Psycho-Babble Medication Thread 211085

Shown: posts 1 to 19 of 19. This is the beginning of the thread.

 

Lamictal and Trileptal-starlight

Posted by catmint on March 21, 2003, at 1:55:27

Hi!
I was reading the Lamictal thread with Kristen, Ron, Maximus, et al and I read your post that you are currently on Lamictal and Trileptal.
I am taking 65 mg. of Lamictal and will be adding Trileptal soon. My pdoc and I have decided to only use the Trileptal prior to my menstrual cycle. I will be taking it twice a day at about 60 mg. per dose. The reason for this strange way of dosing is because I always cycle during the week before my period.
Anyway, I would love to hear from you. How long have you been on this combo, at what dosages, etc?
Thanks,
::Amy

 

Re: Lamictal and Trileptal » catmint

Posted by Ron Hill on March 21, 2003, at 12:33:45

In reply to Lamictal and Trileptal-starlight, posted by catmint on March 21, 2003, at 1:55:27

Hi Amy,

Just a note to wish you well in your Trileptal trial. Please post your response to the trial. I have a good feeling about this medication for you.

-- Ron

 

Re: Lamictal and Trileptal » Ron Hill

Posted by catmint on March 23, 2003, at 1:21:35

In reply to Re: Lamictal and Trileptal » catmint, posted by Ron Hill on March 21, 2003, at 12:33:45

> Hi Amy,
>
> Just a note to wish you well in your Trileptal trial. Please post your response to the trial. I have a good feeling about this medication for you.
>
> -- Ron
>
>
Hello Ron,
Thanks for the post. I am really unsure how I'm going to react to being on 2 AEDs. I wish the previous poster would respond! Oh well.
I have been doing fairly well on Lamictal for the past two weeks, but coming up now is when I lose stability (usually happens monthly), hence the Trileptal add on.
Haven't heard from our friend Colin. I wonder how he is doing? I know he was considering Trileptal as well.
I hope you are doing well, Ron!
Talk to you soon,
::Amy

 

Re: Yo, Colin Wallace. Pick up the phone! » catmint

Posted by Ron Hill on March 29, 2003, at 13:56:32

In reply to Re: Lamictal and Trileptal » Ron Hill, posted by catmint on March 23, 2003, at 1:21:35

Amy,

> Haven't heard from our friend Colin. I wonder how he is doing? I know he was considering Trileptal as well.

I've been assuming that Colin is doing okay and that he merely needed some time away from the board. But now I'm starting to become concerned. Perhaps we need to ring-him-up and make sure that he is doing okay over on his side of the pond.

I wonder if he got in to see the BP specialist.

-- Ron

 

Re: Yo, Colin Wallace. Pick up the phone!

Posted by catmint on March 30, 2003, at 1:55:00

In reply to Re: Yo, Colin Wallace. Pick up the phone! » catmint, posted by Ron Hill on March 29, 2003, at 13:56:32

Hey Ron,
I'm not going to take Trileptal just yet, I'm still going to give the Lamictal only thing a few more months. One thing I have noticed is that I think I am becoming emotionally blunted, like I don't feel joy as much. It's not depression. The Lamictal is still good, but I wake up in the morning kind of angry and I'm sleeping too much.
I'm on disability and going through the whole vocational rehab thing which is making me worried. I have to decide what I want to be when I grow up! Seriously, it is bugging me cause I might need to go back to college to get a degree. We all know that BP is an illness that worsens with stress (the last time I was under some I flipped out).
I am a single mother of a ten year old boy, and because of the choices I made, I have to accept my life as it is.
Tonight I had 1/2 a beer (I rarely drink) and felt so mellow, not my usual irritable self). Do you think it's ok to drink?
Speaking of beer!! Yes, I hope Colin is doing ok.
Thanks for your post Ron, How are you doing?
::Amy

 

Re: Lamictal and Trileptal » catmint

Posted by Ron Hill on March 30, 2003, at 9:10:22

In reply to Re: Yo, Colin Wallace. Pick up the phone!, posted by catmint on March 30, 2003, at 1:55:00

Hi Amy,

> I'm not going to take Trileptal just yet, I'm still going to give the Lamictal only thing a few more months. One thing I have noticed is that I think I am becoming emotionally blunted, like I don't feel joy as much. It's not depression. The Lamictal is still good, but I wake up in the morning kind of angry and I'm sleeping too much.

