Posted by Mr. Scott on January 31, 2002, at 22:07:21
In reply to what to do next? add on AD or more stabilizers?, posted by JohnX2 on January 31, 2002, at 16:59:49
>
> Well, I'm pretty close to finishing tapering off
> my Klonopin after replacing it with Topamax. I
> had some wild rebound mania which could be either
> the Topamax or the Klonopin tapering. Leaning towards
> the Klonopin tapering inducing this.
>
> Anyways, I'm feeling as though the Topamax may be
> what I was thinking it would initially be for me;
> a Klonopin replacement. i.e. a med with stabilizer
> properties and really good fixes for my myofacial pain.
> Also, it seems to open doors for me to try other meds
> that triggered weird emotional states or myofacial pain.
>
> So, if I finish this Klonopin tapering, and I settle
> down into a bit of a dysphoric state (aren't I positive),
> I need to decide what to do next
> (and discuss this at my next pdoc meeting).
>
> Here is my current med regimen:
>
> Lamictal 150 mg
> Klonopin 1 mg
> Topamax 400 mg
> Zyprexa 10 mg
>
> In the past I got robust and tolerable AD responses
> from Wellbutrin and Zoloft, but they were fleeting
> (this was pre Topamax) and triggered myofacial
> pain. I did find the meds good for my psychomotor agitation.
> I tried Zoloft twice. Before Klonopin it gave severe
> myofacial pain and emotional flattening, with Klonopin
> it seemed to work Ok, but I aborted the experiment
> (don't remember why). Klonopin did not releive Wellbutrin
> myofacial pain, but Topamax did in a quick trial.
>
> I also tried bumping my Lamictal dose to 300 mg and
> this gave me myofacial pain and bizarre emotional numbing.
> This was also pre Topamax.
>
> So it seems Topamax is alleviating quite nicely some
> sort of strange neurological quirk. I would hope this
> may also alleviate the emotional numbing and
> any potential for triggering of additional myofacial
> pain if I do add on an AD.
>
> So what to do next? I was thinking the 1st thing may
> be to retest the 300 mg Lamictal dose and see if I
> can get a response in light of the addition of Topamax?
> Seems the most sense not to add new meds first.
> I still wonder what was so secret about 300 mg of
> Lamictal??? I do OK on 150-225 mg. Its just at 300 mg
> in the past that I would get a weird myofacial pain
> and emotional blunting.
>
> If this stinks, maybe revisit Wellbutrin or Zoloft?
>
> My primary complaints (if they return after this
> mania binge) are psychomotor agitation, lack of interest,
> hypersomnia. I think these are typical bipolar ii
> downer symptoms.
>
> Any thoughts? I hate to try new meds at this point and
> would rather try old meds that I could stand quickly
> 1st to see what would happen given that Topamax is
> fixing a neurological tick.
>
> Thanks for any feedback.
>
> -JohnAre you currently hypomanic?
After you're totally stabilized I'd go Wellbutrin route if you need an AD and it worked in the past.
However, I would exhaust completely ALL stabilizer options and combo's first.Scott
poster:Mr. Scott
thread:92412
URL: http://www.dr-bob.org/babble/20020131/msgs/92464.html