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  1. ..as my pdoc affectionately refers to it.. "Dopamax" because of the pronounced problem with word finding and cognition. I don't notice any problems at 100mg of Trokendi XR, but I don't plan on going any higher, because it's doing it's job as migraine prophy. Depakote screwed my cognition to hell, though. Trileptal was OK for cognition, although I did experience some word finding problems. I think over the years I've gotten used to a certain degree of "I can't find the right word anymore" so I don't notice it as much, but Depakote turned entire conversations into "does not compute." That was not so fun. How are you liking Rexulti? I see you're at 3mg. I find it tends to do more to keep me generally calm and level more than any other single med, and it beats the hell out of my depression.
  2. Trokendi XR is indicated for migraines (at least, that the mfg's marketing angle,) although I suppose it could be beneficial for anyone prescribed Topamax. Supposedly the ER formulation is NOT the same as Trokendi XR, although not enough studies have been done to assess the pharmacological differences between the ER and XR formulations. UpToDate notes that bioequivalency has not been demonstrated between the two forms. I find Trokendi XR to be very tolerable as far as side effects go (compared to IR Topamax) and it has been highly effective as migraine prophylaxis. YMMV. I like it though. Trileptal was tolerable until 1200mg, then it made me eat like crazy. Supposed to be good for particular types of seizures according to my pdoc, moderately effective as a mood stabilizer (hit/miss.) I trialed it for several months at 900, then 1200, and it did nothing for my mood, so I stopped it. You might get that double benefit, though.
  3. 10mg is low for therapeutic use. Not sure how effective it would be at treating anything. I'm sensitive to APs and I had to hit 40mg before I got any mood benefit from Latuda (and the accompanying side effects that caused me to d/c it.)
  4. My personal opinion is that Lithium can cause the anhedonia, but pdocs generally don't seem to agree. I was on it for a year, and when I finally stopped it, my tdoc said she noticed a brightening in my mood and I seemed happier, even though consciously I wasn't aware of being any different. She said it was a marked difference and started pointing out things I was doing differently that I just didn't notice. Lithium had dulled me out and given me a flat affect too. Things weren't going well at the time, so I just chalked it up to life being difficult, but I wasn't really happy on Lithium either. Just my own experience...
  5. I was on Lithium + Seroquel + Klonopin for a bit, although at lower doses for the Seroquel and Klonopin, and it only provided some relief from my depression. Mostly just made me sleepy nearly 24x7 and jumped my anxiety through the roof, along with GI side effects from the Lithium. I'm surprised you can function on that combo, that's a lot of sedating meds, Buspar included!
  6. You're sitting in about the middle of the range, I don't know that I would want to push it much higher. There isn't really a correlation between a higher TI range and feeling better, and Lithium is toxic at too high of a dose. If you're feeling better, I'd stay there for a while and work with that.
  7. 5mg of Abilify is pretty low, lots of room for increasing the dose there. If it was working, why not try increasing the dose a bit higher?
  8. This. Seroquel has zero practical affinity for dopamine until at least 200mg, and really doesn't show much efficacy for depression until around 400mg in most studies. At 100mg it's mostly good for making you sleepy and hungry (and I'm speaking from personal experience.) It also gave me a flat affect, so I looked like I had no emotion all of the time. There's just not much benefit at that low of a dose.
  9. It's worth a shot to see if it helps your depression, although it's understandable if you can't tolerate the drowsiness from it during the daytime either. Perhaps the XR version would be worth a shot?
  10. Usually a serum level is drawn to check your levels. The reference range is determined by the lab, so it can vary slightly from place to place. It usually takes about a week for your levels to stabilize when you switch dosages due to the half-life. I know that when I was on 1500mg of ER, my level was above therapeutic, so we cut it back to 1000mg to keep it in range. Ultimately, Depakote didn't work for a lot of reasons, but your serum level should be checked to see where it falls in the range, and if it's clinically therapeutic or not as a starting point.
  11. Xanax XR

    This. Valium and Klonopin don't work well at all for me, at what my pdoc will prescribe as the typical max dose (20mg and 2mg, respectively.) I was hoping the XR version would work as well as the IR version; alas, it didn't, and some days I have to dose twice a day. I was trying to avoid that, but the XR just isn't as effective. I could've pushed for the 2mg XR, but 2x day IR dosing is more effective at treating my anxiety, so why go down that road?
  12. Xanax XR

    I was hoping for good things, as the IR version works extremely well for me, but the XR formulation is just not even close to equivocal in efficacy.
  13. I finally found some relief from migraines with Trokendi XR. I had to get up to the recommended 100mg dose before I got any effect, though. For some reason my neuro started me at 50mg, which did absolutely nothing, and left the dose there, until I called to tell him I was still getting 10+ migraines a month and would he please try the 100mg dose. I know it's just reformulated Topamax, and I have no experience with regular Topamax, so I can't speak to whether or not the XR formulation makes a difference or not. I know it's specifically targeted for migraines and has a 31h half-life so you only have to dose once a day, and side-effects are extremely minimal compared to IR Topamax. The MFG also has a really good PA program, because the shit is expensive! I sound like a walking advertisement, lol, but I've been on the 100mg dose for 2 months now, and had zero migraines the first month, and only 2 the second, compared to 10+ every month for well over two years (that I've journaled.) Depakote did nothing for me, neither did Trileptal, or Lamictal. 80%+ reduction in the number of migraines is a success, and I hate taking triptans, they all make me feel weird or worse (Imitrex is horrible!) but they work as an abortive. If you can find a neuro or pdoc willing to write for it, I suggest giving Trokendi a shot, but start at 100mg (the recommended dose!) I dunno why they even make 25mg and 50mg doses when the guideline for migraine prophy is 100mg...
  14. Xanax XR

    UPDATE: I ended up dropping the Xanax XR. It just wasn't effective enough at 1mg. I still had breakthrough anxiety and needed IR to help with the breakthrough. Pdoc just adjusted my IR dose upward for 2x day dosing based on what I feel works for me (usually start with 1mg, and re-up with 0.5mg.) I ended up taking the XR pretty much every day to get relief from anxiety; it just couldn't match the efficacy of the IR version. With the IR, I don't feel like I need it every day, and when I do take it, it flat out works.
  15. Temazepam?

    Temazepam is back in rotation for my insomnia. I alternate it with Lunesta and I find that I don't build a tolerance to it like I used to. It's not heavily sedating, but enough that I can fall asleep at the end of a long day at a reasonable hour.