Posted by SLS on March 19, 2016, at 18:04:10
In reply to Re: Tricyclics and bipolar depression » SLS, posted by B2chica on March 19, 2016, at 16:52:33
> very helpful. so could i add nortriptyline (or the like) to pristiq?
Yup. If in doubt, just be sure to use blood tests for nortriptyline as a guideline to find the right dosage.
With Topamax, it is important to start low and increase the dosage very gradually. You could start at 25 mg/day and move up by 25 mg every week. That may seem ridiculous, but doing so is likely to help you avoid cognitive impairments altogether. You might end up responding to 100 mg/day rather than the 200 mg/day most often targeted. Also, the risk of kidney stones is dosage-dependent. I witnessed a woman in a mixed-state hypomania respond completely to Topamax 200 mg/day. At some point, her dosage was reduced to 100 mg/day and she was fine.
> i would like to lower pristiq as i know that has shifted me into this mixed state
That was my initial thought.
I'm still wondering if Trileptal would help with the manic component of your mixed-state *and* reduce your cycling.
I don't know. Don't exclude Saphris from consideration. Latuda sucks.
Brintellix?
- ScottSome 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:1087318
URL: http://www.dr-bob.org/babble/20160306/msgs/1087334.html