Hmmm. In a small way the emotional blunting sounds similar to what SSRIs do to me. But not the anger.

Let me know what happens when you start taking the Trileptal. Why are you waiting? Are you concerned about possible side effects? I'm curious to see if it will help your irritability.

> I'm on disability and going through the whole vocational rehab thing which is making me worried. I have to decide what I want to be when I grow up! Seriously, it is bugging me cause I might need to go back to college to get a degree. We all know that BP is an illness that worsens with stress (the last time I was under some I flipped out).

Yeah, there is no question that stress can trigger scrambled brain chemistry for us BPs. Daily rigorous exercise is the best solution I have found to keep stress in check. I think you have found the same to hold true in your life.

> I am a single mother of a ten year old boy, and because of the choices I made, I have to accept my life as it is.

I bet you are a great Mom. Are you able to keep your BP II irritability in check when interfacing with your child? If this is a problem, are there any support groups available that could help you in this regard?

> Tonight I had 1/2 a beer (I rarely drink) and felt so mellow, not my usual irritable self). Do you think it's ok to drink?

Two or three beers do the same thing for me, and I love it. Focused, mellow, peaceful, socially outgoing, jovial, etc. But prolonged depression always follows starting the next day. Therefore, I have instituted a zero tolerance policy in my life with regard to alcohol.

> Speaking of beer!! Yes, I hope Colin is doing ok.

Me too.

> Thanks for your post Ron, How are you doing?

I'm doing very well, Amy. Thanks for asking. My 600 mg/day of Lithobid and 2.5 mg every four days of Enada NADH is still working.

-- Ron

 

Re: Lamictal and Trileptal » Ron Hill

Posted by catmint on March 30, 2003, at 15:37:02

In reply to Re: Lamictal and Trileptal » catmint, posted by Ron Hill on March 30, 2003, at 9:10:22

> Hmmm. In a small way the emotional blunting sounds similar to what SSRIs do to me. But not the anger.

>Yea, just this morning I was observing how amazing the cherry blossoms looked against the bright sky, just like the painting Van Gogh did. I felt really joyful and immersed in the beauty. I then took my 75 mg. of Lamictal which hits my brain in 15 minutes, and the feelings were completely gone.

> Let me know what happens when you start taking the Trileptal. Why are you waiting? Are you concerned about possible side effects? I'm curious to see if it will help your irritability.

> I'm concerned about mixing two AEDs. Ritch said Trilepal didn't do much for his irritability like Depakote does, and I also liked Depakote for that reason. But who know? We're all different.
I get so stressed out around dinner time, I sometimes am so irritable that I start to blame other people. That causes a fight, etc, etc.

> Yeah, there is no question that stress can trigger scrambled brain chemistry for us BPs. Daily rigorous exercise is the best solution I have found to keep stress in check. I think you have found the same to hold true in your life.

> I have to say, the Lamictal is great for getting me motivated to exercise.


> I bet you are a great Mom. Are you able to keep your BP II irritability in check when interfacing with your child? If this is a problem, are there any support groups available that could help you in this regard?

> Thanks. I do take good care of him, but I can snap at any moment and yell. I never, ever hit him of course, I'm just an angry person to be around a lot.
I am worried about him possibly having a mood disorder when he's grown up. I read somewhere, I think on psycheducation.org, that there is a 70% chance that he will if more than one family member is affected. My father is BP1 and who knows if my grandmother was. She sure drank a lot and was pretty irritable from what I remember. Oh, and my son's dad has ADD. So you can see why I'm concerned. On the flip side, I am doing so much more for my son than my parents did for me. I give him and incredibly healthy diet, no soda, food additives, fish oil, and I make him run around the block several times, most everyday. I teach him about self-talk, to challenge that negative voice. He is a sweet, extremely bright boy with an incredibly vivid imagination. We'll see what changes he'll go through during puberty. I am crossing my fingers!

> > Tonight I had 1/2 a beer (I rarely drink) and felt so mellow, not my usual irritable self). Do you think it's ok to drink?
>
> Two or three beers do the same thing for me, and I love it. Focused, mellow, peaceful, socially outgoing, jovial, etc. But prolonged depression always follows starting the next day. Therefore, I have instituted a zero tolerance policy in my life with regard to alcohol.

