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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by qbsbrown on August 7, 2009, at 16:35:15
I began taking tegretol the other week. It seemed to work really well for a couple of hours, then poop out. So logically thinking, I thought that the XR version would be much better.
Turns out to me, that the XR version turned out to act exactly like Trileptal did for me, some really strange and adverse effects (don't wanna go in to detail) that I didn't like.
But the tegretol xr is taken 2 times daily, as well as the trileptal.
So i guess my options are to take the tegretol 4 times a day, instead of 3, it works about 4 hours.
Or I could try the Tegretol XR 3 times daily.
Any recommendations/experiences?
Regards,
Brian
Posted by Phillipa on August 7, 2009, at 17:36:04
In reply to Tegretol VS Tegretol XR VS Trileptal, posted by qbsbrown on August 7, 2009, at 16:35:15
For me trileptal no side effects but I was only on 150mg a day. Phillipa
Posted by yxibow on August 7, 2009, at 23:09:42
In reply to Tegretol VS Tegretol XR VS Trileptal, posted by qbsbrown on August 7, 2009, at 16:35:15
> I began taking tegretol the other week. It seemed to work really well for a couple of hours, then poop out. So logically thinking, I thought that the XR version would be much better.
>
> Turns out to me, that the XR version turned out to act exactly like Trileptal did for me, some really strange and adverse effects (don't wanna go in to detail) that I didn't like.
>
> But the tegretol xr is taken 2 times daily, as well as the trileptal.
>
> So i guess my options are to take the tegretol 4 times a day, instead of 3, it works about 4 hours.
>
> Or I could try the Tegretol XR 3 times daily.
>
> Any recommendations/experiences?
>
Hmm.... Trileptal didn't do much for me, as I was going through the list of most of the AEDs, but its generally recommended as safer with a lot fewer potentially dangerous side effects.
So I can't say.. if the regular Tegretol didn't have these concerns for you (doctors usually prefer the more modern Trileptal I would imagine) then I would say just stick to the regular release.-- Jay
Posted by qbsbrown on August 10, 2009, at 16:23:09
In reply to Re: Tegretol VS Tegretol XR VS Trileptal » qbsbrown, posted by yxibow on August 7, 2009, at 23:09:42
> > I began taking tegretol the other week. It seemed to work really well for a couple of hours, then poop out. So logically thinking, I thought that the XR version would be much better.
> >
> > Turns out to me, that the XR version turned out to act exactly like Trileptal did for me, some really strange and adverse effects (don't wanna go in to detail) that I didn't like.
> >
> > But the tegretol xr is taken 2 times daily, as well as the trileptal.
> >
> > So i guess my options are to take the tegretol 4 times a day, instead of 3, it works about 4 hours.
> >
> > Or I could try the Tegretol XR 3 times daily.
> >
> > Any recommendations/experiences?
> >
>
>
> Hmm.... Trileptal didn't do much for me, as I was going through the list of most of the AEDs, but its generally recommended as safer with a lot fewer potentially dangerous side effects.
>
>
> So I can't say.. if the regular Tegretol didn't have these concerns for you (doctors usually prefer the more modern Trileptal I would imagine) then I would say just stick to the regular release.
>
> -- JayI was using it more or less to assist in benzo wd. I hope that I'm not on it very long to have the potentially bad side effects.
But you don't really see any clinical advantage to taking the regular or the XR?
Regards,
Brian
Posted by yxibow on August 11, 2009, at 5:51:02
In reply to Re: Tegretol VS Tegretol XR VS Trileptal, posted by qbsbrown on August 10, 2009, at 16:23:09
> > > I began taking tegretol the other week. It seemed to work really well for a couple of hours, then poop out. So logically thinking, I thought that the XR version would be much better.
> > >
> > > Turns out to me, that the XR version turned out to act exactly like Trileptal did for me, some really strange and adverse effects (don't wanna go in to detail) that I didn't like.
