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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 182. This is the beginning of the thread.
Posted by qbsbrown on March 27, 2010, at 12:31:09
Oh I love the semi hypomanic trileplat mornings. I feel like myself. I have humor and wit with friends and collegues. But then the afternoon rolls around, and I hit a huge depression, where I'm bed bound. then night rolls around, and there is some semi normalcy. doesn't matter what dose, or when I dose. Any other alternatives to this drug that might act the same (sodium channels?), and no, i suck on lamictal. Basically I'm horrible on all meds, and am at my wits end. UGH!
Brian
Posted by Phillipa on March 27, 2010, at 12:34:14
In reply to Trileptal, why do you do this to me?, posted by qbsbrown on March 27, 2010, at 12:31:09
Brian I'm sorry I'm kind of the oposite up late at night and in morning. Trileptal for bipolar? I took it once very low dose didn't do a thing. Hoping you get some very good suggestions. Phillipa
Posted by qbsbrown on March 27, 2010, at 12:36:57
In reply to Re: Trileptal, why do you do this to me? » qbsbrown, posted by Phillipa on March 27, 2010, at 12:34:14
Perhaps I'm just a really low dose responder, and would be better severed by 150mgs two times a day. HHHMM. I remember that working before.
Brian
Posted by qbsbrown on March 27, 2010, at 13:20:03
In reply to Re: Trileptal, why do you do this to me?, posted by qbsbrown on March 27, 2010, at 12:36:57
Trileptal 300mgs
xanax 6mgs
provigil 400mgs
Thanks,Brian
Posted by qbsbrown on March 27, 2010, at 17:06:11
In reply to Re: Trileptal, why do you do this to me? » qbsbrown, posted by Phillipa on March 27, 2010, at 12:34:14
> Brian I'm sorry I'm kind of the oposite up late at night and in morning. Trileptal for bipolar? I took it once very low dose didn't do a thing. Hoping you get some very good suggestions. Phillipa
Well my neurologist of all people said that if taking it 2 times a day, was inducing hypomania, depression, then normalcy, then perhaps I should spread it out over 3 times daily. It doesn't have the longest half life, so maybe something to it.
Brian
Posted by bulldog2 on March 27, 2010, at 17:21:22
In reply to Trileptal, why do you do this to me?, posted by qbsbrown on March 27, 2010, at 12:31:09
> Oh I love the semi hypomanic trileplat mornings. I feel like myself. I have humor and wit with friends and collegues. But then the afternoon rolls around, and I hit a huge depression, where I'm bed bound. then night rolls around, and there is some semi normalcy. doesn't matter what dose, or when I dose. Any other alternatives to this drug that might act the same (sodium channels?), and no, i suck on lamictal. Basically I'm horrible on all meds, and am at my wits end. UGH!
>
> BrianI use neurontin 2-4 times a day. That's 800-1200 mg two to four times a day.. Perhaps you can dose twice with trileptal. It seems as if your dosing does not last all day. I know neurontin is very safe with overdose.
Posted by qbsbrown on March 27, 2010, at 19:42:16
In reply to Re: Trileptal, why do you do this to me?, posted by bulldog2 on March 27, 2010, at 17:21:22
> > Oh I love the semi hypomanic trileplat mornings. I feel like myself. I have humor and wit with friends and collegues. But then the afternoon rolls around, and I hit a huge depression, where I'm bed bound. then night rolls around, and there is some semi normalcy. doesn't matter what dose, or when I dose. Any other alternatives to this drug that might act the same (sodium channels?), and no, i suck on lamictal. Basically I'm horrible on all meds, and am at my wits end. UGH!
> >
> > Brian
>
> I use neurontin 2-4 times a day. That's 800-1200 mg two to four times a day.. Perhaps you can dose twice with trileptal. It seems as if your dosing does not last all day. I know neurontin is very safe with overdose.
>
>Thanks bulldog.
I found if i split it up into 3 smaller doses, 3x 150mgs, and took provigil with the mid day dose, the depression was lessened.
I actually just finished a series of 6 ect treatments, for psychosis unresponsive to medications, and it helped some, i would like more, but can't afford it.
Is there a particular reason why my PDOC is now AVIDLY against putting me on trileptal, or perhaps he said we wouldn't talk about it til next week.
Is the brain already adjusting and creating it's own antiseizure mechanisms? But i have the trileptal RX, and it helps, so why do i wait til next week?
Brian
Posted by ed_uk2010 on March 28, 2010, at 9:42:20
In reply to Trileptal, why do you do this to me?, posted by qbsbrown on March 27, 2010, at 12:31:09
>Any other alternatives to this drug that might act the same (sodium channels?), and no, i suck on lamictal.