> You're wise to not drink. Thanks for the reminder, I too get depressed the next day. I just wish I could find something to ease the irritability. My next experiment is using nervine herbs on a daily basis and see if that helps.

I'm glad to hear that you are still doing well on the Enada NADH.

Talk to you soon,
::Amy

 

Re: Bipolar II Irritability » catmint

Posted by Ron Hill on March 30, 2003, at 17:28:55

In reply to Re: Lamictal and Trileptal » Ron Hill, posted by catmint on March 30, 2003, at 15:37:02

Amy,

Refresh my memory. If I remember correctly you were on a benzo at one point in time? Did it reduce your irritability? Which benzo? You’re not on it now, right? Just Lamictal monotherapy, correct?

And you also tried Neurontin, right? Did that reduce your irritability? Why did you quit?

Sorry to ask all these questions that I'm sure I've asked you before, but I have a hard time keeping everyone's medication history straight in my mind. At one point I started to keep track of some of the poster's dx and Rx histories in Word documents. But the problem is that it is too time consuming to track these data for everyone, and I do not know in advance which posters I am going to stay in contact with for extended periods of time and, therefore, I don't know which poster's data to track.

I can relate to your irritability issues. I hate the feeling and I hate the hurtful words I say to people in my life when I am in a dysphoric mood state.

What have you found over the years that help to reduce your irritability?

-- Ron

PS Do you smoke cigarettes? If so, how much?

 

Yo, Colin Wallace How Are You? Hi Ron

Posted by johnj on March 30, 2003, at 20:09:33

In reply to Re: Yo, Colin Wallace. Pick up the phone! » catmint, posted by Ron Hill on March 29, 2003, at 13:56:32

how are things with you??? Spring is around the corner and I can't wait. Have you sprung back from the winter depression? Hope things are well

Johnj

 

Re: Bipolar II Irritability » Ron Hill

Posted by catmint on March 30, 2003, at 23:57:13

In reply to Re: Bipolar II Irritability » catmint, posted by Ron Hill on March 30, 2003, at 17:28:55

> Amy,
>
> Refresh my memory. If I remember correctly you were on a benzo at one point in time? Did it reduce your irritability? Which benzo? You’re not on it now, right? Just Lamictal monotherapy, correct?

> No I haven't ever taken a benzo except one time during a surgical procedure I was given intravenous valium. Wow, that stuff is incredible. Total euphoria. Anyway, my pdoc is benzophobic and to be frank I don't want one anyway. I have an addictive personality so I doubt it would be good for me. I read a lot about it on this board; it seems like people are split down the middle on them (good vs. bad).

> And you also tried Neurontin, right? Did that reduce your irritability? Why did you quit?

Yes, I took it for about a year and I don't know if it helped with irritability cause I was on Wellbutrin and Prozac at the time. That combo, along with copious amts. of marijuana, sent me into a mixed state episode that almost got me hospitalized.
Isn't Colin on Neurontin and Lamictal? I need to ask him about that.

> Sorry to ask all these questions that I'm sure I've asked you before, but I have a hard time keeping everyone's medication history straight in my mind. At one point I started to keep track of some of the poster's dx and Rx histories in Word documents. But the problem is that it is too time consuming to track these data for everyone, and I do not know in advance which posters I am going to stay in contact with for extended periods of time and, therefore, I don't know which poster's data to track.

> No worries, Ron. I think it's fabulous that you are such a great support for me and others on this board!

> I can relate to your irritability issues. I hate the feeling and I hate the hurtful words I say to people in my life when I am in a dysphoric mood state.
>
> What have you found over the years that help to reduce your irritability?

> High doses of pure Kava Kava root from the island of Vanuatu. Seriously! Prepared the traditonal way by chewing the dried root and spitting the quids in a bowl, then kneading and working the mashed material in water, is a sure way to get the most benefits from this amazing herb. All other form, tincture or pills do nothing.
Other herbs I've used(and I'm going to order real soon), are wood betony, passionflower, valerian, skullcap, catnip. I haven't tried gota kola but I want to.
All these herbs support the nervous system quite well, so I am hoping I'm on to something here.
I only just need to be consistent.

> PS Do you smoke cigarettes? If so, how much?