> > >
> > > But the tegretol xr is taken 2 times daily, as well as the trileptal.
> > >
> > > So i guess my options are to take the tegretol 4 times a day, instead of 3, it works about 4 hours.
> > >
> > > Or I could try the Tegretol XR 3 times daily.
> > >
> > > Any recommendations/experiences?
> > >
> >
> >
> > Hmm.... Trileptal didn't do much for me, as I was going through the list of most of the AEDs, but its generally recommended as safer with a lot fewer potentially dangerous side effects.
> >
> >
> > So I can't say.. if the regular Tegretol didn't have these concerns for you (doctors usually prefer the more modern Trileptal I would imagine) then I would say just stick to the regular release.
> >
> > -- Jay
>
> I was using it more or less to assist in benzo wd. I hope that I'm not on it very long to have the potentially bad side effects.
>
> But you don't really see any clinical advantage to taking the regular or the XR?
I don't know about clinical advantage, I can't say I'd advise tegretol over trileptal, but then it seems to work for you.But I'm confused...
"Turns out to me, that the XR version turned out to act exactly like Trileptal did for me, some really strange and adverse effects (don't wanna go in to detail) that I didn't like."
So why take the XR version of Tegretol if it had unpleasant effects... especially if they're unpleasant to the point of being strange and adverse ?Or am I missing something ?
Posted by qbsbrown on August 11, 2009, at 17:58:30
In reply to Re: Tegretol VS Tegretol XR VS Trileptal » qbsbrown, posted by yxibow on August 11, 2009, at 5:51:02
> > > > I began taking tegretol the other week. It seemed to work really well for a couple of hours, then poop out. So logically thinking, I thought that the XR version would be much better.
> > > >
> > > > Turns out to me, that the XR version turned out to act exactly like Trileptal did for me, some really strange and adverse effects (don't wanna go in to detail) that I didn't like.
> > > >
> > > > But the tegretol xr is taken 2 times daily, as well as the trileptal.
> > > >
> > > > So i guess my options are to take the tegretol 4 times a day, instead of 3, it works about 4 hours.
> > > >
> > > > Or I could try the Tegretol XR 3 times daily.
> > > >
> > > > Any recommendations/experiences?
> > > >
> > >
> > >
> > > Hmm.... Trileptal didn't do much for me, as I was going through the list of most of the AEDs, but its generally recommended as safer with a lot fewer potentially dangerous side effects.
> > >
> > >
> > > So I can't say.. if the regular Tegretol didn't have these concerns for you (doctors usually prefer the more modern Trileptal I would imagine) then I would say just stick to the regular release.
> > >
> > > -- Jay
> >
> > I was using it more or less to assist in benzo wd. I hope that I'm not on it very long to have the potentially bad side effects.
> >
> > But you don't really see any clinical advantage to taking the regular or the XR?
>
>
> I don't know about clinical advantage, I can't say I'd advise tegretol over trileptal, but then it seems to work for you.
>
> But I'm confused...
>
> "Turns out to me, that the XR version turned out to act exactly like Trileptal did for me, some really strange and adverse effects (don't wanna go in to detail) that I didn't like."
>
>
> So why take the XR version of Tegretol if it had unpleasant effects... especially if they're unpleasant to the point of being strange and adverse ?
>
> Or am I missing something ?Good question. I did only give the tegretol xr a 2-3 day trial, and it was causing some of the same probs as trileptal.
I would go w/ trileptal, but i've taken it many times, and my brian/body is actually rejecting it now, especially during benzo wd.
The trileptal would actually INDUCE rapid cycling in me, crazy stuff.
But the tegretol regular version, only lasts 4 hours, so i'd have to dose 5 times a day. That, or i could give the XR version a bigger trial, and take it 3 times a day instead of 2 times. I'm an extremely fast metabolizer.
Then again, i have strange and adverse effects from every psychotropic med, hence me wanting off all of them.
