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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 30. This is the beginning of the thread.
Posted by Taylor123 on June 19, 2003, at 12:04:38
I CHOSE CARBAMAZEPINE (TEGRETOL)
Hay all!
Saw my P.doc, and he wasn't happy that I had stopped my Lithium and was mowing the grass at 3:00am. He thinks I am very close to launching into fullblown mania, and told me that I would have to agree with another mood stabalizer, or it's time to put me in hospital (again)Am back on Olanzapine, untill the Tegretol kicks in, so am feeling very sleepy.
Does anyone have experience with Tegretol. Don't like what i've read, with depression , aggression and activation of psychosis being amongst the side-effect profile.
Feeling annoyed, as my p.doc seems to be hindering me whenver I start to feel good. Although my head was very busy and my thoughts were racing, I still felt good.
I hope that the Tegretol works, because I am afraid of coming down with a thud.
Thanx for any feedback
Your not so happy- vibed friend,
Tay
Posted by stjames on June 19, 2003, at 13:16:03
In reply to HOSPITALIZATION OR CARBAMAZEPINE?, posted by Taylor123 on June 19, 2003, at 12:04:38
Feeling annoyed, as my p.doc seems to be hindering me whenver I start to feel good. Although my head was very busy and my thoughts were racing, I still felt good.
In this case "feeling good" means mania, which is not good
Posted by McPac on June 19, 2003, at 13:28:13
In reply to Re: HOSPITALIZATION OR CARBAMAZEPINE?, posted by stjames on June 19, 2003, at 13:16:03
Why'd you stop the lithium.
Posted by Ritch on June 19, 2003, at 13:41:09
In reply to HOSPITALIZATION OR CARBAMAZEPINE?, posted by Taylor123 on June 19, 2003, at 12:04:38
> I CHOSE CARBAMAZEPINE (TEGRETOL)
>
> Hay all!
> Saw my P.doc, and he wasn't happy that I had stopped my Lithium and was mowing the grass at 3:00am. He thinks I am very close to launching into fullblown mania, and told me that I would have to agree with another mood stabalizer, or it's time to put me in hospital (again)
>
> Am back on Olanzapine, untill the Tegretol kicks in, so am feeling very sleepy.
>
> Does anyone have experience with Tegretol. Don't like what i've read, with depression , aggression and activation of psychosis being amongst the side-effect profile.
>
> Feeling annoyed, as my p.doc seems to be hindering me whenver I start to feel good. Although my head was very busy and my thoughts were racing, I still felt good.
>
> I hope that the Tegretol works, because I am afraid of coming down with a thud.
>
> Thanx for any feedback
> Your not so happy- vibed friend,
> TayI've been on Trileptal (oxcarbazepine) and it definitely had an antidepressant and anticycling effect. It just made me too nauseous though. I've known others that switched to Tegretol from Lithium and liked it a lot better, however.
Posted by starlight on June 19, 2003, at 15:03:34
In reply to HOSPITALIZATION OR CARBAMAZEPINE?, posted by Taylor123 on June 19, 2003, at 12:04:38
Hi Tay,
Verrrry interesting! Mowing the lawn at 3am eh? Sounds like you've been busy!You might ask your doc about Trileptal rather than tegretol which can be hard to take due to the side effects. Tegretol = carbamazapine, Trileptal = oxcarbamazapine. So the difference is Trileptal has an extra oxygen molecule stuck on it that miraculously negates the side effects that Tegretol comes with, plus no blood draws, whoo hoo! Just a suggestion.
starlight
Posted by Ron Hill on June 19, 2003, at 16:29:12
In reply to Re: HOSPITALIZATION OR CARBAMAZEPINE?, posted by starlight on June 19, 2003, at 15:03:34
> Hi Tay,
> Verrrry interesting! Mowing the lawn at 3am eh? Sounds like you've been busy!
> You might ask your doc about Trileptal rather than tegretol which can be hard to take due to the side effects. Tegretol = carbamazapine, Trileptal = oxcarbamazapine. So the difference is Trileptal has an extra oxygen molecule stuck on it that miraculously negates the side effects that Tegretol comes with, plus no blood draws, whoo hoo! Just a suggestion.
