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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 35. This is the beginning of the thread.
Posted by stresser on May 16, 2005, at 23:09:26
I'm getting frustrated with our doctor, because he doesn't seem to be taking this problem as serious as I am regarding my daughter. I wonder if he has ever had to live with a bipolar 17 year old girl? It's like PMS 24/7. Is it safe to take Zoloft with Wellbutrin? What can be taken along with Wellbutrin, or should it be taken out of the Topamax, Wellbutrin, Adderall Xr, combination. I never know who is coming through the door when she gets home from school. Is it Miss Nice, or Miss Nasty? Thanks, I do APPRECIATE you so very much.-L
Posted by Nickengland on May 17, 2005, at 5:28:26
In reply to Paging Ed UK:Can Zoloft be taken with Wellbutrin?, posted by stresser on May 16, 2005, at 23:09:26
Hello there,
I know i'm not Ed, but have read afew of your posts and see your having abit of trouble with your daughter..sorry to hear about this i hope things get better soon..
I was just curious about 1 thing. For someone with bipolar she seems to be taking alot of medications that push her mood "up", there doesn't seem to be much of a mood stabiliser to help even out her moods.
I heard topamax can cause agitation and anixety..what with the anti depressant and stimulant that seems like a dangerous mix.
Have you though about possibly dropping some anti-depressants and the stimulant so that you could get a baseline reading of her symtoms? It could be that those medications are aggravating her bipolar?
Hope you dont mind me suggesting this, i'm bipolar myself and i know people react differently to medication and what a struggle this must be controlling her symtoms...I just wondered if maybe your daughter would have more success with the more traditional well known mood stabilisers eg, lithium, sodium valproate, carbamazepine/oxcarbazepine even lamotrigine?
Kind regards
Nick
Posted by stresser on May 17, 2005, at 7:57:34
In reply to Re: Paging Ed UK:Can Zoloft be taken with Wellbutrin?, posted by Nickengland on May 17, 2005, at 5:28:26
Thank you for responding, and I don't mind that you are popping in with your information. She is taking the topomax because she has had a binge eating disorder, and the other mood stabilizers seem to cause weight gain and bring on more of the problem. The Adderall has helped her with her grades, in fact, it has been a miracle. I am surely open to ANYTHING that will help with this short temper, personality she has developed. This psychiatrist is not an aggressive doctor, and I am starting to wonder if she needs to find someone else. I also have just thought about giving up. -L
Posted by stresser on May 17, 2005, at 8:02:36
In reply to Re: Paging Ed UK:Can Zoloft be taken with Wellbutrin?, posted by stresser on May 17, 2005, at 7:57:34
I wanted to add on that I am also bipolar II, and I am taking Topamax as well, along with Adderall XR and Zoloft. I am having excellent results and feel better than I have in years. Could that work for her?-L
Posted by Nickengland on May 17, 2005, at 8:37:31
In reply to Re: Paging Ed UK:Can Zoloft be taken with Wellbutrin?, posted by stresser on May 17, 2005, at 8:02:36
Hello there : )
Thats good that your doing well on that mix.
You would think that she would also do well on the same as you, i agree. Its funny though as i'm the son (22years old) of my mother who has bipolar too lol - the other way round of your scenario!
My mum has done great on lithium for many years, nearly 20. So the psychiatrist said I should take that this as in his words "look at how well your mother has done on it" Unfortunately though when i tried it, the lithium didn't work at all for me and possibly made me worse. But it had to be ruled out first, as like your probably thinking it makes sense that it should work for her too.
Sodium valproate and lithium..I guess you can rule out these 2 then for weight issues. How about carbamazepine/oxcarbazepine and lamotrigine? These don't apear to cause weight gain, has she tried these?
Just out of curosity, have you had no problems taking a stimulant then with regards to pushing you too up? I'm quite interested if a stimulant could benefit me, but i thought this was a no no for people with bipolar?
I hope you can find something soon for your daughter, i'm sure you will get this sorted out in time..thats the thing it takes time but your get there in the end : )
Kind regards
Nick
Posted by ed_uk on May 17, 2005, at 10:13:02
In reply to Paging Ed UK:Can Zoloft be taken with Wellbutrin?, posted by stresser on May 16, 2005, at 23:09:26
Hi L!
I'll have to reply quickly because I'm supposed to be studying!!!
>Is it safe to take Zoloft with Wellbutrin?
