Posted by Scott L. Schofield on December 23, 1999, at 20:00:33
In reply to Depakote anecdote -- Noa, posted by Zeke on December 20, 1999, at 13:43:54
> >Sure enough, he switched to tegretol, and the depression lifted.
>
> Noa, I think there's more to consider...
>
> 1. Tegretol has antidepressant effects.
>
> 2. People with epilepsy -- especially with temporal lobe (limbic) foci -- are much more prone to depression. Further, as seizures become controlled, depression etc. often becomes worse, and vice versa...
>
> You could be right but the lifting of the depression could have been due to the Tegretol, rather than the absence of the Depakote. If Depakote did influence the depression, remember that he had epilepsy and the seizure control could set off the depression.
>
> I think this story speaks more strongly of Tegretol. So Scott, consider that as an alternative if things don't improve...
>
>
Thanks.For now, I plan to stick with the Depakote for a while longer. I am titrating up more slowly this time, hoping to minimize any idiosyncratic transient effects. My doctor has set 1500 mg/day as the first target. I want to see just how much of an improvement can be squeezed out of it before attempting to add another antidepressant. I found it interesting that my doctor said that the therapeutic range for efficacy in bipolar disorder is actually higher than that of epilepsy. I know that the drug reps are telling psychiatrists to push the dosage beyond 2000 mg/day.
I don't recall ever giving Tegretol an extended trial. I'll definitely keep it in mind.
Has anyone tried a combination of lamotrigine and topiramate?
Thanks again.
- Scott
poster:Scott L. Schofield
thread:16772
URL: http://www.dr-bob.org/babble/19991212/msgs/17399.html