArmy4me on January 26, 2001, at 17:48:33
In reply to Scott?, posted by judy1 on January 26, 2001, at 16:25:15
You're still on a really low dose of Lamictal. Perhaps raising it will help you, considering that Lamictal has the most antidepressant properties of all the anticonvulsants.
> I keep throwing up i think depakote? 1500mg usually over 100 blood level. On 100 mg lamictal and 3mg risperdal and 6mg klonopin. Called pdoc but he is not there. Can you help? Thank you- judy
Posted by SLS on January 26, 2001, at 18:38:58
In reply to Scott?, posted by judy1 on January 26, 2001, at 16:25:15
> I keep throwing up i think depakote? 1500mg usually over 100 blood level. On 100 mg lamictal and 3mg risperdal and 6mg klonopin. Called pdoc but he is not there. Can you help? Thank you- judy
Hi Judy,How are you feeling now?
You sound very much better, although I'm sure that you are not happy with the way you are feeling. Treating your mania was critical. Depakote 1500mg is usually a good dosage to help squash the mania. It can work very quickly, sometimes within hours. 100mg of Lamictal should be O.K., but remember that with Depakote, the Lamictal dosage really equals 200mg.
As you guessed, it is most likely the Depakote that is producing nausea. There are people here who are more qualified than I to suggest how to prevent the nausea. Cam W. should have some tricks up his sleeve.
You don't want to take Depakote on an empty stomach. Even eating a single piece of bread along with your dose of Depakote should help quite a bit. The nausea is not really dependant upon daily dosage.
I wish I could help out more here. You have done the right thing to treat your mania. That you were even receptive enough to recognize mania and ask for feedback is extraordinary. I doubt that I would be as smart as you if I were to become manic. We are all very proud of you.
Let's see what other suggestions people come up with.
Very truly yours,
Scott
Posted by Ron Hill on January 26, 2001, at 21:21:11
In reply to Scott?, posted by judy1 on January 26, 2001, at 16:25:15
Judy,
Ginger helps to relieve nausea for me. I buy it in bulk in the health food section of a local grocery store. I like crystallized ginger the best. Ginger ale helps some people, but it must be true ginger ale with ginger as one of the ingredients.
I truly hope you feel better soon.
-- Ron
-------------------------------------> I keep throwing up i think depakote? 1500mg usually over 100 blood level. On 100 mg lamictal and 3mg risperdal and 6mg klonopin. Called pdoc but he is not there. Can you help? Thank you- judy
Posted by Sunnely on January 26, 2001, at 22:33:00
In reply to Scott?, posted by judy1 on January 26, 2001, at 16:25:15
Hi Judy1,
You may want to try one of the H2 blockers such as Pepcid or Axid to ease the nausea and dyspepsia. Furthermore, there were also ANECDOTAL REPORTS of weight loss or curbing of the weight gain induced by psychotropics with the use of H2 blockers. The previous poster mentioned ginger an herbal preparation which is effective for nausea and motion sickness.
If everything else fails but must remain on Depakote due to positive response, ask your doctor for the new formulation Depakote ER. Given only once a day and released in the stomach at a much slower and uniform rate avoiding unnecessary stomach irritation.
Scott mentioned the potential drug-drug interaction between Depakote and Lamictal - raising Lamictal's blood level. This may also a have bearing on your problem.
On a related note, the most serious (potentially deadly) drug interaction between Depakote and Lamictal is the occurrence of a condition called Stevens-Johnson Syndrome (SJS). Children, rapid increase in dose of Lamictal, using high dose of Lamictal, and the combined use of Depakote and Lamictal appear to pose higher risks for the development of this condition. If you develop a rash, you should stop your medications immediately and notify your doctor.
