Posted by SLS on January 17, 2009, at 9:56:18
In reply to Re: Ideas on female hormonal dilemma?, posted by Cady on January 17, 2009, at 9:00:18
> Thanks, that is helpful.
>
> I have non-menstrual ultra-rapid cycling, too. Lamictal has never stabilized me, but my doctors have kept me on it while trying various additions (Gabapentin, Topamax, Abilify). Gabapentin did not work. Topamax was ok but incompatible with the hormone therapy. Abilify is currently helping, so I would be reluctant to stop it. I have never tried Seroquel. Would I take it in addition to Abilify, or rather as a substitute? Do you know if Seroquel has more of an antidepressant effect than Abilify? If I switch from Lamictal to Trileptal, I am thinking I might need another med that is more on the antidepressant side. My understanding is that Trileptal is more antimanic.Generally, but it had a slight antidepressant effect on me.
> > If you take Trileptal, and it doesn't seem to be helping or hurting, I would leave it in place and then perhaps add Topamax. If 2 is better than 1, you will never discover this by taking 1 at a time.
The point I was trying to make, is that I would add stuff instead of swapping out stuff. If the Lamictal isn't exacerbating your PMDD, then I would leave it in place and try adding Trileptal or possibly lithium. Lithium + Lamictal is supposed to be able to penetrate the rapid cycle. As I may have mentioned, a friend of mine with a dramatic ultra-rapid-cycle has had success with Lamictal + Trileptal along with Keppra and Nardil. You have a plethora of options yet to explore.
Again, you must allow for at least 6 months for a mood-stabilizer regime to penetrate and abolish rapid cycling. The NIMH (NIH) has done much work in this area. They support the Lamictal + lithium strategy. They use retrospective life charting and contemporaneous mood charting to help elucidate patterns of illness and responses to medication. I think you might profit from charting your mood. I have a chart on my website that you can use:
http://www.slschofield.com/medicine/mood_chart_beam.pdf
You'll need a PDF file reader to view and print out the chart:
You can use the free official Adobe Reader, which is a large program:
Instead, you might prefer to use a lightweight, but excellent free program, Foxit Reader:
Additionally, this is an example of life chart:
http://www.slschofield.com/medicine/mood_chart_nimh_r.pdf
- Scott
poster:SLS
thread:874289
URL: http://www.dr-bob.org/babble/20090104/msgs/874492.html