Posted by Mitch on July 29, 2001, at 23:05:30
In reply to Re: No more Geodon...topamax? » Mitch, posted by chloe on July 29, 2001, at 17:31:51
> Thanks Mitch
> You are right about the withdrawal stuff. I have to be a positive thinker!
>
> I also am taking some nuerontin (400mgs) with the miniscle dose of Trileptal (375 mgs). I just posted something about it farther down this list in "Trilepal Experiences."
>
> My pdoc also thinks going back to Li maybe a good idea. God, I just can't put up with the tremors and nausea and inability to feel anything good. It's the blah drug for me.
> She also mentioned adding maybe 125 mgs of Depakote to my mood stabilizer hodge podge. I am not sure about that one either. I don't like being on so many at subtherapuetic doses... Have you heard of such a treatment stradegy?
>
> Ah, I am not really thinking straight. And can't decide what to do about anything right now. But I do think Top. sounds interesting. I need to research and hear more about it. My only concern is the weight loss that tends to come with that med. I am already thin and don't want to have any less of an appetite...
> Top. sounds a little like Lamictal, in that you have to titrate slowly...But I hope Top. isn't as activating! I was too racy on Lamictal.
>
> I am sorry that Topomax didn't work out for you. But is a retry in the future ruled out?
>
> Thanks for your timely post
> Chloe
Chloe,Well, that is a lot of info! You can check off Lamictal obviously, and you had some negative reactions to Lithium (why revisit something that you had some neg reactions to if you have the time to check out other possibilities?) You know, given that you are on low-doses of everything that you are taking currently and you don't have a stressful demanding job to throw monkey-wrenches in the mix I would suggest you discuss further withdrawals of current meds with your pdoc (Trileptal first) and see how you are feeling...you know take it as it goes...one step at a time.
POSSIBLY: Get to a point where all meds are withdrawn except the one that currently works the *best* for you, say Neurontin, and optimize that ONE med.
When you are ONLY on the Neurontin, push THAT dose UP a *little* at a time and plumb your limits with that ONE med. When you have figured out what the max dose you can take of it that helps you, THEN,
*ADD* some Topamax (the lowest dose is actually 15mg sprinkle-not 12.5mg) at bedtime. You see, you don't want to blow off something that is helpful-if you think that it is causing a side effect when SOMETHING ELSE is really causing it-that is the problem with *modern* polypharmacy-not liver/kidney/CYPxxx interaction problems, but being able to DETERMINE what is REALLY causing problems. The bottom line is that you don't want to "throw out the baby with the bathwater" due to polypharmacy and the confusion that results from it.
I just say this because I am also in a current state of low-dose polypharmacy where it is unclear what is helping/hindering progress.
I wouldn't worry about excessive weight loss with low-dose Topamax. I found Topamax NOT to be activating at all-quite anxiolytic almost neuroleptic-like (well here might be a Geodon replacement??). I would also try Topamax before Depakote.Mitch
poster:Mitch
thread:71234
URL: http://www.dr-bob.org/babble/20010725/msgs/72435.html