Psycho-Babble Medication Thread 538236

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Re: Keppra (levetiracetam) for bipolar disorder? SLS

Posted by Nickengland on August 6, 2005, at 13:53:50

In reply to Keppra (levetiracetam) for bipolar disorder?, posted by SLS on August 6, 2005, at 8:37:17

Hi Scott..

After all my waffle about Topamax and not much said about Keppra I thought this may be of some interest...

-------------------------------------------------

Levetiracetam in the treatment of acute mania: an open add-on study with an on-off-on design.

Grunze H, Langosch J, Born C, Schaub G, Walden J.

Department of Psychiatry at the University of Munich, Germany. grunze@psy.med.uni-muenchen.de

BACKGROUND: Levetiracetam is a novel antiepileptic drug with a broad spectrum of efficacy in epilepsy. We have tested the antimanic properties of the drug as an add-on to haloperidol in an open trial. METHOD: After giving informed written consent, 10 bipolar I acutely manic (DSM-IV) inpatients were investigated in an on-off-on study design. All patients were treated with 5 to 10 mg/day of haloperidol, depending on tolerability, throughout the investigation. Levetiracetam (up to 4000 mg/day) was added until day 14, then discontinued and reintroduced at day 21. The psychopathologic changes were assessed with the Young Mania Rating Scale (YMRS). RESULTS: After a mean decrease of the YMRS scores from 29.6 to 17.2 during the first "on" phase, manic symptoms worsened during the "off" period (YMRS score 20.9) and ameliorated again during the second "on" phase, with a decrease of the mean YMRS score to 14.7 at the end of the study. The mean dose of levetiracetam was 3125 mg/day. At day 14, only 2 (20%) of 10 patients were responders (defined as a decrease in YMRS scores of 50%) compared with 7 (70%) of 10 responders at the end of the study at day 28. CONCLUSION: The results from this open on-off-on add-on study suggest that levetiracetam exhibited additional antimanic effects. Controlled studies are clearly required.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12934978&dopt=Abstract


 

Re: Keppra (levetiracetam) for bipolar disorder? Nickengland

Posted by ed_uk on August 6, 2005, at 14:10:04

In reply to Re: Keppra (levetiracetam) for bipolar disorder? ed_uk, posted by Nickengland on August 6, 2005, at 13:49:42

Hi Nick!

>.......when I hit the target dose (only 50mg).......

Why 50mg? The optimum dose cannot be predicted in advance - you'll need to experiment with different doses until you find the dose which provides the best balance between side effects and efficacy.

Kind regards

~Ed

 

Re: Keppra (levetiracetam) for bipolar disorder? med_empowered

Posted by SLS on August 6, 2005, at 14:53:26

In reply to Re: Keppra (levetiracetam) for bipolar disorder?, posted by med_empowered on August 6, 2005, at 10:27:18

Thanks M_E.

Do you recall where you came across the NIMH study? If not, I'll try to find out more about it through their clinical trials postings (If I can find them).

I appreciate your time in checking things out for me.

Be well.


- Scott

 

Re: Keppra (levetiracetam) for bipolar disorder? ed_uk

Posted by Nickengland on August 6, 2005, at 15:01:10

In reply to Re: Keppra (levetiracetam) for bipolar disorder? Nickengland, posted by ed_uk on August 6, 2005, at 14:10:04

Hi Ed!

>Why 50mg? The optimum dose cannot be predicted in advance - you'll need to experiment with different doses until you find the dose which provides the best balance between side effects and efficacy.

Totally agree! What I mean by 50mg being the target dose, is just that its all i've been prescribed so far from the psychiatrist...So far now 50mg is all I have to work with. Side effects permitting, I'd be willing to go higher of course if/when the need should arise.

