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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by MomO3 on July 3, 2002, at 23:38:56
I have been taking neurontin for several months and I am trying to figure out why???
I am somewhere between ADD and rapid cycling or mixed-states BP. I have tapered up to 2400mg (4/4 pills per day) - and I definitely don't feel stable. The pdoc had me stop the SSRIs completely and when I asked him what I should do when depressed - he said to trust that the mood stabilizer would do it's job.
I know something is not right, because suddenly chopping my regular daily dosage of ritalin seems like a good idea. Intellectually I know it is stupid, but I just feel BAD and I want a quick UP>
My friend diagnosed BP is taking 1500mg Neurontin + Effexor. She claims that if you take a mood stabilizer without an AD it will cause depression.
I don't know... anyone please share your thoughts.
Posted by cybercafe on July 4, 2002, at 4:09:51
In reply to Is Neurontin really a mood stabilizer?? , posted by MomO3 on July 3, 2002, at 23:38:56
yes i believe neurontin is considered a mood stabilizer, .. though not necessarily a powerful onemixed-states BP. I have tapered up to 2400mg (4/4 pills per day) - and I definitely don't feel stable. The pdoc had me stop the SSRIs completely and when I asked him what I should do when depressed - he said to trust that the mood stabilizer would do it's job.
okay i have no clue how ADD works... so who knows if it the ADD or BP causing non-stableness
now as for neurontin... i don't think it's shown to be that effective in the depressive phase of the illness ... (i believe lamictal is the only one that has shown some signs of working there... ) ...
it also would depend on whether you are type I or type II .. if you are type II, you would probably need some antidepressant to keep you normal, whereas type I is more likely to get away with just a mood stabilizer...
> My friend diagnosed BP is taking 1500mg Neurontin + Effexor. She claims that if you take a mood stabilizer without an AD it will cause depression.nope that's just not true... :)
i know a lot of people who do it...
i think type I s are much more likely to get away with it though
> I don't know... anyone please share your thoughts.
Posted by Ritch on July 5, 2002, at 10:11:13
In reply to Is Neurontin really a mood stabilizer?? , posted by MomO3 on July 3, 2002, at 23:38:56
> I have been taking neurontin for several months and I am trying to figure out why???
>
> I am somewhere between ADD and rapid cycling or mixed-states BP. I have tapered up to 2400mg (4/4 pills per day) - and I definitely don't feel stable. The pdoc had me stop the SSRIs completely and when I asked him what I should do when depressed - he said to trust that the mood stabilizer would do it's job.
>
> I know something is not right, because suddenly chopping my regular daily dosage of ritalin seems like a good idea. Intellectually I know it is stupid, but I just feel BAD and I want a quick UP>
>
> My friend diagnosed BP is taking 1500mg Neurontin + Effexor. She claims that if you take a mood stabilizer without an AD it will cause depression.
>
> I don't know... anyone please share your thoughts.Hi,
I think Neurontin has "mood-stabilizing" qualities about it, but it often doesn't address many fundmental "core" symtpoms of mania (at least not very well). The thing it helped me with the most was the agitation that accompanied mild mixed-states. I still had hypomanic spells with anger outbursts. I guess, to sum it up-it worked the best on the mixed anxious/depressive symptoms that accompanied hypomania or mixed states, but not as well on cycling, and anger (as depakote or lithium does).
"Mood stabilizers" are really antimanic agents. Most of them have little or no antidepressant effects. If anxiety is driving your depression, then they might be useful indirectly as an antidepressant. They can make you "flat" and "tired" at higher doses. Sometimes just taking *less* antimanic agent (to combate fatigue or flatness) and avoiding (or reducing dosages) of meds that can aggravate mania works better than escalating doses of everything up and up.
Mitch
Posted by Hattree on July 5, 2002, at 10:18:30
In reply to Re: Is Neurontin really a mood stabilizer?? » MomO3, posted by Ritch on July 5, 2002, at 10:11:13
I think neurontin is used more as an adjunct than on its own. I don't know that it helps me as a mood stabilizer (Lamictal does that) but it does help me feel more relaxed and sleep better.
--hat
Posted by cybercafe on July 5, 2002, at 14:59:17
In reply to Re: Is Neurontin really a mood stabilizer?? » MomO3, posted by Ritch on July 5, 2002, at 10:11:13
> I think Neurontin has "mood-stabilizing" qualities about it, but it often doesn't address many fundmental "core" symtpoms of mania (at least not very well). The thing it helped me with the most was the agitation that accompanied mild mixed-states. I still had hypomanic spells with anger outbursts. I guess, to sum it up-it worked the best on the mixed anxious/depressive symptoms that accompanied hypomania or mixed states, but not as well on cycling, and anger (as depakote or lithium does).
