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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by Nickengland on June 8, 2005, at 17:29:34
...Like who have had success with Neurontin for bipolar, for a few years?
Look forward to any replies :-)
Posted by ed_uk on June 8, 2005, at 17:50:53
In reply to Are there any Long-Term Neurontin users in here?, posted by Nickengland on June 8, 2005, at 17:29:34
Hi Nick!
I know you're looking for a mood stabiliser.............
Some antipsychotics are effective mood stabilisers. Which antipsychotics have you tried? Have you ever tried Seroquel? It can be anti-manic and anti-depressant.
Kind regards,
Ed.
Posted by Nickengland on June 9, 2005, at 5:08:28
In reply to Re: Are there any Long-Term Neurontin users in here? » Nickengland, posted by ed_uk on June 8, 2005, at 17:50:53
Hi Ed!
>I know you're looking for a mood stabiliser.............
lol Yes you are certianly right there!...I'm now getting kidney pain from the Tegretol, so a switch looks inevitable now.
I acutally haven't tried any antipsychotics. To be perfectly honest though I don't think I would really want to. I think for me they would be too "heavy duty" for want of a better word I'd probably find them too strong.
I read that the newer ones like Seroquel have less side effects than the old type, but still the side effects like tardive dyskinesia, weightgain and diabetes pretty much scare me off too.
I'm surprised people get them for anxiety as i've been reading on here, even if they have had no psychoctic symtoms. I've never really had true "psychotic" symtoms either, I don't really think that kind of medication would help treat my symtoms..
Its a good suggestion though, thanks very much for mentioning it :-)...lol..who knows theway meds are going with me, maybe I will have to try it in the future!
Would you consider taking Seroquel for anxiety?
Oh did you get my babble-mail I sent you yesterday?..I know you've changed your email address, wasn't sure if its been changed for your babble mail to?
Kind regards
Nick
Posted by ed_uk on June 9, 2005, at 6:45:57
In reply to Re: Are there any Long-Term Neurontin users in here? » ed_uk, posted by Nickengland on June 9, 2005, at 5:08:28
Hi Nick!
>I acutally haven't tried any antipsychotics. To be perfectly honest though I don't think I would really want to.
It's GOOD to have options though :-)
>I think for me they would be too "heavy duty" for want of a better word I'd probably find them too strong.
Some APs are more sedating than others. Zyprexa and Seroquel are often sedating. Abilify doesn't generally seem to be that sedating.
>I've never really had true "psychotic" symtoms either..............
There were called 'antipsychotics' because they were originally approved for schizophrenia. They can treat other conditions as well though, even if no psychotic symptoms are present. In the UK, Zyprexa, Seroquel and Risperal are all licensed for mania.
>tardive dyskinesia, weightgain and diabetes........
It's certainly true that they can have serious side effects. The thing is, anticonvulsants can also cause serious side effects eg. liver damage, pancreatitis, blood clotting disorders and obesity with valproate (Depakote, Epilim)............glaucoma and kidney stones with Topamax..........toxic epidermal necrolysis with Lamictal.......fatal blood disorders, kidney failure, hepatitis, Stevens- Johnson syndrome and arrhythmias with Tegretol..............
Frightening!
>I don't really think that kind of medication would help treat my symtoms.......
Which symtoms are most problematic for you??
>Would you consider taking Seroquel for anxiety?
Possibly. If I have another bad episode of OCD in the future, I might ask for a combination of Seroquel and an SSRI. On the other hand, I'm also scared of antipsychotics since the last one I took landed me in A&E! I tried chlorpromazine (Largactil, Thorazine, an old antipsychotic) for OCD a couple of years ago and it gave me severe akathisia (restlessness) and muscle spasms.
>Oh did you get my babble-mail I sent you yesterday?
No - I didn't get it :-( Can you send it again?? I'm not sure why I didn't get it, my babblemail has been redirected to my new email address. Here is my email address.......
[xxx]
Kind regards,
Ed.
Posted by Nickengland on June 9, 2005, at 10:30:54
In reply to Re: Are there any Long-Term Neurontin users in here? » Nickengland, posted by ed_uk on June 9, 2005, at 6:45:57
Hi Ed!
Yes thats very true, far better to have options than none at all! It would be foolish to dis-count anti-psychotics altogether, I guess I really see it the very, very, very last option..
Zyprexa and Seroquel, which would be the most mild of all these? Abilify, is this not as well establised as the other 2 for a mood stabiliser?
The list of side effects sure is frightening, scary stuff :-/
The symtoms most problematic for me? hmm thats a tough one to answer. The worst is a particular mind set I seem to get, when that happens it then sparks off a whole list of symtoms...The things that i'd most like to prevent is the high level of anxiety, racing thoughts, inability to sleep and deep depression (possible mixed state) which happens on a cycle of aprrox every 12-14 months. Inbetween those times is bad depression lasting 6-8months and 6 months of feeling :-)...very very good :-) Thats my illness in a nutshell! But overall the worst is when I crash, *worst* symtoms lasting about 4-8weeks.