> starlight
-------------------------------Hey Tay,
This was my thought exactly. Starlight beat me to the post.
Do your homework, Tay. There is a moodstabilizer out there somewhere that allows your creativity to survive (if not thrive) AND keeps your hypomania (mania) in check. Your job, with the help of your pdoc, is to find a medication (or medications) that work for you.
If you need help, give a yell.
-- Ron
Posted by nmk on June 19, 2003, at 18:41:41
In reply to HOSPITALIZATION OR CARBAMAZEPINE?, posted by Taylor123 on June 19, 2003, at 12:04:38
Just to put another plug in for Trileptal... I have been on it for awhile now and haven't experienced any side effects when titrating up SLOWLY. Initially, my pdoc had me jumping up too fast and I expereinced dizziness and extreme nausea. After backing down and working up 150 x 2 per day for approx. 5 days, I reached 1200 mg. Worked wonders for the depression but I was still cycling from anxiety/agitation to a hyponmanic state. I dropped the Strattera, am on a low dose of Zoloft, and so far, so good.
I hope this works for you and keep us posted.
Nicole
Posted by KimberlyDi on June 20, 2003, at 10:16:46
In reply to HOSPITALIZATION OR CARBAMAZEPINE?, posted by Taylor123 on June 19, 2003, at 12:04:38
Tay,
Wise decision. I keep smiling to think of you mowing the lawn at 3:00am. What do your neighbors think of you? I'm guessing that Dr KillJoy has good intentions. This feelgood time would probably be followed by a crash. I wish you luck with your new med.
Kim
Posted by KimberlyDi on June 20, 2003, at 10:26:20
In reply to HOSPITALIZATION OR CARBAMAZEPINE?, posted by Taylor123 on June 19, 2003, at 12:04:38
The brain is so interesting. Listening to Tay wanting to enjoy his mania, it's like his brain produces his own cocaine/meth. I guess it would be difficult to give up that feelgood time.
Kim
Posted by McPac on June 20, 2003, at 11:14:44
In reply to Re: HOSPITALIZATION OR CARBAMAZEPINE?, posted by nmk on June 19, 2003, at 18:41:41
Seems like different folks here like their trileptal.
Wondering if most people would prefer trileptal over lithium?
What would be the advantages of being on trileptal instead of lithium (less side effects?, stronger anti-depressant effect? is it very effective for anxiety, mood stabilization, etc.)? Would love to hear both pros and CONS too about trileptal! Ron, have you ever tried Trileptal or considered it? Thank you to all!!!
Posted by starlight on June 20, 2003, at 12:37:08
In reply to Lithium or Trileptal? HOSPITALIZATION OR , posted by McPac on June 20, 2003, at 11:14:44
I was terribly afraid of taking lithium - and did a lot of research. Doc tried me on Depakote, but I started gaining weight right away. LIked the feeling I got from it though. I'm a highly creative person, front person for a band, singer songwriter, so I didn't want any dulling of that aspect of my personality. Have a good friend who's a pdoc, and he suggested that plenty of alternatives were available and told me about a few. Then I did alot of research on my own - and convinced my pdoc (who's really more conservative) to go with me on this. He was hung up on the FDA approval - I told him I didn't give a damn about the FDA - as far as I'm concerned they're a big conspiracy anyway :0) so he agreed to give it a go and so far it's been great. I find it really interesting in that now that I'm more stable, I can look back and see my moods swinging like a monkey in a tree!
Good luck.I would like to hear the people who have positive things to say about lithium. Have they experienced weight gain? Any dulling of the personality? etc?
starlight
Posted by Ron Hill on June 20, 2003, at 12:54:13
In reply to Lithium or Trileptal? HOSPITALIZATION OR , posted by McPac on June 20, 2003, at 11:14:44
Pac Man,
> Ron, have you ever tried Trileptal or considered it? Thank you to all!!!
I've never taken it, but in the past I have seriously considered it as an add-on to my low dose of Lithobid (600 mg/day, 0.4 mEq/l blood level). But now that my brainchemistry is squared away (at least for now) using Lithobid and nutritional supplements, I'm not currently seeking anything to add-on.