I assume you've tried Tegretol?
As a treatment for bipolar disorder, Tegretol is better established than Trileptal. It has certainly received more study. Tegretol appears to have a slightly different mechanism of action of Trileptal.
Tegretol XR (and similar brands) may be better tolerated than regular Tegretol because they avoid the high peak plasma concentrations which sometimes cause dizziness and nausea. You can start with 100mg at night then increase gradually.
Unfortunately, Tegretol may increase the metabolism of Provigil and Xanax. The doses of these medications may therefore need to be adjusted.
Posted by qbsbrown on March 28, 2010, at 11:54:14
In reply to Re: Trileptal, why do you do this to me? » qbsbrown, posted by ed_uk2010 on March 28, 2010, at 9:42:20
Thanks Ed. Yeah, Tegretol and Tegretol XR sure seemed to run me the wrong way. The XR version seemed to act much like trileptal though. After taking a night dose of trileptal last night, i hit a calm i haven't known in ages.
Sure wish i could continue ect.
The second i wake up is a nightmare. Conversations, debates, arguments, intrusive thoughts, memories, commentaries, memories of sanity, and what i would be doing if i was sane, that just don't stop. Adding benzos might have helped a little, (because this psychosis was brought on by cold turkey from benzos) but zyprexa no go, not even clozaril a go, just being awake is pretty sickening, and that's not the person i am.
Posted by ed_uk2010 on March 28, 2010, at 14:31:01
In reply to Re: Trileptal, why do you do this to me?, posted by qbsbrown on March 28, 2010, at 11:54:14
>The second i wake up is a nightmare. Conversations, debates, arguments, intrusive thoughts, memories, commentaries, memories of sanity, and what i would be doing if i was sane, that just don't stop.
Brian, how do you manage to write so clearly on babble when you're feeling so awful? It must be difficult.
Regarding anti-seizure meds, what is your experience with Depakote?
Posted by qbsbrown on March 29, 2010, at 10:47:09
In reply to Re: Trileptal, why do you do this to me? » qbsbrown, posted by ed_uk2010 on March 28, 2010, at 14:31:01
Tried the depakote many a time, sometimes as high as 2000mgs just to slow me down enough. Still hated it, induced depression, made me internalize a lot, and give me this existential angst that i view people and the world through.
Ed, I have having thoughts of Lyrica. I once had a doc put me up to 900mgs of it, i was able to drive long distances alone on it, did fun things like golfing etc. Giving that one a thought, what do you think? Seems all of the other anticonvulsants are so harsh for me
Posted by ed_uk2010 on March 29, 2010, at 13:01:31
In reply to Re: Trileptal, why do you do this to me?, posted by qbsbrown on March 29, 2010, at 10:47:09
> Ed, I have having thoughts of Lyrica. I once had a doc put me up to 900mgs of it, i was able to drive long distances alone on it, did fun things like golfing etc. Giving that one a thought, what do you think? Seems all of the other anticonvulsants are so harsh for me.
Lyrica is known to be effective for generalised anxiety in some cases, at least in the short term. It's not an established treatment for mood disorders though. Non-serious side effects are very common eg. sedation and dizziness. Serious side effects are uncommon so I guess it might be worth a try. Difficult to say. What do you think?
Posted by qbsbrown on March 29, 2010, at 15:25:29
In reply to Re: Trileptal, why do you do this to me? » qbsbrown, posted by ed_uk2010 on March 29, 2010, at 13:01:31
Yeah, I think it's worth a shot, since nothing else is helping or working. Although it's heir apparent, gabapentin did nothing for me, I would hope that lyrica might act somewhat similar to what it had done for me previously. I bipolar doc here had had a few patients that were soley taking it and doing ok.
Seeing as having no clue what i have now, perhaps schizo/psychosis induce from benzo cold turkey, maybe it can help.
Also seeing as I'm already getting interdose wd from xanax 3 times a day, it seems that it's time for good ole diazepam. Hope it doesn't make me as depressed and irritable as usual, and i hope lyrica may help with that.
I once did decent on lyrica plus a stimulant, but it seems like a stimulant would be a no go during benzo wd huh? I do have provigil.
Last year, was doing a slow painful wd from diazepam, then cracked and went back on, depressed that i lost 5 months of tapering, i opted for detox, came out crazy, tried to go back on, and was still in wd, and it seemed as if i was having "benzo sensitivity", a psychotic toxic reaction to the librium.
I was diagnosed with multiple sclerosis around xmas, and i don't know how much that is playing into it.
All that i know is that i could not be more crazy and sick:( Oh how i miss those days of sanity.
