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Dr. Bob is Robert Hsiung, MD,
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Posted by Wendy B. on October 19, 2001, at 22:22:21
In reply to Re: Neurontin as a mood stabilizer-max. dose? » Wendy B., posted by Mitch on October 17, 2001, at 23:59:42
Hi Mitch,
I went to therapy today, we had a good talk. She understands my need to not feel like a lab rat. Of course, as a good therapist, she wants me to feel the opposite - well enough, *because* of the meds, that I will go out into the world now with a little more bravery. Since last spring's major manic/depressive episode I have been a little reclusive, underachieving as usual, don't have a good, secure job. My bills pile up and I can't pay them. I dread it, but I have to bring up the issue of appropriate child support money with my ex-husband, and I'm avoiding filling out the paperwork on it. I can't seem to even fill out the insurance papers to get my refund back for therapy sessions. The therp said she'd help me out with that. She is out-of-network, so it's partly her job to do this. Anyway, the point is, I feel limited and insecure...
About the 4200 mg dose: I think we're doing a little dance around a 'Who's-In-Control-of-the-Meds' situation. I told her what the last few days have been like: just reciting the number of times I've had to dose the Neurontin per day is exhausting: 7am, 10am, 1pm, 4pm, 7pm, 10pm, & 1 at bedtime. She did wince a little when I performed this recitation.
I made a 'freudian' slip at one point during the session, and called the Neurontin 'lithium.' She smiled and said she'd been thinking about lithium for me. I had mentioned it to her Monday night after group, I reminded her. She just told me that I would have to have blood levels taken on a regular basis on lithium. I asked her if/when my dose stabilized, couldn't the blood tests eventually stop? And she was adamant that blood levels would have to be taken regularly, the entire time I might be on lithium. So I guess if I feel like an invalid now with the pill-popping, I might feel just as much, or more, of one when going in for tests and blood-letting. She said it's expensive, and it's a pain in the ass.
We didn't talk about depakote or about using it as adjunct to the Neurontin, I'll mention it next week.
Thanks again for listening, Mitch.
Wendy
Posted by Mitch on October 20, 2001, at 11:05:59
In reply to Re: Neurontin -max. dose? -- update » Mitch, posted by Wendy B. on October 19, 2001, at 22:22:21
> I made a 'freudian' slip at one point during the session, and called the Neurontin 'lithium.' She smiled and said she'd been thinking about lithium for me. I had mentioned it to her Monday night after group, I reminded her. She just told me that I would have to have blood levels taken on a regular basis on lithium. I asked her if/when my dose stabilized, couldn't the blood tests eventually stop? And she was adamant that blood levels would have to be taken regularly, the entire time I might be on lithium. So I guess if I feel like an invalid now with the pill-popping, I might feel just as much, or more, of one when going in for tests and blood-letting. She said it's expensive, and it's a pain in the ass.
>
> We didn't talk about depakote or about using it as adjunct to the Neurontin, I'll mention it next week.
>
> Thanks again for listening, Mitch.
>
> WendyWendy,
I would ask about adding Depakote (and then reduction of Neurontin to a 3x daily dosage!) before the lithium. Lithium has to be monitored because of its potential toxicity (the therapeutic doses for many people get close to toxic ones). My pdoc doesn't want to use it because of that reason. The blood tests (lithium levels) are important when treatment is being initiated and after dosage changes, but beyond that I think it is basically CYA for the pdoc. The symptoms of lithium toxicity are fairly easy to recognize.
Mitch
Posted by Wendy B. on October 21, 2001, at 8:20:44
In reply to Re: Neurontin -max. dose? -- update » Wendy B., posted by Mitch on October 20, 2001, at 11:05:59
> Wendy,
>
> I would ask about adding Depakote (and then reduction of Neurontin to a 3x daily dosage!) before the lithium. Lithium has to be monitored because of its potential toxicity (the therapeutic doses for many people get close to toxic ones). My pdoc doesn't want to use it because of that reason. The blood tests (lithium levels) are important when treatment is being initiated and after dosage changes, but beyond that I think it is basically CYA for the pdoc. The symptoms of lithium toxicity are fairly easy to recognize.
