![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by stresser on January 25, 2005, at 14:48:17
The psychiatrist just took my daughter off topamax and welbutrin, and put her on Trileptal and zoloft. She is taking 75mg of Trileptal at night, and 25mg of Zoloft in the morning. I have read some of the previous posts about Trileptal and know it can be sedating, but that's about all. Does it cause weight gain, or any congnative problems? I would like to hear from any of you that have taken it. Thanks.-L
Posted by Minnie-Haha on January 25, 2005, at 18:14:00
In reply to Trileptal and Zoloft for Bipolar II, posted by stresser on January 25, 2005, at 14:48:17
I've found Trileptal to be pretty clean. (I take 150mg am and pm.) It is especially effective, I think, in controlling the manic side. I wish it were a little better on depression -- like Lamictal, which I seem to be allergic to.
Posted by Maxime on January 25, 2005, at 19:21:12
In reply to Re: Trileptal and Zoloft for Bipolar II, posted by Minnie-Haha on January 25, 2005, at 18:14:00
Trileptal is weight neutral. The sedation will go away with time (it did with me). It is probably the medication with the least amount of side effects that I have ever taken. I hope it works well for your daughter. It's tamed my manic side and those mixed states where I become so irritable that I am almost in a rage. Those are gone now.
Maxime
Posted by Ritch on January 26, 2005, at 0:05:35
In reply to Trileptal and Zoloft for Bipolar II, posted by stresser on January 25, 2005, at 14:48:17
> The psychiatrist just took my daughter off topamax and welbutrin, and put her on Trileptal and zoloft. She is taking 75mg of Trileptal at night, and 25mg of Zoloft in the morning. I have read some of the previous posts about Trileptal and know it can be sedating, but that's about all. Does it cause weight gain, or any congnative problems? I would like to hear from any of you that have taken it. Thanks.-L
I never gained any weight on Trileptal. Whenever I was taking 75-150mg doses in the daytime (150mg-300mg total per day) I noticed some cognitive sfx, but they weren't really bad. No worse than taking Neurontin or Depakote in the middle of the day. What I think would be nice to see from the Trileptal people is a high-tech 300mg, 600mg, and 1200mg XR pill that you can take once every 24hrs at bedtime.... There hasn't been one mood stabilizer that I've taken in the daytime that didn't make me a little cognitively flattened. I think a lot of that is peak blood levels occuring so rapidly during daytime hours. I was nauseated excessively from taking it, and that's why I'm not on it now.
Posted by stresser on January 26, 2005, at 6:51:11
In reply to Re: Trileptal and Zoloft for Bipolar II » stresser, posted by Ritch on January 26, 2005, at 0:05:35
Is that really common? Were you so much that you couldn't work through it?-L
Posted by Ritch on January 26, 2005, at 9:05:42
In reply to Re: Trileptal and Zoloft for Bipolar II » Ritch, posted by stresser on January 26, 2005, at 6:51:11
> Is that really common? Were you so much that you couldn't work through it?-L
I get nauseated easily from a variety of meds. Weirdly enough, Depakote doesn't make me nauseous. If I took a higher dose I probably would though (above 500mg/day). It is possible I could have stayed at a very low dose of Trileptal and waited a couple of months to see if it would fade and then increase it a tad more, but the nausea didn't seem to fade after a month of being on 225mg/day (the max I could tolerate). I also got the worst blurred vision on it, street signs were getting tough to read. Daytime dosing really zonked my cognition at times.. I could be in a meeting where people were discussing complicated issues and just get lost.. HUH? WHAT? I'd rather just take all my Depakote in the evening/bedtime and let the blood level fade down while I'm trying to work the next day.
