Posted by undopaminergic on April 3, 2008, at 18:54:43
In reply to Transition from Depakote to Trileptal, posted by BGB on April 2, 2008, at 14:43:06
> Well, after 3 months of pleading and begging, my pdoc has finally changed my regimen by removing the 1,500 mg of Depakote ER (which I have taken for about 8 years) and replacing it with 600 mg of Trileptal (he did it because my sister has epilepsy and bipolar and that's what she takes). All I've noticed so far is that I am having tremors in.....my head! I kind of look like Audrey Hepburn in her last days (but not nearly that bad).
>
> Did anybody else experience anything strange like this if they cross-tapered from Depakote to Trileptal? I don't know if it is the decrease in the Depakote or the addition of the Trileptal that's giving me the shakes, but I hope it doesn't get any worse.
>
> I am diagnosed as bipolar I and am currently in a deep depressed state. My pdoc has me on the following ridiculous concoction:
>
> Depakote/Trileptal
> Lamictal 200mg
> Wellbutrin SR 600mg
> Cymbalta 120mg
> Remeron 60mg
> Trazodone 150mg prn for sleep
> Valium 5-10mg prn for anxiety (I hardly ever take it)
>
> Hopefully next time I go to my dr. I can convince him to trade in a few of these antidepressants for one that works. I kind of feel like he is trying to poison me!
>
> Thanks for any input!!It's not uncommon to have to use a combination of many medications, especially if bipolar. I hope there is some sort of rationale behind the cocktail, and that each of the antidepressants and mood stabilisers was tried on its own at first before using them all in combination - otherwise there's no way to know whether they contribute to the solution or to the problem (or perhaps both). Tremors are a well known problem of valproate, but can occur with oxcarbazepine (Trileptal) also - once you're off the valproate, you will see whether the combination of the two, or Trileptal on its own is responsible. Theoretically, some of the other drugs may also contribute.
Memantine may be worth trying, as it sometimes does wonders. Replacing the antidepressants with a MAOI may be another option - in that case, try tranylcypromine before resorting to phenelzine.
poster:undopaminergic
thread:821201
URL: http://www.dr-bob.org/babble/20080330/msgs/821412.html