![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by lara5953 on May 30, 2013, at 12:37:21
Wondering if 600mg trileptal is canceling the 200 mg of modafinal out, I'm not feeling any benefit, it's been a month...Supposed to be taking 900 but am so tired...Took same combo (below) in addition to trileptal for almost two years but the past 9 months have been horrible, sleeping days away and so depressed..Doc won't change anything except added the modafinal/provigil.. Only thing I have found on internet is on drugs.com, I really don't understand them talking about the chemical components..
Also taking 100 lamictal, 450 wellbutrin, 2.5 abilify...Bipolar2 Would Adderal possibly work...900 Trileptal also makes me so cognitive impaired esp. when at work...Thank you!
Posted by ed_uk2010 on May 30, 2013, at 17:19:51
In reply to trileptal and modafinal, posted by lara5953 on May 30, 2013, at 12:37:21
>Wondering if 600mg trileptal is canceling the 200 mg of modafinal out, I'm not feeling any benefit, it's been a month...Supposed to be taking 900 but am so tired...Took same combo (below) in addition to trileptal for almost two years but the past 9 months have been horrible, sleeping days away and so depressed..
Were you prescribed modafinil to reduce drowsiness/fatigue?
Amphetamine (Adderall) is a potent stimulant. It can reduce tiredness in the short term but can readily lead to dependence. It's rarely a good idea to add more meds to treat a problem which may be worsened due to being on too much medication in the first place.
It's vital to discuss with your doctor the underlying reasons why you are feeling so tired. Fatigue has many different causes including physical, psychiatric and medication related problems. If you haven't already had them, your doc may arrange some blood tests. Tests may include: Electrolytes (especially sodium because Trileptal can affect this), complete blood count, thyroid function, glucose, and possibly liver tests.
Assuming that major physical causes have been ruled out, there are 3 main possibilities:
1. You are tired due to your bipolar depression.
2. You are tired due to your meds.
3. A combination of the above.In my opinion, it seems likely that Trileptal is making you more tired. Do you believe that you benefit from this drug? Did you feel any less tired before you started taking it? Does the time that you started to feel tired match up with the time you started Trileptal, increased the dose, or adjusted any of your other meds?
You say your doctor won't change anything. Is this because he believes it would destabilise your illness? Or because he doesn't think your meds are causing any side effects?
Sorry if I've asked too many questions. I think it important to know some facts before giving too many opinions!
Posted by lara5953 on May 30, 2013, at 20:06:56
In reply to Re: trileptal and modafinal » lara5953, posted by ed_uk2010 on May 30, 2013, at 17:19:51
Thank you Ed, Yes I was prescribed the provigil for fatigue..My blood work all came back fine..I've been on the same combo for around two years, and have been blah but never this extreme fatigue..trileptal has lengthened the time in between cycling..It is/was every 3 months approx. versus every 6-8 weeks before being diagnosed. Also have SAD bad, physically sick for few weeks...Used to be 5 now down to two with the trileptal..Lamictal didn't work at 200 mg..Trying to be short, this year after Jan. episode I continued to be exhausted..When warm weather comes I am always fine till Sept, until this year..He doesn't want to change anything because he believes it will destabilize me..Been trying to tell him that the extreme fatigue must be from depression and wellbutrin isn't working anymore...I have been on that for years..I apologize for not being clearer..Thank you for the info on Adderal, need something for this cognitive issues at work...Ppl tease, I know they mean no harm but it is frustrating...Provigil does help with that some, expensive though.. I wish Lamictal alone would help :)
Posted by ed_uk2010 on June 1, 2013, at 8:40:09
In reply to trileptal and modafinal, posted by lara5953 on May 30, 2013, at 12:37:21
I can understand why your doctor is reluctant to change your meds, but you cannot continue with this level of fatigue.
You are clearly sensitive to the effects of Trileptal, since increasing from 600mg to 900mg has such as large effect. Have you tried 150mg in the morning and 300mg at night?
To what extent do you think you are obtaining benefit (or not), from Lamictal, Wellbutrin and Abilify? Combining 2 antiseizure medications (Lamictal, Trileptal) often causes tiredness.
Do you think your doctor is right that your primary problem is depression right now? Do you have the usual symptoms of depression or is the fatigue much more prominent that other depressive symptoms right now?
Posted by Lara5953 on June 10, 2013, at 8:56:02
In reply to Re: trileptal and modafinal » lara5953, posted by ed_uk2010 on June 1, 2013, at 8:40:09
Sorry to take so long to reply, Ed....Definitely depression....Doc said I already tried Adderal, but I sure don't remember, not in chart, thinned out..Gave me pristiq which promptly put me to sleep and made me sick, still sick, took for three days...Quit lamictal, am doing 300 at night and 150 in morning....Thinking of taking leave from work :(. Maybe Seraquil? I don't know :) Appreciate it!
Posted by ed_uk2010 on June 13, 2013, at 4:49:15
In reply to Re: trileptal and modafinal, posted by Lara5953 on June 10, 2013, at 8:56:02
>Quit lamictal, am doing 300 at night and 150 in morning....
Is your doctor aware? I hope so, this is really important.
>Maybe Seroquel?
Seroquel is a sedating antipsychotic. It is sometimes effective in depression, but drowsiness and dizziness are very common. It might not be a good choice for you.
Hope you start to feel better soon.
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.