Posted by stresser on January 26, 2005, at 14:16:58
In reply to Re: Trileptal and Zoloft for Bipolar II » stresser, posted by Ritch on January 26, 2005, at 9:05:42
Thanks for the infomation. I am hoping this works for her, because she really needs the mood stablizer. Have you take an MMPI before? She took one, and deffinatly came out bipolar. The doctor said she has a lot of deep anger and is a very unsettled girl. We are crossing our fingers with this medication, and I hope it starts to work farily soon. Do you know how quickly it will start working?-L
Posted by Ritch on January 27, 2005, at 1:20:45
In reply to Re: Trileptal and Zoloft for Bipolar II, posted by stresser on January 26, 2005, at 14:16:58
> Thanks for the infomation. I am hoping this works for her, because she really needs the mood stablizer. Have you take an MMPI before? She took one, and deffinatly came out bipolar. The doctor said she has a lot of deep anger and is a very unsettled girl. We are crossing our fingers with this medication, and I hope it starts to work farily soon. Do you know how quickly it will start working?-L
MMPI? Oh yes, about twenty-five years ago.. definitely bipolar. I remember the question about whether I wanted to be a race-car driver. YES. I was *already* doing some serious road racing at that time. Deep anger, very unsettled.. sounds pretty familiar. Trileptal wasn't as "quick" as Depakote or antipsychotics (Thorazine or Mellaril) to bring down my energy level (generally). But Trileptal was superior in the actual impulse control effectiveness relating to the anger issues. Depakote is like shutting down the energy valve (for me) that fuels the anger, whereas Trileptal seemed to be better at foiling the hair triggers on the mouse traps when you throw the ping pong balls in. Different dynamics. Everybody's different. I hope your daughter responds well to the Trileptal. All I can say is watch out for the antidepressants. Zoloft was fairly activating for me, no major temper spells that I can recall attributable to it.
Posted by stresser on January 27, 2005, at 12:12:49
In reply to Re: Trileptal and Zoloft for Bipolar II » stresser, posted by Ritch on January 27, 2005, at 1:20:45
I remember that question also, because I took the test two weeks ago. ( I have anxiety, guess why?) I can bet anything she put "yes", for the race car drive question also. I do know she has incredible road rage. Are you still on medication? Do you still have those symptoms or are they under control now? Your help has been greatly appreciated, thank you so much. -L
Posted by Ritch on January 27, 2005, at 13:32:40
In reply to Re: Trileptal and Zoloft for Bipolar II, posted by stresser on January 27, 2005, at 12:12:49
> I remember that question also, because I took the test two weeks ago. ( I have anxiety, guess why?) I can bet anything she put "yes", for the race car drive question also. I do know she has incredible road rage. Are you still on medication? Do you still have those symptoms or are they under control now? Your help has been greatly appreciated, thank you so much. -L
You are welcome. Medication? I've long accepted the fact that I will be on meds for bipolar indefinitely. There might be different ones, combos, dosages, etc., but I just don't see any future without them. Maybe a non-invasive treatment? New tech rTMS or VNS? I sort of 'drifted' off of meds in the past once with disastrous results. Wasted about five years of my life by going off of meds for one-two years. I'm pretty stable now, but pdoc and I are still fine-tuning things. I'm taking Depakote+clonazepam+gabapentin right now along with a very tiny amt. of Celexa for anxiety and an occasional tiny bit of Stratterra for the lows. Interestingly, I had a pdoc appt. today and got a full metabolic panel, CBC, etc. and I'm to stop the gabapentin (pdoc just doesn't like the way it seems to trigger a relatively benign, but clear hypomania for me), wait a day or two and start just 75mg of Trileptal at bedtime to see if I can get better sleep (that the gabapentin provided) but better mood stability at a low dose without the nausea I got from it previously. If that doesn't help enough with sleep after a couple of weeks, then I'm to increase to 150mg at bedtime. If it appears to work well at that low dosage for sleeping, then we will consider reducing the Depakote from 375>250 and see if I am less tired and hungry with that mix. Whether I get nauseated or not from the Trileptal we are going to re-check electrolytes (esp. sodium)in a couple of months and compare to baseline. We'll see. Whoa, that was a lot of verbiage there, sorry! I have definitely been a little high the last three weeks ::)
Posted by stresser on January 27, 2005, at 15:33:58
In reply to Re: Trileptal and Zoloft for Bipolar II » stresser, posted by Ritch on January 27, 2005, at 13:32:40
What is making you hungry?
Posted by Ritch on January 27, 2005, at 23:42:43
In reply to Re: Trileptal and Zoloft for Bipolar II » Ritch, posted by stresser on January 27, 2005, at 15:33:58
> What is making you hungry?
Depakote. Trouble feeling that I'm full and don't need to continue eating. Remeron was much worse, but Depakote is the 2nd worst for me of all the meds I've taken. It takes a lot of will power and a careful scrupulous diet with Dep. to not gain weight on it.
Posted by Minnie-Haha on January 28, 2005, at 10:26:33
In reply to Re: Trileptal and Zoloft for Bipolar II » stresser, posted by Ritch on January 27, 2005, at 23:42:43
I gained weight on Depakote, but not on Trileptal. I wasn't on Lamictal long enough to know how it was gonna effect me long-term, but it was more activating/energizing and didn't seem to increase my appetite. The Depakote seemed to increase my appetite a little, but mostly I felt like my metabolism changed. I'm a middle-aged woman, and I also started having menstrual problems (long, heavy bleeding) on Depakote that has since resolved with an outpatient procedure and dropping the Depakote.
