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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 Christ_empowered on October 18, 2014, at 18:42:20
OK. So I take 1200/Trileptal, 30 Abilify, and 100/Lamictal. To make my life easier, do you think I could ask my doc to go to 200 lamictal and drop the trileptal? I have much more of an issue with (psychotic) depression than I do mania, although hypomanic agitation is sometimes an issue.
Posted by oceansun on October 18, 2014, at 22:01:30
In reply to how about..., posted by Christ_empowered on October 18, 2014, at 18:42:20
Do you mean you want to make your life easier by cutting down the number of meds you're taking? I wish I could do that! :). But if they are working for you, maybe you might want to stick with them, and not worry about withdrawal and titration side effects.
But I did notice a huge difference in my mood (re depression and stabilization) when I went from 100 mg Lamictal to 200 mg. And again when I went from 200 to 400 mg, though not as drastic. I have to say I love Lamictal, except of course for the cognitive side effects. I didn't have any agitation or hypomania, but I'm not bipolar, just moody.
What is Trileptal doing for you? Does Abilify nix the psychosis part? Not sure Lamictal would help with psychosis, just mood stabilization and depression. Can you use Lamictal alone for bipolar or does it have to be with another mood stabilizer? I forget.
> OK. So I take 1200/Trileptal, 30 Abilify, and 100/Lamictal. To make my life easier, do you think I could ask my doc to go to 200 lamictal and drop the trileptal? I have much more of an issue with (psychotic) depression than I do mania, although hypomanic agitation is sometimes an issue.
Posted by Christ_empowered on October 19, 2014, at 17:35:25
In reply to Re: how about... » Christ_empowered, posted by oceansun on October 18, 2014, at 22:01:30
Trileptal was prescribed first. I was on 30/Abilify and still having agitation and mood swings. 1200/day calms things down.
100/Lamictal was added for depression when Prozac and Tofranil both proved unsatisfactory.
Lamictal as monotherapy is do-able with some people. I think in Bipolar II they use 200mgs+ and see where that goes.
Trileptal is weird. I mean, its easy to tolerate. I don't know of any solid data behind it. I find that it helps in combo with other things.
I guess 3 daily meds isn't bad, lol. I was just thinking that maybe 2 anticonvulsants might contribute to depression. Also, I don't understand anticonvulsants, so I don't know what they're doing in my brain, you know? And 2 of them, lol.
Posted by rjlockhart37 on October 23, 2014, at 12:25:07
In reply to Re: how about..., posted by Christ_empowered on October 19, 2014, at 17:35:25
i take 400 of lamictal, all it does when you increase the dose, one it does help with the mood, in some seperate way than antidepressants, but increasing the dose, makes you stare into space, but thats a bit above 300mg, 200 will help with depression
but....maybe drop trileptal, nuerontin and lamictal? those are vary good anxiety smoothers with some help with agitated depression, but nuerontin has to be above 400-500mg to provide anxiety smoothe
Posted by oceansun on October 23, 2014, at 12:49:49
In reply to Re: how about..., posted by Christ_empowered on October 19, 2014, at 17:35:25
I don't really understand anticonvulsants either...I get lost at "sodium channels" ;). Trileptal is weird in that anecdotally it helps with mood and depression, but not necessarily strongly in clinical studies, at least the ones I've read. Have you ever tried lithium? It's supposed to help with everything, except psychosis I believe. I'd try it except I can't afford the frequent blood tests right now.
My cognitive effects don't seem to get worse the higher I go on Lamictal, but that's just me.
Posted by Christ_empowered on October 23, 2014, at 15:29:58
In reply to Re: how about... » Christ_empowered, posted by oceansun on October 23, 2014, at 12:49:49
Lithium scares me. But, I should do something that has more data behind it, right? Right.
So, I'm thinking...up Lamictal to 200, which I think is fairly standard. Drop Trileptal. Gradually switch out Abilify @ 30 for Seroquel @...well, whatever works (for some reason, I was thinking 200 x 3=600, since I get agitation, anxiety, and bad depression...plus psychosis now and then).
My low moods can be pretty intense, so I'm hoping that if my doc can go for this (and the seroquel titration isn't too terrible), the Seroquel will do double duty--mood elevator and antipsychotic.
Problem is sedation :-( Abilify doesn't seem to help the blues much, but at least I'm not sleeping 12 hours/day. Now that seroquel is generic, I guess I could just ask for some on top of the Abilify, but then...why take 2 antipsychotics, you know?
Posted by oceansun on October 23, 2014, at 22:26:44
In reply to Re: how about..., posted by Christ_empowered on October 23, 2014, at 15:29:58
Lithium isn't scarier than any other med :). I have a friend who took it and it helped her a lot.
Upping the Lamictal sounds like a good idea. And if Abilify isn't doing much, then switching to Seroquel could be good, but I would cross taper. Or go off Abilify cold turkey (because of its long half-life that shouldn't be a problem) and start Seroquel right away. I agree that 2 antipsychotics at once may not be the best thing as a long-term strategy.
For activation, Wellbutrin's always good for that...also, you don't know if Seroquel and the higher dose of Lamictal would equal sleepiness, so think: YMMV :).
Posted by Lamdage22 on October 24, 2014, at 11:40:48
In reply to Re: how about..., posted by Christ_empowered on October 23, 2014, at 15:29:58
You lost me.
It seems pretty complicated what you want to do.
No idea.
This is the end of the thread.
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