Hi Ritch,
Yeah I suppose gabapentin would probably not be used alone to address a patient who is manic (type I)
Did you try the maximum dose? How high did you go dude?
I really like it for agitation and anxiety... but you're right it's definately not perfect...
but I often wonder if raising the dose would help...
> "Mood stabilizers" are really antimanic agents. Most of them have little or no antidepressant effects. If anxiety is drivingI'm really interested in this... since a lot of people say this... but I once went to a support group where 70% of the patients on lithium said it worked when they were depressed...
plus i looked on the net, and saw that lithium was often used in unipolar depression... so... i don't know what to do...Might I ask what your source is for this?
my personal experience was... valporate depressed me... but that's because i'm Type II and we tend to average a negative state.... whereas Type I tends to be as high as they are low ...
>your depression, then they might be useful indirectly as an antidepressant. They can make you "flat" and "tired" at higher doses. Sometimes just taking *less* antimanic agent (to combate fatigue or flatness) and avoiding (or reducing dosages) of meds that can aggravate mania works better than escalating doses of everything up and up.Yeah I found that too... but I don't know if that result is typical...
My doc gave me 4 different meds that were very sedating, and then wondered why I couldn't keep my job.... Hah... falling asleep for an hour at a time just isn't good
Posted by cybercafe on July 5, 2002, at 15:00:08
In reply to Re: Is Neurontin really a mood stabilizer??, posted by Hattree on July 5, 2002, at 10:18:30
> I think neurontin is used more as an adjunct than on its own. I don't know that it helps me as a mood stabilizer (Lamictal does that) but it does help me feel more relaxed and sleep better.
...Lamictal sounds like an awesome drug...
...does it relieve anxiety at all?
Posted by Zo on July 5, 2002, at 17:07:37
In reply to Is Neurontin really a mood stabilizer?? , posted by MomO3 on July 3, 2002, at 23:38:56
Posted by Ritch on July 5, 2002, at 18:47:31
In reply to Re: Is Neurontin really a mood stabilizer??, posted by cybercafe on July 5, 2002, at 14:59:17
> Hi Ritch,
>
> Yeah I suppose gabapentin would probably not be used alone to address a patient who is manic (type I)
>
> Did you try the maximum dose? How high did you go dude?
>
> I really like it for agitation and anxiety... but you're right it's definately not perfect...
> but I often wonder if raising the dose would help...I started off at 900mg/day along with Depakote, Klonopin, and Celexa (about 3 years ago). Then I stopped the Depakote because I felt so much better-it was during a depression). Then the neuro I was seeing doubled it to 1800mg/day. That's when I got derealization/depersonalization from it along with bad cognitive side effects (this also happened with Gabitril and Topamax). So, the dose had to go down. It went all the way down to 100mg 4x daily, and I stayed on that for quite some time until recently. I added Depakote back in for hostility (which worked during a hypo spell and still is working), then swapped low-dose Celexa for low-dose Effexor(which has worked for this current depressive spell). Then most recently went off the Neurontin to boost alertness during the day (which helped). I got a little uptight from stopping it, but I am OK. I am just trying to simplify my med regime and save some $$$.
>
>
> > "Mood stabilizers" are really antimanic agents. Most of them have little or no antidepressant effects. If anxiety is driving
>
> I'm really interested in this... since a lot of people say this... but I once went to a support group where 70% of the patients on lithium said it worked when they were depressed...
> plus i looked on the net, and saw that lithium was often used in unipolar depression... so... i don't know what to do...
>
> Might I ask what your source is for this?
>
> my personal experience was... valporate depressed me... but that's because i'm Type II and we tend to average a negative state.... whereas Type I tends to be as high as they are low ...
Lithium and Lamictal probably are the only two antimanic agents that generally have much significant antidepressant effect. When I first switched to Depakote from lithium my depression worsened. There is NO WAY I could take Depakote by itself and get any antidepressant effect from it. There HAS to be something else. As far as the "source" goes (about mood stabilizers being really only antimanic agents)-it was a link to an article by a psychiatrist that was complaining about the misunderstandings regarding the term "mood stabilizer". It is stashed here-but it has been a month or so-and I can't remember it-it was very convincing however.Mitch
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