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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 2 of 2. This is the beginning of the thread.
Posted by HawaiiStud on January 3, 2003, at 15:27:32
Hi. I have recently been diagnosed with Bipolar II and GAD. I take 400mg Neurontin twice a day, I take Lamictal twice a day, and now Keppra once at night. I can't remember the dosages for Lamictal or Keppra (not at home right now).
The Neurontin has seemed to help with anxiety and irritability. The lamictal some with mood stability. The Keppra I just started and I think it is really making me very moody and anxious. I hear that multiple pyschiatric side effects can occur with Keppra, but that they generally subside.
Anyone know anything about Keppra and side effects? It seems to make me very emotional and anxious...
Also the Neurontin, Lamictal, Keppra combination...what do you think?
Posted by Jumpy on January 4, 2003, at 15:12:58
In reply to KEPPRA (+ Neurontin and Lamictal), posted by HawaiiStud on January 3, 2003, at 15:27:32
> Hi. I have recently been diagnosed with Bipolar II and GAD. I take 400mg Neurontin twice a day, I take Lamictal twice a day, and now Keppra once at night. I can't remember the dosages for Lamictal or Keppra (not at home right now).
>
> Also the Neurontin, Lamictal, Keppra combination...what do you think?Sorry, but I haven't had much experience with Keppra (except that Dr. Goldberg from Depression Central is prescribing it often). In terms of you current medication combination, I will call in the "Semi-Dr Phelps" combo. Dr Phelps from www.psycheducation.org along with a few other psychiatrists have been advocating "all mood stablizers and no antidepressants" medication combos for patients with any type of bipolar disorder. If a patient is depressed, manic, anxious ... they would propose keep adding more mood stablizers until the patient felt relief (along with exercise, therapy, no alcohol, good sleep). Dr Phelps and the other handful of psychiatrists report tremendous sucess with this approach. They also report most patients fail medication combination because of an antidepressant in the mixture ... and that all antidepressant must be withdrawn from bipolar patient medication regimens.
Unforunately, you often don't seen this working in clinical practice. Many bipolar patient may need low dose or short course treatments with antidepressants to control their moods. I have have met very few patients who have been able to survive on mood stablizers alone over a long period of time. One such person is "BarbaraCat" who seems to be doing well on Lithium and Lamictal.
So I am totally confused on this topic .... whether a patient should be on all mood stablizers or not. Can anyone help me out?
Jumpy
PS I said "semi-Dr Phelps" because he report neurontin as a mood stablizer that destablizes most patients. He reports there have been studies with neurontin that showed it to be worse that placebo. So in general he reports neurontin should be avoided.
This is the end of the thread.
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