-- Ron
Posted by starlight on June 20, 2003, at 13:23:22
In reply to Re: Trileptal? » McPac, posted by Ron Hill on June 20, 2003, at 12:54:13
What is the difference between lithobid and lithium?
starlight
Posted by nmk on June 20, 2003, at 13:31:10
In reply to Re: Lithium or Trileptal? HOSPITALIZATION OR , posted by starlight on June 20, 2003, at 12:37:08
> I was terribly afraid of taking lithium - and did a lot of research. Doc tried me on Depakote, but I started gaining weight right away. LIked the feeling I got from it though. I'm a highly creative person, front person for a band, singer songwriter, so I didn't want any dulling of that aspect of my personality. Have a good friend who's a pdoc, and he suggested that plenty of alternatives were available and told me about a few. Then I did alot of research on my own - and convinced my pdoc (who's really more conservative) to go with me on this. He was hung up on the FDA approval - I told him I didn't give a damn about the FDA - as far as I'm concerned they're a big conspiracy anyway :0) so he agreed to give it a go and so far it's been great. I find it really interesting in that now that I'm more stable, I can look back and see my moods swinging like a monkey in a tree!
> Good luck.
>
> I would like to hear the people who have positive things to say about lithium. Have they experienced weight gain? Any dulling of the personality? etc?
> starlight
Hey Starlight,I am a Trileptal user also and I was wondering what dosage you are taking? Also, what other meds do you take with it? If you suffer from anxiety, is the trileptal taking care of it or do you take an anti-anxiety med?
Thanks in advance!
Nicole :)
Posted by nmk on June 20, 2003, at 14:26:46
In reply to Re: Lithium or Trileptal? HOSPITALIZATION OR , posted by nmk on June 20, 2003, at 13:31:10
> > I was terribly afraid of taking lithium - and did a lot of research. Doc tried me on Depakote, but I started gaining weight right away. LIked the feeling I got from it though. I'm a highly creative person, front person for a band, singer songwriter, so I didn't want any dulling of that aspect of my personality. Have a good friend who's a pdoc, and he suggested that plenty of alternatives were available and told me about a few. Then I did alot of research on my own - and convinced my pdoc (who's really more conservative) to go with me on this. He was hung up on the FDA approval - I told him I didn't give a damn about the FDA - as far as I'm concerned they're a big conspiracy anyway :0) so he agreed to give it a go and so far it's been great. I find it really interesting in that now that I'm more stable, I can look back and see my moods swinging like a monkey in a tree!
> > Good luck.
> >
> > I would like to hear the people who have positive things to say about lithium. Have they experienced weight gain? Any dulling of the personality? etc?
> > starlight
>
>
> Hey Starlight,
>
> I am a Trileptal user also and I was wondering what dosage you are taking? Also, what other meds do you take with it? If you suffer from anxiety, is the trileptal taking care of it or do you take an anti-anxiety med?
>
> Thanks in advance!
>
> NicoleSorry for the double post, I forgot to direct it to you.
>
Posted by Taylor123 on June 20, 2003, at 17:03:48
In reply to Re: HOSPITALIZATION OR CARBAMAZEPINE? » Taylor123, posted by KimberlyDi on June 20, 2003, at 10:16:46
Hey all!
THANK YOU
Thanx for the feedback, it is sincerely appreciated. A few warning bells were given by some seriously awesome people and that spured me on to attend my p'doc.
I am now in a Zyprexa haze. But up and down.Seemingly, my activities over the past week or so, have bought a smile to some of your faces! I thought I might just fill in the blanks about me mowing the lawn at 3:00am
I had a problem: it was pitch black and I couldn't see a thing... so I made a wonderful contraption, which consisted of a mag light torch, ducktape and my old baseball cap from when I was at school!!! I think I'll call it my manic hat! Except I wore it untill the next morning, because my long, blonde hair was all stuck to the ducktape and I couldn't pull it off!!!
Crazy gal!Research is tyring on a full dose of Zyprexa, but I have lookied into oxcarbazapine and seemingly it looks better than carbamazapine. I have an appointment with the P.doc Monday and will ask him if he can prescribe that for me instead.
One thing though: the S/e profile states "deppression." has anyone crashed down to the dark depths of hell after starting it? I'm worried that it will happen to me.
