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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by spike4848 on February 23, 2002, at 21:03:53
Hey Mitch (or anyone with advice),
So I started neurontin at 300 mg in the morning, 2 pm and at bed. This is with 50 to 100 mg of zoloft and 0.5 of klonopin. WOW! So much anxiety was lifted .... felt like a vicelock was removed from my head. I am having some memory problems and sedation, so I might go down to 200 mg of the neurontin.
My questions are:
1. How do you take your neurontin .... 100 mg four times a day? 200 mg twice a day? 400 mg all at once?
2. How is wellbutrin for your mood? (I feel 50 to 60% better now, but still some apathy so I want to add maybe desipramine or wellbutrin or seligine)
Thanks. I really appreciate your help. It is a life saver!
Spike
Posted by Ritch on February 24, 2002, at 0:11:16
In reply to Mitch (and anyone with advice) .... question?, posted by spike4848 on February 23, 2002, at 21:03:53
> Hey Mitch (or anyone with advice),
>
> So I started neurontin at 300 mg in the morning, 2 pm and at bed. This is with 50 to 100 mg of zoloft and 0.5 of klonopin. WOW! So much anxiety was lifted .... felt like a vicelock was removed from my head. I am having some memory problems and sedation, so I might go down to 200 mg of the neurontin.
>
> My questions are:
>
> 1. How do you take your neurontin .... 100 mg four times a day? 200 mg twice a day? 400 mg all at once?
>
> 2. How is wellbutrin for your mood? (I feel 50 to 60% better now, but still some apathy so I want to add maybe desipramine or wellbutrin or seligine)
>
> Thanks. I really appreciate your help. It is a life saver!
>
> Spike
Hi Spike,Glad you are feeling better. I take Neurontin 100mg 3x daily. If I get a little tweaky I increase to 100mg 4x daily. If you are feeling too sedated from it you might be able to take 300mg just 2x daily. Once daily never worked for me. Twice daily works, but it is noticeably a little uneven. Three-four times daily works the best.
Wellbutrin is a lot like a pstim. It generally just increases my energy level and alertness. Which is all I need for seasonal bipolar depression anyways. If you are prone to get really anxious-be careful with it. I could never handle more than 150mg/day. I was taking it with Zoloft a couple of months ago and I got a little tweaky with it, had to reduce the dose. Now I am a little on the hypomanic side and I just take 1/4 of a 75mg tab in the morning with coffee and it seems to work OK. I know I will need more this summer when I get depressed again.
good luck,
Mitch
Posted by JohnX2 on February 24, 2002, at 0:40:04
In reply to Mitch (and anyone with advice) .... question?, posted by spike4848 on February 23, 2002, at 21:03:53
Spike,Neurontin shoots pretty quickly through the
kidney and so more dosing is needed to keep a
steady level in the brain. This helps to alleviate
brain fog. I found that if I took it less than
3x a day that I would get start up and stop
dizziness. When I increased the dosing to 3x a day
8 hrs a part I was okay, I believe the medicine
maintained a fairly consistent level in my body
for the 24 hr day which is the goal to avoid side
effects. Alas, I wish there was a sustained release
pill. I liked the anti-anxiety effect too.Regards,
John> Hey Mitch (or anyone with advice),
>
> So I started neurontin at 300 mg in the morning, 2 pm and at bed. This is with 50 to 100 mg of zoloft and 0.5 of klonopin. WOW! So much anxiety was lifted .... felt like a vicelock was removed from my head. I am having some memory problems and sedation, so I might go down to 200 mg of the neurontin.
>
> My questions are:
>
> 1. How do you take your neurontin .... 100 mg four times a day? 200 mg twice a day? 400 mg all at once?
>
> 2. How is wellbutrin for your mood? (I feel 50 to 60% better now, but still some apathy so I want to add maybe desipramine or wellbutrin or seligine)
>
> Thanks. I really appreciate your help. It is a life saver!
>
> Spike
Posted by spike4848 on February 24, 2002, at 7:23:00
In reply to Re: Mitch (and anyone with advice) .... question?, posted by JohnX2 on February 24, 2002, at 0:40:04
Hey Guys,
Thank you so much for the advice. I think I will try 200mg every 8 hours.
I think the pieces of the puzzle are finally coming together in terms of figure out what the hell I have, depression versus bipolar versus anxiety. What I have noticed is that when I take a mood stablizer, lithium-depakote-neurontin-lamictal, my circadian rhythm is corrected. I am able to wake up in the morning with ease and feel sleepy at night. Off mood stablizers, I sleep all day and awake all night. I know this is a sign of bipolar disorder. The only problem is I still am depressed on a mood stablizer alone .... so I need an antidepressant.
Question: (Mitch/John/Anyone) Have you noticed a problem with you circadian rhythms off mood stablizers? Is this bipolar/seasonally affective?
So I guess it all makes sense now. I basically have a unipolar-bipolar hybrid disease. I got a few bipolar genes from my father (but not enought for full blown bipolar I) and a few unipolar genes from my mother.