Regards,
Brian
Posted by yxibow on August 11, 2009, at 21:05:45
In reply to Re: Tegretol VS Tegretol XR VS Trileptal, posted by qbsbrown on August 11, 2009, at 17:58:30
I have adverse effects too... I am medication sensitive to -some- types of psychotropics, but I think its also a matter of benefits vs. risks and side effects and sticking out a trial for at least two weeks to a month or more to see if there is any benefit.
Its hard to qualify anything if you've only been on it a few days.
Posted by qbsbrown on August 11, 2009, at 21:51:55
In reply to Re: Tegretol VS Tegretol XR VS Trileptal, posted by qbsbrown on August 11, 2009, at 17:58:30
> > > > > I began taking tegretol the other week. It seemed to work really well for a couple of hours, then poop out. So logically thinking, I thought that the XR version would be much better.
> > > > >
> > > > > Turns out to me, that the XR version turned out to act exactly like Trileptal did for me, some really strange and adverse effects (don't wanna go in to detail) that I didn't like.
> > > > >
> > > > > But the tegretol xr is taken 2 times daily, as well as the trileptal.
> > > > >
> > > > > So i guess my options are to take the tegretol 4 times a day, instead of 3, it works about 4 hours.
> > > > >
> > > > > Or I could try the Tegretol XR 3 times daily.
> > > > >
> > > > > Any recommendations/experiences?
> > > > >
> > > >
> > > >
> > > > Hmm.... Trileptal didn't do much for me, as I was going through the list of most of the AEDs, but its generally recommended as safer with a lot fewer potentially dangerous side effects.
> > > >
> > > >
> > > > So I can't say.. if the regular Tegretol didn't have these concerns for you (doctors usually prefer the more modern Trileptal I would imagine) then I would say just stick to the regular release.
> > > >
> > > > -- Jay
> > >
> > > I was using it more or less to assist in benzo wd. I hope that I'm not on it very long to have the potentially bad side effects.
> > >
> > > But you don't really see any clinical advantage to taking the regular or the XR?
> >
> >
> > I don't know about clinical advantage, I can't say I'd advise tegretol over trileptal, but then it seems to work for you.
> >
> > But I'm confused...
> >
> > "Turns out to me, that the XR version turned out to act exactly like Trileptal did for me, some really strange and adverse effects (don't wanna go in to detail) that I didn't like."
> >
> >
> > So why take the XR version of Tegretol if it had unpleasant effects... especially if they're unpleasant to the point of being strange and adverse ?
> >
> > Or am I missing something ?
>
> Good question. I did only give the tegretol xr a 2-3 day trial, and it was causing some of the same probs as trileptal.
>
> I would go w/ trileptal, but i've taken it many times, and my brian/body is actually rejecting it now, especially during benzo wd.
>
> The trileptal would actually INDUCE rapid cycling in me, crazy stuff.
>
> But the tegretol regular version, only lasts 4 hours, so i'd have to dose 5 times a day. That, or i could give the XR version a bigger trial, and take it 3 times a day instead of 2 times. I'm an extremely fast metabolizer.
>
> Then again, i have strange and adverse effects from every psychotropic med, hence me wanting off all of them.
>
> Regards,
>
> BrianWell, it's kinda strange. I can tell how a med is going to act the whole time from the get go, and I typically feel it's whole effects from day 1. but yes, it is worth a try. Having to take the generic every 4 hours is a pain in the butt.
Well, this is my last taper of diazepam (5th attempt), and has been my most difficult. I hope that with carbamazipine on board, it think it will help, as many studies have shown.
Secondly. Dr. Heather Ashton mentions Doexepin being used for benzo wd for anxiety and sleep.
Ironically, after waking up at 3am last night after horrible brutal sleep (which is more common now), I took a benadryl. Although it did not allow me to sleep, but gave me relaxation that i haven't experienced during this whole taper in the past 5 months.
I took 2 more doses of benadryl during the day today, and it has been the most relaxing day thus far, hands down.
