Posted by SLS on May 16, 2012, at 6:03:52
In reply to Re: Wellbutrin yuk - old meds..., posted by bleauberry on May 16, 2012, at 5:17:20
> Hey that sounds great.....take a pscyhiatrict patient and put them on a med that makes them a lot more depressed and keep them on that med. Yeah right. Ok. Not me.
How long would you allow SC's current depression to continue following the discontination of Trileptal before reinstating it so as to prevent mania? It has already demonstrated efficacy. Mania isn't always that easy to treat.Sometimes, the only way to manage an acute manic episode with a mood stabilizer is to cause a subsequent mood shift towards depression. This oscillation is the natural course of the illness, and is often temporary. Perhaps a drug like Abilify can avoid this sequalae. It would be interesting to study this. It may not be the Trileptal that is perpetuating the depression, but the switch into depression that the drug originally facilitated by resolving the mania. However, SC reported feeling great for awhile immediately upon starting Trileptal. How would one interpret this? The depression appeared later.
I guess the quickest way to determine the role that Trileptal plays in SC's depression is to discontinue it, although it can be argued that her already reducing the dosage to 75 mg is tantamount to doing this. If the depression continues post discontinuation, then it might be a good idea to restart Trileptal at 300 - 600 mg/day and begin to treat the depression more aggressively with drugs such as Lamictal and Abilify. If this tactic doesn't work, then it might be time to add an antidepressant.
It is critical to prevent the mania from reemerging. If it recurs, then the whole process, including a switch into depression, must begin again. If it turns out that Trileptal is not tolerated, some other strategy must be employed to prevent the mania.
- Scott
Some see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1017948
URL: http://www.dr-bob.org/babble/20120508/msgs/1018008.html