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Scott- what to add?

Posted by sheilac on May 19, 2012, at 8:09:59

In reply to Re: Scott- what to add? » Sheilac, posted by SLS on May 19, 2012, at 6:45:46

> > I guess I understand that Trileptal and Lithium are keeping me stable and the depression just needs to be addressed.
>
> Remember, though, that it often takes 600 mg of Trileptal in order to get the most out of it. Depakote made me feel more depressed. Trileptal was neutral, and probably the cleanest anticonvulsant mood-stabilizer I have tried.
>
Scott, I like Trileptal, but at a higher dose I felt even flatter, with no personality and motivation. But I do wonder if just going higher on Trileptal if I could tolerate low dose Adderall better (I hate the come down effect of Adderall later in the day) or if I could tolerate a low dose of Wellbutrin. Then, maybe a higher dose of Trileptal would be worth it. If it would address the depression. Trileptal dose nothing for my depression.

> > Is Abilify the right med to do that?
>
> Maybe yes and maybe no. You never really know for sure. You just have to try it. It is a lifesaver for some people with depression.
>
> > I took it last night and I feel groggy this morning, like I need some Adderall.
>
> I don't think you could come to any conclusions after the first dose. That "drugged" feeling could be a startup side effect that completely disappears within the first week. For you, I think that feeling groggy is better than experiencing hyperarousal or anxiety. Some people cannot tolerate Abilify because of these effects. Perhaps this initial grogginess is an indicator that Abilify will have anti-manic effects.

Scott, I'm not sure I need anymore anti-manic effects at this point. The Trileptal and Lithium seem to be taking care of that. Will more anti-manic effects with Ablilify just make me more depressed?

Because you are bipolar, you might need 10 mg of Abilify to glean an antidpressant effect. I would keep this in mind if dosages of 5 mg and less don't work, AND you are tolerating the drug well.
>
> What was it about Lamictal that you could not tolerate?

Lamictal made my mouth and gums break out in blisters. It was an awful experience. I tried this med several times in lesser and lesser doses and it still did it to me.
>
> > Maybe I should have just tried to go down to 18mg of Wellbutin and work up from there?
>
> Your reaction to Wellbutrin was so intense at a relatively low dosage, that I doubt you would feel well on it at any dosage.

Scott, even if I went up on Trileptal and down on dose of Wellbutrin?
>
> > I'm not used to feeling this drugged.
>
> Well, lets hope that this is only a startup effect.
>
> Parnate is a drug worth considering for your type of depression. Even Emsam might help.
>
> So, you can speak to your doctor about:
>
> 1. Returning to Wellbutrin at an extremely low dosage.
> 2. Increasing the Trileptal to 600 mg.
> 3. The grogginess that might eventually disappear.
> 4. Using higher dosages of Abilify if necessary.
> 5. Trying an MAOI like Parnate or Emsam.
>
> I really would like to know about your experience with Lamictal. What happened with it that caused you to abort your trial?
>
>

Soctt, why do you think 600mg of Trileptal would be better? Would it kick in some anti-depressant effects? I could go higher, I just don't want to feel flatter, with no motivation and still this lingering depression. I need some energy.

Thanks for all your input! I really appreciate your thoughts.

Sheila


> - Scott


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poster:sheilac thread:1018227
URL: http://www.dr-bob.org/babble/20120508/msgs/1018235.html