Zoloft and Wellbutrin are often combined successfully. On the other hand, there may be an increased risk of seizures when Wellbutrin is combined with other ADs. Topamax is an anticonvulsant though.....
Kind regards,
Ed.
Posted by stresser on May 17, 2005, at 16:56:25
In reply to Re: Paging Ed UK:Can Zoloft be taken with Wellbutrin?, posted by Nickengland on May 17, 2005, at 8:37:31
Nick,
Wellbutrin was no good for me, because it made me manic and on the verge of driving off a bridge! I was a nasty *^%^#, and had to get away from it. The three other meds I take don't bother me at all, and I thought the Adderall might. I did try Strattera, but that was sedating me to much. You may want to give some of those a try. -L
Posted by stresser on May 17, 2005, at 16:58:22
In reply to Re: Paging Ed UK:Can Zoloft be taken with Wellbutrin? » stresser, posted by ed_uk on May 17, 2005, at 10:13:02
The nurse just called back, and the doctor has put her on 75mg of Trileptal as well as what she has been taking. How does that sound to all of you? Will that cause weight gain? I really hate the fact that she is taking four medications, because that seems to be quite a bit for a 17 year old. -L
Posted by ed_uk on May 17, 2005, at 17:40:44
In reply to Re: Paging Ed UK:Can Zoloft be taken with Wellbutrin?, posted by stresser on May 17, 2005, at 16:58:22
Hi L!
>Will that cause weight gain?
Trileptal doesn't usually seem to cause weight gain. Having said that, anything's possible!
Ed x
Posted by Phillipa on May 17, 2005, at 18:12:20
In reply to Re: Paging Ed UK:Can Zoloft be taken with Wellbutrin? » stresser, posted by ed_uk on May 17, 2005, at 17:40:44
Stressor, I did take l50mg of trileptal and it didn't cause any wt gain. I thought l50mg was consided a low dose? It was supposed to help me sleep and improve my mood. I don't have a dx of bipolar that I'm aware of. Fondly, Phillipa
Posted by stresser on May 17, 2005, at 20:32:13
In reply to Re: Paging Ed UK:Can Zoloft be taken with Wellbutrin?, posted by Phillipa on May 17, 2005, at 18:12:20
Phillip,
Did it improve your mood? I'm a really nervous for her to start taking it, anything else. How do people deal with this for an entire life time? How long does it take to find the correct medication? -L
Posted by HappyGirl on May 18, 2005, at 0:25:43
In reply to Re: Paging Ed UK:Can Zoloft be taken with Wellbutrin?, posted by stresser on May 17, 2005, at 16:58:22
Hi:
>>> The nurse just called back, and the doctor has put her on 75mg of Trileptal as well as what she has been taking. How does that sound to all of you? <<<--- Recalling your daughter has 'irritability problem' in your previous post, ... in my 'good' guess, ... this/irritability is somehow related to 'bad-side hypomanic' side, not due to depression, ... for that reason she NEEDS more 'legitimate' mood-stabilizer, Trileptal. Also, I recall, she's on another M.S., Topamax, however this med. is NOT a truly mood-stabilizer. Rather, it's an 'add-on' mood-stabilizer to assist 'pure' form mood-stabilizer, such as Depakote, Lithium, and others. In this regard, ... hopefully your daughter gets a 'good' benefit from starting on Trileptal.
I read some of Bper's are quite content with this mood-stabilizer. As we all know, everyone reacts differently on various form of psycho.meds. In regard to 'weight-gain,' I rarely read 'terrible' weight issue attached to this M.S. Rather, some are quite happy about a good result with it. As for 'four' different meds., ... most of Bper's need this amount/# meds., believe or not, ... partly because of a complexity of this M.I. I, too have been on 'four' meds., ... it didn't happen overnite tho'. My competent pdoc. rx'ed one med. at a time over the years and my Bp symptoms/Bp II with rapid-cycler has been ALMOST 'remission,' not having the highs and lows I was years ago. Then, 'HOPE' is there.
Please keep us posted how she's doing on new med. regimen.
H.G.