So i think there is something there to histamine for me. I don't do very well with anything serotonin based, as it usually induces a feeling of depression, or even sometimes even mania/hypomania.
I see that doexepin is a great histamine blocker. Do you think that that is something worth looking into and talking to my dr about?
Is it ok to mix a tca w/ tegretol?
Thanks,
Brian
Posted by yxibow on August 12, 2009, at 6:12:37
In reply to Jay, Doexipin?, posted by qbsbrown on August 11, 2009, at 21:51:55
>
> Well, it's kinda strange. I can tell how a med is going to act the whole time from the get go, and I typically feel it's whole effects from day 1. but yes, it is worth a try. Having to take the generic every 4 hours is a pain in the butt.
>
> Well, this is my last taper of diazepam (5th attempt), and has been my most difficult. I hope that with carbamazipine on board, it think it will help, as many studies have shown.
I'm not sure why all the medications are necessary to taper off of a benzodiazepine, I mean I can understand the "reverse anxiety" that comes with it, but that is a natural part of coming off one, I can tell you it can become worse with intense GI/bowel effects.
The benzodiazepine will always be there around for you if you have to go back, why make an agonizing taper, just take it easy at the standard care of about 10% a week, more if you can, less if you can't.
> Secondly. Dr. Heather Ashton mentions Doexepin being used for benzo wd for anxiety and sleep.I'm not going to comment on "Ashton" methods... I believe it is a scope outside of evidence based psychiatry and demonizes even proper use of benzodiazepines...
> Ironically, after waking up at 3am last night after horrible brutal sleep (which is more common now), I took a benadryl. Although it did not allow me to sleep, but gave me relaxation that i haven't experienced during this whole taper in the past 5 months.
So would Atarax... some antihistamines also act for some people as calming agents; but they can cause blurry vision, tachychardia, etc. Thorazine came from a particular class of antihistamines
> I took 2 more doses of benadryl during the day today, and it has been the most relaxing day thus far, hands down.Glad to hear that... I'd have a hangover and blurred vision, but everyone is different.
> So i think there is something there to histamine for me. I don't do very well with anything serotonin based, as it usually induces a feeling of depression, or even sometimes even mania/hypomania.Well, even some antihistamines act barely on serotonin, such as chlorpheniramine.
> I see that doexepin is a great histamine blocker. Do you think that that is something worth looking into and talking to my dr about?
For people with bad allergies, it is one of the only drugs with antihistamine properties that blocks both H1 and H2, small doses would only be needed
Otherwise... its an antidepressant in any useful dose, so I don't see the purpose of using it otherwise... and it does act on serotonin more than NE, as well as being a fairly strong antihistamine.
> Is it ok to mix a tca w/ tegretol?Most likely.. I'd still go with Trileptal personally as being more safe and having less side effects since you'd be mixing TCAs which have their own side effects, but you respond better to Tegretol.
-- Jay
Posted by qbsbrown on August 12, 2009, at 9:25:41
In reply to Re: Jay, Doexipin? » qbsbrown, posted by yxibow on August 12, 2009, at 6:12:37
>
> >
> > Well, it's kinda strange. I can tell how a med is going to act the whole time from the get go, and I typically feel it's whole effects from day 1. but yes, it is worth a try. Having to take the generic every 4 hours is a pain in the butt.
> >
> > Well, this is my last taper of diazepam (5th attempt), and has been my most difficult. I hope that with carbamazipine on board, it think it will help, as many studies have shown.
>
>
> I'm not sure why all the medications are necessary to taper off of a benzodiazepine, I mean I can understand the "reverse anxiety" that comes with it, but that is a natural part of coming off one, I can tell you it can become worse with intense GI/bowel effects.
>
>
> The benzodiazepine will always be there around for you if you have to go back, why make an agonizing taper, just take it easy at the standard care of about 10% a week, more if you can, less if you can't.