>
> Mitch
I will arm myself with more info on the depakote, then, before I see her next week. I don't know much about it, except the horror stories about hair loss...Will update you then, and thank you!
Wendy
Posted by susan C on October 21, 2001, at 11:13:51
In reply to Re: Neurontin -max. dose with depakote » Mitch, posted by Wendy B. on October 21, 2001, at 8:20:44
Hi Wendy and Mitch,
Ah, here we are again, Mitch, crossing paths...you can see my up date on Keppra soon, still wozzy this am, just to let you know I am reading and will post something about depakote/neurton
Regards from a wozzy mouze
susan C
Posted by Krazy Kat on October 21, 2001, at 12:15:14
In reply to Re: Neurontin -max. dose with depakote, posted by susan C on October 21, 2001, at 11:13:51
> Hi Wendy and Mitch and Susan:
>
Sorry, I didn't see this post until today.Mitch, your comments are always So helpful!
Wendy, I started with Neurontin alone and it didn't do much for me. It was a little calming at first, but didn't really help until Topamax was added. Then I could tell a difference if I didn't take a Neurontin dose.
Topamax has been too sedating so now I'm taking Depakote which has helped me quite a bit. Hadn't thought about keeping the Neurontin up - might be helpful. The Depakote really is stronger for me.
No hair loss, no weight gain yet. But it feels more like a heavy med - Neurontin is so gentle (at least it was for me).
I am having a difficult time coming to terms with being dependent on meds right now, myself. Going in for lab tests. Worrying about side effects. But I know I have to at some point... The mania sneaks back in, so does the depression. It's not going to go away.
I could never take the doses of Neurontin you're being asked to take - it's just ludicrous. MHO.
Is any other info helpful?
- K.
P.S. I was wondering if Lithium or Depakote was the better choice re: side effects - from what Mitch says, it sounds like Depakote.
Posted by Mitch on October 21, 2001, at 15:27:04
In reply to Re: Neurontin -max. dose with depakote, posted by Krazy Kat on October 21, 2001, at 12:15:14
> > Hi Wendy and Mitch and Susan:
> >
> Sorry, I didn't see this post until today.
>
> Mitch, your comments are always So helpful!
>
> Wendy, I started with Neurontin alone and it didn't do much for me. It was a little calming at first, but didn't really help until Topamax was added. Then I could tell a difference if I didn't take a Neurontin dose.
>
> Topamax has been too sedating so now I'm taking Depakote which has helped me quite a bit. Hadn't thought about keeping the Neurontin up - might be helpful. The Depakote really is stronger for me.
>
> No hair loss, no weight gain yet. But it feels more like a heavy med - Neurontin is so gentle (at least it was for me).
>
> I am having a difficult time coming to terms with being dependent on meds right now, myself. Going in for lab tests. Worrying about side effects. But I know I have to at some point... The mania sneaks back in, so does the depression. It's not going to go away.
>
> I could never take the doses of Neurontin you're being asked to take - it's just ludicrous. MHO.
>
> Is any other info helpful?
>
> - K.
>
> P.S. I was wondering if Lithium or Depakote was the better choice re: side effects - from what Mitch says, it sounds like Depakote.
Hi Krazy Kat,As far as Depakote versus Lithium goes that is soooo person specific. My experience has been that Depakote has the edge as far as antimanic effects, however I found lithium to be clearly better for depression. IF I didn't get so much cognitive dulling and diarrhea from the lithium I would prefer it over Depakote. However, some people find Depakote has a good antidepressant effect for them. As far as the hair loss I didn't notice any on Depakote (at 500mg/day). I DID however gain about 20 lbs., but I didn't *continue* to gain the weight (thank God!). All in all I think most people would find Depakote easier to *tolerate*, but many people will get a better positive response to lithium (esp. antidepressant). Also, I found Neurontin to have a clear antidepressant effect. If Depakote was a little more tolerable than lithium and the Neurontin has a mild AD effect, the combo of Depakote/Neurontin might work well for many.