25mg was providing benefits too (the best i've had so far) since i've been on 37.5mg (last wednesday) things have been ok, but I got a slight flu at around about the same time, so what with that and slight side effect increase my mood has been a little sensitive lol

Ahhh...another good thing about the NHS you might like to here...My GP said, when I leave to go to Australia (afew months still planning) he should only provide me with 3months medication - But, he will provide me with *6 months* medications! - Hey now that is what I call being generous :-) First prioroty of course when I arive there will be to get a new doctor though - make sure when that 6 months is up I have more medication!

Kind regards

Nick

 

Re: Keppra (levetiracetam) for bipolar disorder? Nickengland

Posted by SLS on August 6, 2005, at 15:05:38

In reply to Re: Keppra (levetiracetam) for bipolar disorder? SLS, posted by Nickengland on August 6, 2005, at 12:28:09

Hi Nick.

> I know you've tried many medications in the past (I remember your list you posted of what you have tried before) I'm curious, as you haven't yet tried Topamax (Topiramate) in your line of treatments for bipolar depression.
>
> I wonder if this would be of any benefit for you?...

:-)

I can't believe you went back and checked that out! Yes, I have avoided Topamax because of its cognitive side effects. How silly, right? Considering the severity and refractoriness of my condition, it doesn't make sense to avoid it forever. I guess I should go ahead and put it back near the top of my list of things to try. Thanks. One more ray of hope to cling to.

> You know i'm presently using it and I can speak well of it in terms for helping with depression for sure.
>
> The intial response was that of very much a similar response of an anti-depressant medication

That is a pretty compelling testimonial. Did the antidepressant effect fade with time?

> Of interest as well, I've read that Tegretol, Trileptal and Topamax are the main 3 medications that effect the Temperal Lobes.

Hmm.

> *If* for instance you have any problems in your temoral lobes then Topamax could be very good for this, seeing as you have had fairly good results with Trileptal - although I know they may not have benn the *best* results you were expecting.

Things with Trileptal certainly started out well enough. Damned tachyphylaxis!

> The final advantage with Topamax which i know of, is that it would be a very easy medication for you to rule out in terms of if it will be effective for your needs.

The titration period would be protracted if I were to go low-and-slow. How long and at what dosage do you feel I should wait before passing judgment?

Thanks!


- Scott

 

Re: Keppra (levetiracetam) for bipolar disorder? SLS

Posted by ed_uk on August 6, 2005, at 15:20:01

In reply to Re: Keppra (levetiracetam) for bipolar disorder? med_empowered, posted by SLS on August 6, 2005, at 14:53:26

>Do you recall where you came across the NIMH study? If not, I'll try to find out more about it through their clinical trials postings (If I can find them).

Please post if you find anything :-)

~Ed

 

Re: Keppra (levetiracetam) for bipolar disorder? Nickengland

Posted by ed_uk on August 6, 2005, at 15:25:18

In reply to Re: Keppra (levetiracetam) for bipolar disorder? ed_uk, posted by Nickengland on August 6, 2005, at 15:01:10

Hi Nick!

>Totally agree! What I mean by 50mg being the target dose, is just that its all i've been prescribed so far from the psychiatrist...

Oh I see! LOL, sorry!

>Hey now that is what I call being generous :-)

6.50 for about 100 worth medication isn't bad!

Kind regards

~Ed

 

Re: Keppra (levetiracetam) for bipolar disorder? SLS

Posted by Nickengland on August 6, 2005, at 18:04:30

In reply to Re: Keppra (levetiracetam) for bipolar disorder? Nickengland, posted by SLS on August 6, 2005, at 15:05:38

Hi Scott,

>I can't believe you went back and checked that out! Yes, I have avoided Topamax because of its cognitive side effects. How silly, right? Considering the severity and refractoriness of my condition, it doesn't make sense to avoid it forever. I guess I should go ahead and put it back near the top of my list of things to try. Thanks. One more ray of hope to cling to.

I have another surprise for you..lol I didn't need to go and check the list as I remembered specifically that Topamax wasn't on it! :-) I have a very good longterm memory for things that interest me - quite literally they stay in mind. that said my everyday short-term memory is a joke, I forget everything, but longterm I have the memory of an elephant lol On a serious note, it maybe of interest (I read somewhere a couple of years ago, memory again, see lol) that one of the benefits, yep benefits of manic-depressives, is that they quite often have very good longterm memories..Good and bad I guess, but mine are often based on factual information.

