Posted by SLS on May 19, 2012, at 9:33:47
In reply to Scott- what to add?, posted by sheilac on May 19, 2012, at 8:09:59
> Scott, I like Trileptal, but at a higher dose I felt even flatter, with no personality and motivation.
That is definitely not what we are looking for. So, it seems that 300 mg is an ideal dosage for you. It knocked out the mania and left you feeling great for awhile and without flattening.
> But I do wonder if just going higher on Trileptal if I could tolerate low dose Adderall better (I hate the come down effect of Adderall later in the day) or if I could tolerate a low dose of Wellbutrin. Then, maybe a higher dose of Trileptal would be worth it. If it would address the depression. Trileptal dose nothing for my depression.
I am guessing that going higher on Trileptal will still not allow you to take either of those two drugs without experiencing the psychiatric side effects that you describe. That is not to say that you cannot take antidepressants in general. With mood stabilizers in place, you might be okay with certain antidepressants. I like the idea of your being on Abilify before going the antidepressant route. If Abilify is of some help at lower dosages, I would consider optimizing the dosage and leaving it in place while you try other drugs. Personally, it has been my experience that MAOIs, Effexor, and nortriptyline help to treat my bipolar depression.
> Scott, I'm not sure I need anymore anti-manic effects at this point.
You would be using the Abilify for depression. It just so happens that it helps to prevent mania as well. It is not necessary that you feel flat by Abilify just because of this. It usually doesn't do that, especially at lower dosages (2 - 10 mg). I think that it really does stabilize dopamine systems as has been theorized.
> > What was it about Lamictal that you could not tolerate?
> Lamictal made my mouth and gums break out in blisters. It was an awful experience. I tried this med several times in lesser and lesser doses and it still did it to me.
I am sure you are aware that those are the symptoms of true Stevens-Johnson Syndrome (SJS). This reaction is serious, and can be fatal. It probably was not such a good idea to rechallenge you with Lamictal after displaying SJS.
> Soctt, why do you think 600mg of Trileptal would be better?I thought it would guarantee protection against mania and possibly allow antidepressants to work better. However, it sounds like 300 mg is optimal for you.
> Would it kick in some anti-depressant effects? I could go higher, I just don't want to feel flatter, with no motivation.
How long did you remain at 600 mg before deciding to return to a lower dosage?
I don't think you are at the point where you should feel desperate. You have several alternatives for treatment, and I think you should be optimistic that you will find a treatment regime that keeps you stabilized and euthymic. However, in order to give you the best chances of finding the right drugs and dosages for you, compliance to the treatment plans chosen is essential. If you are reacting badly to something, contact your doctor. It is important to be vigilant if side effects emerge that are likely to be startup effects that soon disappear. I get the feeling that you might be inadvertantly sabotaging your treatment if you experiment on yourself out of impulse. I wouldn't blame you for this. However, you should fight the urge to self-medicate and work with your doctor in making treatment decisions.
Oh, yes... and don't place too much faith in me to know exactly what is best for you. I am only guessing.
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1018227
URL: http://www.dr-bob.org/babble/20120508/msgs/1018236.html