Mitch
Posted by Krazy Kat on October 21, 2001, at 15:57:51
In reply to Re: Neurontin -max. dose with depakote » Krazy Kat , posted by Mitch on October 21, 2001, at 15:27:04
Posted by susan C on October 21, 2001, at 20:01:43
In reply to Re: Neurontin -max. dose? -- update » Mitch, posted by Wendy B. on October 19, 2001, at 22:22:21
OHHHHkayyy,
since we are talking aboot all these wonderful meds...I would like your opinions on these questions...
Why I didnt try neurotin (pdoc said, we had already tried big guns, so 'gentle' med like neurotin wouldn't help)?
Depakote (1000mg) works a little, if I add lithium or neurontin or both, which one first, how much...which second?
I took lithium a long time ago and it didn't really help much, but that was by itself and it upset my stomach......what if all three were together?
Mulling Mouse
susan C
Posted by Mitch on October 21, 2001, at 23:39:52
In reply to Neurontin+Depakote+lithium+Mitch and anyone else, posted by susan C on October 21, 2001, at 20:01:43
> OHHHHkayyy,
>
> since we are talking aboot all these wonderful meds...I would like your opinions on these questions...
>
> Why I didnt try neurotin (pdoc said, we had already tried big guns, so 'gentle' med like neurotin wouldn't help)?
>
> Depakote (1000mg) works a little, if I add lithium or neurontin or both, which one first, how much...which second?
>
> I took lithium a long time ago and it didn't really help much, but that was by itself and it upset my stomach......what if all three were together?
>
> Mulling Mouse
> susan CHi Susan,
I think you should try adding the Neurontin. I once saw a pdoc a few years ago that didn't like *retrials* of stuff that you either got no response to or got bad side effects (that was readily attributable to the med in queston). I was skeptical at the time thinking that different combos could turn up different results (sudden tolerability of the previous med or sudden unexpected efficacy in combo with something new). Well.... I am inclined to agree with him (not entirely, but much more so now)after all the crap I have been through over the past several years. So, I suggest adding the Neurontin to your Depakote (because you haven't tried it yet!). I think it would be reasonable to add the NEW med BEFORE you consider retrial in combination of a previous agent that produced either a partial response and/or nasty side effects. I would like to find some form of closure to this circus myself and I have been somewhat dissapointed with retrials of agents.
Mitch
Posted by Wendy B. on October 22, 2001, at 15:59:13
In reply to Re: Neurontin+Depakote+lithium+Mitch and anyone else » susan C, posted by Mitch on October 21, 2001, at 23:39:52
> > OHHHHkayyy,
> >
> > since we are talking aboot all these wonderful meds...I would like your opinions on these questions...
> >
> > Why I didnt try neurotin (pdoc said, we had already tried big guns, so 'gentle' med like neurotin wouldn't help)?
> >
> > Depakote (1000mg) works a little, if I add lithium or neurontin or both, which one first, how much...which second?
> >
> > I took lithium a long time ago and it didn't really help much, but that was by itself and it upset my stomach......what if all three were together?
> >
> > Mulling Mouse
> > susan C
>
> Hi Susan,
>
> I think you should try adding the Neurontin. I once saw a pdoc a few years ago that didn't like *retrials* of stuff that you either got no response to or got bad side effects (that was readily attributable to the med in queston). I was skeptical at the time thinking that different combos could turn up different results (sudden tolerability of the previous med or sudden unexpected efficacy in combo with something new). Well.... I am inclined to agree with him (not entirely, but much more so now)after all the crap I have been through over the past several years. So, I suggest adding the Neurontin to your Depakote (because you haven't tried it yet!). I think it would be reasonable to add the NEW med BEFORE you consider retrial in combination of a previous agent that produced either a partial response and/or nasty side effects. I would like to find some form of closure to this circus myself and I have been somewhat dissapointed with retrials of agents.