Anyway, i'm waffling again lol

To be perfectly honest with you, I really havent found the cogitive effects that bad at all. In fact carbamazepine, lithium and sodium valproate I found had worse cognitive side effect compared with Topamax so far. That said, like yourself, before trying Topamax, the 'Dopamax' fear was the thing that held me back.

I always looked at it like this aswell, interms of firstline and order of what should be tired first for a mood stabilser (this is in order of what I tired first to get to Topamax)

Sodium Valproate

Lamotrigine

Lithium

Lamotrigine (shortly again)

Carbamazepine

Oxcarbazepine

Gabapentin

Topiramate

Finally ending with Topiramate and Gabapentin so far (plus omega 3 fish oils & Taurine - taurine is one great supplement, proven anticonvulsant properties and great calming effect)
*Experimental - Niacinamide & Tyrosine (vitamin C and vitamin b complex thrown in just for good measure!
I'm possibly wondering about a gabba supplement, but somehow don't see the point, although that Amen psychiatirst thinks its good..Hmmm Blood brain barrier has got me on that one, seeing as it doesn't cross it.

>Did the antidepressant effect fade with time?

Like most medication that had a great intial response (for me Trileptal & Gabapentin) the first few days, first week was the best. My body then adapted and of course this did fade alittle. That said, the effects (positive) have still remained and I would say have leveled off to some extent. Nothing perfect, but i'm coping you know, take away the medication and i'd have to deal with the illness and that far, far worse. So all in all I'd say the benefits are still there. The anti-depressant response from this for me, has been alot more pronouced than that of Trileptal, that for sure. It works so differently from Trileptal, I mean side effects wise, not so much drowsyness and no blurred vision. Its different, a whole new ball game. I will say there are side effects and in some repects its not as 'smooth' as Trileptal. I really like the stuff though. Given the choice now if I didnt have the kidney thing with Trileptal, you know id probably stay with Topamax. Oh its great for headaches as well as an added bonus - if you get these, I do and now with this I do not anymore, well very rarely.

> Of interest as well, I've read that Tegretol, Trileptal and Topamax are the main 3 medications that effect the Temperal Lobes.

>Hmm.

I know, lol i'm no expert on the Temeral Lobe area of the brain and i'll adit I got this information from 'crazymeds.org' Thats said, there are pubmed studies that confirm topamax was shown to work on areas of the temeral lobes. (I think) that study may have been on rats lol hmmm No seriously, I've heard its good for temperal lobe epilepsy, there must be a link somewhere. Tegretol is a first line medication for temeral lobe epilepsy, trileptal related. Topamax would be second line for Temperal lobe epilepsy I think. Dr Amen speaks about bipolar being a Temperal lobe condition on his site from what I can gather with responds to anticonvulsants. There could be a link somewhere?

>Damned tachyphylaxis!

Im not sure what tachyphylaxis is?..does not sound good though! :-(

>How long and at what dosage do you feel I should wait before passing judgment?

Thats a very difficult question for me to answer Scott. Its my understanding that huge un-wanted side effects would be the limiting factor in you continuing with Topamax. That and the fact, that because of these side effects you would be getting no real benefit. If that was the case then dosage would only be small, perhaps only in the region of 25-75mg, thats if what I am saying would be true for you and it then could only be a matter for a few weeks, 1 month tops. This could be an unfair judement though based on my experience of medications and more so topamax...I wouldn't want to add anymore as I know there are many more factors with yourself. Bearing in mind your on other medications and you will no doubtly react differently somewhat to me. In general though, I think and feel with this medication, you'll either love it or hate it. I know its hard, but try not to think about quiting it, before you try it :-)

Go low and slow is definately the key if you decide. When I first started it was at 25mg for afew weeks and I had some word finding problems but funnily enough could laugh them off (see what I mean either love it or hate it) anyway, due to some circumstances I re-started the medication and this time at 12.5mg. It certianly made a difference with those word finding skills, when I reached 25mg and now i'm at 37.5mg I dont even have that originally problem that I had back then when I jumped straight in at 25mg, if you get what I mean.