Oh man, sounds like you had a rough ride with chlorpromazine. I must say I fear those medications too, even though I havent tried one! I dread the thought of taking a medication orginally for Schizophrenia...so stupid because if it worked all that doesn't matter! I've always had the thought though that antipsychotic medication is, like the last resort of the most powerful medications psychiatry has to offer..with mood stabilisers ranking close behind in 2nd place and then antidepressants...lol maybe thats just my wacky thinking?!
Cheers for the email address, strange the babble-mail didnt work??...I've used the email address, hopefully you've receieved the mail.. :-)
Cheers Ed,
Nick
Posted by ed_uk on June 9, 2005, at 11:00:35
In reply to Re: Are there any Long-Term Neurontin users in here? » ed_uk, posted by Nickengland on June 9, 2005, at 10:30:54
Hi Nick!
>Zyprexa and Seroquel, which would be the most mild of all these?
I'd probably be inclined to try Seroquel first. It needs to be started at a small dose and gradually increased as required.
>Abilify, is this not as well establised as the other 2 for a mood stabiliser?
Well........it's new so experience in bipolar disorder is limited.
>high level of anxiety, racing thoughts, inability to sleep and deep depression (possible mixed state) which happens on a cycle of aprrox every 12-14 months. Inbetween those times is bad depression lasting 6-8months and 6 months of feeling :-)...very very good :-)
Most of your symptoms could potentially respond to Seroquel. The thing is, Seroquel tends to make people quite drowsy. You'll have to try it and see!
>I dread the thought of taking a medication orginally for Schizophrenia......
Trileptal, Lamictal, Depakote, Tegretol and Neurontin were originally for epilepsy!
RE valproate: what dose did you try??
>I've used the email address, hopefully you've receieved the mail.. :-)
I've replied :-)
Kind regards,
Ed.PS. When you were on lithium, what was your blood level? (approx)
Posted by Nickengland on June 9, 2005, at 11:50:44
In reply to Re: Are there any Long-Term Neurontin users in here? » Nickengland, posted by ed_uk on June 9, 2005, at 11:00:35
Hello Ed!
Hmm I think now I will possibly consider Seroquel as an option....Weightgain, at low doses, who would be the worst offender out of this and sodium valproate do you think?
LOL yeah you're dead right about Lamictal etc.. originally for epilepsy!
Funny you should mention valproate, I have been thinking that I should maybe go back to this. I was taking Epilim Chrono @ only 400 mg a day (this was my first ever mood stabiliser) However I was also taking Mirtazapine @ 30mg a day.
Started both at the same time, finished both at the same time, only took for about 6 weeks. What a recipe for weightgain! I was deeply depressed though before I began these and so thinking back my mind was in a pretty bad way back then. It certainly wasn't a good trial mainly because of the mirtazapine and the fact that at that time I really didn't want to be taking any meds.
What puts me off about sodium valproate is the weightgain and hair loss. It was pretty strong med too. With lithium, lamictal and now tegretol and trileptal and definate no no, this seems perhaps the next logical med to try again before any anti-psychotic. I could try and keep the dose very low though along with neurontin ahem lol and iv'e thought about alittle verapamil. I definately do want a solid well established mood stabiliser on board.#
Never knew my lithium level, @ 400mg it must have been low, but in all honestly I detest the stuff it made me a fat zombie!
Kind regards
Nick
Posted by ed_uk on June 9, 2005, at 13:14:48
In reply to Re: Are there any Long-Term Neurontin users in here?, posted by Nickengland on June 9, 2005, at 11:50:44
Hi Nick!
>Weight gain, at low doses, who would be the worst offender out of Seroquel and sodium valproate do you think?
Difficult to say - I expect they'd be quite similar. Zyprexa seems to cause more weight gain than either of them.
>Epilim Chrono.........
If you'd like to try it again, you could always start at 200mg and increase the dose as required.
>LOL yeah you're dead right about Lamictal etc.. originally for epilepsy!
.........and Epilim's called Epilim for a reason! Lamictal is named after the drug name: lamotrigine.........and ictal - which refers to a seizure.
>mood stabiliser
Although the term 'mood stabiliser' tends to be used to refer to lithium and the anticonvulsants. Atypical antipsychotics could also be thought of as mood stabilisers. It might be useful to give Epilim a second trial first though. The thing is, Epilim doesn't often seem to help depression - it can do occasionally but it often seems to make it a bit worse. Seroquel seems to be useful for bipolar depression as well as for hypo/mania and mixed states. Sadly, both Seroquel and Epilim frequently cause problematic side effects.
