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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Nixon on March 6, 2005, at 10:55:15
Hi Everybody,
I am curious to see if anyone has an idea of what 500mg Depakote per day would equal in Tileptal. Possibly 600mg or less? Thanks. JN
Posted by Nixon on March 6, 2005, at 11:01:55
In reply to Trileptal/Depakote Equivalency Dosage, posted by Nixon on March 6, 2005, at 10:55:15
Hi Ed,
Read my response to you up the ladder and get back to me with your thoughts on this post. John
Posted by ed_uk on March 6, 2005, at 11:25:05
In reply to Trileptal/Depakote Equivalency Dosage, posted by Nixon on March 6, 2005, at 10:55:15
Hi John!
There isn't really an equivalent dose because the two drugs have such different pharmacology. Given your response to a low dose of Depakote, I'd imagine that you might do well on a small dose of Trileptal.
>Possibly 600mg or less?
Quite possibly. Sadly, you're going to have to do some trial and error!
Ed.
Posted by Nixon on March 6, 2005, at 11:30:13
In reply to Re: Trileptal/Depakote Equivalency Dosage, posted by ed_uk on March 6, 2005, at 11:25:05
> Hi John!
>
> There isn't really an equivalent dose because the two drugs have such different pharmacology. Given your response to a low dose of Depakote, I'd imagine that you might do well on a small dose of Trileptal.
>
> >Possibly 600mg or less?
>
> Quite possibly. Sadly, you're going to have to do some trial and error!
>
> Ed.Thanks Ed,
What would be your recommendation regarding starting dose and titration with Trileptal? You gave it to me before but refresh my memory. John
PS. Initial Side effects?(double vision etc..)
Posted by ed_uk on March 6, 2005, at 12:10:55
In reply to Re: Trileptal/Depakote Equivalency Dosage, posted by Nixon on March 6, 2005, at 11:30:13
Hi!
A flexible dose titration is best, you have to play it by ear, increasing the dose when you know you can tolerate your current dose. Once you reach a dose which might reasonably be therapeutic eg. 600mg/day, you'll need to come of the Depakote. Reduce the Depakote in stages before coming off it completely. Once your off the Depakote, maintain the Trileptal dose at a constant level for a couple of weeks to see if it's adequate. If it's not, proceed to increase the dose. Obviously, if you 'freak out' in the absense of the Depakote, you may need to make some alterations to your titration schedule!
Here is a suggestion for starting.....
Friday night may be a good time to start. If it knocks you out you'll have the weekend to relax!
Friday night..... 150mg
Saturday, Sunday... 150mg twice dailyIncrease if you can tolerate 150mg twice daily...
Every day next week... 300mg twice daily.
When you're ready, reduce the Depakote to 250mg/day. If immediate release, total daily dose in two divided doses. Next, come of the Depakote completely.
Now you're on 300mg Trileptal twice daily and no Depakote. This dose may be adequate. Give it a couple of weeks if you can. If it's not adequate, increase the Trilepal. According to the product literature.....
'The dose may be increased thereafter, if necessary, in maximum increments of 600 mg daily at approximately weekly intervals.'
Remember, the total daily dose is always given in two divided doses. If you're fairly stable, increasing the dose in smaller steps may be best.
Initial side effects may include..... dizziness, drowsiness, loss of coordination, gastro-intestinal side effects.
Ed.
Posted by Nixon on March 6, 2005, at 13:13:38
In reply to Re: Trileptal/Depakote Equivalency Dosage, posted by ed_uk on March 6, 2005, at 12:10:55
> Hi!
>
> A flexible dose titration is best, you have to play it by ear, increasing the dose when you know you can tolerate your current dose. Once you reach a dose which might reasonably be therapeutic eg. 600mg/day, you'll need to come of the Depakote. Reduce the Depakote in stages before coming off it completely. Once your off the Depakote, maintain the Trileptal dose at a constant level for a couple of weeks to see if it's adequate. If it's not, proceed to increase the dose. Obviously, if you 'freak out' in the absense of the Depakote, you may need to make some alterations to your titration schedule!
>
> Here is a suggestion for starting.....
>
> Friday night may be a good time to start. If it knocks you out you'll have the weekend to relax!
>
> Friday night..... 150mg
> Saturday, Sunday... 150mg twice daily
>
> Increase if you can tolerate 150mg twice daily...
>
> Every day next week... 300mg twice daily.
>
> When you're ready, reduce the Depakote to 250mg/day. If immediate release, total daily dose in two divided doses. Next, come of the Depakote completely.
>
> Now you're on 300mg Trileptal twice daily and no Depakote. This dose may be adequate. Give it a couple of weeks if you can. If it's not adequate, increase the Trilepal. According to the product literature.....
>
> 'The dose may be increased thereafter, if necessary, in maximum increments of 600 mg daily at approximately weekly intervals.'
>
> Remember, the total daily dose is always given in two divided doses. If you're fairly stable, increasing the dose in smaller steps may be best.
>
> Initial side effects may include..... dizziness, drowsiness, loss of coordination, gastro-intestinal side effects.
>
> Ed.
>
>
>
Awesome Job Ed!I knew I could count on you. You must have read my mind about starting on Friday.lol I have a meeting with a client on Thursday morning and was definitely not going to risk stumbling or general loss of coordination while trying to get my idea across:) Your schedule is perfect and I will follow it. I am sure I will adjust to the side effects because I usually do regardless of the med. I think I will get my pdoc to give me an initial script for 1 month at 600mg.( 60 300mg tablets ) with a refill. I can always get more if I need it. I am looking forward to it and I will keep you posted. Thanks again. John
>
Posted by ed_uk on March 6, 2005, at 13:20:27
In reply to Re: Trileptal/Depakote Equivalency Dosage » ed_uk, posted by Nixon on March 6, 2005, at 13:13:38
Hi :-)
>Awesome Job Ed!
Thanks!
Best of luck,
Ed.
This is the end of the thread.
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