> No, used to, but not now. By the way, no pot anymore either. Quit that about 7 months ago, and am damn happy I did!

::Amy

 

Re: Bipolar II Irritability » catmint

Posted by Ron Hill on March 31, 2003, at 9:40:11

In reply to Re: Bipolar II Irritability » Ron Hill, posted by catmint on March 30, 2003, at 23:57:13

Amy,

Thanks for your reply.

> > What have you found over the years that help to reduce your irritability?

> High doses of pure Kava Kava root from the island of Vanuatu. Seriously! Prepared the traditonal way by chewing the dried root and spitting the quids in a bowl, then kneading and working the mashed material in water, is a sure way to get the most benefits from this amazing herb. All other form, tincture or pills do nothing.

The island of Vanuatu? Is this located on one of the Vulcan planets? Where do you buy this stuff? Are you concerned about the reported possible health risks associated with Kava Kava?

> > PS Do you smoke cigarettes? If so, how much?

> No, used to, but not now. By the way, no pot anymore either. Quit that about 7 months ago, and am damn happy I did!

Good for you.

-- Ron

 

Re: Lamictal and Trileptal

Posted by SpreadDaALoha on April 1, 2003, at 6:40:18

In reply to Re: Lamictal and Trileptal » Ron Hill, posted by catmint on March 30, 2003, at 15:37:02

I take 300mg Lamictal, 1500mg Keppra, and 2.5mg Selegiline. I just started the Selegiline two weeks ago. I am supposedly Bipolar II with severe social anxiety. Tomorrow is my psychiatrist appointment...I wonder what he will decide.

I notice someone mentioned motivation to exercise on Lamictal. It's strange you mention that, because I recently started jogging frequently and I have never done that consistently. Who knows.

I am really concerned about my social anxiety. You know that was my original reason to go to psych years ago! I tried Zoloft which helped for a while.

My doc seems to promote psychotherapy for social anxiety (he has NEVER mentioned benzos; he had me quit the Neurontin because it does something similar to alcohol and the whole possible cancer thing seen in rats or something).

I give him credit because he seems to be on top of things and very progressive. Last time he thought about doing Remeron instead of Selegiline. I don't know why he chose Selegiline. Tomorrow I am going to voice my serious concern about my anxiety.

I wonder what drugs might be a good addition? Doesn't Klonopin lose it's effectiveness after time? Nardil and Parnate make me nervous about the diet issue. What about Maclomebide (or however you spell it)--I read it was just a little less effective than SSRI's in depression.

Also, I can definitely relate to feeling sluggish from the Lamictal and/or Keppra. Last semester I took 16 credits in grad school (did fine with lots of energy) and now I am taking 12 and it is so rough (my dosages increased this semester). But let me tell you: I am thrilled to not be so irritable.

So about this social anxiety. What to do?

 

Re: Lamictal and Trileptal » SpreadDaALoha

Posted by Ritch on April 1, 2003, at 8:48:45

In reply to Re: Lamictal and Trileptal, posted by SpreadDaALoha on April 1, 2003, at 6:40:18

> I take 300mg Lamictal, 1500mg Keppra, and 2.5mg Selegiline. I just started the Selegiline two weeks ago. I am supposedly Bipolar II with severe social anxiety. Tomorrow is my psychiatrist appointment...I wonder what he will decide.
>
> I notice someone mentioned motivation to exercise on Lamictal. It's strange you mention that, because I recently started jogging frequently and I have never done that consistently. Who knows.
>
> I am really concerned about my social anxiety. You know that was my original reason to go to psych years ago! I tried Zoloft which helped for a while.
>
> My doc seems to promote psychotherapy for social anxiety (he has NEVER mentioned benzos; he had me quit the Neurontin because it does something similar to alcohol and the whole possible cancer thing seen in rats or something).
>
> I give him credit because he seems to be on top of things and very progressive. Last time he thought about doing Remeron instead of Selegiline. I don't know why he chose Selegiline. Tomorrow I am going to voice my serious concern about my anxiety.
>
> I wonder what drugs might be a good addition? Doesn't Klonopin lose it's effectiveness after time? Nardil and Parnate make me nervous about the diet issue. What about Maclomebide (or however you spell it)--I read it was just a little less effective than SSRI's in depression.
>
> Also, I can definitely relate to feeling sluggish from the Lamictal and/or Keppra. Last semester I took 16 credits in grad school (did fine with lots of energy) and now I am taking 12 and it is so rough (my dosages increased this semester). But let me tell you: I am thrilled to not be so irritable.
>
> So about this social anxiety. What to do?


