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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Ben on November 19, 2011, at 2:21:22
I`m BPII and I take Litium. Valproat, Lamictal and Abilify as mood stabilizers. Now I have to much side effects from the Valproat (tremor!) and we replace it with Gabapentin. How long does it need to kick in as I have also a social anxiety disorder. For depression I take Parnate with lim. success. It should help anxiety, mood and tremor?! Whats your experience with this drug?
Posted by SLS on November 19, 2011, at 6:06:57
In reply to Gabapentin kick in?, posted by Ben on November 19, 2011, at 2:21:22
> I`m BPII and I take Litium. Valproat, Lamictal and Abilify as mood stabilizers. Now I have to much side effects from the Valproat (tremor!) and we replace it with Gabapentin. How long does it need to kick in as I have also a social anxiety disorder. For depression I take Parnate with lim. success. It should help anxiety, mood and tremor?! Whats your experience with this drug?
The choice of gabapentin makes sense based upon common beliefs about its effectiveness in treating the conditions you have. I think it should start working quickly for tremor and anxiety. However, I don't think gabapentin is considered to be an effective mood stabilizer anymore, despite its being prescribed routinely for this purpose 10 years ago.
What are your current bipolar symptoms?
- Scott
Posted by Ben on November 19, 2011, at 8:41:28
In reply to Re: Gabapentin kick in? » Ben, posted by SLS on November 19, 2011, at 6:06:57
Hi Scott
My main symptoms are depression, mood swing (low mood in the morning) and anxiety.
As you know the Valproat doubles the plasma level of Lamictal. Should I check the Lamictal levels when I get rid of the Valproat? I take 200mg/d now and the plasma level is 31 μmol/l .
Ben
Posted by SLS on November 19, 2011, at 9:27:53
In reply to Re: Gabapentin kick in? » SLS, posted by Ben on November 19, 2011, at 8:41:28
> My main symptoms are depression, mood swing (low mood in the morning) and anxiety.
Having low mood in the morning is often a symptom pattern of unipolar depression and is not considered a true bipolar mood swing. Only rarely will someone have an ultradian rapid cycle.
> As you know the Valproat doubles the plasma level of Lamictal. Should I check the Lamictal levels when I get rid of the Valproat? I take 200mg/d now and the plasma level is 31 micromol/l .
400 mg of Lamictal is a high dosage for treating bipolar depression. 200 mg is the average. You are fortunate if you experience no cognitive impairments at your present dosage. I am not familiar with the blood test you take as given as micromol/l. When taken as mcg/mL, a value of 20 is considered the maximum recommended. My doctor does use blood tests as a guide for dosing. We established my optimum dose through titration, and not by using blood tests. 200 mg works for me. If I go any higher, I experience cognitive and memory impairments as well as "brain-fog".
- Scott
Posted by Phillipa on November 19, 2011, at 9:51:04
In reply to Re: Gabapentin kick in? » Ben, posted by SLS on November 19, 2011, at 9:27:53
I was going to say same as feel worse in hours get up. But am not bipolar now ocd anxiety. The low mood is it ruminating of what the day will bring? Just wondering also. Phillipa
Posted by Ben on November 20, 2011, at 1:18:52
In reply to Re: Gabapentin kick in?, posted by Phillipa on November 19, 2011, at 9:51:04
Low mood in the morning is very common in depression so I think it dosen`t seems to be different in bipolar depression. For me I cant say that the mood in the morning will predict the day. Of course It`s easier starting with better mood.
Posted by Phillipa on November 20, 2011, at 18:11:30
In reply to Re: Gabapentin kick in? » Phillipa, posted by Ben on November 20, 2011, at 1:18:52
Yes same here I was just thinking some say they are morning people and others say the opposite so maybe part of it is normal? Phillipa
Posted by Ben on November 22, 2011, at 23:57:26
In reply to Re: Gabapentin kick in? » Ben, posted by SLS on November 19, 2011, at 6:06:57
I`m on 300-200-300mg of Gabapentin now and I dont have the feeling that it helps with my tremor. The Valproat is now on 150mg at bed time. Perhaps I should go higher withe Gabapentin?
Perhaps it is the Litium too? The level is 0.8. Or the Abilify (10mg in the morning)? Or the hole combination!!!
Not forgotten the Lamictal (100-0-100mg).
Posted by Ben on November 23, 2011, at 7:21:58
In reply to Re: Gabapentin kick in? » SLS, posted by Ben on November 22, 2011, at 23:57:26
Posted by Ben on November 23, 2011, at 7:22:17
In reply to Re: Gabapentin kick in? » SLS, posted by Ben on November 22, 2011, at 23:57:26
Posted by Ben on November 23, 2011, at 7:23:06
In reply to Re: Gabapentin kick in? » SLS, posted by Ben on November 22, 2011, at 23:57:26
I woke up in the morning an I felt depesses again. After a week of Gabapentin. The first days were okay but today its really bad. I feel depressed have headaches and the mood swings strange. Not to normal or hypomania but below euthymic (normal). Whats your experiences with Gabapentin? I fear to go any longer but I dont like to miss a chance.
Posted by SLS on November 23, 2011, at 8:59:44
In reply to Gabapentin causes depression?!, posted by Ben on November 23, 2011, at 7:23:06
> I woke up in the morning an I felt depesses again. After a week of Gabapentin. The first days were okay but today its really bad. I feel depressed have headaches and the mood swings strange. Not to normal or hypomania but below euthymic (normal). Whats your experiences with Gabapentin? I fear to go any longer but I dont like to miss a chance.
Yes. Drug trials can be difficult to endure. It is hard to decide what to do when a new drug does not work quickly enough or makes things worse. Gabapentin made me feel better in the beginning and worse later on. I had the same results with Lyrica (pregabalin).
- Scott
Posted by Ben on November 23, 2011, at 10:12:52
In reply to Re: Gabapentin causes depression?! » Ben, posted by SLS on November 23, 2011, at 8:59:44
What do you mean with beginning and Later (time frame)? I felt like good or better when I begun to take it a week ago but now like a bomb from yesterday to today - I feel really depressed and I have headaches. I had the same experience with Lyrica besides Lyrica was making me depressed from the first day! Have you any experiences with Trileptal (Oxcarbamazepin). My pdoc speaks from it from for a while now. But I have fear that it makes my tremor worser! Perhaps I have to go back to Valproate and look what the Abilify is causing the tremor?!
Posted by SLS on November 23, 2011, at 15:55:39
In reply to Re: Gabapentin causes depression?! » SLS, posted by Ben on November 23, 2011, at 10:12:52
> What do you mean with beginning and Later (time frame)? I felt like good or better when I begun to take it a week ago but now like a bomb from yesterday to today - I feel really depressed and I have headaches. I had the same experience with Lyrica besides Lyrica was making me depressed from the first day! Have you any experiences with Trileptal (Oxcarbamazepin). My pdoc speaks from it from for a while now. But I have fear that it makes my tremor worser! Perhaps I have to go back to Valproate and look what the Abilify is causing the tremor?!
Combining lithium with valproate can cause very bad tremors.
I tried Trileptal combined with Lamictal. I had no tremors.
Caffeine can make tremors worse.
- Scott
This is the end of the thread.
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