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Re: Augmenting Bipolar 'Cocktail' with Trodenki XR » LouisianaSportsman

Posted by LouisianaSportsman on September 27, 2013, at 15:56:25

In reply to Augmenting Bipolar 'Cocktail' with Trodenki XR, posted by LouisianaSportsman on September 24, 2013, at 20:51:00

doxogenic boy,

Thank you for sharing your experiences as well as the informative article on topiramate! You're right, it's a rocky road to reach the right path-- but you can eventually find the cocktail that works for you!

Follow up:

After consultation with pdoc, we decided to change the Lyrica to Gabapentin 900mg. QID. We're hoping the slightly different metabolic processes of gabapentin and the augmentation of Nuvigil 250mg. would hopefully ease up the weight gain.

Next visit is in one week. We're going to observe my weight and likely add topiramate 50mg. BID and titrate up from there. She is fine with the Trodenki XL idea after I titrate up to the 200mg. dosage we both agreed on. She doesn't want to make too many changes at once; yet, she wants to get me stable as possible which is why she will likely add the topiramate next week.

We made two changes:

Abilify (aripiprazole)10mg.
REPLACED: Concerta (methylphenidate ER) 54mg
Lamictal (lamotrigine) 200mg.
REPLACED Lyrica (pregabalin) #60 150mg. [300mg.]
Pristiq (desvenlafaxine) 50mg.

Therefore, I am now taking:

Current Psychiatric "Cocktail":

Abilify (aripiprazole)10mg.
Nuvigil (armodafinil) 250mg.
Lamictal (lamotrigine) 200mg.
Neurontin (gabapentin) 1,800mg. [400mg. QID]
Pristiq (desvenlafaxine) 50mg.

As you can see, we replaced the Concerta with Nuvigil and the Lyrica with the Neurontin this visit.

One week till next visit. We will, assuming things don't change, --> Pristiq 100mg.; Topiramate titration to 200mg. Trodenki after one month.

One month until second visit. We will investigate the addition of:

Mirapex (pramipexole)
Namenda (memantine)
Gabatril (baclofen)

If anyone has any thoughts (concerns?) on these medications or my cocktail, let me know!

I appreciate any input.

Thanks!!


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poster:LouisianaSportsman thread:1051278
URL: http://www.dr-bob.org/babble/20130828/msgs/1051362.html