Posted by BPPsychFellow on July 7, 2008, at 10:32:01
In reply to Lamictal combinations, posted by bidatheraptor on July 6, 2008, at 22:42:35
I'm sorry for your awful return of symptoms. It sounds like your current mood episode is very similar to the one you had 5 years ago. Bipolar disorder is cyclical so this isn't so unusual. Remember, mood episodes don't last forever! I hope you and your doctor can find a med adjustment that will get rid of it quickly (and keep it from coming back). Rather than attacking the current mood episode, concentrate on stopping the cycling (i.e. strengthen your mood stabilizer regimen).
What combination of drugs did you take 5 years ago to stabilize your mood? What works in the past often works again.
I wouldn't give up on the Lamictal; I ask my patients to keep it on board to delay the time until the next episode. As far as Topamax, I don't prescribe it. Topamax does not have approval as a mood stabilizer and doesn't have the best evidence. I stick to drugs that have been proven in the most rigorous studies: lithium, valproate, carbamazepine, lamotrigine. Those four drugs can be used in combination to work in synergy. Now, in my opinion, olanzapine and quetiapine are the best options as add-ons for a breakthrough episode like you are having.
I always like to point out: all decisions about your treatment must be discussed with your own doctor. Views expressed here are simply my opinions.
You will feel better again. Stick it out. Make a few appointments to meet with your psychologist while you wait for the mood stabilizers to smooth things out.
Regards -- BPPsychFellow
poster:BPPsychFellow
thread:838531
URL: http://www.dr-bob.org/babble/20080706/msgs/838607.html