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Dr. Bob is Robert Hsiung, MD,
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Posted by JahL on April 19, 2001, at 20:19:41
Anyone had any success with this combination? I'm considering adding 3x300mg of Gabapentin to my partially effective 150mg of Lamotrigine.
Also, anyone who's had success with Gabapentin (however qualified), could you tell me how long it took for these benefits to make themseves apparent?
Thanks in advance,
Jah.
Posted by Lorraine on April 19, 2001, at 21:29:27
In reply to Lamotrigine Gabapentin., posted by JahL on April 19, 2001, at 20:19:41
Neurontin is both dose and time dependent. For me over a 4 week period.
Posted by SalArmy4me on April 19, 2001, at 22:36:11
In reply to Lamotrigine Gabapentin., posted by JahL on April 19, 2001, at 20:19:41
After getting up to a 3600 mg dose of Neurontin within a few days of my first starting the drug, I experienced some relief in 2 weeks. Adding Lamictal boosted the Neurontin enough such that I was happy and able to go back to work again. Are you sure that you cannot tolerate more Lamictal? 500 mg is the maximum (for epilepsy, at least).
{My success with Neurontin/Lamictal lasted for two months until it pooped-out. I don't know why that happened}.
Posted by SLS on April 19, 2001, at 22:37:38
In reply to Lamotrigine Gabapentin., posted by JahL on April 19, 2001, at 20:19:41
Hi Jah.
I think there is sufficient reason for you to explore the combination of lamotrigine and gabapentin if you are bipolar. About a year ago, the NIMH published the life-chart of a patient with bipolar disorder whose depression was refractory to many antidepressant regimens. When they administered each of lamotrigine and gabapentin separately, lamotrigine proved partially effective while gabapentin was all but inert. When they combined the two, the patient remitted within a few weeks and was rated as being improved to a point of being symptom-free. Unfortunately, they didn't list the dosages used. Since then, they have continued working with the combination, but I don't know what are their impressions at this point. I wouldn't discourage you from trying the combination if you are unipolar, but I only know of its use in bipolar disorder.
You might consider increasing the lamotrigine to 200mg - 300mg before determining its usefullness.
- Scott
Posted by Kingfish on April 20, 2001, at 7:13:34
In reply to Re: Lamotrigine Gabapentin., posted by SLS on April 19, 2001, at 22:37:38
Jah:
I take Celexa 40 mg, Topamax 250 mg, and Neurotin (Gab.) 2400 mg. I took just Celexa and Neurontin last year and the Neurontin had no effect. Combined with the Topamax, it actually helps counteract the Topamax' sedation, which apparently makes no sense, but it also seems to act as a secondary stabilizer. My pdoc said that it is an anti-anxiety med on its own, but can act as a stabilizer when combined with another stabilizer.
Anyhoo, I felt a difference immediately, and feel a difference every four hours when it's time to take yet another dose. Perhaps part of this is psychological- I don't know. The Topamax is definitely my main life saver, but the Neurontin helps.
Good luck.
- K.
Posted by Kingfish on April 20, 2001, at 7:15:57
In reply to Lamotrigine Gabapentin., posted by JahL on April 19, 2001, at 20:19:41
Also, Jah, I had no side effects from Neurontin. It's apparently not metabolized by the liver, which you may already know, and it didn't bother me at all, except for maybe a little stomach upset at first. I'm not sure if others have similar experiences or not.
- K.
Posted by JahL on April 20, 2001, at 13:02:33
In reply to Lamotrigine Gabapentin., posted by JahL on April 19, 2001, at 20:19:41
> > Anyone had any success with this combination? I'm considering adding 3x300mg of Gabapentin to my partially effective 150mg of Lamotrigine.
> > Also, anyone who's had success with Gabapentin (however qualified), could you tell me how long it took for these benefits to make themseves apparent?Thanx 4 yr posts, all, especially if it's as much effort 4 you as it is 4 me right now.
So, 2-4 weeks; I think I can handle that. My guess is that it may work quicker for the anxiety side of things (my reason 4 considering it + I've heard odd rpts of usefulness 4 social phobia). Lamictal's 4 the depression.
Scott, Sal, I fully intend increasing the Lamictal to aroud 300mg if necessary, but a recent brush with the rash has convinced me to keep it slow, & right now I'm *v* depressed+anxious, hence the Gabapentin *now*. Also, Klonopin seems to bolster the Lamictal somewhat & I'm hoping another, similarish AED will do likewise. I like the fact that Gabapentin won't interfere with the Lamotrigine.
Funnily enough Scott, it was while doing a srch last night that I came across an old post of yrs, quoting the URL of said case-study. It was (half) reading the accompanying PDF that prompted me to place this post! So double thanks.
My Gabapentin's in the post so I'll letcha all know how it pans out...
Ta,
Jah.
Posted by JahL on April 20, 2001, at 13:23:33
In reply to Re: Lamotrigine Gabapentin., posted by Kingfish on April 20, 2001, at 7:13:34
> > I take Celexa 40 mg, Topamax 250 mg, and Neurotin (Gab.) 2400 mg. Combined with the Topamax, Neurotin seems to act as a secondary stabilizer. My pdoc said that it is an anti-anxiety med on its own, but can act as a stabilizer when combined with another stabilizer.> > Anyhoo, I felt a difference immediately, and feel a difference every four hours when it's time to take yet another dose. Perhaps part of this is psychological- I don't know. The Topamax is definitely my main life saver, but the Neurontin helps.
