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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by ben on May 27, 2005, at 1:08:02
I am on Neurontin (2 x 800 mg) for mood swings and pain but I have developed severe constipation from it, which failed to treat several methods.
I tried Lamictal about three years ago but it made me sleepy at tiny doses but perhaps it was the combo with Paroxetine ?! My pdoc wants me nowto switch to Lamictal because my depression broke through. I am taking Lithium, Effexor (450 mg) and Remeron 45 mg in addition. Does the Lamictal works for pain as well as Neurontin? I think the Neurontin stopped working after about 3years!
Posted by ben on May 27, 2005, at 1:09:06
In reply to How to switch from Neurontin to Lamictal ?, posted by ben on May 27, 2005, at 1:08:02
Posted by med_empowered on May 27, 2005, at 2:09:14
In reply to How to switch from Neurontin to Lamictal ?, posted by ben on May 27, 2005, at 1:08:02
hi! Neurontin is an odd drug. The FDA only approved it for adjunctive therapy in Epilepsy and treatment for some times of pain. Apparently, the companies that owned Neurontin pushed it for "off-label" uses like anxiety, sleep, depression, bipolar disorder, etc....recently, the company that owns Neurontin had to pay a couple hundred million dollars to some insurance companies b/c of unlawful marketing practices that cost the insurance industry some serious $$$. Anyway, back to your question-- Lamictal is great as a mood-stabilizer or epilepsy treatment, but it isn't exactly hailed for its pain-relieving qualities. If you're having severe constipation from the Neurontin that just won't go away, you should probably taper as fast as possible...your doc will do this (taper set-ups vary by doc). The lamictal helps a lot with depression (treatment and prevention), although some people do still have some hypomanic symptoms now and then (I would think your lithium would handle this). For neurontin-style pain relief, Lyrica might help (I **think** its available now, but I don't know). Some types of pain can be cleared up with antidepressants (especially tricyclics, but also cymbalta, possibly effexor) and/or benzodiazepenes. Good luck!
Posted by SLS on May 27, 2005, at 8:11:21
In reply to How to switch from Neurontin to Lamictal ?, posted by ben on May 27, 2005, at 1:08:02
> I am on Neurontin (2 x 800 mg) for mood swings and pain but I have developed severe constipation from it, which failed to treat several methods.
> I tried Lamictal about three years ago but it made me sleepy at tiny doses but perhaps it was the combo with Paroxetine ?! My pdoc wants me nowto switch to Lamictal because my depression broke through. I am taking Lithium, Effexor (450 mg) and Remeron 45 mg in addition. Does the Lamictal works for pain as well as Neurontin? I think the Neurontin stopped working after about 3years!
There is no reason why you could not combine Neurontin and Lamictal. The NIMH does this quite often. This combatability should allow you to begin the lengthy titration with Lamictal while tapering the Neurontin. It is not necessary to make an abrupt switch.Good luck with the Lamictal. It sounds like a great idea - especially because you will be combining it with lithium.
- Scott
Posted by ben on May 27, 2005, at 10:43:12
In reply to Re: How to switch from Neurontin to Lamictal ?, posted by SLS on May 27, 2005, at 8:11:21
Hi Scott
Why do you think combing Lamictal with Lithium is good? I have the feeling that Neurontin pooped out and that my bouwle got worse with Neurontin - its like IBS (a lot of bloating and constipation). My doc tells me that it could be a long term side effect. Effexor could be also an evil concerning the bouwle but it doesnt have any anticholinergic side effects.
Perhaps Abilify could be an option too? I think of the 5-ht1 agonism an also dopamin in a partial way. Ritalin keeps me going at the moment and Trazodone/Nefazodone was a good adjunct to Effexor.ben-
> > I am on Neurontin (2 x 800 mg) for mood swings and pain but I have developed severe constipation from it, which failed to treat several methods.
> > I tried Lamictal about three years ago but it made me sleepy at tiny doses but perhaps it was the combo with Paroxetine ?! My pdoc wants me nowto switch to Lamictal because my depression broke through. I am taking Lithium, Effexor (450 mg) and Remeron 45 mg in addition. Does the Lamictal works for pain as well as Neurontin? I think the Neurontin stopped working after about 3years!
>
>
> There is no reason why you could not combine Neurontin and Lamictal. The NIMH does this quite often. This combatability should allow you to begin the lengthy titration with Lamictal while tapering the Neurontin. It is not necessary to make an abrupt switch.
>
> Good luck with the Lamictal. It sounds like a great idea - especially because you will be combining it with lithium.
>
>
> - Scott
>
Posted by ben on May 27, 2005, at 10:46:26
In reply to Re: How to switch from Neurontin to Lamictal ?, posted by med_empowered on May 27, 2005, at 2:09:14
hi
could the Neurontin trigger an IBS or could it also be the Effexor. The sever constipation and bloating occured after more than a year! I hope I can handle the Lamictal because I had a bad expierience with it the first time!
