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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by rainy on December 12, 2004, at 6:56:37
This could get confusing. Pdoc suggested either Effexor or Abilify as antidepressants. Or maybe mood stabilizers?? I have bipolar II and have been on 400 mgs wellbutrin SR q.i.d., 300 Topmax t.i.d and .5 mgs klonopin b.id. PRN. Mucho anxiety. Cried when I saw her, to my dismay. I said no to either Effexor or Abilify until I researched. She gave me a sample of Abilify and said to return in three weeks. I still say no. I cut down to 200 wellbutrin myself and am (on her reccomendations) slowly titrating up Topamax to 400--after a week, now at 325. I feel better with dose reduction.
What about Trileptal as mood stabilizer? Really want to go alternative but want to hear from you guys, too. Also don't think she'll cooperate with kinder, gentler form of treatment. Want new pdoc. Help.
rainy
Posted by Ritch on December 12, 2004, at 10:33:09
In reply to trileptal as mood stabilzer?, posted by rainy on December 12, 2004, at 6:56:37
> This could get confusing. Pdoc suggested either Effexor or Abilify as antidepressants. Or maybe mood stabilizers?? I have bipolar II and have been on 400 mgs wellbutrin SR q.i.d., 300 Topmax t.i.d and .5 mgs klonopin b.id. PRN. Mucho anxiety. Cried when I saw her, to my dismay. I said no to either Effexor or Abilify until I researched. She gave me a sample of Abilify and said to return in three weeks. I still say no. I cut down to 200 wellbutrin myself and am (on her reccomendations) slowly titrating up Topamax to 400--after a week, now at 325. I feel better with dose reduction.
>
> What about Trileptal as mood stabilizer? Really want to go alternative but want to hear from you guys, too. Also don't think she'll cooperate with kinder, gentler form of treatment. Want new pdoc. Help.
>
> rainyWellbutrin can be incredibly anxiogenic. It definitely can bust any depression that I have, but it tends to make me too panicky. Trileptal I found to work better than the Depakote I now take. I just can't tolerate it-too much nausea. Some folks are just sensitive to it-you might not be-I definitely would recommend trying it before Abilify or Effexor. I found it really smashed my mood cycling and even worked better for my temper than Depakote. Haven't taken it with Topamax though. I got some significant cognitive blunting from Trileptal and Topamax. But it seems like you are tolerating the Top pretty well. Good luck!
Posted by rainy on December 12, 2004, at 12:07:24
In reply to Re: trileptal as mood stabilzer? » rainy, posted by Ritch on December 12, 2004, at 10:33:09
thanks, Ritch. Does it have AD effects, too? I can't figure out which she was trying for--AD or mood stabilization. Wellbutrin is sort of pooping out on me.
rainy
Posted by Ritch on December 12, 2004, at 12:46:18
In reply to Re: trileptal as mood stabilzer? » Ritch, posted by rainy on December 12, 2004, at 12:07:24
> thanks, Ritch. Does it have AD effects, too? I can't figure out which she was trying for--AD or mood stabilization. Wellbutrin is sort of pooping out on me.
>
> rainyI found it to have some antidepressant effect that Depakote apparently lacks. But, the thing I liked about the T the most was improved sleep, and clearly reduced panic and rage reactions. Keeping those under control tends to reduce my depressive cycling.
Posted by rainy on December 12, 2004, at 20:37:32
In reply to Re: trileptal as mood stabilzer? » rainy, posted by Ritch on December 12, 2004, at 10:33:09
Sorry to keep poking at you Ritch, or anybody, but I just remembered the part about the "significant cognitive blunting." Eeek. When I first went on Topamax and got up to 350, I couldn't remember my own name, let alone anybody else's. Just how bad is this blunting? I'm already blunt. Blunted. If you start slowly, would that help soften that effect?
rainy
Posted by Ritch on December 13, 2004, at 10:18:20
In reply to Re: trileptal as mood stabilzer?, posted by rainy on December 12, 2004, at 20:37:32
> Sorry to keep poking at you Ritch, or anybody, but I just remembered the part about the "significant cognitive blunting." Eeek. When I first went on Topamax and got up to 350, I couldn't remember my own name, let alone anybody else's. Just how bad is this blunting? I'm already blunt. Blunted. If you start slowly, would that help soften that effect?
>
> rainyIt would be worthy of trying. Meds causing cognitive troubles vary so much per individual. I'm been on Depakote two or three different times over the last several years, and when I start that one up I have word-finding problems-spelling difficulties, etc. But.. they DID fade over the course of a few weeks. If I would have stuck with the Trileptal longer it might have worked out (cognitive-wise) in a similar fashion. I was doing it as an experiment to see if I could get off antidepressants for a winter depression and use it (Trileptal) instead of Depakote as a mood stabilizer... I think it would have worked in that department quite well, it it wasn't for the nausea that developed with it. But, that's *also* very subjective. Some people can hook down megadoses of it or Tegretol and not have any of those problems. I couldn't stay on 300mg/day for more than a few days. .... I've noticed that people that tend to tolerate standard or high doses of certain meds tend to be able to tolerate higher or standard doses of others. If you could tolerate 350mg of Topamax (and its associated cognitive dulling effects), I doubt if you would find Trileptal to be that dulling. Topamax... the highest dose I could get to (over several weeks) was 25mg twice daily and I still was snoozing half the day-taking naps. If you are finding the Topamax to be "too" dulling and you add the Trileptal and don't find things worsening much in that respect.. maybe you can reduce the Topamax?
Posted by rainy on December 13, 2004, at 10:55:27
In reply to Re: trileptal as mood stabilzer? » rainy, posted by Ritch on December 13, 2004, at 10:18:20
good thought! I'm not about to go off Top, but I'm not too worried about the trileptal, either, now. It's worth a try. Thanks.
rainy
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