I hope that helps

:-)

Kind regards

Nick

 

Re: Keppra (levetiracetam) for bipolar disorder? ed_uk

Posted by Nickengland on August 6, 2005, at 18:12:58

In reply to Re: Keppra (levetiracetam) for bipolar disorder? Nickengland, posted by ed_uk on August 6, 2005, at 15:25:18

Hi Ed!

>Oh I see! LOL, sorry!

No need to be sorry Ed ..Acutally you gave me a good reminder that indeed its not as easy as just keeping the medication at one dosage - it has to meet the needs of your moods! Thanks for the reminder :-)

>6.50 for about 100 worth medication isn't bad!

Its a great exchange rate!...So when someone buys generic prozac at 2.00, they are being made to pay 6.50!...and then I get that all that, man I feel guilty lol I've often wondered how they balance the accounts in pharmacy's over here, but maths are not my strong point!

Kind regards

Nick

 

Re: Keppra (levetiracetam) for bipolar disorder? Nickengland

Posted by Slinky on August 6, 2005, at 20:19:57

In reply to Re: Keppra (levetiracetam) for bipolar disorder? ed_uk, posted by Nickengland on August 6, 2005, at 15:01:10

But, he will provide me with *6 months* medications! - Hey now that is what I call being generous :-)

Blimey Nick...

One suitcase just full of meds..

Slinky

 

Amineptine/Survector?

Posted by EERRIICC on August 6, 2005, at 20:56:26

In reply to Keppra (levetiracetam) for bipolar disorder?, posted by SLS on August 6, 2005, at 8:37:17

Hey Scott,

Did you ever get a chance to try this drug?
It's interesting stuff, e-mail me at ericaroundtheclock@hotmail.com.

 

Re: Keppra (levetiracetam) for bipolar disorder? Slinky

Posted by Nickengland on August 7, 2005, at 8:34:47

In reply to Re: Keppra (levetiracetam) for bipolar disorder? Nickengland, posted by Slinky on August 6, 2005, at 20:19:57

>Blimey Nick...

>One suitcase just full of meds..

Hello Slinky lol

Yeah I know that has crossed my mind too!

Its quite strange, he said really is only supposed to give me 3 months worth, if i'm to leave the counrty for a such a long period of time, but then he said (with a weird look on his face :-o) i'll give you 6 months worth.. Hmm, no worries, thanks very much, I replyed!

Honestly though he's quite an intersting GP, sometimes when I see him he can be really nervous, stuttering, and just seem quite unconfident and in a low mood. Other times he really focused, switched on and extreamly confident - I do sometimes wonder if he's Bipolar!...he once admited to me in a round-about way they he get depressed. Must of caught him in quite a funny mood that day, thats for sure!

Good to know he'll trust me with that amount of medication anyway, never been any problems with me in that department before so, I guess that was something he took into consideration, and the fact I havent worked for a year, I could do with some extra help. Top man :-)

Kind regards

Nick

 

Re: Keppra (levetiracetam) for bipolar disorder?

Posted by platinumbride on August 8, 2005, at 14:22:07

In reply to Keppra (levetiracetam) for bipolar disorder?, posted by SLS on August 6, 2005, at 8:37:17

Scott,
I wish I could say more positive things than that keppra was one of the most expensive placebos I ever tried.....
Then again, so was trileptal.

Sorry for the bad news, but of course, only my experience.

Diane

> I am thinking about trying Keppra next.
>
> Any comments?
>
> Thanks.
>
>
> - Scott

 

Re: Keppra (levetiracetam) for bipolar disorder?