I sure wish that the trileptal did not make me hypomanic, which i like, then hit a huge snag of depression, and then some semi normalcy. But my chemical sensitivity seems even too high for that. All though the other night as the horrible conversations ran rampant, it helped seem to slow them.
Thanks ed
Posted by ed_uk2010 on March 29, 2010, at 15:54:22
In reply to thanks ed, posted by qbsbrown on March 29, 2010, at 15:25:29
>i opted for detox, came out crazy, tried to go back on, and was still in wd, and it seemed as if i was having "benzo sensitivity", a psychotic toxic reaction to the librium.
If by detox you mean abrupt withdrawal as an inpatient, detox seems like a good way of making people a lot more sick.
You might need quite a bit of Valium initially to replace the Xanax but please try to reduce it down to a 'normal' dose as soon as possible ie. less than 30mg/day. Very high doses seem to mess people up.
I hear that Lyrica tends to 'poop out' a lot. Seems to be a particular problem.
I take it that you've tried lithium and the atypical antipsychotics?
Posted by qbsbrown on March 29, 2010, at 16:39:36
In reply to Re: thanks ed » qbsbrown, posted by ed_uk2010 on March 29, 2010, at 15:54:22
> >i opted for detox, came out crazy, tried to go back on, and was still in wd, and it seemed as if i was having "benzo sensitivity", a psychotic toxic reaction to the librium.
>
> If by detox you mean abrupt withdrawal as an inpatient, detox seems like a good way of making people a lot more sick.
>
> You might need quite a bit of Valium initially to replace the Xanax but please try to reduce it down to a 'normal' dose as soon as possible ie. less than 30mg/day. Very high doses seem to mess people up.
>
> I hear that Lyrica tends to 'poop out' a lot. Seems to be a particular problem.
>
> I take it that you've tried lithium and the atypical antipsychotics?
>Yeah, I'm 4 months removed from a cold turkey, and just barely re-introduced the xanax, did some ect, tried neurontin, some of the antipsychotics, even clozaril/clozapine.
Don't know why i can take some trileptal in the morn, and i'm social, looking for jobs and things to do etc, then get depressed. Then at night, as i am trying to play a game, and conversations are running rampant, i take a small dose of trileptal, and it really seemed to slow down and allow me to concentrate, although i wake up with the same conversations, debates, arguments, suicidal talk etc.
I'm really at a wits end and loss here as what to do. So are my docs, as I badger mine a few times a day lolRegards,
Brian
Posted by qbsbrown on March 29, 2010, at 16:45:43
In reply to Re: thanks ed, posted by qbsbrown on March 29, 2010, at 16:39:36
I wonder that if in my state, if lyrica could give me back the false sense of well being as it once had, as i sure need one lol.
Drug combinations used to work for me, but my sensitivity just seems out of control right now. I don't know if MS has anything to do with it.
I'm assuming you are of the opinion Ed that going back on valium is a better idea that xanax xr, correct?
Brian
Posted by ed_uk2010 on March 29, 2010, at 16:56:24
In reply to Re: thanks ed, posted by qbsbrown on March 29, 2010, at 16:45:43
>I'm assuming you are of the opinion Ed that going back on valium is a better idea that xanax xr, correct?
It sounds like Xanax and Valium are both problematic medications for you, but in different ways. Which ever benzo you choose to take, I think you need to find the lowest dose which prevents withdrawal symptoms. Have you tried other benzodiazepines such as lorazepam (Ativan)?
Posted by qbsbrown on March 29, 2010, at 17:06:50
In reply to Re: thanks ed » qbsbrown, posted by ed_uk2010 on March 29, 2010, at 16:56:24
> >I'm assuming you are of the opinion Ed that going back on valium is a better idea that xanax xr, correct?
>
> It sounds like Xanax and Valium are both problematic medications for you, but in different ways. Which ever benzo you choose to take, I think you need to find the lowest dose which prevents withdrawal symptoms. Have you tried other benzodiazepines such as lorazepam (Ativan)?
>
>
>
>
I was on ativan for a while. It really seemed to lose it's effectiveness, almost like a sugar pill, i think i was at 3mgs at the time for sleep, and would have to take much more to feel effect, so we the switched to klonopin 3mgs, then i remember that klonopin made me VERY depressed and irritable, so then finally made the switch to valium, and began a taper from 30mgs, until i became housebound and psychotic.
I had then saw an addiction psychiatrist, who put me on librium, because it didn't really have much of a self-reinforcing action.
Once again, it made me quite irritable and depressed, and that is when i opted for detox.The 2mgs of xanax i take right now, 3 times a day, i don't really feel depression from it, irritability, and/or sedation. I just know that i feel crazy, and physically ill.
The XR version is TOO much, and my dr is willing to go back to diazepam, as it's longer acting, and easier to come off of. Diazepam in the past yes, had made me quite irritable and depressed as well.