>
>
> > Secondly. Dr. Heather Ashton mentions Doexepin being used for benzo wd for anxiety and sleep.
>
>
>
> I'm not going to comment on "Ashton" methods... I believe it is a scope outside of evidence based psychiatry and demonizes even proper use of benzodiazepines...
>
>
> > Ironically, after waking up at 3am last night after horrible brutal sleep (which is more common now), I took a benadryl. Although it did not allow me to sleep, but gave me relaxation that i haven't experienced during this whole taper in the past 5 months.
>
>
> So would Atarax... some antihistamines also act for some people as calming agents; but they can cause blurry vision, tachychardia, etc. Thorazine came from a particular class of antihistamines
>
>
> > I took 2 more doses of benadryl during the day today, and it has been the most relaxing day thus far, hands down.
>
> Glad to hear that... I'd have a hangover and blurred vision, but everyone is different.
>
>
> > So i think there is something there to histamine for me. I don't do very well with anything serotonin based, as it usually induces a feeling of depression, or even sometimes even mania/hypomania.
>
> Well, even some antihistamines act barely on serotonin, such as chlorpheniramine.
>
> > I see that doexepin is a great histamine blocker. Do you think that that is something worth looking into and talking to my dr about?
>
>
> For people with bad allergies, it is one of the only drugs with antihistamine properties that blocks both H1 and H2, small doses would only be needed
>
>
> Otherwise... its an antidepressant in any useful dose, so I don't see the purpose of using it otherwise... and it does act on serotonin more than NE, as well as being a fairly strong antihistamine.
>
>
> > Is it ok to mix a tca w/ tegretol?
>
> Most likely.. I'd still go with Trileptal personally as being more safe and having less side effects since you'd be mixing TCAs which have their own side effects, but you respond better to Tegretol.
>
> -- JayThanks Jay.
Oh well I've been in a big tolerance/interdose withdrawal from benzos for at least 5 years, that have caused many many problems. I came to this board screaming for help to get off of them 5 years ago, because I couldn't (and I couldn't tolerate meds as well). So I hope that now is the time.
Thanks for the Atarax suggestion, I'll look into that one.
I would go with the trileptal, but the body/brain is rejecting it (after being on it numerous times, plus being in such a delicate wd state, my cns is ultra sensitive), pluse it gives me weird rapid cycling experiences.
Not sure what to do about the antihistamine stuff, or looking into doexipin etc. I don't do well with anything serotonin based, and anything that hits dopamin and NE seems to be too much for the wd right now.
Thanks for your suggestions.
Brian
Posted by qbsbrown on August 12, 2009, at 21:20:42
In reply to Re: Jay, Doexipin? » qbsbrown, posted by yxibow on August 12, 2009, at 6:12:37
It looks like the risk of mixing doxepin and tegretol are pretty high, aren't they? I already have a little chest tightness. Wonder if it's the mix of the the antihistamine w/ the tegretol? HHHMM
Brian
Posted by SLS on August 13, 2009, at 5:19:03
In reply to Re: Jay, Doexipin?, posted by qbsbrown on August 12, 2009, at 21:20:42
> It looks like the risk of mixing doxepin and tegretol are pretty high, aren't they?
I hadn't heard that. What is the problem?
- Scott
Posted by yxibow on August 14, 2009, at 0:44:39
In reply to Re: Jay, Doexipin? » qbsbrown, posted by SLS on August 13, 2009, at 5:19:03
> > It looks like the risk of mixing doxepin and tegretol are pretty high, aren't they?
>
>
> I hadn't heard that. What is the problem?
>
>
> - ScottI think he's referring to P450 interactions noted with some TCAs which probably can be titrated properly by a psychopharmacologist.
It may increase some of the problems that are associated with Tegretol instead of Trileptal.
-- Jay
Posted by qbsbrown on August 15, 2009, at 14:22:21
In reply to Re: Jay, Doexipin? » SLS, posted by yxibow on August 14, 2009, at 0:44:39
I read that 200mgs tegretol is simply 300mgs trileptal, and that you can switch them out easily, correct?