Thanks again.
Spike
Posted by JohnX2 on February 24, 2002, at 10:31:18
In reply to One More Question Please, posted by spike4848 on February 24, 2002, at 7:23:00
Hi spike,I have trouble falling asleep, but then I like
to sleep 10 hrs+. I'm a night person when not
medicated. Before my major mood problems, I
naturally would prefer to keep hours from 12 pm
to 2-3 am. But i know a lot of people like this
who aren't bipolar.A lot of bipolar ii people are hypersomniacs
and have anergic symptoms of depression.When I take medicines that give me an anti-depressant
response, albeit they never stick, they seem to
be affecting my noradrenergic system. My sleep
schedule is shifted back to 11 pm to 7 am. Its
really weird and I am the 1st person to work and
it freaks out my boss. But alas I can never get
the medicines to "stick" they always poop out
(the best candidates being Wellbutrin and Zoloft).
Serzone fixes my inability to fall asleep, but
still makes me want to sleep 10 hrs.mood stabilizers do not affect my sleep patterns.
Also I have noticed that since I have taken Lamictal
that the cognitive declines from other medicines
has decreased substantially. At first i thought
it might be zyprexa, but I stopped it. So I
take this really strong dose of Topamax with no
cognitive decline (seems everyone else complains).
I just started Serzone again with little cognitive
decline (last time off Lamictal it wiped me out).
I have been taking Neurontin with few cognitive
issues. Last time it made me dumb.
I think what is happening is the Lamictal is
guard banding glutamate transmission and preventing
these other medicines from hypostimulation of
glutamate (which is what helps you concentrate).
Also I think Lamictal may have mild monoamine reuptake
properties. sorry for babbling.-John
> Hey Guys,
>
> Thank you so much for the advice. I think I will try 200mg every 8 hours.
>
> I think the pieces of the puzzle are finally coming together in terms of figure out what the hell I have, depression versus bipolar versus anxiety. What I have noticed is that when I take a mood stablizer, lithium-depakote-neurontin-lamictal, my circadian rhythm is corrected. I am able to wake up in the morning with ease and feel sleepy at night. Off mood stablizers, I sleep all day and awake all night. I know this is a sign of bipolar disorder. The only problem is I still am depressed on a mood stablizer alone .... so I need an antidepressant.
>
> Question: (Mitch/John/Anyone) Have you noticed a problem with you circadian rhythms off mood stablizers? Is this bipolar/seasonally affective?
>
> So I guess it all makes sense now. I basically have a unipolar-bipolar hybrid disease. I got a few bipolar genes from my father (but not enought for full blown bipolar I) and a few unipolar genes from my mother.
>
> Thanks again.
>
> Spike
Posted by spike4848 on February 24, 2002, at 10:40:50
In reply to Re: One More Question Please » spike4848, posted by JohnX2 on February 24, 2002, at 10:31:18
> Sorry for babbling.
>
> -JohnDear John,
Never say that again, keep babbling. You and everyone here at babble have such great advice and information. Pretty much saved my life. Thanks so much.
Spike
Posted by Ritch on February 24, 2002, at 11:58:46
In reply to One More Question Please, posted by spike4848 on February 24, 2002, at 7:23:00
> Question: (Mitch/John/Anyone) Have you noticed a problem with you circadian rhythms off mood stablizers? Is this bipolar/seasonally affective?
Well, I never go completely off of them :-), but there are times where I need to take more and I just can't seem to *stay* asleep and then I am tired and irritable all day long. Lately I have been adding 150mg Trileptal (oxcarbazepine) at bedtime with 200 micrograms of Melatonin (with Neurontin+Klonopin) to try to shut down my head so I can sleep and it seems to be helping. I feel calmer and more alert during the day, too.My fluctations are very chronic and very seasonal. Now I am entering a period of aggravated hypomania and more intense mood flips.
My cycle *length* has been the same for 20 years at 20 days (peak to peak). Right now the "roller coaster" just starts getting steeper, and right now the high part of the cycle is more protracted. In winter and summer the roller coaster just sort of gets submerged in the ocean (so to speak), I still have the burned-in 20 day thing going-I just feel my depression varying in intensity.Mitch
Posted by Merritt on February 24, 2002, at 12:14:43
In reply to Re: One More Question Please » spike4848, posted by Ritch on February 24, 2002, at 11:58:46
I appreciate the Neurontin discussion...just added 300mg 3x day for anxiety attacks and waking up 3-4 times a night. I am foggy and a little sick to my stomach (5th day), but I haven't wanted a Xanax since the 2nd day...I am not tired or hyper. I have been taking 400mg a day Wellbutrin and 20mg a day Celexa for quite while, always used Xanax for the anxiety/sleep, but then I am too sleepy.
Thanks for the advice of regularly scheduled dosing to maintain level...I will pay extra attention. Merritt
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