==============================================
> I keep throwing up i think depakote? 1500mg usually over 100 blood level. On 100 mg lamictal and 3mg risperdal and 6mg klonopin. Called pdoc but he is not there. Can you help? Thank you- judy
Posted by judy1 on January 27, 2001, at 22:21:33
In reply to Depakote and Nausea - How to Treat ?, posted by SLS on January 26, 2001, at 18:38:58
Thank you Scott, your support has helped me a lot. I get to lower the depakote tomorrow, maybe that will help my nausea. I don't think I recognized I was getting manic as much as I was terrified of voices I started hearing. For me there's a point where I stop feeling euphoric and kind of cross a line to well, honesty here- psychotic. Is that what happens to you? Take care, judy
Posted by judy1 on January 27, 2001, at 22:23:42
In reply to Ginger Helps Relieve Nausea » judy1, posted by Ron Hill on January 26, 2001, at 21:21:11
Hi Ron,
That's a really good suggestion. I like that it is natural since i'm taking so many drugs. I'll let you know howit works. take care, judy
Posted by judy1 on January 27, 2001, at 22:28:18
In reply to Re: Scott? » judy1, posted by Sunnely on January 26, 2001, at 22:33:00
Hi,
thank you for all the great information. I'm lowering depakote tomorrow, I think my pdoc just wanted to get the mania under control, and believe me it's gone. I hate depakote, I think it keeps me depressed, but we are running out of options here. take care, judy
Posted by SLS on January 28, 2001, at 7:38:29
In reply to Re: Depakote and Nausea - How to Treat ? » SLS, posted by judy1 on January 27, 2001, at 22:21:33
Dear Judy,
> Thank you Scott, your support has helped me a lot. I get to lower the depakote tomorrow, maybe that will help my nausea.
I was able to lower the dosage of Depakote once my mania was pretty much gone. After about a week, the dosage was lowered, but I forget if it was to 750mg or 1000mg.
> I don't think I recognized I was getting manic as much as I was terrified of voices I started hearing.
> For me there's a point where I stop feeling euphoric and kind of cross a line to well, honesty here- psychotic. Is that what happens to you? Take care, judy
Was the diagnosis of *schizoaffective* disorder ever considered? Although hearing voices can be a symptom of a psychotic mania in bipolar disorder, it is not very common. On the other hand, hearing voices is one of the more common features of schizophrenia and schizoaffective disorder. One of the scenarios that can occur in schizoaffective disorder is that a bipolar mania develops first, which in turn triggers schizoid thought disturbances and audio halluciations (hearing voices).
My manias can get pretty psychotic. During these times, the only voice I here is my own. That's because I never shut up. I argue with everyone! Arguing is so out of character for me. :-)
Seriously.
One time I became convinced that a little known earthquake fault line extending into Manhattan was about to give-way. I figured it would be of a greater magnitude than San Francisco or Anchorage. Total anihilation. So I packed up my car with survival tools and drove over to my parents house to help them get ready to follow me. They disappointed me. I thought they respected my sanity enough to save thier own lives. When they declined, I decided that I would at least take the dog - poor innocent thing. Well, when I could not bring the dog, I just drove away and continue with my emergency plan. I was going to drive down to the Goddard Space Center in Washington D.C. and get a job as a rocket scientist. No experience necessary. I figured I could sell myself. I actually drove down there, and parked just before the gate. I skipped the "interview" and headed back to see how bad the damage was.
This was not the most intense and embarrasing experience. Just the funniest. I did not hear voices, but I sometimes experienced something called visual illusions. A real object appears to be similar or exactly like another object, or symbolizes and appears as an icon of an idea or associataion.
:-)
- Scott
Posted by judy1 on January 28, 2001, at 13:10:22
In reply to Re: Depakote and Nausea - How to Treat ? » judy1, posted by SLS on January 28, 2001, at 7:38:29
Thanks for sharing your story Scott, I could totally follow your mind set and smiled at an image of you approaching Goddard Space Center- you probably could have talked yourself into some position there. I haven't talked to my shrink about schizoaffective disorder- would the only treatment change be anti-psychotic medication? I do have times where I don't have these symptoms (really!), would I have to stay on an AP always? Thank you so much for your help- judy
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