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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 willyee on August 9, 2005, at 6:08:44
I see my Doc this afternoon,i made a cancelled appt. due to being in such bad shape,and im taking my mother in case i fail to project the seriosness of my condition now.
Whats happening is the med parnate is hardly doing its job as a anti-depressant,more importantly im having break down spells through the day,and come back around hour or to later,wihout being a docter im assuming its some sort of rapid clycling,i feel like i might be ok and BAM anxiety and depression and total loss of self control (maniac like) tide waves over me!
To control the anxiety and break out spells,ive sought to meds to discuss with my doc,topamax...and keppra.Ive tried everything else and this is what i am considering at the momeny.
Please knowing i take parnate i am in need of some general opinions on whic of these two i should lean towards more!Please dont confuse me more with any others,BUT i really would value all`s opinion on these two.
I think im expecting parnate to be a AD,a stablizer,and anti-anxiety agent rolled in one!My hope is one of these two help lighten the load on parnate and the medication might work much better for me.
Please im in dier need,my appt is soon and im too much of a mess to think clearly,all i want is something to calm racing thoughts,sever up and downs,with the least sedating effect!
Even if u post to say how u did on either med is fine.
Personaly im leaning towards keppra as it says to be a help with anxiety,stop maniac episodes and even work a lil on ocd,its also unlike the others all which i failed on!
Parnate helps a bit with anxiety so i dont need a hardcore anxiety agent like a benzo,so keppra can have little anxiety relieaf,long as its something.
Im just worried either of these two instead of helping will worsen my depressiom,its one of my fears!Thanks million x a million for listening to this post.
A babbler in a very scary spot!Thanks
Posted by SLS on August 9, 2005, at 6:36:10
In reply to Pls Pls Pls Hurry!!!!!, posted by willyee on August 9, 2005, at 6:08:44
Hi Wylee.
> A babbler in a very scary spot!Thanks
It is also a very scary spot to try to recommend to someone a course of action that might make them worse and not better. I, myself, am considering both of the same drugs that you are. The only thing I can impart to you is that there is very little experience with using Keppra except for a few anecdotes and pilot studies with questionable results. My doctor opted for me to try Trileptal for bipolar depression before Keppra because he has seen some people get worse on Keppra.
I am currently taking:
Trileptal 900mg
Parnate 80mg
nortriptyline 100mg
Abilify 10mgI think Trileptal, Lamictal, and Topamax have all shown some utility in treating mood lability or rapid cyclicity. If depression is your main complaint right now, I would consider Trileptal and Lamictal before Topamax or Keppra. It is difficult to be able to outperform a doctor on guessing games. They are supposed to have more direct experience with these drugs. Each will have their favorites, just as each of us here will have our favorites. If Trileptal hadn't produced an excema like condition for me, I wouldn't think of discontinuing it. I feel that it produces a cleaner response than Lamictal.
I spoke to the doctor whom wrote the following paper. His first choice for me was Keppra (levetiracetam).
1: Epilepsy Behav. 2004 Dec;5(6):1017-20. Related Articles, Links
Monotherapy treatment of bipolar disorder with levetiracetam.Kaufman KR.
Department of Psychiatry, UMDNJ-Robert Wood Johnson Medical School, 125 Paterson Street, Suite 2200, New Brunswick, NJ 08901, USA. kaufmakr@umdnj.edu
Bipolar patients with early-onset, comorbid substance abuse, rapid cycling, and mixed episodes are difficult to treat and frequently require rational polypharmacy. When polypharmacy is unsuccessful, the clinician must consider the off-label use of newer psychotropics. Levetiracetam is a novel anticonvulsant with antikindling, inhibitory, and neuroprotective properties that is effective in an animal model of mania. This case report describes a patient with treatment-resistant rapid cycling bipolar disorder who failed 15 psychotropics, individually or in various combinations (maximum of 6), but ultimately responded to levetiracetam monotherapy and remained without bipolar features during 1 year of maintenance treatment, excluding 1 week during which the patient was medicine noncompliant. Further, methylphenidate used to treat comorbid attention deficit disorder did not precipitate manic features. Levetiracetam should be further studied for its potential use in the treatment of bipolar disorders.
