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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by krazy kat on July 19, 2002, at 10:39:12
I was prescribed a low dose of Gabitril about a week ago as I was entering into a hypo-manic/manic state. I was so agitated/irritable/paranoid that I could not leave the house. Was hardly sleeping at night, yet had that horrible "itchy" energy the next day where I couldn't focus on anything long enough to finish it. Classic, terrible BP.
So, I took 2.5 mg of Gabitril As Soon as I got it filled. That didn't really do much. So I took another 2.5 mg about a half hour later (empty stomach). Oh, boy, could I feel that. Except for Depakote when I take it for the first time after stopping for a period, this had the most calming effect I've experienced.
Now, taken at night, it does not help me sleep, which was its main purpose, but during the day it provides a low calm (of course that initial effect has already subsided).
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).
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.
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?
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
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
Posted by krazy kat on July 19, 2002, at 20:54:24
In reply to Re: A question about Gabitril for Ritch and others... » krazy kat , posted by Ritch on July 19, 2002, at 13:07:20
I appreciate your quick responses, always!!! Mr. Mitch!!! :)
Posted by Ritch on July 19, 2002, at 21:24:19
In reply to thank you so much » Ritch, posted by krazy kat on July 19, 2002, at 20:54:24
> I appreciate your quick responses, always!!! Mr. Mitch!!! :)
You are welcome. There was something I forgot to add. Have you tried Depakote with Lithium? You might try that one before you go with exotic and expensive 2nd and 3rd line agents. Just an idea.. you might be able to tolerate a more *moderate* dose of both agents without being so *tired*. Maybe you wouldn't need a stimulant-that seems to make you anxious?good luck,
Mitch
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