Hi Kingfish.
A coupla Qs if you don't mind...
What does the Topomax do for you (you're BPII, right)? Does it help with the depression side of things? Are you depressed w/o the Celexa?
The 'immediate difference' (re Gabapentin) you speak of; is this akin to the 'calming' effect I frequently read of?
Lastly, how close to remission does this combo bring you (pretty close I hope!)?
Thanx 4 any info,
J.**Yr pdoc's view of Gabapentin's augmenting action, + yr own experiences, seem to bear out my line of thinking, doncha think?!
Posted by Kingfish on April 22, 2001, at 14:39:50
In reply to Re: Topomax Gabapentin. » Kingfish, posted by JahL on April 20, 2001, at 13:23:33
Jah:
See my answers below.
I'm sorry you're having a tough time right now. I certainly understand. Thoughts are with you.
** What does the Topomax do for you (you're BPII, right)?
I am BPII. The Topamax:
> stops my thoughts from racing
> allows me to process things better
-for example, I self-medicated and substance-abused big time and that has been pretty much under control because I can reason with myself better now and I think the medicine has helped curb the desire> helps me think more linearly (is that a word?) - I can discuss subjects more clearly and stay more focussed
> helps control the hypomania (however I did have an episode a couple of weeks ago)
> there's much more I'll think about and share - I need to work on putting it into words.
** Does it help with the depression side of things? Are you depressed w/o the Celexa?I think the Topamax does help with the depression because I haven't had any trouble with depression since I started it, and I had a bad depressive episode last fall while on the Celexa alone. But I have not heard any evidence that Topamax has anti-depressive qualities while apparently the Lamictal does.
My main problem is depression and I do think the Celexa helped some but certainly not enough. I'd be interested in dropping the dose and possibly stopping it completely to see if the Topamax could "handle" it alone, but my pdoc is very hesitant to do this.
**Yr pdoc's view of Gabapentin's augmenting action, + yr own experiences, seem to bear out my line of thinking, doncha think?!I do think you hit it right on the head.
**The 'immediate difference' (re Gabapentin) you speak of; is this akin to the 'calming' effect I frequently read of?
I think so, but it also feels "stabilizing", if that makes sense, and it's not a major change in mood at all. It's more like I feel "off" now if I don't take it.
** Lastly, how close to remission does this combo bring you (pretty close I hope!)?I feel so much better, Jah. I still have trouble with sedation, though. Some folks have recommended to switch to Lamictal because it's not sedating like Topamax and I'm sure that's a good suggestion but I'm too nervous to change stabilizers right now. My pdoc is, too. He tried me on Wellbutrin because it's activating - it was not a good med for me. Everyone is so very different. He has also suggested an anti-narcoleptic, but I'm afraid it will have the same effects as Wellbutrin. For now, I'm trying to work with the sedation.
When everything came together, and it was a fluke, because I decided to re-add the Neurontin, I woke up one morning and it was as if the last twelve to fifteen years or so had been a bad dream, and I knew that things were going to be different.
Let me know how things go for you.
- K.
P.S. ItsJustMe seems to have found another board to torture. :)
Posted by JahL on April 22, 2001, at 16:34:01
In reply to Re: Topomax Gabapentin. » JahL, posted by Kingfish on April 22, 2001, at 14:39:50
Thanx 4 the reply, it's given me more to work with.
> > The Topamax:
> > stops my thoughts from racing
> > I self-medicated and substance-abused big time and that has been pretty much under control because I can reason with myself better now and I think the medicine has helped curb the desireNice. I can relate; I have a spliff hanging out the cnr of my mouth right now, as I do all day everyday. I feel so empty w/o some kind of buzz; I'm sure you understand (the heavy stuff is well behind me tho').
> > allows me to process things better.
> > helps me think more linearly (is that a word?) - I can discuss subjects more clearly and stay more focussed.Could I do with some of that! That's interesting since I've often heard of Topomax impairing cognitive function, a reason I haven't considered it up til now (terrible problems concentrating etc)
> > I feel so much better, Jah. I still have trouble with sedation, though. Some folks have recommended to switch to Lamictal because it's not sedating like Topamax and I'm sure that's a good suggestion but I'm too nervous to change stabilizers right now. My pdoc is, too. Everyone is so very different.
Don't mess with what works, huh?
> >He has also suggested an anti-narcoleptic, but I'm afraid it will have the same effects as Wellbutrin. For now, I'm trying to work with the sedation.
I've tried Provigil/Adrafinil for the same reason; both made me feel wired rather than alert.
> >When everything came together, and it was a fluke, because I decided to re-add the Neurontin, I woke up one morning and it was as if the last twelve to fifteen years or so had been a bad dream, and I knew that things were going to be different.
I've (briefly) had that 'waking up' experience. It's amazing how 15+ yrs of incessant suffering can, in an instant, seem like a distant memory. Hopefully a recurrence is not too far away...
Thanks again & glad you're doing well...
(stoned) Jah.
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