Posted by Phillipa on May 18, 2005, at 0:31:59
In reply to Re: Paging Ed UK:Can Zoloft be taken with Wellbutrin? » stresser, posted by HappyGirl on May 18, 2005, at 0:25:43
Stressor, To be honest, I really don't know. I switched pdocs and he discontinued it after about a month. I still have a bottle in my drawer. I'll have to watch all of your posts and others. Right now I could use something to improve my mood. But I really think that is quite a low dose and she will probably not have any problems. Fondly, Phillipa
Posted by Nickengland on May 18, 2005, at 5:30:57
In reply to Re: Paging Ed UK:Can Zoloft be taken with Wellbutrin? » stresser, posted by HappyGirl on May 18, 2005, at 0:25:43
I agree with what happy girl said. The topamax is not a well established mood stabilier, I think even in epilepsy its a second line drug.
Its worth considering, putting lithium aside, all the other main mood stabiliers are drugs for epilepsy..and how well these drugs perform in epilepsy often reflect how well they treat bipolar.
Carbamazepine is considered one of the best drugs for epilepsy and theres hardly any difference between carbamazepine and oxcarbazepine/Trileptal.
Try not to worry about your daughter having yet another drug, because now she has a very good mood stabiliser on board.
75mg is as smallest dose as you can get. As in you can't make the tablets any smaller. The minium dose from epilepsy is 600mg.
I take 1 drug for my bipolar and I have 300mg of Trileptal - its the best mood stabiliser ive taken, and pretty much controls all my symptoms, and no weightgain.
Have a read of:
http://www.psycheducation.org/depression/meds/moodstabilizers.htm
Its a psychiatrists point of view of mood the different mood stabiliers(you can click the link for each one) that will give you some information of how well they perform
Posted by stresser on May 18, 2005, at 12:27:20
In reply to Re: Paging Ed UK:Can Zoloft be taken with Wellbutrin?, posted by Nickengland on May 18, 2005, at 5:30:57
I wonder why Topamax and Zoloft are working so well for me? If Topomax is an add-on stabilizer, then why am I responding to it? -L
Posted by Phillipa on May 18, 2005, at 17:50:27
In reply to Re: Paging Ed UK:Can Zoloft be taken with Wellbutrin?, posted by stresser on May 18, 2005, at 12:27:20
Nickengland, So does this mean that the old pdoc lied to me? He never diagnosed me as bipolar. Just said the trileptal would help my mood and with sleep. Fondly, Phillipa
Posted by HappyGirl on May 18, 2005, at 18:27:37
In reply to Re: Paging Ed UK:Can Zoloft be taken with Wellbutrin?, posted by stresser on May 18, 2005, at 12:27:20
Hi:
>>> I wonder why Topamax and Zoloft are working so well for me? If Topomax is an add-on stabilizer, then why am I responding to it? -L <<<--- My 'best' guess is that your Bipolar is a VERY milder form, and more close to 'depression'/unipolar with miniscule hypomania.
However, on the otherhand, your daughter is most likely a true nature of Bipolar, called Bipolar II. It's not serious but still she needs Bipolar med. regimen that includes a mood-stabilizer, anti-depressant and plus ADD brought on by a depressive side of her Bipolar(very commmon among Bper's).
As for Mom of a 17-year High-school kid, you must be quite disappointed to read/hear this. However, unlike 'old' days, in the 70' and 80', with a modern med. regimen along with necessary psycho-therapy, your daughter will be back to 'old' self soon.
H.G.
Posted by Nickengland on May 19, 2005, at 7:13:31
In reply to Re: Paging Ed UK:Can Zoloft be taken with Wellbutrin?, posted by Phillipa on May 18, 2005, at 17:50:27
Hello Phillipa
When you say why did the pdoc lie to you, do you mean why did he give you a mood stabiliser which is used for bipolar - if you not bipolar?
If you were having sleeping problems at that time and perhaps your mood was such that things needed to be balanced out, i can only guess that for those reasons he thought the Trileptal may help - As I doubt he was giving it to you to prevent mania.
It makes sense in some ways as Trileptal deifnately does help with sleep..
