Posted by LouisianaSportsman on September 28, 2013, at 11:31:15
In reply to Re: Augmenting Bipolar 'Cocktail' with Trodenki XR » LouisianaSportsman, posted by SLS on September 28, 2013, at 6:41:26
Thanks, Scott. I was looking forward to your reply. It makes me feel good that you think I'm heading in the right direction. Thanks for the gabatril correction. I try not to make mistakes-- remaining as professional as I can get. Do you mean Pristiq 100 equivalent to 300 generic venlafaxine? Pristiq 300mg is equal to 900mg of venlafaxine! :O I know you made an error lol.
Like a lot of members on Babble, I know my stuff. I think you can tell from my posts; however, I want to address some issues in particular.
1. What do you y'all think about extended release topiramate over the classic instant release?
2. Right now, the gabapentin is PRN. Should it be taken at full dosage everyday to act as a proper adjunct mood stabilizer?
3. How bad is the cognitive side effects of topiramate? I was thinking about augmenting with #90 bupropion SR 75mg. One in the morning, one in the afternoon and one at bedtime to keep steady state concentration. I was also thinking about adding #90 Dexedrine (dextroamphetamine) 10mg. to go with it. Take 2 in the morning with the bupropion and one in the afternoon with the bupropion. Dexamphetamine can cause aniexty and I was thinking Xanax XR 1mg. would be a smooth ride; also, my gabapentin tolerance is out of control. I was thinking about another benzodiazepine to augment with the night-time dose of my bupropion such as Ativan 0.5mg. It has been shown to lower blood pressure and be good for the dextroamphetamine "crash"
Next Visit idea:
1. Begin titration of Topamax.
2 Increase Pristiq to 100mg3.
New Scheduling of Meds:
#90 75mg. bupropion SR.
#90 10mg. dexamphetamine
#30 1mg Xanax XR
#30 0.5mg. lorazepamTheoretical:
7:30 A.M
Psychostimulants:
75mg. bupropion SR
20mg. dexamphetamine
250mg. NuvigilAnti-Anxiety
1mg. Xanax XR
800mg. GabapentinMood Stabilizer
200mg. Trodenki XL (topiramate)
200mg lamotrigine
10mg. Abilify (aripiprazole)Anti-Depressant
100mg. Pristiq2:00 P.M.
10mg. dextroamphetamine
75mg. bupropion SR
400mg. gabapentin9:30 P.M.
75mg. bupropion SR
400mg gabapentin
0.5mg Ativan (lorazepam)^^^ What do you think about the above plan? Right now, I suffer from extreme ADHD, lethargy (hope the Nuvigil gets rid of that!) and constant mood swings. I want to take the gabapentin everyday for an adjunct mood stabilizer with Lamictal and Topamax. I also suffer from overwhelming anxiety which I believe calls for BZD maintenance. The increase in Pristiq should eliminate some of my down periods, and the Abilify helps me look at things more rationally and has alleviated my symptoms more than any psychiatric drug I've had. Just an idea.
Let me know what you think! I'd appreciate it. :D
poster:LouisianaSportsman
thread:1051278
URL: http://www.dr-bob.org/babble/20130828/msgs/1051383.html