Publication Types:
Case ReportsPMID: 15582854 [PubMed - indexed for MEDLINE]
Maybe:
lithium
Trileptal
Lamictal
Topamax
Keppra
Posted by willyee on August 9, 2005, at 7:19:42
In reply to Re: Pls Pls Pls Hurry!!!!!, posted by SLS on August 9, 2005, at 6:36:10
Youre right,i should have made myself more clear,i would just like opinions from different individuals to kinda get an idea for myself since there as you pointed out not a lot of info out there.
I have taken lamictal and it worsened my depression,tegatrol does not help at all,the only one i got partial response from was Nuerontion.
Again sorry if it seemed like i wanted someone to tell me what to do,i just would like some information to work with.
After the two days i just had,im terrified right now,i changed my doc and the new one isnt for quite some time,i wish i had condifdence in the on im seeing now,but she never seems intersted in progressing with anything unless i mention it.
I really need a sense of calm right now,im hyper maniac and klono is just depressing me more.Keppra i know as u said is new,i can hardly find much on it for depression/mania.The plus is it supposedly works well with little side effects,the negative is it might worsen some depression.
Im not even sure if my doc will even know or be willing to use keppra.
My last choice for hope is to switch to xanax for daytime anxiety and use klonopin at night only.I believe xanax is less depressing from what i understand.
Sorry if i sound manaic,my appt is at 1pm and this visit is going to mean a LOT to me with my current condition worsening with severity by the day.
Posted by Tom Twilight on August 9, 2005, at 8:05:45
In reply to Pls Pls Pls Hurry!!!!!, posted by willyee on August 9, 2005, at 6:08:44
Hey Willyee
I'm really sorry your feeling so bad
I've got about two minuets to write this post, so here goes!I don't know a great deal about ever med, but for some reason I faver Keppra
I have a feeling it would be more calming, although it probably would be more likely to worsen depression than Topomax
Interestingly both Topomax and Keppra have had succseful trials for social anxiety, for some reason I think Keppra would be more helpful
Do you think your doctor might let you try a less depressing Benzo than Klonopin? Something
like Xannax XR, Bromazepam or DiazepamWhen I tried Klonopin it made me very depressed!
Posted by willyee on August 9, 2005, at 9:47:25
In reply to Re: Pls Pls Pls Hurry!!!!!, posted by Tom Twilight on August 9, 2005, at 8:05:45
Thank you,im checking the board periodiacly as my appt is in 2 hrs.
Yess i totaly agree with you about the benzo,abosoultly,what am going to ask is if she can cut my normal klonopin script in half and give me xanax xr.
Id rather take xanax for day time anxiety as i agree totaly with u that klonopin can worsen depression.I still want klonopin though to take as needed since xanax has a short half life,but i hope to use xanax more for anxiety during the day,this morning i felt like i was literaly in fire with anxiety.
Keppra seems promsising too since im reading keppra helps with symtoms in genral and topamax seems to help a certain percent of people for whatever reason.
I just dont know if shell be willing to scribe it.Thank you,yours and sls response are greatly appreciated,i think ur post could have come right out of my own mouth as keppra and xanax is what i had down on paper for asking.
Every single comment this morning will be read and appreciated,thanks in advance to everyone taking the time out of their day to add here.I have a sick stomach right now im just hoping she works with me and can help make me feel better.
God Bless !!
Posted by willyee on August 9, 2005, at 11:31:26
In reply to Re: Pls Pls Pls Hurry!!!!!, posted by willyee on August 9, 2005, at 9:47:25
Well im leaving now,wish me luck!
Posted by KaraS on August 10, 2005, at 3:44:35
In reply to Re: Pls Pls Pls Hurry!!!!!, posted by willyee on August 9, 2005, at 11:31:26
Posted by KaraS on August 10, 2005, at 3:48:24
In reply to Re: Pls Pls Pls Hurry!!!!!, posted by willyee on August 9, 2005, at 11:31:26
This is the end of the thread.
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