Kind regards
Nick
Posted by stresser on May 19, 2005, at 13:36:35
In reply to Re: Paging Ed UK:Can Zoloft be taken with Wellbutrin? » stresser, posted by HappyGirl on May 18, 2005, at 18:27:37
I am actually relieved to have a diagnosis as to what is wrong with her. She had been seeing a psychologist for about a year and one half, and not getting any better. I had asked him if he thought she was bipolar, and he said no. After some time, we decided to find someone else, because her father and I couldn't stand her anymore. She was unhappy, and her grades were falling. She had gone from an A student to a C student, within one year. She couldn't handle the smallest situation, and was using food as a self-medication. I did endless amount of research and new there was something else other than depression going on with her. I went to her old pdoc and asked for the Topamax myself, and that's how she got started on it to begin with. I had to ask for the Adderall several times, (her new pdoc) before he would give it to her. It helped emmediatly, and I wish he had given it to her months ago. I hope this is making sense, because I am in a hurry. Thanks for your help. -L
Posted by Nickengland on May 19, 2005, at 14:33:50
In reply to Re: Paging Ed UK:Can Zoloft be taken with Wellbutrin? » HappyGirl, posted by stresser on May 19, 2005, at 13:36:35
Hello there,
Just out of curosity, what were the symptoms of your daughters hypomania/mania to get a diagnosis of manic depression?
Kind regards
Nick
Posted by Phillipa on May 19, 2005, at 19:10:57
In reply to stresser, posted by Nickengland on May 19, 2005, at 14:33:50
So, you think he just wanted to give me the trileptal to help augment my other sleep meds? Fondly, Phillipa
Posted by stresser on May 19, 2005, at 20:40:03
In reply to Re: stresser » Nickengland, posted by Phillipa on May 19, 2005, at 19:10:57
She was continuing to be intollerable, and everything that happened was a drama. Getting up and going to school was an event in itself. When she comes home, I never know who is coming through that door. It's as if she's angry at everyone, and can't find any humor in anything anymore. Do you consider that symptoms for needing Trileptal? Please give me you opinion. -L
Posted by Phillipa on May 19, 2005, at 20:49:48
In reply to Re:Symptoms for Trileptal, posted by stresser on May 19, 2005, at 20:40:03
Stressor, How much of it do you suppose could be due to being that age and all the hormone surges? Fondly, Phillipa
Posted by HappyGirl on May 20, 2005, at 0:31:03
In reply to Re:Symptoms for Trileptal, posted by stresser on May 19, 2005, at 20:40:03
Hi:
In my 'good' guess is that your daughter at 17, she has a lot going on in her mind, ... school work, peer-pressure, clothes-wearing, boy-friend and much more and plus, an added-problem, Bipolar.Has she been on any sorts of therapy, or counselling to get through all of this? Most of cases, those with newly dx'ed Bipolar need definitely some sort of 'counselling.' Because, talking 'inner' pressure, ... 'stress' does NOT resolve on medications-therapy alone. As we all knows, 'Stress' is #1 enemy once coming to M.I. I got a VERY good one in the beginning and recalling that the lady with a good knowledge of M.I. helped me tremendously, although I was in my early 20's, then. Because, talk with the close members is NOT enough. Needs a professional help. At least this was my view through the experience.
Lastly, ... if her 'intense' irritability keeps on, then you need to call her pdoc. to get 'further' evaluation. Most likely, she may need another form of med. In my case, Zyprexa is a good answer for this, ... but if you're worrying about weight issue, then other similar A.Ps., Geodon or Abilify might be a good choice. But, this is just my 'personal' view. You need to talk to her pdoc., if she doesn't show 'any'improvement next few more days.
H.G.
Posted by Nickengland on May 20, 2005, at 5:22:49
In reply to Re: stresser » Nickengland, posted by Phillipa on May 19, 2005, at 19:10:57
Generally the main use of Trileptal in mood disorders will be given to prevent mania, even that use is "off license" Seeing as its so similar to Tegretol it makes sense to use it for a mood stabiliser/anti manic though.
If you have no problems with your mood going "up" then there would be no need really to use this med.
However you use benzo's for sleep? Because of the risks they can have with regards to loosing their effectiveness...possibly meaning they are not working so well for sleep as they should - Taking the trileptal although its not a sleeping tablet, it sure does promote sleep. So maybe he gave it to you for like a safety barrier measure against if your benzos were to reduce in effectiveness?
I have read somewhere aswell that carbamazepine/tegretol is sometimes used when trying to come off of benzos, to help with withdrawal symptoms. So there seems to be a link somewhere there.
If you found that the oxcarbazepine/trilepal didnt work so well for sleep and you still feel you need something........I defiantely suggest you try Tegretol/carbamazepine as ive tried both and found the tegretol seems to have more power..i.e it will be like 10x better with regards to sleep.
Its kind of like Marlborough and Marlborough Lights....with trileptal being the light version you know? lol
Hope that makes sense :-)
Kind regards
Nick
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