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Re: Bipolar ll: Trileptal vs. Tegretol » Ritch

Posted by CareBear04 on January 14, 2005, at 16:40:45

In reply to Re: Bipolar ll: Trileptal vs. Tegretol » ed_uk, posted by Ritch on January 14, 2005, at 9:28:37

ritch, would an antiemetic to go along with the trileptal help? it seems like if trileptal worked so well for you, there have to be other ways to stay on it instead of dropping it just because of nausea. i don't know if all drs, especially pdocs approve, but for med-induced nausea, i've tried reglan, phenergan, and zofran for the past two months. reglan was ineffective, but it was good for GI motility. phenergan is available as generic, and it's defeinitely better than reglan. i think it's more for motion sickness type nauseas, but i'm not sure. it has helped me significantly, though. zofran is maybe the best, but it costs more than an arm and a leg. i used mail order to pay a lower copay, and they put major restrictions on how much you can take. my doctor wrote for 3x a day, and the pharmacy would only fill one a day-- they gave me 36 pills, and i can't refill till sometime in february or even march. ridiculous! but even for just 36 pills, the cost was about $570. i thought atypical antipsychotics or stomach proton pump inhibitors were expensive, but nothing compared to $15+ for a single pill!
still, antiemetics have helped me a lot. they've helped me keep down unpleasant medications and have helped with motion sickness, which is a recent phenomenon. i've found that they work best when i take them regularly, whether or not i feel nauseated. when i miss a dose, i sometimes have breakthrough vomiting and horrible hangover type feelings without the fun of alcohol.
one concern is that most antiemetics work by hitting the neurotransmitters, too. i think many are dopamine antagonists, which can cause extrapyramidal effects just like antipsychotics. zofran is a serotenergic drug. and used together, there's a risk of CV effects like prolonged QT interval and stuff. i don't know much about this stuff, except to be careful.
still, you might find that if trileptal is effective for you with the exception of nausea, antiemetics might be an option worth trying. le me know what you think.


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URL: http://www.dr-bob.org/babble/20050113/msgs/442224.html