Posted by SLS on August 13, 2005, at 12:35:00

In reply to Re: Keppra (levetiracetam) for bipolar disorder?, posted by platinumbride on August 8, 2005, at 14:22:07

I began taking Keppra yesterday. I will be at 500mg until I see my doctor on Tuesday.

I decided to discontinue the Trileptal, as the excema-like lesions have continued to spread. I'm disappointed. It was helping a bit.

Right now, I'm taking:

Parnate 80mg
nortriptyline 100mg
Abilify 10mg
Keppra 500mg

I am expecting to feel worse because the Lamictal and Trileptal have been removed from the regime. I guess I can add back the Lamictal if things get tough.


- Scott

 

Re: Keppra (levetiracetam) for bipolar disorder? SLS

Posted by ed_uk on August 13, 2005, at 18:08:08

In reply to Re: Keppra (levetiracetam) for bipolar disorder?, posted by SLS on August 13, 2005, at 12:35:00

Hi Scott :-)

I really hope the Keppra helps. Perhaps it will have some positive cognitive effects?

Kind regards

~Ed

 

Re: Keppra (levetiracetam) for bipolar disorder?

Posted by SLS on August 14, 2005, at 8:55:13

In reply to Re: Keppra (levetiracetam) for bipolar disorder? SLS, posted by ed_uk on August 13, 2005, at 18:08:08

> Hi Scott :-)
>
> I really hope the Keppra helps. Perhaps it will have some positive cognitive effects?
>
> Kind regards
>
> ~Ed

At 500mg / day, I'm not expecting very much. My guess is that 1000-2000mg is the range most people would find helpful to treat bipolar depression. This is still uncharted territory.

Because I have discontinued both Trileptal and Lamictal, I am deteriorating rather quickly. Psychomotor retardation and fatigue are becoming more prominent, and I doubt I will be able to function very well without either of those two drugs. I don't know whether or not to ride it out and hope that some portion of the worsening is due to rebound and will eventually be recovered. I wouldn't have hesitated continuing with the Trileptal had the eczema not continued to spread. I call it eczema for lack of a true indentification. The eruptions and dry patches do not itch and do not exude serous fluids, but they do look eczematous. All of my fingers are affected as well as my scalp and ears. Not pretty.


- Scott

 

Re: Keppra (levetiracetam) for bipolar disorder? SLS

Posted by ed_uk on August 14, 2005, at 9:37:21

In reply to Re: Keppra (levetiracetam) for bipolar disorder?, posted by SLS on August 14, 2005, at 8:55:13

Hi Scott,

>Because I have discontinued both Trileptal and Lamictal, I am deteriorating rather quickly.

I was worried because you weren't posting. Perhaps you could restard Lamictal? I don't think you were having any major side effects from Lamictal, were you?

~Ed

 

Re: Keppra (levetiracetam) for bipolar disorder? SLS

Posted by theo on August 14, 2005, at 10:15:29

In reply to Re: Keppra (levetiracetam) for bipolar disorder?, posted by SLS on August 13, 2005, at 12:35:00

Hello Scott!

I hope the Keppra works for you. I'm very close, after taking Keppra for a year and being off now for about 6 months, to starting it again. The only reason I stopped was the quest for something new and better.

I've tried Topamax, Lamictal and Keppra and it seemed to be the most user friendly for me as far as fast adjustment to dosing. Usually within a couple of days of dose increase you feel the change, and side effects (mainly muscle weakness, slight headache) diminish. I don't know how med sensitive you are but if you are going in 500mg increments, you might try going up in 250mg increments instead. You really have to fine tune this med. If you get angry, agressive for longer than 4 days, chances are you need to back down 250mg.

My pdoc doc started me this way: 250mg bedtime for 4 days, then add another 250mg morning. Then after 4 days add another 250mg bedtime, then 4 days another 250mg morning, etc.

Hopefully for convenience, twice daily dosing will work for you. I actually split my dosing three times daily for a while because my morning dose at 7:00am seemed to wear off about 3:00pm.

Once you increase the dose, are you on a twice daily schedule? Keep me posted on your progress with Keppra and I hope the withdrawal from Triliptal and Lamictal isn't to harsh.

