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Re: A question about Gabitril for Ritch and others... » krazy kat

Posted by Ritch on July 19, 2002, at 13:07:20

In reply to A question about Gabitril for Ritch and others..., posted by krazy kat on July 19, 2002, at 10:39:12

> Since we share similar traits, Mitch, I wondered if you have tried this. And, please, anyone who has any info on this med, please share.
>
> Here are my questions:
>
> 1. What cost have you run into? I've seen it for @$30 for a month's supply (4mg - 12 mg) (I think).


HI there KK,

I never bought the stuff. The neurologist I was seeing gave me samples of 4mg tabs.


>
> 2. I'm wondering if I could get by on Gabitril and a stimulant when necessary... everytime I stop Depakote, though, I get suicidal. Is that withdrawal or a sign that I can't live without Depakote now? The cognitive side effects of Depakote are better, but still not good.


Whew, it sounds like stopping Depakote would be a bad idea. It definitely could be withdrawal, however. Interestingly, when I tried Gabitril it was a switch from Depakote. I *was* fairly agitated for several days (and that was dropping the Depakote from 500mg..250mg..125mg..zero over two weeks time)! I am back on Depakote now after trying out everything else under the sun. Perhaps a dose *reduction* in the Depakote with the Gabitril might be possible later on.

>
> 3. What's a therapeutic dose of Gabitril for anxiety/mood control (rather than seizure control). Is it even considered a stabilizer?
>
> 4. What are the side effects?


I started off at 4mg/day and followed the slowest titration recommended by the manufacturer (4mg/day increase per day for a week at a time). Week 1 4mg/day, Week 2 8mg/day, etc. I did notice an antidepressant effect from the stuff right off from the getgo, but that could be placebo effect. I was OK at 4mg at bedtime, 4mg twice daily was ok..., but I noticed some cognitive blunting at work (but it wasn't really bad yet..). I then went to 8mg at bedtime and 4mg midday. The cognitive sfx got a little worse, but were still reasonably tolerable. Then I went to 8mg twice daily and I noticed the first few hours after my daytime dose I was pretty much trashed. Then I progressed to 12mg at bedtime, and 8mg daytime and felt about the same. BUT, when I got to 12mg twice daily I had some serious derealization problems after the daytime dose. I felt like I didn't know where I was or who I was or what I was doing. Also, I had this severe facial/forehead numbness. I stopped it after that experience-it was just too weird (it was like PCP!). I get dp/dr from other anticonvulsants, too. Also, I am very med sensitive. YMWV. IF you can tolerate 2G of Depakote and the max I can tolerate is 500mg/day, you might not have much problem with the Gabitril. It felt a LOT like Topamax come to think of it. But the lower doses weren't as sedating as Topamax and actually seemed to be somewhat activating. It really isn't considered a "mood stabilizer". It is used for complex partial seizures as an adjunct, just like Neurontin, i.e. So pdocs tend to use it as an "adjunct" with another first-line antimanic like Depakote or Lithium.

>
> 5. Do others experience this initial rush of "help" with meds, only to have them even out very quickly? This has happened with almost every med I have tried. Is it psycho-somatic to an extent?
>
> My guess is, from searching the archive, that this is a new med for BP and there are few who have experience with it. I am happy to share any further info I find on it.
>
> I have yet to achieve that awake calm that I seek. It's so frustrating...
>
> - KK


It could be just placebo effect, but it defnitely seemed activating at the 4mg 1x,2x daily level-it was when I hit 12mg and went beyond is when I ran into a lot of problems with it. I am certain I have had placebo effects from new meds. You get something new, and you are hopeful it will help. I would suggest following the slow titration schedule recommended. Stay at 4mg bid, for a while and see what happens, who knows? it might work for you. I haven't heard of any success stories yet. I think Sal was trying it and thought it was great.. but not for very long.

hope this helps some,

Mitch


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poster:Ritch thread:112900
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