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Re: Neurontin -max. dose? -- update » Wendy B.

Posted by Mitch on October 20, 2001, at 11:05:59

In reply to Re: Neurontin -max. dose? -- update » Mitch, posted by Wendy B. on October 19, 2001, at 22:22:21

> I made a 'freudian' slip at one point during the session, and called the Neurontin 'lithium.' She smiled and said she'd been thinking about lithium for me. I had mentioned it to her Monday night after group, I reminded her. She just told me that I would have to have blood levels taken on a regular basis on lithium. I asked her if/when my dose stabilized, couldn't the blood tests eventually stop? And she was adamant that blood levels would have to be taken regularly, the entire time I might be on lithium. So I guess if I feel like an invalid now with the pill-popping, I might feel just as much, or more, of one when going in for tests and blood-letting. She said it's expensive, and it's a pain in the ass.
>
> We didn't talk about depakote or about using it as adjunct to the Neurontin, I'll mention it next week.
>
> Thanks again for listening, Mitch.
>
> Wendy

Wendy,

I would ask about adding Depakote (and then reduction of Neurontin to a 3x daily dosage!) before the lithium. Lithium has to be monitored because of its potential toxicity (the therapeutic doses for many people get close to toxic ones). My pdoc doesn't want to use it because of that reason. The blood tests (lithium levels) are important when treatment is being initiated and after dosage changes, but beyond that I think it is basically CYA for the pdoc. The symptoms of lithium toxicity are fairly easy to recognize.

Mitch


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