 

Re: Keppra (levetiracetam) for bipolar disorder? theo

Posted by SLS on August 14, 2005, at 14:26:09

In reply to Re: Keppra (levetiracetam) for bipolar disorder? SLS, posted by theo on August 14, 2005, at 10:15:29

Hi Theo.

Thanks for the information. You have given me much insight as to the personality of this drug.

I did experience the headaches you referred to. So far, they have been minor and short-lived.

Are you bipolar, Theo?

How would you describe the therapeutic effects of Keppra? Did it act as an antidepressant? Did it work well at first and then fade? Anything else you could offer me regarding Keppra would be much appreciated.

Thanks again.


- Scott

 

Re: Keppra (levetiracetam) for bipolar disorder? ed_uk

Posted by SLS on August 14, 2005, at 14:37:56

In reply to Re: Keppra (levetiracetam) for bipolar disorder? SLS, posted by ed_uk on August 14, 2005, at 9:37:21

> Hi Scott,
>
> >Because I have discontinued both Trileptal and Lamictal, I am deteriorating rather quickly.
>
> I was worried because you weren't posting. Perhaps you could restard Lamictal? I don't think you were having any major side effects from Lamictal, were you?
>
> ~Ed


It probably makes sense for me to return to Lamictal. I dropped it in favor of Trileptal, hoping that the eczematous eruptions were the result of the two drugs in combination. Lamictal alone does produce a mild form of these skin lesions. Unfortunately, it turned out that Trileptal was the culprit and not the Lamictal. Nothing is ever easy, you know? Damned drugs.

I will probably restart the Lamictal this evening. My intention is to begin at 75mg and move up to 150mg if necessary. Generally, it is recommended that one use the same titration schedule to restart Lamictal as to begin taking it for the first time once a period of non-use has exceeded a week. There have been times when I purposely maintained a dosage of 50mg just to avoid a restart titration once I made a decision to continue treatment at 300mg.


- Scott

 

Re: Keppra (levetiracetam) for bipolar disorder?

Posted by ed_uk on August 14, 2005, at 16:30:40

In reply to Re: Keppra (levetiracetam) for bipolar disorder? ed_uk, posted by SLS on August 14, 2005, at 14:37:56

Hi Scott,

How long have you been off Lamictal?

~ed

 

Re: Keppra (levetiracetam) for bipolar disorder? SLS

Posted by theo on August 14, 2005, at 23:50:43

In reply to Re: Keppra (levetiracetam) for bipolar disorder? theo, posted by SLS on August 14, 2005, at 14:26:09

>
> Are you bipolar, Theo?
>
> How would you describe the therapeutic effects of Keppra? Did it act as an antidepressant? Did it work well at first and then fade? Anything else you could offer me regarding Keppra would be much appreciated.
>
> Thanks again.
>
>
> - Scott

My regular doc thinks I suffer from a low grade depression, my pdoc thinks I'm BPII. I basically suffer from chronic low self esteem, worry. So, whatever that falls under. I also used to drink quite a bit but am sober now 2 years, so alcoholism is in the mix also. I'm never manic, but my pdoc insists any anxiety that pops up is my mania. Who knows! I've almost given up on diagnosis and just trying different meds hoping to find a fit. My regular doc actually prescribed me Concerta 18mg, which my pdoc never would, and it caused no anxiety and was actually very helpful. The only thing I didn't like is the up and down ride every day.

So, I've been med free just to get a feeling of where I am so when I do start a med, I'll have a better read. I do feel like I need to be on something, but my big dilema is to start with.

Keppra helped me be more assertive in a positive way and even helped with OCD. It also did have some mood lifting properties. And free of side effects except 1 or 2 days headache and muscle weakness.

Since I've been off meds, amazingly I'm not as nervous and feel much more in control. Unfortunatly, I feel domb and gloom depression alot. So I was feeling anxiety from some of my past med trials, especially Lamictal which now looking back amplified my OCD very much.