>
> Mitch
Arrrgghhh. Mitch, I know what you mean about the circus aspect of all this. I feel the lab rat thing happening... as if I'm slowly poisoning myself to death, just so the therapist can make a point. Not good...I am so NOT INTO doing this neurontin regimen. I am taking 600 mg every 3 hours. My therp/pdoc says: tell the schoolchildren that you're on medicine for a mental illness and educate them about the issue, don't hide in the closet when you have to dose at 10:00 and 1:00 while you're teaching... Is this a reasonable answer to my question: how do I do this while teaching? I mean, what if it gets to the principal? Then I won't get called to substitute, I don't have a union position like the tenured teachers...
Thank you Kelly (KK) and Susan, as always. Mitch has been exceedingly kind.
Kelly, can you read the other posts above, and give me a response to the therp? She has been great, but won't budge on the neurontin thing, upping the dose as much as possible to eliminate the hypomanic episodes... When I told her I was doing 4200 mgs, even she raised her eyebrows, like 'that's a lot,' but she asked me to do this... I don't know what to do, I've been on the higher dose (raised from 2400 mg per day) for a week now. Today I've felt the cognitive dulling that Mitch mentions, and also some apathy. I just feel >blechy< , slept 3 hours this morning, could not go in to teach, was too sick. Maybe pre-menstrual stuff, maybe pre-mens PLUS being on so much neurontin. And the fact that I was on my feet all weekend at the winery pouring tastes for customers. I couldn't walk when I got home last night...
But I'm veering from the meds issues. Susan, I would try the neurontin as Mitch suggests. It is so easy to take, in lower doses than the one I'm on anyway. Are you totally off the Keppra withdrawal? I would wait till that's done...
love to all,
Wendy
Posted by sar on October 22, 2001, at 17:35:41
In reply to Re: Neurontin+Depakote+lithium+Mitch and anyone else, posted by Wendy B. on October 22, 2001, at 15:59:13
Wendy,
thanks for tipping me off to this thread.
as far as the lab-rat thing goes...personally, i love taking my pills, i think oh yum yum this is making me better...but i've never had to dose every few hour like you. can you afford consultation with a really hot-shot pdoc?
does neurontin make you tired? it makes me crawl back into bed even after tea every morning.
explaining to students--these are middle schoolers, right? i'd equate that to a 5 year-old asking about where babies come from. they don't want the lurid details, just a simple explanation. i would say to the students (if they even asked) "i take these to maintain my health"--end of subject. i don't think i'd venture to educate middle-schoolers on mental illness in the classroom as a sub. if it was in the textbooks (which it should be, like in health class) fine, but--
i don't have the experience of the other posters, but my pdoc said to me, "Some people go as high as 2400 mg on neurontin"--so nearly double that kinda makes my eyebrows jump up...
love,
sar
Posted by Mitch on October 22, 2001, at 22:59:10
In reply to Re: Neurontin+Depakote+lithium+Mitch and anyone else, posted by Wendy B. on October 22, 2001, at 15:59:13
> I am so NOT INTO doing this neurontin regimen. I am taking 600 mg every 3 hours. My therp/pdoc says: tell the schoolchildren that you're on medicine for a mental illness and educate them about the issue, don't hide in the closet when you have to dose at 10:00 and 1:00 while you're teaching... Is this a reasonable answer to my question: how do I do this while teaching? I mean, what if it gets to the principal? Then I won't get called to substitute, I don't have a union position like the tenured teachers...
Wendy,
I would go and get a 2nd opinion from another psychiatrist. Don't tell your current one this, however-wait till you have had a chance to talk to one or two others first. Just go and do it. I mean, geez, just how *bad* are the "hypomanic episodes" anyways?? Do they significantly interfere with you being able to teach-OR does taking a ton of Neurontin interfere with your day to day activities just as much?? You have got to weigh this all in. If your current pdoc can't see this, then maybe you should be checking out a different one. I am starting to see a pattern based on what you and some others have said about Neurontin. I think it is very useful and *often* needs to be supplemented by other meds to be effective for many people. It seems like pdocs give you some Neurontin and YES, they see some improvement and they think that MORE, MORE, could just do the trick! Monotherapy mecca! Well...I doubt that somehow.
