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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 11 to 35 of 35. Go back in thread:
Posted by lois on September 3, 2015, at 8:23:27
In reply to Re: Replacement for respiridone » lois, posted by porkpiehat on September 3, 2015, at 8:00:45
Hummmmm. I've been on Lamictal forever.I wonder if Geodon can take the place of it as well as the Cymbalta. I wouldn't want to over do the antidepressants, but would like to be on enough. Does Geodon present problems with being too hot or too cold? The Latuda has - that's why I'm coming off of it without going up to a therapeutic dose.
I am under the impression that I need 2 stablizers. We'll see. I see the Dr. next week. I wonder which AD's Lamictal should not be given with.....
Posted by porkpiehat on September 3, 2015, at 9:25:07
In reply to Re: Replacement for respiridone » porkpiehat, posted by lois on September 3, 2015, at 8:23:27
I don't know that there are any AD's that "shouldn't" go with Lamictal, I'm just saying it's different for me. When I take it alone I feel dull and "stabilized" when I take with Celexa at more than 15mgs it has its own racy antidepressant effect.
Why do you think you need two stabilizers?
Posted by lois on September 3, 2015, at 11:33:03
In reply to Re: Replacement for respiridone » lois, posted by porkpiehat on September 3, 2015, at 9:25:07
I take Lamictal with Clymbalta. I was on clonazepam for anxiety, sleep, and mood stabilizer - I was told. Maybe it's not a stablizer, I don't know.I am on Lamictal. Since I was on supposedly 2 stablizers I think I need 2. I guess it depends on how 1 alone does.
Posted by phidippus on September 4, 2015, at 20:00:51
In reply to Re: Replacement for respiridone » phidippus, posted by lois on September 1, 2015, at 19:08:21
Clonazepam is not much of a stabilizer.
Gabitril is a great sleep med that won't cause brain fog. 4-12 mgs at night,
Eric
Posted by phidippus on September 4, 2015, at 20:04:28
In reply to Re: Replacement for respiridone » phidippus, posted by lois on September 1, 2015, at 19:11:23
I've taken 160 mg of Geodon with 160 mgs of Cymbalta with no problems.
Eric
Posted by phidippus on September 4, 2015, at 21:39:31
In reply to Re: Replacement for respiridone » porkpiehat, posted by lois on September 3, 2015, at 8:23:27
I would not replace the lamictal with the Geodon-it is not a mood stabilizer. When you're bipolar you want to be on a mood stabilizer then add things like antidepressants and antipsychotics to further treat remaining depressive and manic symptoms.
About being too hot or cold-you may or may not be on the geodon, however it seems to be a rare side effect of Geodon.
You dont necessarily need to be on 2 mood stabilizers unless your mood is still uneven on just one.
Most ADs can be given with Lamictal.
Eric
Posted by phidippus on September 4, 2015, at 22:12:12
In reply to Re: Replacement for respiridone » porkpiehat, posted by lois on September 3, 2015, at 11:33:03
>Since I was on supposedly 2 stablizers I think I need 2.
You really weren't on 2 mood stabilizers, so I don't think you need 2. Sometimes being on two mood stabilizers can improve depressive symptoms, but with clonazepam, the risk of depression is increased.
What are your main concerns? What main problems are you having?
Eric
Posted by lois on September 5, 2015, at 7:32:38
In reply to Re: Replacement for respiridone » lois, posted by phidippus on September 4, 2015, at 20:04:28
I thought 120 mgs was the most cymbalta you could take.(?)
Lois
Posted by lois on September 5, 2015, at 7:37:12
In reply to Re: Replacement for respiridone » lois, posted by phidippus on September 4, 2015, at 21:39:31
I hope to stay on the cymbalta and lamictal and replace the respiridone with either another try of it, or another AP. But might ask about Gabitril for sleep. Unless one can't be on G if on AD's.
Lois
Posted by lois on September 5, 2015, at 7:38:55
In reply to Re: Replacement for respiridone » lois, posted by phidippus on September 4, 2015, at 22:12:12
>
> What are your main concerns? What main problems are you having?
>
> Eric
Concerned about motivation and sleep.
Lois
Posted by lois on September 5, 2015, at 7:47:12
In reply to Re: Replacement for respiridone » phidippus, posted by lois on September 5, 2015, at 7:38:55
Are respiridone and other AP's activating or sedating? They had me on respiridone at bedtime. I wonder if taking any AP's in the day would help me sleep better? I went off the respiridone in July. I wonder if it's too soon to try it again. It may not have the same effect anyway because I was also on clonazepam then. (?)
Thx.Lois
Posted by phidippus on September 5, 2015, at 14:51:48
In reply to Re: Replacement for respiridone » phidippus, posted by lois on September 5, 2015, at 7:32:38
No, you can push it up to 200 mg if you really need to...Patients who have OCD may take 240 mg of the drug.
