![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by HMK on April 9, 2002, at 13:10:46
I'm taking Effexor, Geodon, Valium, and Neurontin. I'm bipolar II and need to add another mood stabilizer. I'm hypothyroid so I want to avoid taking lithium and Depakote made me gain too much weight (I'm already 100 lbs overweight the way it is so I simply can't afford to gain more). The only thing left (other than Trileptal which made me sick) is Tegretol.
Could people please share their experiences with Tegretol? Is it effective? How are the side effects?
Your imput is appreciated.
Heather
Posted by TSA West on April 9, 2002, at 16:20:57
In reply to TEGRETOL questions!, posted by HMK on April 9, 2002, at 13:10:46
Good news: Your recovery on Tegretol may be speedy, according to a study in 1998 on Tegretol in bipolar depression -
"Findings.-Sixty-three percent of patients with Bipolar Depression entered remission. Remission occurred after 7 days of treatment in 14 patients, after 14 days in 9, and after 21 days in 4... Of 9 patients with depressive mania (6 women and 3 men), 22.2% entered remission after 14 days of treatment."
--Year Book of Psychiatry and Applied Mental Health, Volume 1998(10) Annual 1998 pp 421-422
Posted by JohnX2 on April 9, 2002, at 16:31:45
In reply to TEGRETOL questions!, posted by HMK on April 9, 2002, at 13:10:46
You can also try Trileptal, a newer version of Tegetrol.John
> I'm taking Effexor, Geodon, Valium, and Neurontin. I'm bipolar II and need to add another mood stabilizer. I'm hypothyroid so I want to avoid taking lithium and Depakote made me gain too much weight (I'm already 100 lbs overweight the way it is so I simply can't afford to gain more). The only thing left (other than Trileptal which made me sick) is Tegretol.
>
> Could people please share their experiences with Tegretol? Is it effective? How are the side effects?
>
> Your imput is appreciated.
> Heather
Posted by Chloe on April 9, 2002, at 20:03:32
In reply to TEGRETOL questions!, posted by HMK on April 9, 2002, at 13:10:46
> I'm taking Effexor, Geodon, Valium, and Neurontin. I'm bipolar II and need to add another mood stabilizer. I'm hypothyroid so I want to avoid taking lithium and Depakote made me gain too much weight (I'm already 100 lbs overweight the way it is so I simply can't afford to gain more). The only thing left (other than Trileptal which made me sick) is Tegretol.
>
> Could people please share their experiences with Tegretol? Is it effective? How are the side effects?
>
> Your imput is appreciated.
> HeatherHeather,
I was on Tegretol for about a year and a half. It's a very good mood stabilizer, esp. for rapid cyclers, IMHO. But I had a hell of a time with side effects. The dry mouth, constipation, GI problems were uncomfortable and I felt unsteady on my feet alot. So I switched to Trileptal, which unlike you, thought was a breeze in terms of side effects!I would say Tegretol is definitely worth a trial. I would start with the smallest dose which I think is 100 mgs chewables (made for kids with seizures). It took me WEEKS to adjust to this drug. So low and slow would be my suggestion. It's definitely a worthy medication for BP.
Take care
Chloe
Posted by Jackster on April 13, 2002, at 5:45:48
In reply to TEGRETOL questions!, posted by HMK on April 9, 2002, at 13:10:46
I'm actually taking 200mg Tegretol for panic disorder. (and it seems to be very good at blocking panic attacks). At this level I have no trouble with the side effects - and don't seem to have gained any weight from it. (Unlike Paxil). The doc did a blood check, and I was just under the effective range - so he put me up to 300mg. That's when all the side effects came raging in. I had bad headaches every day, felt nauseas, and had terrible digestion to the point where I just couldn't eat. I went back down to the 200mg, where I am now fine again. I don't know what level you would need for BP though.
Jackie
Posted by Ritch on April 13, 2002, at 10:25:52
In reply to Re: TEGRETOL questions!, posted by Jackster on April 13, 2002, at 5:45:48
> I'm actually taking 200mg Tegretol for panic disorder. (and it seems to be very good at blocking panic attacks). At this level I have no trouble with the side effects - and don't seem to have gained any weight from it. (Unlike Paxil). The doc did a blood check, and I was just under the effective range - so he put me up to 300mg. That's when all the side effects came raging in. I had bad headaches every day, felt nauseas, and had terrible digestion to the point where I just couldn't eat. I went back down to the 200mg, where I am now fine again. I don't know what level you would need for BP though.
>
> Jackie
Hi Jackie,So, you are taking 100mg twice daily of Tegretol? That's nice that it is blocking panic attacks for you. I knew you were tinkering with that as an alternative antipanic med. Are you taking any other meds with it? Just curious.
Glad you are doing better. I ran out of Depakote so now I am not on Depakote (there WAS a withdrawal however!). Do you notice any cognitive problems with the Tegretol? I *might* wind up retrying that one as a mood stabilizer again. I tried it about 15 years ago during a bad depression and it didn't seem to be helping after a couple of weeks and I switched back to lithium at the time.Thanks for responding to any of my questions
in advance,Mitch
Posted by Jackster on April 14, 2002, at 0:59:05
In reply to Re: TEGRETOL questions! » Jackster, posted by Ritch on April 13, 2002, at 10:25:52
> Hi Jackie,
>
> So, you are taking 100mg twice daily of Tegretol? That's nice that it is blocking panic attacks for you. I knew you were tinkering with that as an alternative antipanic med. Are you taking any other meds with it? Just curious.
