Posted by Ron Hill on November 19, 2007, at 16:42:04
In reply to Re: Keppra » Ron Hill, posted by tecknohed on November 19, 2007, at 5:36:03
Teck,
You have a difficult case, don't you?
Have you considered gabapentin (Neurontin)?
http://www.priory.com/focus8.htm#Gabapentin%20for%20Mood%20Disorders
Also, as a tx for your irritability/temper, I'd like to see you conduct a trial of Deplin. I've been taking Deplin for a month and right from the beginning it completely took away my dysphoric mood states.
Depakote is a first line moodstablizer and it is supposedly a good tx for irritability. However, I hated Depakote. It caused me to pack on 30 pounds and it made me depressed. But, everyone is different.
Teck, my gut feeling is that Keppra is not a good med for you. I can't seem to put my finger on it, but it feels like Keppra might worsen your irritability. And, it is often the case that if the patient takes more than 1000 mg/day, depression occurs. This low dosage level limits the amount of moodstablization that Keppra can provide.
Teck, take all of this with a grain of salt. I'm just a patient like you.
But if I were in your position, I'd conduct a trial of Deplin. If it doesn't help, I'd dump it. If it helped, I'd keep it on-board. Next, I'd give Neurontin a trial to see if it will reduce the anxiety and provide some moodstabilization. However, it should be noted that Neurontin is a rather weak moodstablizer.
Teck, your dx is much different than mine. If you had bipolar disorder, I could be more help. But, I know very very little about social phobia.
Click through Ritch's posts regarding his trials of Keppra:
http://www.dr-bob.org/babble/20041002/msgs/398228.html
http://www.dr-bob.org/babble/20050418/msgs/487754.html
http://www.dr-bob.org/babble/20050428/msgs/492291.html
http://www.dr-bob.org/babble/20050428/msgs/493398.html
http://www.dr-bob.org/babble/20050504/msgs/494314.html
http://www.dr-bob.org/babble/20050504/msgs/494475.html
-- Ron
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> > What makes your pdoc think that you need a moodstablizer?
> >
> > Which moodstabilizer does your pdoc recommend that you try?
>
> I've been put on lamotrigine twice. First time was an attempt to enhance Nardil but all I got was more tiredness, worsened hypersomnia & apathy. Second time was with another pdoc (my current one) . Again it was to help enhance Nardil (I assumed) but he did say in his own words, "it will stabilize your moods". He was already aware of my mood swings & irritability.
>
> > What is your diagnosis?
>
> Social Phobia (or more likely Avoidant Personality Disorder), Depression (not always associated with the anxiety - I can often feel one & not the other), lifelong Hypersomnia, some OCD symptoms, Irritability & a temper (since I was teenager - I'm now 28). I have other symptoms that come & go. My mood never seems to level out, ie even when an AD is working well for me I'm never the same from one day to the next. I might appear to relapse for 3 days then the AD will just seem to spring into action again. Wierd.
>
> > What caused you to be interested in Keppra?
>
> Just looking for an alternative stabilizer (to lamotrigine) for future consideration. Something I can tolerate. I'm currently doing pretty well on Marplan, Klonopin, Idebenone & Vinpocetine. But after my 'sort of' Nardil poop-out I dont think I'll ever feel confident of a LOOOOONG lasting response to any drug again. But I'm thinking a mood stabilizer might help with this(?).
> Nardil was very cruel to me - it totally changed my personality when it first worked, the first 8 months were the best 8 months of my life. Then it went pear shaped. Often makes me wonder if my initial responce to it was really hypomania. I mean, I went from being a TOTAL recluse to suddenly starting work for the first time, getting my own place, getting my first proper girlfriend (& losing my virginity), making new friends & contacting old ones, making up with my parents. I also overspent on credit & store cards & became £5,000 in debt (NEVER done that before).
> But then after about 8 months Nardil started to lose it's efficacy. No addons helped in the long run & after nearly 4 years it became more trouble than it was worth.
>
> At the end of the day I have a hunch that I would benifit from a mood stabilizer. It just needs to be one which I can tolerate otherwise I simply wont comply.
>
> Anyway, thanks for your reply & all the links - lots for me to read.
>
> teck
>
poster:Ron Hill
thread:793089
URL: http://www.dr-bob.org/babble/20071115/msgs/795996.html