Many thanks for your input!> hi! Neurontin is an odd drug. The FDA only approved it for adjunctive therapy in Epilepsy and treatment for some times of pain. Apparently, the companies that owned Neurontin pushed it for "off-label" uses like anxiety, sleep, depression, bipolar disorder, etc....recently, the company that owns Neurontin had to pay a couple hundred million dollars to some insurance companies b/c of unlawful marketing practices that cost the insurance industry some serious $$$. Anyway, back to your question-- Lamictal is great as a mood-stabilizer or epilepsy treatment, but it isn't exactly hailed for its pain-relieving qualities. If you're having severe constipation from the Neurontin that just won't go away, you should probably taper as fast as possible...your doc will do this (taper set-ups vary by doc). The lamictal helps a lot with depression (treatment and prevention), although some people do still have some hypomanic symptoms now and then (I would think your lithium would handle this). For neurontin-style pain relief, Lyrica might help (I **think** its available now, but I don't know). Some types of pain can be cleared up with antidepressants (especially tricyclics, but also cymbalta, possibly effexor) and/or benzodiazepenes. Good luck!
Posted by ed_uk on May 27, 2005, at 14:51:26
In reply to Re: How to switch from Neurontin to Lamictal ? » med_empowered, posted by ben on May 27, 2005, at 10:46:26
Hi,
>sever constipation.....
Which laxatives have you tried so far? How did you respond? What does your doc say about the constipation??
Kind regards,
Ed.
Posted by ben on May 28, 2005, at 4:47:03
In reply to Re: How to switch from Neurontin to Lamictal ? » ben, posted by ed_uk on May 27, 2005, at 14:51:26
bulking agents, osmotic laxatives with salts and macrogol (=PEGs), zelnorm, senna and the synthetic athrachinones bisacodyl and picosulfate, fruits like prunes .....and of course many combos! The problem ist more the bloatinhand discomfort in the right lower part of the colon.
As last but not least probiotics of good quality in sufficient amounts. Each time, wen I clean my hole Bouwle (gut) with about 5 litres of a laxative solution., I am painfree and no bloating for about 2 to 3 weeks. Then the hole crap is starting from de novo.
ben
> Hi,
>
> >sever constipation.....
>
> Which laxatives have you tried so far? How did you respond? What does your doc say about the constipation??
>
> Kind regards,
> Ed.
Posted by ed_uk on May 28, 2005, at 10:57:30
In reply to Re: How to switch from Neurontin to Lamictal ? » ed_uk, posted by ben on May 28, 2005, at 4:47:03
Hi Ben,
Interestingly, I started 6g/day fish oil (capsules) a few weeks ago and it's acting as a great laxative for me! It hasn't caused any GI side effects, or any other side effects for that matter.
Regards,
Ed.
Posted by ben on May 30, 2005, at 0:37:13
In reply to Re: How to switch from Neurontin to Lamictal ? » ben, posted by ed_uk on May 28, 2005, at 10:57:30
> Hi Ben,
>
> Interestingly, I started 6g/day fish oil (capsules) a few weeks ago and it's acting as a great laxative for me! It hasn't caused any GI side effects, or any other side effects for that matter.
>
> Regards,
> Ed.Hi
thats a good idea, but I think it works only for constipation without serious bloating gas and cramps!
thanks anyway!
Posted by ben on May 30, 2005, at 0:40:54
In reply to Re: How to switch from Neurontin to Lamictal ?, posted by SLS on May 27, 2005, at 8:11:21
Hi Scott why do you think combining Lithium with Lamictal sounds good? I read of Lamictal having better capabilities to prevent depression as Lithium! Lithium the other way: better in prevention of mania. Is that right?
best regards
ben> > I am on Neurontin (2 x 800 mg) for mood swings and pain but I have developed severe constipation from it, which failed to treat several methods.
> > I tried Lamictal about three years ago but it made me sleepy at tiny doses but perhaps it was the combo with Paroxetine ?! My pdoc wants me nowto switch to Lamictal because my depression broke through. I am taking Lithium, Effexor (450 mg) and Remeron 45 mg in addition. Does the Lamictal works for pain as well as Neurontin? I think the Neurontin stopped working after about 3years!
>
>
> There is no reason why you could not combine Neurontin and Lamictal. The NIMH does this quite often. This combatability should allow you to begin the lengthy titration with Lamictal while tapering the Neurontin. It is not necessary to make an abrupt switch.
>
> Good luck with the Lamictal. It sounds like a great idea - especially because you will be combining it with lithium.
>
>
> - Scott
>
Posted by ed_uk on May 30, 2005, at 6:59:45
In reply to Re: How to switch from Neurontin to Lamictal ? » ed_uk, posted by ben on May 30, 2005, at 0:37:13
Hi Ben,
........well, it certainly hasn't caused any side effects and it seems to work better than lactulose, senna or psyllium.
Ed.
This is the end of the thread.
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