Mitch
Posted by Chloe on October 23, 2001, at 9:44:28
In reply to Re: Neurontin+Depakote+lithium+Mitch and anyone else, posted by Wendy B. on October 22, 2001, at 15:59:13
>I don't know what to do, I've been on the higher dose (raised from 2400 mg per day) for a week now. Today I've felt the cognitive dulling that Mitch mentions, and also some apathy. I just feel >blechy<
Hi Wendy
I just wanted to jump in, because I can relate to some of what you are saying. But not at the doses you are taking, I am extremely med sensitive. I was taking 400 mgs of Neurontin with a dab of Celexa for my depression and cycling. It was absolutely no help with the cycling and irritability. So 600mg of Li was adding. Wow, the Li has a nice AD effect and really smoothed things out. Neurontin alone is useless IMHO!
Things seemed to be fine for a while, but I have had a return of cycling and depression. So pdoc said why not try to get the N up to 600 mgs since that has the least amount of side effects. Well, I did it 100/week and I didn't really have any side effects except added dry skin and sore hair (I really hate that one, it hurts, and I fear I am going to shed all my hair). BUT, after at least 1 week at 600 mgs N, I just started feeling >blechy< . No energy, can't focus, tired all the time, but unable to nap, irritable (I think because I feel so crappy) and just unhappy.So, I am not sure N should be hailed as this side effect free medication. It's powerful in a very subtle way, but not necessary in a good way for emotions. I think if you go beyond your own "therapeutic" window, you can get nasty side effects, that increase emotional INstability.
If I were brave enough to go through the withdrawal and change, I might consider a dab of depakote instead of the N. But I am so tired...I think from the Neurontin!
Anyway, good luck sorting this issue out. I hope you can get a second opinion on this
Chloe
Posted by Krazy Kat on October 24, 2001, at 10:06:04
In reply to Re: Neurontin+Depakote+lithium+Mitch and anyone else, posted by Wendy B. on October 22, 2001, at 15:59:13
Wendy:
Your therp: By all accounts I've seen, Neurontin just doesn't work on its own as a stabilizer. It seems to me your therp. is being a tad condescending, but that's just my opinion. Especially if you are BPI, this just doesn't make sense to me. My pdoc, for what it's worth, considers Neurontin more of an anti-anxiety med.
You're in a different situation b/c you're doing therapy. I'm not. So if you're comfortable with her, it would be difficult to switch.
You may just have to keep insisting, which I know you can do. :) My pdoc has had me on Topamax since last December. It worked well, but was too sedating. I kept telling him that. He just wasn't concerned and didn't see how much that was interferring with my life. It took until August for him to recognize it and switch my, mostly to Depakote, and I kind of had to throw a fit. I shouldn't have put up with it that long.
I think Mitch has the right idea - a second opinion.
Is that what you wanted?
- K., eatin' a bagel and feelin' better today
Posted by Roo on October 24, 2001, at 10:32:47
In reply to Re: Neurontin+Depakote+lithium+Mitch and anyone else » Wendy B., posted by Krazy Kat on October 24, 2001, at 10:06:04
Did you gain weight on depakote?
Posted by susan C on October 24, 2001, at 12:34:35
In reply to Re: Neurontin+Depakote+lithium--Krazy Kat, posted by Roo on October 24, 2001, at 10:32:47
I didn't
but then, I subsequently added Keppra and basically stopped eating,and lost about 15 lbs which I could stand to loose, but it happend so quickly and my eating habits/attitude changed... but even before that, my weight was stable on depakote alone...extra strands of hair fell out, but that has stopped now which coinsides with what pdoc said, it stops after about a year. Oh, and the hair that grew back is curlier. My opinion is if you start Depakote and notice a change in your appetite, contact your doc right away, see if you can manage it...there seems to be a debate about whether or not it is metabolism (so no mater what you do you still gain) or controlable by diet and exercise...a puzzled mouse
susan C
> Did you gain weight on depakote?