We have not discussed ativan, and I'm not against it. Pretty short half-life isn't it? And tough to break up?My brain has been through the frier i tell ya, and hates me, and doesn't really want to accept much of anything right now.
I'd love to hear your suggestions as far as the benzo Ed. I really respect what you have to say.
Regards,
Brian
Posted by qbsbrown on March 29, 2010, at 17:32:41
In reply to Re: thanks ed, posted by qbsbrown on March 29, 2010, at 17:06:50
Also, seeing as i'm at a much worse starting point this go round, wouldn't this withdrawal be much worse?
Given last time, when i got down to 17mgs of valium, i was housebound, and began crazy behavior, trying to add depakote, or tegretol etc, basically was giving me nervous breakdowns,and i couldn't tolerate it.
So i have no clue as for what to do for any sort of sanity here.
Brian
Posted by ed_uk2010 on March 29, 2010, at 17:34:12
In reply to Re: thanks ed, posted by qbsbrown on March 29, 2010, at 17:06:50
> Diazepam in the past yes, had made me quite irritable and depressed as well.
> We have not discussed ativan, and I'm not against it. Pretty short half-life isn't it? And tough to break up?Lorazepam is difficult to come off, yes.
Have you tried taking the Xanax in more than three divided doses eg. 1mg six times per day?
Posted by qbsbrown on March 29, 2010, at 17:41:27
In reply to Re: thanks ed » qbsbrown, posted by ed_uk2010 on March 29, 2010, at 17:34:12
> > Diazepam in the past yes, had made me quite irritable and depressed as well.
> > We have not discussed ativan, and I'm not against it. Pretty short half-life isn't it? And tough to break up?
>
> Lorazepam is difficult to come off, yes.
>
> Have you tried taking the Xanax in more than three divided doses eg. 1mg six times per day?
>No, I've only been taking 2mgs 3x a day.
Would you recommend i try that before venturing back over to valium?
Brian
Posted by ed_uk2010 on March 29, 2010, at 17:53:10
In reply to Re: thanks ed, posted by qbsbrown on March 29, 2010, at 17:41:27
>Would you recommend i try that before venturing back over to valium?
Yes, it might help even things out. There's nothing to lose, it certainly won't do any harm.
Posted by qbsbrown on March 29, 2010, at 18:00:04
In reply to Re: thanks ed, posted by qbsbrown on March 29, 2010, at 17:41:27
It's pretty sad when your mental health history comes down to benzos.
On benzos in 05, came off abruptly, found out about benzo wd, and went on valium, and moved to china. During my valium wd, i was diagnosed ocd, as many in wd do. The AD may have saved my job, but made me very irritable and depressed person. So i have racing thoughts from the benzo wd, and irritability and depression from ssris, so of course DXed bipolar. Run through the gamet of over 30 meds ugh.
Now i am much worse off, and i don't know if any can help me.
While teaching in the middle east a while back, i was on tons of benzos, stimulants, booze, mood stabilizer, ambien, occasional AD, occasion antipsychotic, ended up hospitalized obviously.
The dr there cold turkeyed me from stimulants, ambien, and wanted me off high dose valium in one week. I was left on an AD, some depakote, and some zyprexa. it was a crazy 5 days to say the least, and the flight home, but when i was home, i was totally sane, and could function like a normal person. Only 5 days later, i was having bad racing thoughts, which i thought indicated bipolarity for sure, not thinking it could be part of withdrawal, and began the medication wheel again, and here i am.
Crappy story, and sorry for having to share.
Brian
Posted by qbsbrown on March 29, 2010, at 18:01:52
In reply to Re: thanks ed » qbsbrown, posted by ed_uk2010 on March 29, 2010, at 17:53:10
> >Would you recommend i try that before venturing back over to valium?
>
> Yes, it might help even things out. There's nothing to lose, it certainly won't do any harm.
>
>But don't you think that i want the long action from valium, and isn't my xanax wd gonna be bad, and perhaps tolerance getting higher and higher?
Brian
Posted by qbsbrown on March 29, 2010, at 18:13:09
In reply to Re: thanks ed » qbsbrown, posted by ed_uk2010 on March 29, 2010, at 17:53:10
> >Would you recommend i try that before venturing back over to valium?
>
> Yes, it might help even things out. There's nothing to lose, it certainly won't do any harm.
>
>
And yes Ed, it does even feel like after i take my 2mg doses, that it may perhaps give me anxiety, and make me kinda physically ill.Before i jumped off cold turkey from librium, it seemed to the benzo forum people, that i have/had a bad benzo sensitivity/reaction etc.
I don't know. Just wish there was any/some relief.
Brian
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