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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by BRC on July 24, 2004, at 10:58:40
Hi, I have been taking Lexapro 40mg, Remeron 30mg, and Klonopin 4mg for the past two years for major depression, generalized anxiety, and OCD. My pdoc. just upped my Lexapro to 60mg and. My family doctor put me on the cholesterol lowering medication Tricor for elevated cholesterol and triglycerides. Now my neurologist this week added Trileptal 600mg for nerve damage to my spine and lower leg.
I found that when adding the Trileptal I began to feel so much better. For the first time in over 4 years I went out with my friends last night. Previously I was housebound because of my anxiety and depression. When I went out I actually had a "great time". I laughed was able to go out to eat, went to bowl, and thourly enjoyed myself. Before I knew it was 2 a.m. in the morning.
I was just wondering was the medication was working or was I just "drugged" up because of all of the medication. The only side effects I experienced was a little feeling of nausea.
I am also concerned that if I continue taking this much medication it will do damage to my body. For instance are the liver and other organs at risk for damage. I am a 28 year old male and weigh approx. 160-165lbs and am otherwise in good health. I am just weary of all the different medication I am on. My room looks like a pharmacy with all of the prescription bottles. My doctors are all aware of the medications I am taking, but I am not sure they know how each medication reacts with one another.
Any comments or suggestions would greatly be appreciated. I wanted to ask people that actually have to take these medications and are familiar with how they work. Thanks
BRC
Posted by chemist on July 24, 2004, at 18:01:22
In reply to Help!! Worried about taking so much medication., posted by BRC on July 24, 2004, at 10:58:40
hello there, chemist here...i can comment on trileptal, as i took the same dose you did a while back and it was when i was diagnosed bipolar I/II. i am about 7 years older than you, male, and also the same weight. that does not mean our biochemistry is the same, but your reaction to trileptal is almost identical to what was mine. assuming that your increased energy/lessened anxiety is attributable to trileptal alone, is worthwhile noting that this medication is prescribed off-label for mood disorders. you have remeron and klonopin on board, which might have been keeping you on the down side. again, maybe the upping of lexapro broke the dam, so to speak. as for long-term use of trileptal, it is quite safe, the caveat being to watch your sodium levels, as there is a significant (small) chance that sodium levels drop (resulting in hyponatremia), which is not good. as for your liver function, trileptal is metabolized by aryl ketone reductase, is not auto-inducing, and does not go the way of tegretol (via CYP450 enzymes), thus the intermediate (an epoxide, which is bad for your liver) is not encountered on the way to the active metabolite, the so-called monohydroxide derivative. nonetheless, i would suggest getting a blood test at the outset - the full panel, mind you - and check in 6 months or so, assuming no untoward effects. the nausea you describe is common and transient. finally, because you are seeking to reduce the numer of meds you take, you might discuss lowering or eliminating lexapro or remeron with your doctor. i would also suggest posting a thread for Sad Panda, SLS, or King Vultan, as they (in my opinion) can offer more information about lexapro and remeron that i can. also, you might post for Larry Hoover in re: interactions with the cholesterol med. as for klonopin, i am a fan of benzodiazepines and derivatives, and see no reason to drop it as it will keep your anxiety at bay, although the day may come when you are comfortable in reducing it as well. all the best, chemist
> Hi, I have been taking Lexapro 40mg, Remeron 30mg, and Klonopin 4mg for the past two years for major depression, generalized anxiety, and OCD. My pdoc. just upped my Lexapro to 60mg and. My family doctor put me on the cholesterol lowering medication Tricor for elevated cholesterol and triglycerides. Now my neurologist this week added Trileptal 600mg for nerve damage to my spine and lower leg.
>
> I found that when adding the Trileptal I began to feel so much better. For the first time in over 4 years I went out with my friends last night. Previously I was housebound because of my anxiety and depression. When I went out I actually had a "great time". I laughed was able to go out to eat, went to bowl, and thourly enjoyed myself. Before I knew it was 2 a.m. in the morning.
>
> I was just wondering was the medication was working or was I just "drugged" up because of all of the medication. The only side effects I experienced was a little feeling of nausea.