Posted by Krazy Kat on October 24, 2001, at 13:16:26
In reply to Re: Neurontin+Depakote+lithium--Krazy Kat, posted by Roo on October 24, 2001, at 10:32:47
I haven't but I am also still taking Topamax, 100 mg, so that could make a difference.
Posted by wendy b. on October 25, 2001, at 21:19:46
In reply to Re: Neurontin+Depakote+lithium+Mitch and anyone else, posted by sar on October 22, 2001, at 17:35:41
> Wendy,
>
> thanks for tipping me off to this thread.No problemo. The more you can read about the med they just doubled your dose on, the better.
> as far as the lab-rat thing goes...personally, i love taking my pills, i think oh yum yum this is making me better...but i've never had to dose every few hour like you. can you afford consultation with a really hot-shot pdoc?yeah, I still have good insurance, my ex-hub (who I'm still not divorced from yet) has to keep me on his insurance, and my daughter too, of course. I just need to find one who has an open appointment sometime in this decade...
Yeah, I know what you mean about the meds making you feel better, so you don't mind taking them so much, that's how I used to feel. I think this fall has been rough for some reason, and I feel my therp (who is also the prescribing doc) is patronizing me, so I have a "bad attitude" at the moment. Ever have a bad attitude?? :-]
> does neurontin make you tired? it makes me crawl back into bed even after tea every morning.
No, it doesn't produce somnolence in me the way it does in some people, thank god for that. I wonder if yours will go away in time, after your bod adjusts to this new level.
> explaining to students--these are middle schoolers, right? i'd equate that to a 5 year-old asking about where babies come from. they don't want the lurid details, just a simple explanation. i would say to the students (if they even asked) "i take these to maintain my health"--end of subject. i don't think i'd venture to educate middle-schoolers on mental illness in the classroom as a sub. if it was in the textbooks (which it should be, like in health class) fine, but--THANK YOU for validating my response to this! I know what her point is: that I shouldn't feel I have to crawl away to sneak my meds, but please! people in general, and kids in particular, don't understand this kind of thing. I could see if I were their Health teacher, but even then!
> i don't have the experience of the other posters, but my pdoc said to me, "Some people go as high as 2400 mg on neurontin"--so nearly double that kinda makes my eyebrows jump up...
>
> love,
> sar
Thanks, Sar. Makes my eyebrows go up, too. I have decided to cut back without telling her... and feel more like myself already. Mitch thinks I should augment with Depakote, if anything, and that Neurontin alone doesn't cut it as a mood-stabilizer for some people...much love, more later,
W.
Posted by wendy b. on October 26, 2001, at 8:08:51
In reply to Re: Neurontin -max. dose with depakote, posted by Krazy Kat on October 21, 2001, at 12:15:14
> > Hi Wendy and Mitch and Susan:
> >
> Sorry, I didn't see this post until today.
>
> Mitch, your comments are always So helpful!Yes, this guy is super, if you read some of the archives, he's been very helpful to people here for a long time...
> Wendy, I started with Neurontin alone and it didn't do much for me. It was a little calming at first, but didn't really help until Topamax was added. Then I could tell a difference if I didn't take a Neurontin dose.
So you really saw its benefits only after the Topamax was added, that's interesting.
> Topamax has been too sedating so now I'm taking Depakote which has helped me quite a bit. Hadn't thought about keeping the Neurontin up - might be helpful. The Depakote really is stronger for me.Will you try the Neurontin with it? You haven't been feeling really well lately, have you? Maybe it would help (?)
> No hair loss, no weight gain yet. But it feels more like a heavy med - Neurontin is so gentle (at least it was for me).Yeah, it has been fine. I can't tell any difference in bodily functioning like stomach upset or somnolence. BUT, in July I ran out for a few days when I went out of town, and tapered down before I ran out totally, and I was a mess, very out of sorts and nervous. So that's when I understood that I am really dependent on it.
