[jarn]

Hello....

dx is Bipolar Affective Disorder, manic with pyschotic features, rule out Schiztoaffective Disorder.

After the unsuccessful attempt to go off of Seroquel and onto Ziprasidone, I am back on Seroquel, but at a low dose (400mg).

I am going to my gp Thursday to go over the meds the pyschophamaracologist recommended I use with Seroquel if I stay at a low dose of Seroquel (rather than the Ziprasidone).

He recommended Gapapentin (!!) and/or Pregabalin.

I've done some reading on both and it appears that Gapapentin isn't in fact all that good for Bipolar or mood stabilization in general. My understanding is they are very very similar, but that Pregabalin may be better for anxiety - it wasn't clear to me from my reading how affective a mood stabilizer it was.

Does anyone have any experience with these meds, with or without Seroquel?

The side effects don't seem to be too bad, but I just couldn't find the same kind of info online I could normally with anti-psychotics.

I'm a little concerned b/c I'm not stable right now and I would probably need to double the Seroquel to become stable. I'm worried that I'm going to be counting on what seem to be untested drugs to add that extra stabilization. Right now I feel like I'm very close to fully triggering up....I feel like my head is fighting the reins and is very close to gaining control. The Ziprasidone worked well for my head, it appears to me that AAP's work well for my brain in terms of stopping me getting triggered up AND for stopping my paranoid stuff. I feel like mentally I do the best on them, I just don't like the side effects. I was on lithium and it did not fully control me and I'm concerned the Pregabalin won't either. I guess though, I won't know til I try.

This post has been edited by jarn: 20 April 2009 - 01:15 PM

[jarn]

Anyone....shoot, does nobody have experience with Pregabalin?

I'm really concerned I'm being given a so-so drug....boo.

[Stacia]

My pdoc considers Pregabalin an anti-anxiety med that may or may not also provide some stability. The research that I've read sounds like what you have read. That said, I do know one person w/BPI who finds that it effectively stabilizes her.

I read your other posts, and the thing that stands out to me is that you are being treated by a GP and not a psychiatrist. If at all possible, I'd find a good pdoc. They are the experts, and although you went to a psychopharm, that is a one time appt with someone who knows meds but not you so well. JMHO, fwiw.

A good pdoc would be familiar with meds, you, and mixing/matching meds to meet your needs. There are other stabilizers that you have not mentioned. Depakote is a good med. The issue tends to be side effects, and those tend to hit female hormones. Tegretol is another anticonvulsant. It is not necessarily considered as effective as Lithium or Depakote, but it is considered an effective stabilizer that works for many. Trileptal is related to Tegretol. It tends to have fewer side effects, but may or may not work as effectively. You also said elsewhere that Lamictal was d/c'd due to a non-SJS rash. That may be worth revisiting. Could also be that Lithium plus something else could be more effective than your Li only trial. The only point I'm trying to make is that working with a good pdoc is more apt to get you on an effective treatment regimen faster than a GP with a little psychopharm input.

[jarn]

Thanks Stacia. Everything I've read indicates it has usefulness as a anti-anxiety med, and while I can become panic-y and have this terrible dread at times, I wouldn't say that I really have problems with anxiety - it's something that comes up if I'm not stable, outside of that I don't have anxiety. Good to know you know someone with BP1 who found it useful though.

I agree with you about a pdoc. I'm going to talk to my gp about this on Thursday and try to explore some other avenues. I was just pming with a Canadian member actually asking how she got hers!

I have been seen by this psychopharmacologist multiple times, and can see him without a referral from my gp, but he doesn't work the same was as a normal pdoc does. I was seen by a pdoc for a period of time after I went off of lithium to stabilize me (was seeing the psychopharmacologist at the same time) and he followed me for awhile after I was on Seroquel but I've also been referred to short-term follow-up type clinics.

And I would like a pdoc....I find trying to navigate meds stressful, and while I really like my gp....it's not his area of expertise. And he can't prescribe me beyond what the psychopharmacologist sends him, so it's a longer more wieldy process than I think it should be.

I was wondering about lithium w/Seroquel. Maybe a lower dose of Li wouldn't make me hypothyroid....I am a runner so I had to be careful of long races/runs, particularly in the summer, and dehydration/accidental toxicity - only had an issue once, normally I just skipped Li the night before long races (half/full marathons) but for a shorter trail run once I didn't and I had some issues.