Kind regards,
Ed.
Posted by SLS on June 9, 2005, at 18:31:49
In reply to Are there any Long-Term Neurontin users in here?, posted by Nickengland on June 8, 2005, at 17:29:34
> ...Like who have had success with Neurontin for bipolar, for a few years?
>
> Look forward to any replies :-)
What does your illness look like without medication?Many doctors are beginning to consider Neurontin to have no value in treating affective disorders. I'm not sure I agree with that, but it is probably more limited than what they thought a few years ago when Neurontin was being prescribed to everyone. By itself, I don't think too many physicians feel it is effective. I would not discount it, but it is probably better when combined with a drug like Lamictal.
- Scott
Posted by Slinky on June 9, 2005, at 19:43:36
In reply to Are there any Long-Term Neurontin users in here?, posted by Nickengland on June 8, 2005, at 17:29:34
Hi Nick
I would give Neurontin a try..no harm in trying.
Then maybe add another low dose mood stabiliser if needed.
What about topamax? Or fish oil ?Oh sh*typoo.. I just realised I'm posting again..I needed a break...
good luck anyway.
Slinky
Posted by Nickengland on June 10, 2005, at 5:48:07
In reply to Re: Are there any Long-Term Neurontin users in here? » Nickengland, posted by SLS on June 9, 2005, at 18:31:49
Hi Scott!
Well my illness without medication follows a distinct pattern. I can get along great, feeling on top of the world for on average 6 or 7 months, I then fully crash into depression so badly that I can't work and things. The depression will last about 6-8months then during that time things better and im back to feeling fantastic again for 6 months (brief hypomania lasting afew months) Then I crach again and round and round the pattern goes.
Its been like this for nearly 6 years now. Started when I was 17, im now 22. Since August last year though when my last major crach was, I have been going through various meds for bipolar and this is when I got the diagnosis. Before this it was a diagnosis for clinical depression.
I'm actually now taking some Neurontin since last Saturday and by its self. I'm finding that I am benefiting from it, especially for anxiety..well most anxiety really. I don't feel its going to do much as a mood stabiliser with regards to being an anti-manic. But i'm definagetly pleased with the reduction in anxiety and would like to continue taking it for this reason.
Well I have an appointment in about 3 weeks time for the psychiatrist now, so then i'm going to discuss what to add to this...lol..i've 3 weeks to think about it!
I wouldn't be able to take Lamictal, I had a pretty bad nervous reaction to that.. :-(
Kind regards
Nick
Posted by Nickengland on June 10, 2005, at 5:57:13
In reply to Re: Are there any Long-Term Neurontin users in here?, posted by Slinky on June 9, 2005, at 19:43:36
Hi Slinky :-)
I've been taking some Neurontin since last Saturday at 900mg a day, i'm finding that it does help, mostly just for anxiety, I dont think its going to do much as an anti-manic, but the reduction in anxiety is great.
I'm glad you posted as I know you're a long-term user of Neurontin...I was wondering what you're dose was and if you've found that its lost its effectiveness from when you first started taking it, does it continue to help you?
I may go for Topamax..already taking a large amount of omega 3, I find that helps too.
lol...sorry that i've ot you posting again again Slinky, always good to hear from you though :-)
Kind regards
Nick
Posted by SLS on June 10, 2005, at 7:59:25
In reply to Re: Are there any Long-Term Neurontin users in here? » SLS, posted by Nickengland on June 10, 2005, at 5:48:07
Hi.
It might be a good idea to focus on the hypomania. If you can find something to prevent it, you might break the cycle and prevent the depression that inevitably follows. I am becoming more and more impressed with Trileptal. Depakote is probably the second choice.
The chance you take with any mood stabilizer while manic is that it will stabilize you right into a temporary depression. People often rebound from this quickly.
Another school of thought is that some hypomanias can be allowed to continue untreated. If it is constant, without major depressive episodes, and allows the person to remain functional, sometimes it is best to leave them alone. You don't seem to fall into this category because your major depression is so disabling.
- Scott
Posted by Slinky on June 10, 2005, at 8:43:37
In reply to Re: Are there any Long-Term Neurontin users in here? » Slinky, posted by Nickengland on June 10, 2005, at 5:57:13
> I've been taking some Neurontin since last Saturday at 900mg a day, i'm finding that it does help, mostly just for anxiety, I dont think its going to do much as an anti-manic, but the reduction in anxiety is great.
Yes same here..good for anxiety and somewhat helps with irritation/agitation..although I'm increasingly getting more angry -- due to prozac I'm taking for paroxetine withdrawal...and my online med never delivered the lexapro.........b*stards!