Just one question for you: Did your doctor explain why he was adding the selegiline? Was it for your anxiety?

 

Ritch

Posted by catmint on April 1, 2003, at 15:25:43

In reply to Re: Lamictal and Trileptal » SpreadDaALoha, posted by Ritch on April 1, 2003, at 8:48:45

Hi, how are you?
Are you still taking 125 mg. of Depakote? I am still having problems with irritability on Lamictal so my pdoc added Trileptal. For some reason, I intuitively do not want to take it. I am now consisering going back on 125 mg. of Depakote and add Wellbutrin. Do you take Wellbutrin as well? Sorry, I can't remember what you combo is.
What time do you take the Depakote? Do you have any problems with over-sleeping ? Of course, I don't have a job, so that makes it easier to oversleep. Have you gained any weight whatsoever on 125 mg?
I hope you are doing well.
::Amy

 

Re: Wellbutrin and Kava Kava » catmint

Posted by Ron Hill on April 1, 2003, at 16:27:34

In reply to Ritch, posted by catmint on April 1, 2003, at 15:25:43

Hi Amy,

> I am now consisering going back on 125 mg. of Depakote and add Wellbutrin.

Sorry to jump in on your message to Mitch (please excuse me). Two quick issues.

First, have you ever tried Wellbutrin? The reason I ask is because when I tried it a few years ago it made me VERY irritable (even at a low dosage of 50 mg/day). I wonder if it would do the same to you.

Second, if you have time, please reply to my earlier post in this thread regarding Kava Kava. Here's a link to my previous post:

http://www.dr-bob.org/babble/20030329/msgs/214689.html

-- Ron

 

Re: Ritch » catmint

Posted by Ritch on April 1, 2003, at 22:46:21

In reply to Ritch, posted by catmint on April 1, 2003, at 15:25:43

> Hi, how are you?
> Are you still taking 125 mg. of Depakote? I am still having problems with irritability on Lamictal so my pdoc added Trileptal. For some reason, I intuitively do not want to take it. I am now consisering going back on 125 mg. of Depakote and add Wellbutrin. Do you take Wellbutrin as well? Sorry, I can't remember what you combo is.
> What time do you take the Depakote? Do you have any problems with over-sleeping ? Of course, I don't have a job, so that makes it easier to oversleep. Have you gained any weight whatsoever on 125 mg?
> I hope you are doing well.
> ::Amy


Amy, my current mix is Depakote 375mg, Wellbutrin 150mg, and Klonopin .5mg. I had to reduce the Depakote down to 125mg during my seasonal depression due to oversleeping. I'm well out of that episode, and now the thing I have to be careful about is getting too high. Right now is typically when I experience several intense hypomanic episodes (every 20 days or so for several days) that will last through into June. The trouble now isn't oversleeping, it is simply not getting enough sleep! I quit my little bit of Effexor I was taking (which helped getting to sleep). I can get to sleep easily and sleep quite solidly, but it only lasts five to six hours and I am getting a little sleep-deprived and wirey. That is why my Depakote is upped. I stopped increasing the Wellbutrin because of this. But the WB isn't causing any hypomania, and since I dropped the Effexor my cycling has been dampened down. Just need to sleep a LITTLE more.... I have LOST about five pounds over the last few weeks (despite tripling the Depakote), but that is because of the WB and shaking off the winter depression. Dr. Phelps on his website mentions a "spot" where the Depakote dosage kicks in the weight gain (he mentions "around 750mg"). Previous experience showed that to happen to me at 500mg. I think I am going to be OK on this dose/combo to make it through the Spring. As far as adding Depakote to Lamictal... that depends on what your dosage of Lamictal is. What is it? If you add Depakote it will quickly double your Lamictal blood levels and could trigger a rash. It is much safer from what I understand to add a *little* Lamictal to Depakote. If you want to add Depakote you will need to drop your Lamictal possibly in half (and time it carefully). You will need to get your pdoc to do the math carefully if that's how you want to go. Trileptal wouldn't force you to change your Lamictal dosages. Hey, if you can tolerate the Trileptal it would be probably be safer than Depakote. Just be aware of the hazards.. Take care.

