Posted by Ron Hill on June 17, 2005, at 14:04:30
In reply to Re: Trileptal 600mg - How much higher can I go?, posted by SLS on June 16, 2005, at 8:14:05
> How much higher do people go with Trileptal?
> I know I can go higher on the Trileptal. I wish I knew how many people absolutely need higher dosages to glean a therapeutic effect, especially an antidepressant effect.> - Scott
---------------------Scott,
FWIW, I've been on Trileptal for one year. I use it as a moodstabilizer and I currently take 900 mg/day. I've been as high as 1200 mg/day for a couple of weeks, and once I bumped up to 1600 mg/day for a day or two. The side effects were worse at 1200 and 1600 and, for me, the benefits did not increase at the higher dosages. So early on in the trial, I backed down the dosage and ended up setting in at 900 mg/day.
Sometimes I toy with the idea of reducing to 600 to see if I have more energy and to see if I spend less time in the depressive (atypical) phase of my BP II cycling. But for now, I need the moodstablizing power of 900 mg/day to prevent hypomania during my current (3 week old) Selegiline trial.
I had some trouble with side effects (including cognitive blunting, among others) during Trileptal startup. To minimize these startup effects, I ramped up slowly (i.e.; 300, 450, 600, 750, 900, 1200, 1600 mg/day) with at least a couple weeks between incremental increases.
The startup side effects have long since subsided, but for me, any of the moodstabilizers (including Trileptal) cause some amount of ongoing cognitive blunting. It just seems to come with the MS territory (in my case).
I really like Trileptal (as a moodstabilizer). It is the best med I've found for the tx of hypomania. Further, it reduces (but does not eliminate) my dysphoric irritability, and it is an absolutely excellent sleep agent. However, in my case, I have never attributed any antidepressant action to Trileptal. To the contrary, in a manner reminiscent of Depakote (but much less severe), I sometimes think that Trileptal "holds me in" the depressive phase of my BP II cycling longer than I would reside there otherwise. Are there research data that indicate Trileptal may have antidepressant qualities in certain cases?
Your situation is different than mine, so my anecdotal report is likely of little value to you. None-the-less, just thought I'd relay my experience FWIW.
I hope Trileptal helps you Scotty. You're a good man and I have a ton of respect for you.
-- Ron
BP II and OCPD
600 mg/day Lithobid
900 mg/day Trileptal
50 mg/day Lamictal (level limited by rash)
5 mg/day Deprenyl (as tx for atypical depression)
poster:Ron Hill
thread:511101
URL: http://www.dr-bob.org/babble/20050617/msgs/514359.html