Psycho-Babble Medication Thread 906749

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Tegretol: tweaking doses

Posted by leslieg on July 14, 2009, at 14:45:02

I am probably BP II, recent change in diagnosis from severe recurrent major depression after a mixed state put me in the hospital, and looking carefully at life history shows many times of hypomania and possible mania.

I got off Lexapro (which had stopped working anyway) and since then have been trying to find a med. We've tried Geodon, Abilify and Lamictal, all with problems. Now I'm trying Tegretol. I started about 2.5 weeks ago at 200 mg, went up to 400 mg about 6 days ago.

Many aspects of Tegretol are great for me. For the first time in a long while I've been able to "see" my intelligence and have gone from feeling hopeless about the future to making some solid plans about how to re-train in my field. It has stopped my internal constant negative chatter. I've been making it to my exercise class regularly. I don't enjoy being on this drug, but I hope to stay on it long enough for those "life is hopeless" deep ruts in my brain to smoothe out to where I can go more than a few days in a row without suicidal thinking.

My problem with Tegretol is the stunning sleepiness. After 5 days at 200 mg, the sleepiness eased off, and I expected to get sleepy again when I incrased to 400 mg. It has been 6 days and I'm more tired than I expected to be, although I'm still hopeful it will fade. But I've got a life to live and I'm quite worried about going up that last 200 mg.

My main question is this: can I play with the dosing each day, depending on how much tiredness I can afford? For example, on a day I need to do a lot of driving, can I go down, say, 50 mg, and take my normal dose the next day? I know this may increase the total number of days it takes to get used to my final dose of Tegretol. But will it cause unwanted side effects like withdrawal problems or beyond-expected side effects the next day?

If it isn't wise to reduce my dose as-needed, can I move around when in the day I take it? Right now I'm taking 200 mg in the morning and 200 mg at night (12 hours apart). Could I do 100 mg in the am and 300 mg at night? Or is that asking for trouble?

Advice / experience appreciated!


Re: Tegretol: tweaking doses

Posted by friesandcoke on July 18, 2009, at 22:24:47

In reply to Tegretol: tweaking doses, posted by leslieg on July 14, 2009, at 14:45:02

i hope you get some answers. i took teg and it didn't do anything for me.


Re: Tegretol: tweaking doses

Posted by SLS on July 19, 2009, at 5:12:35

In reply to Tegretol: tweaking doses, posted by leslieg on July 14, 2009, at 14:45:02


Trileptal (oxcarbazepine) is a sister drug to Tegretol (carbamazepine), and seems to make a good replacement for Tegretol. I felt no sedation at all with Trileptal. You can even take it in the morning without it interfering with your day.

Good luck.

- Scott


Re: Tegretol: tweaking doses

Posted by leslieg on July 19, 2009, at 14:38:06

In reply to Re: Tegretol: tweaking doses, posted by SLS on July 19, 2009, at 5:12:35

So glad someone responded. I guess this isn't the best list to ask about Tegretol, but don't know of a better one.

Not sure why my pdoc picked Tegretol over Trileptol.

For future readers of this post, here's what I've tried: The sleepiness got too life-inhibiting, so I reduced to 150 mg in the am and 150 mg in the evening for 1.5 days. By the middle of the 2nd day I could tell I was undermedicated (negative thought patterns) but the sleepiness was gone. I took 200 mg that night and 150 mg the next morning. No sleepiness, but still on the edge of under-medicated. So 200 mg at night and 200 mg the next morning. And no sleepiness! I took 300 mg last night and 200 mg this morning, and there is an edge of sleepiness lurking, but nothing that interferes with working. I'm hoping if I continue this dose for a few days, then go up the final 100 mg, I'll keep sleepiness to reasonable levels. But if it gets too high, I'll try backing down again. Is it safe to do this? I've no idea.

Thanks for noticing my post had gone un-answered.

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