Posted by stresser on January 28, 2005, at 12:35:57
In reply to Re: Trileptal and Zoloft for Bipolar II, posted by Minnie-Haha on January 28, 2005, at 10:26:33
Why must you take the Depakote? Does it do the same thing that the Trileptal does? Also, how long will it take for the Trileptal to start working?-L
Posted by stresser on January 28, 2005, at 13:03:36
In reply to Re: Trileptal and Zoloft for Bipolar II, posted by stresser on January 28, 2005, at 12:35:57
I forgot to add this in my last post....my daughter's grades have been falling in the past year, but her MMPI said she is not ADD or ADHD. The Pdoc won't give her adderall or anything like that to help her concentrate, will the trileptal help her with being motivated to work harder in school? She has gone from being an achiever to someone who really doesn't care much. She's very bright, and throwing her chance at college away at the moment. She's never had to work hard for much, and now things aren't coming very easily for her, so it's a new game. She doesn't know how to play it at all....and we cannot get through to her. Her pdoc said she was a 4/9 on the MMPI. Do you understand anything about the scoring? He told me a little about that.-L
Posted by Minnie-Haha on January 28, 2005, at 13:27:50
In reply to Re: Trileptal and Zoloft for Bipolar II, posted by stresser on January 28, 2005, at 12:35:57
> Why must you take the Depakote? Does it do the same thing that the Trileptal does? Also, how long will it take for the Trileptal to start working?-L
Depakote was my first mood stabilizer, after my DX was changed from depression to Bipolar Type 2. I got off of it after a couple of years because of the weight gain.
The Trileptal took a couple of weeks to become effective for me.
Posted by Minnie-Haha on January 28, 2005, at 13:37:08
In reply to Re: Trileptal and Zoloft for Bipolar II, posted by stresser on January 28, 2005, at 13:03:36
> I forgot to add this in my last post....my daughter's grades have been falling in the past year, but her MMPI said she is not ADD or ADHD. The Pdoc won't give her adderall or anything like that to help her concentrate, will the trileptal help her with being motivated to work harder in school? She has gone from being an achiever to someone who really doesn't care much. She's very bright, and throwing her chance at college away at the moment. She's never had to work hard for much, and now things aren't coming very easily for her, so it's a new game. She doesn't know how to play it at all....and we cannot get through to her. Her pdoc said she was a 4/9 on the MMPI. Do you understand anything about the scoring? He told me a little about that.-L
No, I don't understand about the scoring, but I have a grown son who is very bright and dropped out of high school just months before graduating. My other son has been identified as gifted and he is doing OK academically so far, but he starts middle school next year and I am a little worried about him. He has an IEP (Individualized Education Plan) for a Speech-Language Impairment for pragmatics (basically, the social use of language) and he struggles a bit with writing assignments, too, though we've been working hard on that and it's improving. He ALMOST seems like an Asperger's Syndrome kid, but he doesn't quite fit... probably somewhere on the spectrum.
Do you mind if I ask some questions? How old is your daughter? When did her problems begin? What kinds of evaluations has she had done? By what kinds of professionals?
Dr Bob will probably move this to the Social board or ??? but wherever this thread goes, I'd like to communicate with you for a while and see if I can help you. I've researched this stuff a lot in the last 2 years and maybe I'll have some insights for you that you haven't had.
Posted by stresser on January 28, 2005, at 15:08:32
In reply to Re: Trileptal and Zoloft for Bipolar II, posted by Minnie-Haha on January 28, 2005, at 13:37:08
That sounds wonderful, feel free to babble me, and I can give you my e-mail if you like. This started when she was in 9th grade, and has been going on for two years. She has been on anti-depressants since the end of 9th grade, and they helped with depression. Started with Lexapro, Paxil, Wellbutrin, Effexor, etc. She has just found a new Neuopsychologist and psychiatrist that are really great. It took us three tries before we found them, thanks to a good friend. She has only been with them for a couple of months and just took the MMPI two weeks ago. I sat in his office on Wed. and he told me everything about her, what type person she is, how she reacts to things, etc. and had her down to a science. I was amazed. He described her like he had lived with her for 16 years. She is 16, and will be 17 in April. I hope this information can help. Thanks for being interested and for your help, I will look forward to hearing from you. -L
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.