Posted by SLS on August 9, 2005, at 6:36:10
In reply to Pls Pls Pls Hurry!!!!!, posted by willyee on August 9, 2005, at 6:08:44
Hi Wylee.
> A babbler in a very scary spot!Thanks
It is also a very scary spot to try to recommend to someone a course of action that might make them worse and not better. I, myself, am considering both of the same drugs that you are. The only thing I can impart to you is that there is very little experience with using Keppra except for a few anecdotes and pilot studies with questionable results. My doctor opted for me to try Trileptal for bipolar depression before Keppra because he has seen some people get worse on Keppra.
I am currently taking:
Trileptal 900mg
Parnate 80mg
nortriptyline 100mg
Abilify 10mgI think Trileptal, Lamictal, and Topamax have all shown some utility in treating mood lability or rapid cyclicity. If depression is your main complaint right now, I would consider Trileptal and Lamictal before Topamax or Keppra. It is difficult to be able to outperform a doctor on guessing games. They are supposed to have more direct experience with these drugs. Each will have their favorites, just as each of us here will have our favorites. If Trileptal hadn't produced an excema like condition for me, I wouldn't think of discontinuing it. I feel that it produces a cleaner response than Lamictal.
I spoke to the doctor whom wrote the following paper. His first choice for me was Keppra (levetiracetam).
1: Epilepsy Behav. 2004 Dec;5(6):1017-20. Related Articles, Links
Monotherapy treatment of bipolar disorder with levetiracetam.Kaufman KR.
Department of Psychiatry, UMDNJ-Robert Wood Johnson Medical School, 125 Paterson Street, Suite 2200, New Brunswick, NJ 08901, USA. kaufmakr@umdnj.edu
Bipolar patients with early-onset, comorbid substance abuse, rapid cycling, and mixed episodes are difficult to treat and frequently require rational polypharmacy. When polypharmacy is unsuccessful, the clinician must consider the off-label use of newer psychotropics. Levetiracetam is a novel anticonvulsant with antikindling, inhibitory, and neuroprotective properties that is effective in an animal model of mania. This case report describes a patient with treatment-resistant rapid cycling bipolar disorder who failed 15 psychotropics, individually or in various combinations (maximum of 6), but ultimately responded to levetiracetam monotherapy and remained without bipolar features during 1 year of maintenance treatment, excluding 1 week during which the patient was medicine noncompliant. Further, methylphenidate used to treat comorbid attention deficit disorder did not precipitate manic features. Levetiracetam should be further studied for its potential use in the treatment of bipolar disorders.
Publication Types:
Case ReportsPMID: 15582854 [PubMed - indexed for MEDLINE]
Maybe:
lithium
Trileptal
Lamictal
Topamax
Keppra
poster:SLS
thread:539495
URL: http://www.dr-bob.org/babble/20050803/msgs/539499.html