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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 joe f on September 19, 2015, at 21:37:52
recently had meds adjusted for bipolar with some ocd -much anxiety
seroquil 150 for sleep
lamictal 200 (really 100 because of tegretol
tegretol400
low dose of Prozac 15
klonopin 2.5any thoughts
Posted by Christ_empowered on September 19, 2015, at 21:57:21
In reply to opinions please, posted by joe f on September 19, 2015, at 21:37:52
can you switch out tegretol for trileptal? I mean, I'm not your doc, but it would make for fewer drug-drug interactions and dosing adjustments.
Posted by rjlockhart37 on September 19, 2015, at 23:46:46
In reply to opinions please, posted by joe f on September 19, 2015, at 21:37:52
you could go to trileptal, it's less side effects yet does the same thing (some ways tegratol can be superior in some sizures) but tileptal has much less side effects to it's parent drug
so the prozac is at 15? you could ask about ... depending your situation an increase, that or adding remeron at night for sleep and anxiety, because i have read lots of posts here about people taking remeron and had success......but it also can make you tired, but it depends....
Posted by SLS on September 20, 2015, at 6:21:20
In reply to opinions please, posted by joe f on September 19, 2015, at 21:37:52
Hi.
> recently had meds adjusted for bipolar with some ocd -much anxiety
>
> seroquil 150 for sleep
> lamictal 200 (really 100 because of tegretol
> tegretol400
> low dose of Prozac 15
> klonopin 2.5
>
> any thoughts1. What are you experiencing that still needs to be treated?
2. How long have you been taking this new regime?
3. You might need to take a minimum of 400 - 500 mg/day of Lamictal in order to approximate the 200 - 300 mg/day that is usually necessary to produce an antidepressant response. You can use Lamictal blood tests to help guide you.
4. OCD requires higher dosagea of SRIs to produce results. Prozac is often used at dosages of 60 - 80 mg/day for an extended period of time.
5. Does Tegretol produce sedation?
6. If you use Trileptal, instead of Tegretol, you can avoid the higher risk of agranulocytosis and sedation. It also will not affect the levels of Lamictal.
Good luck.
- Scott
Posted by joe f on September 20, 2015, at 7:24:45
In reply to Re: opinions please » joe f, posted by SLS on September 20, 2015, at 6:21:20
ocd not bad ....dr more concerned about ssri induced mania....on regime for 6 weeks
Posted by joe f on September 20, 2015, at 10:37:23
In reply to Re: opinions please, posted by joe f on September 20, 2015, at 7:24:45
may have to raise dose for ocd but even though 5 meds are they relatively low doses or should I drive myself nuts because there are 5?
Posted by bleauberry on October 2, 2015, at 14:38:19
In reply to opinions please, posted by joe f on September 19, 2015, at 21:37:52
Add the herb Rhodiola Rosea.
By emptying capsules and taking custom tiny doses (tastes like rose, mix in food or water), start at 25mg roughly, increase every 4 days, with a first goal of 100mg, stay there a few weeks, and then if desired keep going....common doses are usually in the 400mg to 500mg range. My best dose is 100mg.
It is one of the world's best medicinal plants and has a lot to offer for depression, anxiety, and insomnia. But it is finnicky to get started, can worsen those things in the beginning, and thus the tiny doses and gradual titration. Many people have ditched this fantastic treatment by taking too high of a dose too fast.
It's powder of a root and used as food as well. Mixes with your meds.
I don't have any med suggestions for your cocktail because of them all, I believe Rhodiola is better.
Posted by phidippus on October 13, 2015, at 22:09:07
In reply to opinions please, posted by joe f on September 19, 2015, at 21:37:52
Your Prozac is too low. You need to take 40-80 mg.
Eric
This is the end of the thread.
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