 

Re: Wellbutrin and Kava Kava » Ron Hill

Posted by catmint on April 2, 2003, at 14:31:46

In reply to Re: Wellbutrin and Kava Kava » catmint, posted by Ron Hill on April 1, 2003, at 16:27:34

Ron,
The country of Vanuatu consists of about 80 small islands in the South Pacific, just west of Fiji.Kava Kava is indiginous to several South Pacific islands and is widely cultivated on many.

As for Wellbutrin, yes I have taken it before when I was on Nuerontin, and yes, I did have as much irritablity as I do now. Since that was not a good mood stabilizer, I thinking that with Depakote it might work. I don't know, I'm getting kind-of frustrated with this whole irritability thing. I see my pdoc in about a week and a half.

I might ask him about combining Lamictal and Depakote.

I sure can't take only Depakote, that is sure to make my depression worse.

I'm also wondering how much my current life situation has an effect on my mood. I am trying to go through vocational rehab., but can't seem to come up with any ideas. All my efforts have lead to dead ends. But I guess that is a subject for psychological babble. Maybe soon, I'll post over there about this troubling situation.

Talk to you soon,
Amy

 

Re: Trileptal or Depakote?

Posted by catmint on April 2, 2003, at 14:54:12

In reply to Re: Ritch » catmint, posted by Ritch on April 1, 2003, at 22:46:21


> Amy, my current mix is Depakote 375mg, Wellbutrin 150mg, and Klonopin .5mg. I had to reduce the Depakote down to 125mg during my seasonal depression due to oversleeping. I'm well out of that episode, and now the thing I have to be careful about is getting too high. Right now is typically when I experience several intense hypomanic episodes (every 20 days or so for several days) that will last through into June. The trouble now isn't oversleeping, it is simply not getting enough sleep! I quit my little bit of Effexor I was taking (which helped getting to sleep). I can get to sleep easily and sleep quite solidly, but it only lasts five to six hours and I am getting a little sleep-deprived and wirey. That is why my Depakote is upped. I stopped increasing the Wellbutrin because of this. But the WB isn't causing any hypomania, and since I dropped the Effexor my cycling has been dampened down. Just need to sleep a LITTLE more.... I have LOST about five pounds over the last few weeks (despite tripling the Depakote), but that is because of the WB and shaking off the winter depression. Dr. Phelps on his website mentions a "spot" where the Depakote dosage kicks in the weight gain (he mentions "around 750mg"). Previous experience showed that to happen to me at 500mg. I think I am going to be OK on this dose/combo to make it through the Spring. As far as adding Depakote to Lamictal... that depends on what your dosage of Lamictal is. What is it? If you add Depakote it will quickly double your Lamictal blood levels and could trigger a rash. It is much safer from what I understand to add a *little* Lamictal to Depakote. If you want to add Depakote you will need to drop your Lamictal possibly in half (and time it carefully). You will need to get your pdoc to do the math carefully if that's how you want to go. Trileptal wouldn't force you to change your Lamictal dosages. Hey, if you can tolerate the Trileptal it would be probably be safer than Depakote. Just be aware of the hazards.. Take care.
>
Ritch,
I see my doctor in about a week.
I remember in one of your posts that the Trileptal did not help your irritabillity and the nausea never went away. I am extremely med sensitive and I believe that we have similar symptoms of depression (irritability, low-energy, anhedonia, basically sleepy-tired, no motivation). Am I correct? So, I wouldn't be surprised if it did the same for me. On Depakote (125 mg.) I didn't have nausea, rather appetite decrease and weight loss. How is you appetite right now? You said you lost five pounds. Is that normal for you when you are getting hypomanic? That is the case for me. Just the opposite, when I'm depressed, it's all about cereal and bread!

I intuitively do not feel right about Trileptal, since it also can be activating. The Lamictal is quite enough! Right now, more than 75mg. would definately cause hypomania. As for Depakote, that was great for my irritability, I didn't fight with anyone practically the whole time I was on it! I am going to mention to pdoc soon about properly combining the Lam. and Dep.

Does the wellbutrin help with motivation?