> I am having a difficult time coming to terms with being dependent on meds right now, myself.Right, I saw the post on PSB. I truly feel for you, even though I didn't write. Everyone else said what I would have said, only they said it better. This latest incident with the pushing of the dose with the Neurontin has made me feel like an invalid, dosing every three hours... Shit!
>Going in for lab tests.For what, can I ask?
>Worrying about side effects. But I know I have to at some point... The mania sneaks back in, so does the depression. It's not going to go away.
Ditto. The hypomanic incident a few weeks ago was a little weird. I felt, at least, that this alien thing was happening to me, whereas in the past, it would have just been one more chaotic chapter in the Life of Wendy. Therapist says this is good to experience it as coming from outside, rather than something that's innately part of my 'self'. If you know what I mean, maybe not expressing myself well.
> I could never take the doses of Neurontin you're being asked to take - it's just ludicrous. MHO.
I wrote to Sar last nite, I am cutting back on the big doses of the N, without telling the therp. Is this bad?
> Is any other info helpful?
>
> - K.
>
> P.S. I was wondering if Lithium or Depakote was the better choice re: side effects - from what Mitch says, it sounds like Depakote.
Yes, yes, everything is helpful, including just talking about it. My ex-boyfriend is also experiencing the therp's incompetence (I feel so bad saying this!), she continually mis-writes his scrips, he never has a smooth prescription transaction with her. Think he's going to get a referral to someone else. (The first time we went to see her was together in November last year. At this stage, we don't talk or see each other very much, but send each other e-mails about meds, and about scrip annoyances... The basis of our relationship, I tell him, was our ability to piss each other off over things...).Anyway, my most recent scrip transaction with her was a disaster, too. Monday after group, she wrote me a new scrip for Neurontin, after I had expressed to the group that I felt over-medicated, felt like a lab rat (thanx, Mitch!), and an invalid (that one was mine). I think she got the point, but wasn't happy about it, didn't give me the usual banter... She wrote it for 900mg tabs of Neurontin, which, if I remembered right, was something she'd done for the ex, and that the pharmacist told him the manufacturer, Parke-Davis, didn't *make* 900mg tabs! So I dutifully took it in anyway, and the pharmacy told me the same thing Tuesday morning! 900mg tabs don't exist. I e-mailed ex about it, he told me she lied to him to cover up for it, said to him, they *used* to make it... Does this do anything to make me feel better about the situation? .... You're right, it doesn't.
Thanks for listening... Any suggestions or words of wisdom appreciated as always.
love,
Wendyps: wasn't the new sign-in for Dr Bob's site a little much?
Posted by Krazy Kat on October 29, 2001, at 10:24:23
In reply to Re: Neurontin -max. dose with depakote » Krazy Kat , posted by wendy b. on October 26, 2001, at 8:08:51
Wendy:
Glad to have a message to respond to from you. Was hoping to communicate with you again soon.
Yeah, I got frustrated with the whole "Quiz" thing which is why I've been away for a few days.
Do you know that I forgot to ask my pdoc about adding Neurontin? How silly is that? Actually, I have no insurance right now and have to pay for my meds and Neurontin is Expensive, so it's probably better not to add it at this point. But definitely am keeping it in mind.
Upped the Depakote - am feeling better today - has been four days I think. My blood level was low. It seems to be a good med for me. I was thinking though, that one reason I may not have gained weight is that I still take Topamax. Also, I do take a vitamin everyday to counteract hair loss.
Um, the story about your therp - yikes. I'd try to find someone else if you can. Are you limited where you are? I don't know if 900 mg were ever made, but all I've heard is that a body can only metabolize 600 mg at a time.
Labs - you have to get Depakote level, blood platelets, liver, maybe something else done everytime a Depakote dose is changed and occassionally forever while on it because it can cause liver damage and immune problems (I think both are quite rare, though).