U guys have been awesome help, do you have any other mood stabilizer to recommend before I go see the P.doc?Take care guys you're all fantastic...
Tay
P.S Maybe I should patent my "night-time-mowing" hat and make a bit of money!?!
Posted by Ed O`Flaherty on June 20, 2003, at 17:09:21
In reply to HOSPITALIZATION OR CARBAMAZEPINE?, posted by Taylor123 on June 19, 2003, at 12:04:38
Tegretol is a very useful mood stabiliser.About 5 years ago a new patient with BP who had spent almost 6 months in hosptal every years for 17 years came my way.Lithium did not work for her depression-mania was rare.Since I put her on tegretol she has remained well-I have left her on lithium too.I had one other good result where tegretol alone is controlling a patient who had over 20 admissions while on lithium and who has not had any episode for about 7 years.Adding omega-3 fish oil with a dose of 3-5g per day may help too.Overall over 40% of BP patients would be on 2 mood stabilisers.Sodium valproate would be another one but other anti-epileptic drugs are being widely used now and antipsychotics like olanzapine and risperidone are being used more too,often long after a manic episode is over.
Posted by Taylor123 on June 20, 2003, at 18:16:02
In reply to Re: HOSPITALIZATION OR CARBAMAZEPINE?, posted by Ed O`Flaherty on June 20, 2003, at 17:09:21
>Thank you very much for taking the time to reply to my post!
I have been on Li+ successfuly for over a year, but went off it (against the advice of my p.doc) as I felt it really inhibited my creativity and dulled my thoughts. (perhaps my blood levels were too high? (my last one was 1.2mmol/L - as you know, top of the theraputic range)I am glad to hear case evidence that Tegretol has worked for your patients, but am anxious of the side-effects. I need to be on a mood stabilizer, as I don't want to be on olanzapine much longer, as I'm worried about the weight gain (which it has definatly given me in the past.) I've been on Seroquel (Quetiapine)in the past which didn't cause weight gain so much. But my p.doc said that Olanzapine was the best choice since I have been "very unwell."
I was wondering what the mode of action of Omega-3 fish oil is? My p.doc hasn't talked about that at all, and a fair few of the posters here have talked about it.
My MIMS says that Carbamazipine shouldn't be taken concomitantly with Li+, as it may induce toxicity; even when Li+ is within the normal range. My p.doc was trying to convince me to go back on the Li+ on a low dose and add the Tegretol. Could this be dangerous?
My other choice, that you mentioned was Na Valproate: Na Vaproate worries me because of the weight gain. Is it common?Feeling like the crash landing is imminent, and feel like upping my Effexor and stopping the Olanzapine now.
Thanx for any feedback...
I'm much more interesting when I'm flying high.Take care
Tay
Posted by starlight on June 20, 2003, at 19:46:50
In reply to Re: Lithium or Trileptal? HOSPITALIZATION OR , posted by nmk on June 20, 2003, at 13:31:10
I think I take 1200 a day. 6 in the am and 6 at night. (I think = I take three yellow pills in the am and at night, but don't recall 100% what the mgs are?). Then I take 100 of lamictal day and night, so 200 a day.
So far the lamictal seems to address the anxiety. I do have anxiety, which is why I think I liked depakote so much when I first tried it, it made me calmer. But the lamictal seems to be doing a good job of that so far.
starlight
Posted by starlight on June 20, 2003, at 19:50:28
In reply to Re: HOSPITALIZATION OR CARBAMAZEPINE?, posted by Ed O`Flaherty on June 20, 2003, at 17:09:21
Why does the fish oil work?
I did not find that trileptal made me more depressed, but it couldn't fully lift my depression either. I have mixed episodes, can be energetic and have suicidal ideation at the same time. - Scary! The lamictal seems to do a better job at keeping the depression at bay.
starlight
Posted by McPac on June 20, 2003, at 23:28:44
In reply to Re: Lithium or Trileptal? HOSPITALIZATION OR , posted by starlight on June 20, 2003, at 19:46:50
"I do have anxiety, which is why I think I liked depakote so much when I first tried it, it made me calmer."
>>>>>>>>Does the trileptal help for your anxiety?p.s. low-dose lithium works very well for me.
