Posted by Sunnely on March 3, 2002, at 0:20:58
In reply to medication compliance?, posted by trouble on March 1, 2002, at 20:41:50
Cam's response to your question is excellent. Just want to add my 2 cents.
The general rules when it comes to taking psychotropic meds are:
1) Do not double the dose without your doctor's approval.
2) If you miss your dose and if its time to take the next dose, don't double the dose to make up for the missed dose.
Wellbutrin in particular may cause seizures if you double the dose. I understand you take 200 mg twice a day. Doubling the dose to 400 mg as a single dose may lead to this problem. In fact, the general recommendation as to Wellbutrin dosing to avoid risk of seizures are:
1) For depression, may start with 100 mg twice a day.
2) Give the doses at least 6-8 hours apart if the total daily dose is greater than 150 mg.
3) Each single dose should not exceed more than 150 mg.
4) The maximum daily dose should not exceed 450 mg.
5) Preferably, use the SR formulation.
6) Avoid use in patients with history of epileptic seizure and eating disorder.
7) Avoid use concomitantly with Zyban.
Gabitril (tiagabine), although use as an anti-epileptic, itself has been reported to cause seizures.
Modafinil (Provigil) induces the cytochrome enzyme P450 3A4 (CYP3A4). Gabitril is metabolized by this enzyme. So, there is the possibility that its blood level and therapeutic effect may be diminished when combined with Provigil.
BTW, I agree with the suggestion with the use of "pillminder" or "pillboxes" to avoid the chance of doubling the dose.
> I've never posted on this board b/c it hurts my pdoc's feelings when I go to the internet for answers. He doesn't even know about PSB yet, but that's another post.
>
> Anyway, my question is about compliance. Is it crucial to take the same number of meds every single day according to the label? My problem is in forgetting, which I do at least twice a week, only at night, and when I realize it I just double up on the next day. So, for example, instead of taking 2 Wellbutrins the next morning, I'll take 4, and then my regular 2 that night.
> I'm alot more on top of things than I was a few years ago, but still rarely manage a perfect medication week. I've been wondering if that's ok, or if I could be paying a price for it.
>
> I currently take Wellbrutin, Provigil and Gabitril.
>
> Thanks for your response!
> trouble
poster:Sunnely
thread:96004
URL: http://www.dr-bob.org/babble/20020301/msgs/96136.html