>
> I am also concerned that if I continue taking this much medication it will do damage to my body. For instance are the liver and other organs at risk for damage. I am a 28 year old male and weigh approx. 160-165lbs and am otherwise in good health. I am just weary of all the different medication I am on. My room looks like a pharmacy with all of the prescription bottles. My doctors are all aware of the medications I am taking, but I am not sure they know how each medication reacts with one another.
>
> Any comments or suggestions would greatly be appreciated. I wanted to ask people that actually have to take these medications and are familiar with how they work. Thanks
>
> BRC
Posted by SLS on July 24, 2004, at 19:55:56
In reply to Re: Help!! Worried about taking so much medication. » BRC, posted by chemist on July 24, 2004, at 18:01:22
> i can comment on trileptal, as i took the same dose you did a while back and it was when i was diagnosed bipolar I/II.
> but your reaction to trileptal is almost identical to what was mine. assuming that your increased energy/lessened anxiety is attributable to trileptal alone, is worthwhile noting that this medication is prescribed off-label for mood disorders.
Hi Chemist.A few questions, if you don't mind...
Do you still consider yourself to be bipolar? How does your illness present? If Trileptal helped, why are you still not taking it? Do you think Trileptal can exert antidepressant effects in bipolar disorder?
Thanks.
I am not too happy with Zonegran at this point. It is producing too much fatigue. It was my hope that it would punch a hole through my bipolar depression. I guess it is still early, though - 24 days. Maybe the fatigue will dissipate and the depression will lift and I will live happily ever after...
- Scott
Posted by chemist on July 24, 2004, at 23:22:59
In reply to Re: Help!! Worried about taking so much medication. » chemist, posted by SLS on July 24, 2004, at 19:55:56
> > i can comment on trileptal, as i took the same dose you did a while back and it was when i was diagnosed bipolar I/II.
>
> > but your reaction to trileptal is almost identical to what was mine. assuming that your increased energy/lessened anxiety is attributable to trileptal alone, is worthwhile noting that this medication is prescribed off-label for mood disorders.
>
>
> Hi Chemist.
>
> A few questions, if you don't mind...
>
> Do you still consider yourself to be bipolar? How does your illness present? If Trileptal helped, why are you still not taking it? Do you think Trileptal can exert antidepressant effects in bipolar disorder?
>
> Thanks.
>
> I am not too happy with Zonegran at this point. It is producing too much fatigue. It was my hope that it would punch a hole through my bipolar depression. I guess it is still early, though - 24 days. Maybe the fatigue will dissipate and the depression will lift and I will live happily ever after...
>
>
>
> - Scotthey scott...i was diagnosed bipolar by a psychiatrist who is a specialist in bipolar disorder, and is a faculty member at a medical school. i was diagnosed with GAD/panic attacks with agoraphobia and depression/OCD by a psychiatrist whom i first sought, years ago. there is a theme here. i am back with my very first psych - the OCD one - and he is currently trying to determine if there is a mood disorder or not. all signs point to mild to moderate unipolar depression and anxiety. we (he, my therapist, and i) have mutually agreed not to even try to label what is wrong: i like this approach in that we are back to therapy and psychiatry to being geared towards treating the patient, not the symptoms. now, to answer your questions: i do not consider myself bipolar, yet i see signs of hypomania and depression, as does my doc/T. this may or may not be the case, as trileptal helped during the period of time that i was being treated as a bipolar patient. i stopped taking it due to a change in life's circumstances that resulted in my being reunited with my first pdoc who made the very salient observation that ``you went to a psychiatrist whose specialty is bipolar illness (Steven Dubovsky: i urge you to look him up on pubmed), spent an hour with him, and were diagnosed as bipolar.'' this was, shall we say, an eye-opener for me. the write-up (sent to my regular pdoc) notes that my speech was pressured, that i have done some questionable things that could be considered self-destructive (things like shoplifting a record when i was 12 years old or being verbally aggresive, qualities that are not true markers for bipolar, maybe being a kid and a loudmouth?), and has recently moved (geographically). depakote was a flop, trileptal + dexedrine + valium was a winner. then, another move, and back to luvox + dexedrine + xanax. in between, the list is endless. trileptal helped quite a bit when i was in the sway of bipolar: luvox helped many years ago, and is doing the job now. what i am trying to state is that i have probably been responsive to treatments that addressed problems that i felt/feel are evident. i am not immune to the placebo effect. trileptal worked for me when i was certain that trileptal worked for me. parnate is another drug i am very much in favor of, having taken that before the bipolar dx. i know this answer is leaving a lot of doors open, but that is the story. my read on my condition is that i am naturally (truly) on the hypomanic side, prone to depression that is not debilitating, and for certain an anxious person with a history of panic attacks. the dexedrine was and is supplied for putative add/adhd, and the current team agrees that it helps but the fact that i do not take it every day or in the maximum dose brings into question the add/adhd dx. that said, i can wash down 30 mg of dexedrine over the course of a day with 2 cups of coffee and still get 8 hours of sleep. go figure. in the end, my winning combos have been: trileptal/dexedrine/valium, parnate/ativan/ambien, and luvox/dexedrine/xanax, and the last one in the list is the one i am on now and differs from my first course of treatment by the addition of dexedrine prn. do let me know if any of this is of help or if i failed to address anything in your post......all the best, chemist
Posted by Lex Luthor on July 24, 2004, at 23:33:31
In reply to Re: Help!! Worried about taking so much medication. » chemist, posted by SLS on July 24, 2004, at 19:55:56
Hiya, there! First, Trileptal is a great medication with people with both depression and OCD like me. It also works for people with bipolar. For me, takind antidepressants alone doesn't help at all. Furthermore, it worsens the problem. I need an antidepressant and an antiepileptic like Trileptal. Trileptal is the best out there because it doesn't affect the way the antidepressants are metabolized. You should continue taking it. It doesn't affect the liver at all.
The next thing you have to do is to get rid of at least two of the antidepressants you're taking and stay with one. Too many antidepressants will make you anxious and irritable. Remeron in particular incredibly irritating for me, and it worsens OCD. I think you should change your doctor. He sounds like a low quality intoxicator. Let me tell you this: most of the best psychiatrists out there are the ones who charge the less. You should find one that makes you stay with only an antiepileptic and ONE antidepressant. SSRI'S are the best ones for OCD. I have tried many antedepressants (one at a time) to discover which one is best for me (because of the sexual side effects and all), and my experience tells me that Lexapro is crap. It is just not a good antidepressant. Oddly enough, Celexa does work for me, although Lexapro is suppossed to be a better version of Celexa. I would recomend you to try Zoloft or Luvox (the later special for people with OCD) next.
Posted by TJO on July 25, 2004, at 6:09:43
In reply to Re: Help!! Worried about taking so much medication., posted by Lex Luthor on July 24, 2004, at 23:33:31
Hi Scott,
Perhaps the Zonegran will work for you-I hope it does!Tammy
Posted by BRC on July 25, 2004, at 15:00:04
In reply to Re: Help!! Worried about taking so much medication. » BRC, posted by chemist on July 24, 2004, at 18:01:22
Thanks for your response and your knowledgeable information. I am hoping that the Trileptal will continue to help serve dual functions; both treating my neurological pain and my anxiety.
My neurlogist did inform me about the possibility of a drop in sodium levels. He wants me to increase the dose gradually up to about 1,200mg a day if I can handle it.
As far as the Remeron I use it mainly for a sleep aid and am thinking about discontinue the use of it all together.
Thanks again for your response.
Posted by BRC on July 25, 2004, at 15:03:21
In reply to Re: Help!! Worried about taking so much medication., posted by Lex Luthor on July 24, 2004, at 23:33:31
Thanks ror your respose. I take the Lexapro and Remeron for my OCD and depression. Remeron really just makes me sleepy and I use it for a sleep aid. I will probably discontinue it. Thanks again for your response
Posted by chemist on July 25, 2004, at 15:07:17
In reply to Re: Help!! Worried about taking so much medication. » chemist, posted by BRC on July 25, 2004, at 15:00:04
This is the end of the thread.
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