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Re: Trileptal reduces Geodon? How much? Sheilac

Posted by SLS on September 14, 2015, at 7:58:10

In reply to Re: Trileptal reduces Geodon? How much? SLS, posted by Sheilac on September 14, 2015, at 7:09:36

> Thank you. That's interesting. Because on just 300mg of Trileptal I noticed a decrease of my Geodon.
>
> I may try 150mg of Trileptal for neuropathy. I may have to up my Geodon.
>
> I'll have to ask my doc about this too. But for now my stability on Geodon is what's most important.

I agree.

Your remedy of increasing the dosage of Geodon when adding Trileptal is simple and makes a great deal of sense. Generally, 160 mg/day is considered to be the maximum dosage. I wonder how high your doctor will allow you to go. Just be sure that you are taking Geodon with meals.

If you do elect to add Trileptal, I wonder if your feeling depressed would only be a temporary condition. You might rebound from the depression given time on both drugs. I would be surprised to learn that 300 mg of Trileptal would induce the P450 enzymes within 24 hours so as to reduce the levels of Geodon and allow for depression to emerge so quickly. Overall, enzyme induction is a gradual process. If it were ME, I would interpret this data to indicate that one add the Trileptal at a dosage of 600 mg/day and maintain the dosage of Geodon at 160 mg/day taken at meals and be patient. Ask your doctor about this. Of course, it is possible that the Trileptal itself is producing depression. Still, I would try to be patient when combining these drugs. This is easier said than done, but you need to give your system some time to establish a new equilibrium.

How do you react to gabapentin (Neurontin) and pregabalin (Lyrica)? Some people really like these drugs for neuropathy. For me, both drugs produced severe cognitive impairments and perhaps some dissociation. These things persisted for 3 weeks after discontinuing them. This seems to be atypical, though.

By the way, duloxetine (Cymbalta) and ziprasidone (Geodon) both inhibit the reuptake of serotonin and norepephrine. Although I doubt anyone could give you a guarantee, but these properties might be functioning to relieve your depression. This was the rationale I used to suggest combining Cymbalta with Trileptal. Mixed states sometimes respond to Trileptal + Lamictal with or without Abilify. I am hoping that it will ease your mind knowing that there are still alternatives for you.

Keep us informed of your progress. You sound better on your current treatment.


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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