I'm dosing the tegretol 4 times a day, but even when on trileptal, i needed to dose that often.
Is it easy to switch over?
Regards,
Brian
PS- the tegretol poses many health side effects correct? I am having some bad tachycardia, and heart beating pretty bad. I had a surgery for arrythmia tachycardia, and I don't really wanna mess with that huh?
Brian
Posted by yxibow on August 15, 2009, at 22:37:27
In reply to Jay, easy to convert over to Trileptal right?, posted by qbsbrown on August 15, 2009, at 14:22:21
> I read that 200mgs tegretol is simply 300mgs trileptal, and that you can switch them out easily, correct?
That depends on the individual and the opinion of your doctor, whether he/she thinks a crosstaper or a direct replacement is wise.
Also bioequivalency is fairly likely always going to be more of an art than a science so its not necessarily equal for everyone.
But I don't think its an agent notorious for switchout problems.
> I'm dosing the tegretol 4 times a day, but even when on trileptal, i needed to dose that often.
>
> Is it easy to switch over?
>
> Regards,
>
> Brian
>
> PS- the tegretol poses many health side effects correct? I am having some bad tachycardia, and heart beating pretty bad. I had a surgery for arrythmia tachycardia, and I don't really wanna mess with that huh?
Tegretol has a non zero possibility of agranulocytosis (low white blood cell count), as well as a whole host of things.
It is theoretically possible that the oxygen molecule attached to Trileptal that Tegretol doesn't have may contribute to avoiding this problem.
No, you don't want to mess with tachycardia if you've had heart surgery for sure -- if that is the case though, Brian, you should really have regular EKGs to check up on all your medications.Arrhythmias are actually fairly common, people can be walking around not knowing. Did you have some sort of ablation surgery ?
Tachycardia though is defined as a consistent pulse over 100, and the arrythmias would be variations in beats.
In that case, I would, if you don't already have one, get a decent cuff measure from a pharmacy to take your blood pressure / pulse every so often, randomly. I assume, I hope that the doctor involved has told you this.
-- Jay
Posted by qbsbrown on August 16, 2009, at 17:30:13
In reply to Re: Jay, easy to convert over to Trileptal right? » qbsbrown, posted by yxibow on August 15, 2009, at 22:37:27
Taking it 4 times a day is a pain in the butt. Can you simply crossover from tegretol generic 200mgs, 4 times a day, to tegretol XR, 400mgs, 2 times a day? Or is there a crossover, or an adjustment period?
Brian
Posted by yxibow on August 21, 2009, at 2:45:19
In reply to Jay, crossover to Tegretol XR, posted by qbsbrown on August 16, 2009, at 17:30:13
> Taking it 4 times a day is a pain in the butt. Can you simply crossover from tegretol generic 200mgs, 4 times a day, to tegretol XR, 400mgs, 2 times a day? Or is there a crossover, or an adjustment period?
>
> BrianI can't tell you from any of my experience because I tried Trileptal (my doctor specifically knows the issues with Tegretol) -- didn't do anything that we could see.
There's always adjustment periods with medication, our brains aren't set in place, its fluid and there's neuroplasticity.
With some medications some doctors just believe in dropping it in place. I couldn't guest honestly but I think this is probably one of those cases (for some people).
On the other hand benzodiazepines, going from say clonazepam to diazepam, e.g., at least personally, I recall it was a titration until there wasn't anything left of the prior.
APs, who knows... if you taper off one, depending on what it was for, your symptoms might come back in different ways and dropping one anyhow more than likely can cause withdrawal dyskinesia so its probably crosstaper.
I'm sure there are a lot of schools of thought on a lot of these things.
SSRIs, probably would go down fairly low on one and then go back up on another to prevent serotonin syndrome, etc.
-- Jay
This is the end of the thread.
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