Thanks for your post! Write back soon!
::Amy

 

Re: Trileptal or Depakote? » catmint

Posted by Ritch on April 2, 2003, at 22:12:46

In reply to Re: Trileptal or Depakote?, posted by catmint on April 2, 2003, at 14:54:12

>
> > Amy, my current mix is Depakote 375mg, Wellbutrin 150mg, and Klonopin .5mg. I had to reduce the Depakote down to 125mg during my seasonal depression due to oversleeping. I'm well out of that episode, and now the thing I have to be careful about is getting too high. Right now is typically when I experience several intense hypomanic episodes (every 20 days or so for several days) that will last through into June. The trouble now isn't oversleeping, it is simply not getting enough sleep! I quit my little bit of Effexor I was taking (which helped getting to sleep). I can get to sleep easily and sleep quite solidly, but it only lasts five to six hours and I am getting a little sleep-deprived and wirey. That is why my Depakote is upped. I stopped increasing the Wellbutrin because of this. But the WB isn't causing any hypomania, and since I dropped the Effexor my cycling has been dampened down. Just need to sleep a LITTLE more.... I have LOST about five pounds over the last few weeks (despite tripling the Depakote), but that is because of the WB and shaking off the winter depression. Dr. Phelps on his website mentions a "spot" where the Depakote dosage kicks in the weight gain (he mentions "around 750mg"). Previous experience showed that to happen to me at 500mg. I think I am going to be OK on this dose/combo to make it through the Spring. As far as adding Depakote to Lamictal... that depends on what your dosage of Lamictal is. What is it? If you add Depakote it will quickly double your Lamictal blood levels and could trigger a rash. It is much safer from what I understand to add a *little* Lamictal to Depakote. If you want to add Depakote you will need to drop your Lamictal possibly in half (and time it carefully). You will need to get your pdoc to do the math carefully if that's how you want to go. Trileptal wouldn't force you to change your Lamictal dosages. Hey, if you can tolerate the Trileptal it would be probably be safer than Depakote. Just be aware of the hazards.. Take care.
> >
> Ritch,
> I see my doctor in about a week.
> I remember in one of your posts that the Trileptal did not help your irritabillity and the nausea never went away. I am extremely med sensitive and I believe that we have similar symptoms of depression (irritability, low-energy, anhedonia, basically sleepy-tired, no motivation). Am I correct? So, I wouldn't be surprised if it did the same for me. On Depakote (125 mg.) I didn't have nausea, rather appetite decrease and weight loss. How is you appetite right now? You said you lost five pounds. Is that normal for you when you are getting hypomanic? That is the case for me. Just the opposite, when I'm depressed, it's all about cereal and bread!
>
> I intuitively do not feel right about Trileptal, since it also can be activating. The Lamictal is quite enough! Right now, more than 75mg. would definately cause hypomania. As for Depakote, that was great for my irritability, I didn't fight with anyone practically the whole time I was on it! I am going to mention to pdoc soon about properly combining the Lam. and Dep.
>
> Does the wellbutrin help with motivation?
>
> Thanks for your post! Write back soon!
> ::Amy
>


Trileptal didn't help *much* with irritability, but I never reached 300mg+ to find out. Depakote at 125mg does zilch for my temper spells. 250mg makes a sudden BIG reduction (in irritability). 375mg didn't seem to help much further in that regard, but I did notice a decrease in generalized anxiety, and it has allowed me to take Wellbutrin without getting mean. When I had tried Wellbutrin previously I was either only on 125mg of Depakote (not enough), or I wasn't taking it at all (taking Neurontin or something else instead) and I would get hostile on it if I went above 18.75mg/day. Now I'm taking 150mg/day and I don't feel the slightest bit irritable (with the Depakote), but I feel a little anxious and buzzy when it peaks for an hour or two (I take 150mgSR once in the AM). Definitely more motivating-it will make you scoot if you need to get stuff done. If you got such positive results with the Depakote maybe you should discuss that with your pdoc. He probably wants to do the Trileptal because he won't have to tinker with your Lamictal dose. So, you are on 75mg of Lamictal now? He may ask you to drop the Lamictal dose down to 50mg or maybe less. But, if your pdoc is too wary of the Depakote and insists on the Trileptal, it still is worthy of trying. You might not get the least bit nauseous with it and for sure it shouldn't cause any significant weight gain. My moods are more seasonal than anything. Very predictable.


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