Posted by SLS on October 17, 2002, at 1:43:26
In reply to Relaps .Please .......(((SLS))) , posted by petters on October 12, 2002, at 5:01:32
Hi Petters.
Sorry to take so long in responding to your post.
Your current regimen:venlafaxine 375 mg (Effexor)
lamotrigine 300 mg (Lamictal)
lithium (0,6)
nefazodone 400 mg (Serzone)First, I would try adding a stimulant. It would help both the depression and ADD / ADHD. It might be very important for your overall condition. Which ones have your tried?
Adderall (mixed amphetamine)
Dexedrine (d-amphetamine)
Ritalin (methylphenidate)
Cylert (pemoline)As you know, bipolar disorder and ADD / ADHD often occur comorbidly. Perhaps you have a bipolar spectrum disorder, in which case, other mood-stabilizers might eventually be tried. However, several people here have reported needing 400mg of lamotrigine for the best effect.
Have you ever tried Neurontin (gabapentin)? It can help with both depression and anxiety. The NIMH has reported that lamotrigine + gabapentin works better than lamotrigine alone for bipolar disorder. Recently, gabapentin has being used for ADD / ADHD. (See below)
I guess the other major option is to raise your dosage of lithium to at least 0.8 mEq/L.
1. Add stimulant
2. Raise lithium
3. Raise lamotrigine
4. Consider gabapentinI hope some of these ideas are useful.
Be well, my friend.
Sincerely,
Scott-----------------------------------
Google Search:
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Only one article appeared on Medline regarding the use of Neurontin in ADD / ADHD:
1: J Child Adolesc Psychopharmacol 2001 Fall;11(3):301-9 Related Articles, Links
Gabapentin and methylphenidate treatment of a preadolescent with attention deficit hyperactivity disorder and bipolar disorder.Hamrin V, Bailey K.
Yale University, School of Nursing, New Haven, Connecticut 06510, USA.
Gabapentin is an anticonvulsant drug released in the United States in 1993 for use as adjunctive therapy in refractory partial epilepsy. The mechanism of action of gabapentin is unknown, but the drug has very favorable pharmacokinetics and a good safety profile, which allows its use in high-risk patients. Several reports have described the successful use of gabapentin for bipolar disorders in adults, but there are no controlled studies in the use of gabapentin in children and adolescents. We describe a 12-year-old boy with a history of attention deficient hyperactivity disorder (ADHD), reading disorder, mixed receptive and expressive language disorder, encopresis, and bipolar disorder II who was treated with gabapentin 200 mg/day added to methylphenidate 30 mg/day. Within 3 weeks the improvement and stabilization of mood symptoms was remarkable, as noted by mother, teacher, and clinician, and remained so for 6 months of follow-up. Comorbid bipolar disorder and ADHD is a hotly debated topic in the child and adolescent psychiatric literature, with rates of comorbid ADHD and bipolar disorder ranging from 22% to 90%. Controlled studies are needed to evaluate the possible antimanic mood stabilizing and/or antidepressant properties or gabapentin in youths.
PMID: 11642481 [PubMed - indexed for MEDLINE]
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poster:SLS
thread:123326
URL: http://www.dr-bob.org/babble/20021012/msgs/123973.html