Posted by yxibow on July 2, 2009, at 23:21:32
In reply to How many anti-epileptic drugs can you take?, posted by SadDoggie on July 1, 2009, at 4:02:37
> I was recently diagnosed with bipolar II. Depakote alone didn't help, but Lamictal along with gabapentin is helping a bit. I was wondering what anti-epileptics can be combined and how many? Do combining them have a bad effect on the liver?
Gabapentin is almost entirely excreted by the kidneys if I recall... and the higher the dose the more it just goes right through and out.
I would be more concerned with continuing to watch for rashes (no need to be hypervigilant though) with Lamictal, I don't think the liver issue is there.
Any polypharmacy though of course is a concern for the liver... if you're on enough multiple agents, a liver panel every 6 months isn't a bad idea.
Jaundice is something though that unless you already have some liver disease to begin with, is quite noticeable and reversible in plenty of time.
Its not just the liver, its your transmitters that are also a concern on polypharmacy..Stacking CNS depressants can contribute to drowsiness, inattention, and rarely respiratory depression, so multiple AEDs that don't need to be there shouldn't be especially in combination with benzodiazepines and other sleep agents.
Basically the rule is simplify, simplify... to what you need to be as productive and functional as possible. If it takes 2 AEDs, so be it.Obviously every AED in the book isn't a good idea.
Moderation, and the main answer to your question is -- its individual, there is no set rule on how many AEDs.
Hope that helps-- Jay
poster:yxibow
thread:904155
URL: http://www.dr-bob.org/babble/20090630/msgs/904651.html