Posted by McPac on June 20, 2003, at 23:32:25
In reply to Re: HOSPITALIZATION OR CARBAMAZEPINE?, posted by starlight on June 20, 2003, at 19:50:28
Still wondering how good Trileptal is for most folks' anxiety and if it has significant anti-depressant properties? THANKS to you ALL for your responses!!!
Posted by Ritch on June 21, 2003, at 0:09:34
In reply to Re: HOSPITALIZATION avoided!, posted by Taylor123 on June 20, 2003, at 17:03:48
> Hey all!
> THANK YOU
> Thanx for the feedback, it is sincerely appreciated. A few warning bells were given by some seriously awesome people and that spured me on to attend my p'doc.
> I am now in a Zyprexa haze. But up and down.
>
> Seemingly, my activities over the past week or so, have bought a smile to some of your faces! I thought I might just fill in the blanks about me mowing the lawn at 3:00am
> I had a problem: it was pitch black and I couldn't see a thing... so I made a wonderful contraption, which consisted of a mag light torch, ducktape and my old baseball cap from when I was at school!!! I think I'll call it my manic hat! Except I wore it untill the next morning, because my long, blonde hair was all stuck to the ducktape and I couldn't pull it off!!!
> Crazy gal!
>
> Research is tyring on a full dose of Zyprexa, but I have lookied into oxcarbazapine and seemingly it looks better than carbamazapine. I have an appointment with the P.doc Monday and will ask him if he can prescribe that for me instead.
> One thing though: the S/e profile states "deppression." has anyone crashed down to the dark depths of hell after starting it? I'm worried that it will happen to me.
> U guys have been awesome help, do you have any other mood stabilizer to recommend before I go see the P.doc?
>
> Take care guys you're all fantastic...
> Tay
> P.S Maybe I should patent my "night-time-mowing" hat and make a bit of money!?!
Ah-haa! I knew duct tape was involved...Hey, I've tried several anticonvulsants and thus far Trileptal had more antidepressant effects than the others (even Tegretol). Have't tried Lamictal though. But.. you need something to set you down without bringing you down. Let us know how your pdoc appt. goes.
Posted by Ron Hill on June 21, 2003, at 12:31:43
In reply to Re: Trileptal?, posted by starlight on June 20, 2003, at 13:23:22
Starlight,
> What is the difference between lithobid and lithium?
Lithobid is the brand name of a slow-release lithium carbonate prescription medication.-- Ron
Posted by Ron Hill on June 21, 2003, at 13:49:08
In reply to Re: HOSPITALIZATION OR CARBAMAZEPINE? » Ed O`Flaherty, posted by Taylor123 on June 20, 2003, at 18:16:02
Tay,
> I was wondering what the mode of action of Omega-3 fish oil is? My p.doc hasn't talked about that at all, and a fair few of the posters here have talked about it.
On the contrary, Lawn-mower-girl. Omega-3 fatty acids have been discussed extensively on this board. Use the google search function to find some of the posts.
Good fish oil is soothing to my brain. It's a good moodstabilizer and perhaps provides me a slight AD benefit. The good stuff is expensive, however. I currently take four teaspoons per day of Carlson's Fish Oil which gives me about 3.2 g/day of EPA, 2.0 g of DHA, and 1.2 g/day of other omega-3 fatty acids.
I'd like to increase the amount I take but, as I said, it's expensive. The retail price for my current dosage of fish oil is $60 per month. As an aside, I think there's something fishy about the price of fish oil, but that's a tune I'll play on a later date.
Tay, you have a lot of homework to do regarding your rx, and I encourage you to put fish oil on your list of items to research. Use your search engine, skip over the sites trying to sell the stuff, and find the research on the subject. Andrew Stoll, M.D. has conducted a lot of the early research regarding omega-3 fatty acids as an adjunct treatment for bipolar disorder. Here is a link to his book:
http://www.omegabrite.com/omcon.htm
Or if you prefer, “”The Omega-3 Connection”” is on Amazon.
Here are a few abstracts of papers on the topic by Dr. Stoll:
> I'm much more interesting when I'm flying high.Level is better. Plus your neighbors need their rest, Lawn-mower-girl.
-- Ron
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