Posted by Ritch on August 12, 2002, at 22:52:15
In reply to Top Edge of Hypomania, posted by Bart1 on August 12, 2002, at 21:04:31
> My wife was taking 1800 mg of Neuronton & 10 mg of Paxil a day for her bipolar situation and it worked fairly well 'til she hit a major manic period (caused by reaction to antibiotics?) and was hospitalized. There, they've added 1000 mg of depakote and 900 mg of seroquel. She no longer seems manic most of the time.
>
> But, every other day, I see the top edge of her hypomania, the portion where she knows almost everything, has no problem with divorce because she has so many alternative places to go, where I am the cause of all ills, and knows how much quicker and clearer she thnks than anyone around her, especially me.
>
> Shouldn't all those meds have stopped that kind of thought and knocked the top edge off? After 3 weeks of this condition, shouldn't she be heading toward her normal lows?
>
> Any thoughts/direction is appreciated.
Just some thoughts,There have been a few reports of Neurontin induced hyperthyroidism and some rare reports of hypomania. It is generally known that Neurontin is not very effective for acute manic reactions. Paxil likely could have been the trigger for this manic episode. SSRI's have likely triggered (or aggravated) most of my hypomanias in the last several years.
Is she still in the hospital? The Seroquel dose seems very high. Do you have any confidence of her compliance with the medications? Seroquel has a very short half-life, and needs to be dosed twice-daily (at least). If she is ditching a 2nd dose during the day, you may be seeing a rebound effect of a Seroquel dose wearing off, instead of a breakthrough hypomania. You might talk to her doctor about withdrawing the Seroquel (and Paxil) and leaving just Depakote and Neurontin, and see how she does (and see what the pdoc thinks about it).
good luck-
Mitch
poster:Ritch
thread:116213
URL: http://www.dr-bob.org/babble/20020807/msgs/116224.html