Posted by JahL on April 2, 2002, at 18:43:42
In reply to Re: Dr Kramer: AED cocktails for BPII/NOS. » JahL, posted by SLS on April 2, 2002, at 16:21:48
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> > I have read encouraging reports about Lamictal + VPA (which reduced SI when I took it alone) but I am concerned about the obvious interaction.
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> Just a thought, JahL...
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> If you are a little squirrely about adding Depakote to Lamictal, you may want to try filling that role by adding Neurontin first. In a superficial way, Neurontin and Depakote are similar in that they are both pro-GABAergic. Lamictal is not. This combination has been used quite a bit at the NIMH by Post's group. They claim some good results with BP II. Otherwise, just cut in half the dosage of Lamictal when you add Depakote. 1/2 is usually right on target.
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> Lamictal: Na+ channel blockade + NMDA antagonism (no increase in GABA activity)
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> Depakote: Na+ channel blockade + increased GABA activity
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> Neurontin: Increased GABA activity (no Na+ channel blockade)+++++++++++++
Hi Scott.
Tried Neurontin but it didn't add anything to the Lamictal. Keppra, another AED I was happy to add because of lack of drug-drug interaction potential, actually worsened my depression.
I'd be a lot happier mixing Depakote with Lamictal if under the supervision of a pdoc. However I doubt any UK pdoc would go near such a combo. Most won't go near Lamictal monotherapy IME. Drug 'rationalisation' is the order of the day here.
I'm worried about provoking a reaction which could force me off Lamictal, which isn't an option. I've had a couple of reactions before... Any self-induced 'injury' would make me a 'liability' and would give pdocs all the justification they need not to continue treating me. Bit of a lose-lose situation.
Still, life's too short to wait for the UK medical establishment to wake up so I'll probably give it a go. I think the Lamictal PDF gives pretty comprehensive guidelines re: adding Depakote. I should read more but I have the same sort of cognition problems I've seen you describe before.
Anyway, thanks.
Any other ideas re: AED cocktials from anyone are welcome.Ta,
J.
poster:JahL
thread:101386
URL: http://www.dr-bob.org/babble/20020402/msgs/101548.html