Posted by Ron Hill on August 26, 2009, at 13:47:21
In reply to Re: Mood Stabilizer for BPII?, posted by SheilaC on August 26, 2009, at 7:05:52
> I started at a very tiny, tiny dose of Lamictil and after the very first dose my mouth started feeling weird again. This was the 3rd or 4th time I tried it. It made me feel like my teeth were going to fall out.
>
> I wish I could take it.Hi SheilaC,
1) How many mg/day did you start at for Lamictal?
Like you, I hope you can find a way to take it. I get severe rashes from Lamictal unless I start at 12.5 mg/day and increase the dosage by 12.5 mg/day each week.
2) Why not see a p-doc instead of using a family doc?
3) What meds are you taking right now?
4) How do you know you are BP II?
5) Trileptal is better than Tegretol. Oxcarbazepine is a much cleaner med than carbamazepine.
For some patients, Trileptal helps reduce irritability which is often associated with a mixed state. As I'm sure you know, some pts have dysphoric hypomania as opposed to euphoric hypomania.
6) May I tell you what I think? Bear in mind that free advice is often worth about what you pay for it.
You have atypical depression. You will need an MAOI to treat the depression. My hunch is that Nardil might work better than Parnate or Emsam because Nardil has a larger serotonin effect than the other two. I believe you need the serotonin to treat your irritability.
HOWEVER, you ABSOLUTELY MUST be on a fully ramped-up dosage of moodstablizer(s) BEFORE you begin ANY antidepressant. I suspect that you will respond best by using more than one moodstabilizer.
Please write back and let's talk more.
-- Ron
dx: Bipolar II and mild OCPD
600 mg/day Trileptal
200 mg/day Lamictal
500 mg/day Keppra
90 mg/day Nardil
poster:Ron Hill
thread:914055
URL: http://www.dr-bob.org/babble/20090826/msgs/914211.html