120 mg is adequate for the treatment of bipolar depression...You won't need to go higher.
How much Lamictal do you take?
Eric
Posted by phidippus on September 5, 2015, at 14:56:39
In reply to Re: Replacement for respiridone » phidippus, posted by lois on September 5, 2015, at 7:37:12
Keeping the Cymbalta and the Lamictal then adding either Invega or Geodon for motivation and clearheadedness is a good route to take. How much Lamictal do you take?
Eric
Posted by phidippus on September 5, 2015, at 15:03:08
In reply to Re: Replacement for respiridone, posted by lois on September 5, 2015, at 7:47:12
Different APs can be activating or sedating. Risperidone is usually on the sedating side. It should help you sleep.
>I wonder if taking any AP's in the day would help me sleep better?
It would definitely help if you decided to take Geodon. If you go with Invega it won't matter when you take it.
Why did you go off the risperidone?
Eric
Posted by phidippus on September 5, 2015, at 17:50:01
In reply to Re: Replacement for respiridone » phidippus, posted by lois on September 5, 2015, at 7:38:55
I would definitely give Seroquel a try.
Eric
Posted by lois on September 6, 2015, at 6:32:41
In reply to Re: Replacement for respiridone » lois, posted by phidippus on September 5, 2015, at 17:50:01
Eric,
I take 200mgs of Lamictal at breakfast and lunch. I went off Seroquel due to sedation and visual s.e. I went off Respiridone due to it 'possibly' not working after having had increased liver function tests from 2 bladder meds I had taken. Now that I'm off clonazepam and Trazodone, I might give it a try again and take it at night.Lois
Posted by phidippus on September 6, 2015, at 20:40:01
In reply to Re: Replacement for respiridone » phidippus, posted by lois on September 6, 2015, at 6:32:41
Which two bladder meds were you on?
Eric
Posted by lois on September 7, 2015, at 7:31:49
In reply to Re: Replacement for respiridone » lois, posted by phidippus on September 6, 2015, at 20:40:01
Myrbetric and Oxitrol. These actually made my affect better, I think, do to the Acetylcholine effect. Too bad it made my liver enzymes increase. I think this liver damage made my other AD's not work. I think it changed my chemistry and metabolism of other drugs. I have a liver sensitivity. I am a difficult case................
Lois
Posted by phidippus on September 7, 2015, at 14:19:10
In reply to Re: Replacement for respiridone » phidippus, posted by lois on September 7, 2015, at 7:31:49
Acetylcholine can do that.
Myrbetriq may have increased levels of CYP2D6 enzyme in your liver tests. CYP2D6 also metabolizes risperidone, so it might be prudent to stay off the risperidone if taking those bladder meds. Invega, on the other hand is metabolized by CYP450, so shouldn't be a problem with the bladder meds.
I don't think you're a tough case!
Eric
Posted by lois on September 7, 2015, at 17:32:17
In reply to Re: Replacement for respiridone » lois, posted by phidippus on September 7, 2015, at 14:19:10
I had to stop the bladder meds because of my liver enzymes. Most of my treatment, my Dr. has said my pathway that was the most sensitive was CYP450, but after trying Pristiq and getting toxic hepatitis from it I know the CYP2D6 is also sensitive. I take a chance either way.
Posted by lois on September 7, 2015, at 17:39:55
In reply to Re: Replacement for respiridone » lois, posted by phidippus on September 7, 2015, at 14:19:10
It's my ALT and AST that were elevated. The ALT is especially stubborn. They came back to normal, but I've had elevated LFT's frequently on some meds I've had to stop taking over the decades.Lois
Posted by phidippus on September 7, 2015, at 18:25:11
In reply to Re: Replacement for respiridone » phidippus, posted by lois on September 7, 2015, at 17:39:55
Both my AST and ALT are always slightly elevated because I have a metabolic syndrome-they also call it fatty liver.
It hasn't stopped me from taking meds that are hard on the liver like Depakote and Tegretol.
Unless LFTs are really elevated you can continue a medication without too much worry.
Eric
Posted by lois on September 7, 2015, at 18:35:10
In reply to Re: Replacement for respiridone » lois, posted by phidippus on September 7, 2015, at 18:25:11
That's good news. I don't know why mine are sensitive, but I am happy you can take meds.
Lois
Posted by lois on September 20, 2015, at 17:24:16
In reply to Re: Replacement for respiridone » lois, posted by phidippus on September 4, 2015, at 20:00:51
Thanks Eric for posting.
I am back on the risperidone and feeling better. I still have some residual Klonipin withdrawal. See new post about Latuda.
Lois
Posted by phidippus on September 21, 2015, at 13:08:19
In reply to Re: Replacement for respiridone » phidippus, posted by lois on September 20, 2015, at 17:24:16
I'm glad your feeling better.
Eric
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