I'm really at a loss right now what class to go with but I might retry Keppra next and see what happens.

Are you dosing twice daily?

 

Re: Keppra (levetiracetam) for bipolar disorder? theo

Posted by SLS on August 15, 2005, at 9:53:36

In reply to Re: Keppra (levetiracetam) for bipolar disorder? SLS, posted by theo on August 14, 2005, at 23:50:43

> My regular doc thinks I suffer from a low grade depression, my pdoc thinks I'm BPII. I basically suffer from chronic low self esteem, worry. So, whatever that falls under. I also used to drink quite a bit but am sober now 2 years, so alcoholism is in the mix also. I'm never manic, but my pdoc insists any anxiety that pops up is my mania.

He might be right. I know someone who remains mixed-state hypomanic without
medication for which an uncomfortable anxiety-like state causes her to pick up alcohol to self medicate. However, she also is very irritable and sometimes has racing thoughts and pressure of speech. She doesn't demonstrate these things except when challenged socially, so, one would never know she was hypomanic
otherwise. She sleeps 7-8 hours. One of the things that complicates her case is that I believe she also suffers from borderline personality disorder (BPD).

> Who knows! I've almost given up on diagnosis and just trying different meds hoping to find a fit. My regular doc actually prescribed me Concerta 18mg, which my pdoc never would, and it caused no anxiety and was actually very helpful.

With bipolar disorder, some people display a paradoxical calming and anti-manic effect from stimulants.

> So, I've been med free just to get a feeling of where I am so when I do start a med, I'll have a better read.

Smart.

> I do feel like I need to be on something, but my big dilema is to start with.

Have you ever tried Risperdal or Seroquel? Both drugs demonstrate antidepressant effects. Risperdal in particular can ameliorate OCD, and they of course will help address the hypomanic mixed-state that you might suffer from.

I wish I could get my crystal ball up and running again to help you out. I think the core processor crashed, and repair parts no longer exist. I will be very interested to know what you decide to do.

Right now, I am dosing Keppra twice a day 250mg b.i.d. Dosing twice or three times a day is not an issue with me. I restarted Lamictal at 75mg, but haven't decided what dosage to target. I might stay right here. I think too much sodium channel blockade can produce cognitive blunting and a mild reduction of motivation to initiate activities. This was my experience with Trileptal as well. I really don't know what dosage of Keppra my doctor had in mind to work up to. I'll find out more tomorrow when I see him. I also need to push him along to do the paperwork so that I can get a hold of mifepristone should Keppra not work out.


- Scott

>
> Keppra helped me be more assertive in a positive way and even helped with OCD. It also did have some mood lifting properties. And free of side effects except 1 or 2 days headache and muscle weakness.
>
> Since I've been off meds, amazingly I'm not as nervous and feel much more in control. Unfortunatly, I feel domb and gloom depression alot. So I was feeling anxiety from some of my past med trials, especially Lamictal which now looking back amplified my OCD very much.
>
> I'm really at a loss right now what class to go with but I might retry Keppra next and see what happens.
>
> Are you dosing twice daily?
>
>
>
>

 

Re: Keppra (levetiracetam) for bipolar disorder? ed_uk

Posted by SLS on August 15, 2005, at 9:56:14

In reply to Re: Keppra (levetiracetam) for bipolar disorder?, posted by ed_uk on August 14, 2005, at 16:30:40

> Hi Scott,
>
> How long have you been off Lamictal?
>
> ~ed

About a week. I restarted it yesterday at 37.5mg and will continue it at 75mg if I get enough of a boost from it.


- Scott

 

Re: Keppra (levetiracetam) for bipolar disorder? SLS

Posted by ed_uk on August 15, 2005, at 10:48:57

In reply to Re: Keppra (levetiracetam) for bipolar disorder? ed_uk, posted by SLS on August 15, 2005, at 9:56:14

>I restarted it yesterday at 37.5mg and will continue it at 75mg if I get enough of a boost from it.

Any benefit so far?

~ed


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