> Glad you are doing better. I ran out of Depakote so now I am not on Depakote (there WAS a withdrawal however!). Do you notice any cognitive problems with the Tegretol? I *might* wind up retrying that one as a mood stabilizer again. I tried it about 15 years ago during a bad depression and it didn't seem to be helping after a couple of weeks and I switched back to lithium at the time.
>
> Thanks for responding to any of my questions
> in advance,
>
> Mitch
Hi MitchI'm glad to finally have a chance to help you! You've answered heaps of my questions in the past.
I take the 200mg of Tegretol once at night. (I think it has a slight sedative effect). I am taking it with 40mg of Paxil (which still has an effect, but nothing like when I first started taking it. So have gone into 'augmentation mode') and 1mg of Xanax which I take half at night and half in the morning. (I have been very slowly reducing the Xanax over the last few months and am now at 1/3 of the original dose. Started taking it after a really bad roller coaster ride after stopping the Paxil one time).
As for cognitive effects from Tegretol - it's hard to tell since I have them from the Xanax. (Poor name recall, inability to think of words sometimes). I notice that as I am winding down the use of Xanax - those side effects are definitely reducing too.
One thing I never realised with Tegretol - is that is does have an anti-depressant effect. When we discussed with my PDoc starting it (my suggestion!) I thought it would just block my panic attacks - like it blocks epilepsy fits. A couple of weeks later I remember saying to someone at work that I felt really happy but I didn't know why! Wasn't til later that I made the connection! Boyfriend reckons I'm a lot more mellower too.
Have been doing exposure therapy - and is going really well - I might get nervous but it doesn't escalate into a panic attack.
PDoc seems to think that the dose is effective at a rather low level for me - don't know if you need higher levels for BP. I've read on here about another drug that is like a 'cleaner' version of tegretol - have you tried that one?
Hope this helps - feel free to ask any more questions.
Jackie
Posted by Ritch on April 14, 2002, at 11:30:15
In reply to Re: TEGRETOL questions!, posted by Jackster on April 14, 2002, at 0:59:05
>
> > Hi Jackie,
> >
> > So, you are taking 100mg twice daily of Tegretol? That's nice that it is blocking panic attacks for you. I knew you were tinkering with that as an alternative antipanic med. Are you taking any other meds with it? Just curious.
> > Glad you are doing better. I ran out of Depakote so now I am not on Depakote (there WAS a withdrawal however!). Do you notice any cognitive problems with the Tegretol? I *might* wind up retrying that one as a mood stabilizer again. I tried it about 15 years ago during a bad depression and it didn't seem to be helping after a couple of weeks and I switched back to lithium at the time.
> >
> > Thanks for responding to any of my questions
> > in advance,
> >
> > Mitch
>
>
> Hi Mitch
>
> I'm glad to finally have a chance to help you! You've answered heaps of my questions in the past.
>
> I take the 200mg of Tegretol once at night. (I think it has a slight sedative effect). I am taking it with 40mg of Paxil (which still has an effect, but nothing like when I first started taking it. So have gone into 'augmentation mode') and 1mg of Xanax which I take half at night and half in the morning. (I have been very slowly reducing the Xanax over the last few months and am now at 1/3 of the original dose. Started taking it after a really bad roller coaster ride after stopping the Paxil one time).
>
> As for cognitive effects from Tegretol - it's hard to tell since I have them from the Xanax. (Poor name recall, inability to think of words sometimes). I notice that as I am winding down the use of Xanax - those side effects are definitely reducing too.
>
> One thing I never realised with Tegretol - is that is does have an anti-depressant effect. When we discussed with my PDoc starting it (my suggestion!) I thought it would just block my panic attacks - like it blocks epilepsy fits. A couple of weeks later I remember saying to someone at work that I felt really happy but I didn't know why! Wasn't til later that I made the connection! Boyfriend reckons I'm a lot more mellower too.
>
> Have been doing exposure therapy - and is going really well - I might get nervous but it doesn't escalate into a panic attack.
>
> PDoc seems to think that the dose is effective at a rather low level for me - don't know if you need higher levels for BP. I've read on here about another drug that is like a 'cleaner' version of tegretol - have you tried that one?
>
> Hope this helps - feel free to ask any more questions.
>
> Jackie
Jackie, thanks for responding. Tegretol is considered the "gold standard" for complex partial seizures. Yes, I have tried the cleaner version of Tegretol...Trileptal. Made me real wired and nauseous. Had no cognitive problems with it though. However, there is something special about Tegretol that Trileptal doesn't seem to touch from my pdoc's experience with switching BP-I patients from Teg to Trileptal-they all got manic and they had to be switched back. That's why I wonder if I could find some effectiveness and tolerability with Tegretol (as a low-dose addon). I know that I will have to get a blood draw and all that hooplah. I just can't tolerate Depakote's cognitive sfx. I am glad that you notice your cognitive sfx being reduced as you drop the Xanax. That kind of sounds like your pdoc's plan-keep you on the carbamazepine+Paxil and wean you away from the benzo. Simplify your med regime-it sounds great to me.good luck,
Mitch
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.