> I'm glad you posted as I know you're a long-term user of Neurontin...I was wondering what you're dose was and if you've found that its lost its effectiveness from when you first started taking it, does it continue to help you?
Yes it does ..I can feel it kicking in now...
sometimes I take more or less depending if I sleep alot.
I take normally 600mg three times a day..I should be taking it 4 times a day but my pdoc is tight .
There'll be days when you may feel it does nothing
then it's effect returns.> I may go for Topamax..already taking a large amount of omega 3, I find that helps too.
Some omegas increase my anger this I never discovered why--I've order some different ones..also magnesuim citrate helps me at bedtime.
I'm going to increase the tegretol..before I go outside biting peoples heads off...I hate this intense irritability..I used to get euphoric but that's gone now.Anyways I'm a rambling..
Hope you feel fluffy soon
Slinky
Posted by Nickengland on June 10, 2005, at 9:09:00
In reply to Re: Are there any Long-Term Neurontin users in here? » Nickengland, posted by SLS on June 10, 2005, at 7:59:25
Hello Scott
I'm glad to see you're on-going success is looking good with the Trileptal. I think that it is such a good anti-manic compared with the others with its efficiency, lack of side effects and general overall effectiveness. I'm so sorry that I had to discontinue it with my kidney reaction..which since I now have from Tegretol. I think you should continue with that if it helps..i'm sure you will reap the benefits in time to come.
I totally agree with you're thoughts on the focus of hypomania. Again you are dead right about the fact I cannot leave my hypomania untreated as it will fall into depression. I definately need a solid mood stabilser to prevent these hypomanias to therefore prevent the crippling depressions. I am thinking of Depokote (hate the weightgain though) but at a low dose it may not be so bad. I would like to avoid anti-psychotics if possible and would probably choose depakote overall an antipsychotic. Lithium, lamotrigine have no worked well.
Thanks for the valid points you made there Scott, I must say we certainly have the same kind of thinking when it comes to how to treat this illness.
Kind regards
Nick
Posted by ed_uk on June 10, 2005, at 9:10:46
In reply to Re: Are there any Long-Term Neurontin users in here? » SLS, posted by Nickengland on June 10, 2005, at 5:48:07
Hi Nick!
Apart from the gabapentin, do you think you'll ask your pdoc for any other meds at your next appointment???
.......I suppose it depends on how the gabapentin's affecting you in three weeks time.
Kind regards,
Ed.
Posted by Nickengland on June 10, 2005, at 9:21:23
In reply to Re: Are there any Long-Term Neurontin users in here? » Nickengland, posted by Slinky on June 10, 2005, at 8:43:37
Hello Slinky
Thanks for the information about Neurontin, and good to see it still helps you...I may try a slight increase to see if I can get further benefits.
Shame about your online med, maybe its late in the post?..Hey if you turn you're babble-mail on I can send you some links to pharmacys i've used which I've found very reliable and the cheap.
Interesting what you say about the omega 3's i think ive noticed that sometimes too. I use seven seas extra high strenth (liquid form) but really after a while the taste isn't so bad, plus it only cost about £5.00 for 2 months use and you a great 2500 serving of omega's 3's per serving!
I must say you may benefit far better taking Trileptal with regards to you're depression, anger and irribility as compared to you're tegretol. I found the difference great, far less side effects and it actually worked like a medicine should..made you feel better! lol
Take care, I hope you feel better in time to come too...
Nick
Posted by Nickengland on June 10, 2005, at 10:40:35
In reply to Re: Are there any Long-Term Neurontin users in here? » Nickengland, posted by ed_uk on June 10, 2005, at 9:10:46
Hello Ed!
I think the gabapentin is great for anxiety....but yes to your question, I still will be asking for another mood stabiliser on top of that. So far i'm either thinking, sodium valproate or topamax. Gabapentin doesnt interact with those at all does it? Oh and does verapamil interact with any of those?..thanks if you're able to answer that Ed
Kind regards
Nick
Posted by ed_uk on June 10, 2005, at 11:35:14
In reply to Re: Are there any Long-Term Neurontin users in here? » ed_uk, posted by Nickengland on June 10, 2005, at 10:40:35
Hi Nick!
>Gabapentin doesnt interact with those at all does it?
AFAIK, there are no specific interactions between gabapentin and valproate or gabapentin and topiramate. Increased drowsiness or cognitive side effects are possible.
Kind regards,
Ed.
Posted by Slinky on June 10, 2005, at 14:43:25
In reply to Re: Are there any Long-Term Neurontin users in here? » Slinky, posted by Nickengland on June 10, 2005, at 9:21:23
>>Hey if you turn you're babble-mail on I can send you some links to pharmacys i've used which I've found very reliable and the cheap.
>Thanks Nick but I don't know how to turn the babblemail on.
~Slinky
This is the end of the thread.
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