Posted by Ritch on March 6, 2002, at 0:19:10
In reply to Re: Zonisamide or Modafinil-Dysphoric Hypomania??, posted by Geezer on March 5, 2002, at 13:21:43
> > > Mitch, John, and others may recall my adventure from the recent past. I am Bipolar II, was stable on 1000mg. Dep. and Remeron 15mg. (refractory TRD persists with this combo). The old pdoc (now fired) pushed the Remeron to 30mg. resulting in dysphoric hypomania (mixed-state ?). Options coming up next Tues. 11th:
> > > 1) Increase Dep. to 1250mg and increase Remeron to 30mg.
> > > 2) Increase Dep. to 1250, leave Remeron at 15mg. and add Modafinil slowly.
> > > 3) Leave Dep. at 1000mg, leave Remeron at 15mg., and add Zonisamide as part of a research study next month.
> > >
> > > This is all being done under the supervision of 2 pdocs, one a treating pdoc, the other in research and in control the Zonisamide part of the plan.
> > >
> > > Geezer
> >
> >
> > Hey, I would be interested in how you do on the Zonegran. But, that is just selfish curiosity. You would be the guinea pig not me. Zonegran got dangled in front of me by my pdoc about a year ago. But, I was put off by its potential for cognitive dysfunction and thought disorders (by reading the monograph on it). BUT, I think the population used included many with schizo-affective disorder, so dunno what to think. So, you can hang onto your present meds just add on the Zonegran?? I see my pdoc Thursday and we are going to have to talk about mood stabilizers-big time. I want to try something different. Maybe I will ask for a sample and check it out. I am worried about it boomeranging big-time, though. From what I understand they just make 100mg capsules (one at bedtime-then more). I am a little unstable right now and I am worried about rocking the boat too much (esp. with stressful full time-job to worry about). What do you think? Ya want me to ask for some Zonegran Thursday? I could be guinea pig I suppose. I wish anybody who is bipolar that has had experience with Zonegran would jump in here and mention something (good or bad), before I take the jump.
> >
> > Mitch
>
> Mitch,
> Thanks for the response. I guess the problem I have here is the "decision tree". Its not a problem to get the Zonegran (in fact I would get it for free as a study participant) but I would have to wait a month for my next appointment at the research center. I have an appointment with the treating pdoc on Mon. 11th; at that time I have to decide to take steps #1 or #2 above - #3 option can't come until next month. All very confusing I know (especially in my mental state) but the real issue is the possibility of mood destabilization with increased Remeron or Modafinil. In brief-do I run the risk of taking steps #1 or #2 now in hopes of relief or try to hold on until next month. I should have pointed out at the beginning the "treating pdoc" and the "research pdoc" are two different people. Any hopes they might talk to each other is probably beyond the realm of possibility.
> Thanks Mitch-always appreciate your comments. If I get first-hand experience with Zonegran you will be the first to know.
>
> Geezer
Geezer,I would go with keeping *everything* the same and adding the Zonegran. I guess what I am saying is don't accept #1 or #2. That way you can be more objective with the Zonegran add-on. Don't your pdocs realize this?? Just tell him-"OK I will take the same Dep. and Rem. dosage and I will wait and try the Zonegran add-on next month". Pdocs whine about changing one thing at a time and being "scientific"-well..why can't he put his money where his mouth is??
Mitch
poster:Ritch
thread:96489
URL: http://www.dr-bob.org/babble/20020301/msgs/96635.html