I wouldn't hesitate to play around with Neurontin's dosage - I have before w/o any problems. Maybe you'll find a dose that works better for you. Considering some of the scrip problems with your pdoc...
I also asked my pdoc about Lithium versus Depakote - he feels Lithium has a higher toxicity rate. I don't know, I'm kind of obsessing on the liver thing. Should probably stop drinking then, eh? ;) And again, the thought of taking something forever... not sitting well.
Oh, well.
Take care.
- K.
Posted by joebob on July 9, 2003, at 23:36:58
In reply to Neurontin+Depakote+lithium+Mitch and anyone else, posted by susan C on October 21, 2001, at 20:01:43
i was told to try a 2 week predose of depakote prior to starting lexapro...........
and then read all this horrible stuff about the depakote..........
will neurontin do the same thing, i.e. prepare the brain for the ssri rush..........?
i had a mild manic break on the 3rd day of trying lexapro at a very low dose...........
any advice or experience?
Posted by fluffy on July 13, 2003, at 18:04:15
In reply to depakote predosing before lexapro, posted by joebob on July 9, 2003, at 23:36:58
Joebob--
Depakote does have a rather sketchy side effect profile. The most bothersome one being weight gain. But some people do very well on it. I have not personally tried it.
I would NOT do Lexapro as an antidepressant without a potent moodstabilizer trial first. I had the most horrible manic/mixed state in my life after 3 weeks of the stuff. I thought about ending my life, and wanted to bang my head into a wall. It is a VERY strong AD--and has a reputation for causing swings into mania (like Celexa).
Neurontin is NOT a potent moodstabilizer. It works OK as an add-on for some people. And it seems to work well for anxiety, but it is WELL documented that it is a weak stabilizer.
I would discuss with your pdoc either Lithium, Depakote, or Tegretol as your main stabilizer before getting the AD on board. They are the gold standards.
As far as an AD goes...Wellbutrin is the least likely to switch someone into mania. And Lamictal is fast becoming the darling AD for BP folks. (What is your formal diagnosis?)
Check some other sites about this stuff. Let me know if you'd like some good links. I don't have them now, but I can post them later.
Good luck with your meds---I hope it goes smoothly for you. (sorry if you already know all of this!)
Take care,
Katy
Posted by joebob on July 14, 2003, at 21:42:42
In reply to Re: depakote predosing before lexapro, posted by fluffy on July 13, 2003, at 18:04:15
thanks so much for replying
it means a lot to me to know i am not alone out here
had no formal diagnosis, really, just major depressive episode......
will i have to keep taking the depakote after the lexapro kicks in, or can i wean off it?
is the other stuff better than depakote?
what about lithium orotate, which i like for a number of reasons?
i could use some good links......if you can post themthank you so very much
Posted by joebob on July 14, 2003, at 21:48:53
In reply to Re: Neurontin+Depakote+lithium--Krazy Kat, posted by Roo on October 24, 2001, at 10:32:47
Posted by Red Sonja on December 6, 2003, at 14:40:05
In reply to Re: Neurontin as a mood stabilizer-max. dose? » Chaston, posted by Wendy B. on October 17, 2001, at 10:46:01
Hi, I just joined this group. I have been diagnosed as Bipolar with suicidal tendencies. I am currently taking 3600mg Neurontin + 3mg Risperdal as mode stabilizers. They seem to be doing better than when I was on Lithium with Neurontin.
Unfortunately I am also disabled (Fibromyalgia and CFS) and waiting for Medicare to kick in. My current psychiatrist claims that the Neurontin does NOT help as a mode stabilizer (or antidepressant or antianxiety med) and is refusing to cover it under my states mental health care system. Neurontin is so expensive that I can't afford to purchase it myself either.
Is there any new research showing the effecy of Neurontin in treating Bipolar symptoms? I am thinking of the list of positive research articles: "Posted by SalArmy4me on March 12, 2001, at 12:29:26". Is there any newer research?? Much thanks. I would love to hear from SalArmy4me.....
Thanks
This is the end of the thread.
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