Mixing mood stabilizers?

[sdjeff]

Ok. I have one hell of a rx regimen. it only halfway works on many levels.

One big problem i'm having is my mood swings. I think the DEpakote ER is pooping out. I want to keep it because it still controls my headaches. My headaches are truly crippling. What I want to know is if I can combine another mood stabilizer with it.

I can't take:

Tegretol: may as well have been sugar pills

Litium: makes me feel too sick, screwed with thyroid too.

Neurontin: grave allergic reaction

I take an MAOI so that might complicate things a bit, I also have major side effects from my current meds but have little choice. I've been on nearly everything.

The situation is nearing critical. My moods are swinging like mad going from mixed states to profoundly depressed. Suicide and SI urges are getting harder and harder to fight everyday. I fear I may end up back in the hospital.

Any thoughts. ideas? am I just screwed?

Yes, I know I need to talk to my pdoc.

[Unregistered]

Lamotrigine? Or Zyprexa can act as a mood stabiliser, but the weight gain can suck.

[AirMarshall]

Sorry you are so uncomfortable right now. Hopefully this is a short term episode. The good news is that you still have options without having to abandon or add new meds. Your Depakote dosage is in the low-medium range. Assuming that you weigh 180lbs, the maximum recommended dosage is approx. 4900mg, or nearly four times your present dosage. The maximum recommended dosage for Risperdal is 6mg per day, about three times your present dosage. Both act as mood stabilizers and have strong anti-manic properties.

Lamictal does not have any interaction warning with MAOI's. However, it is not nearly as strong an antimanic as either Depakote or Risperdal. Also, it may tend to decrease blood level of Depakote by up to 25%.

You MAOI med is the primary consideration in selecting all other medications due to dangerous interactions.

Don't wait to call your pdoc!

Best, a.m.

[Loon-A-TiK]

you do have some latitude with your current meds.

risperdal is a great drug, but made my prolactin levels and hence estrogen levels go nuts, and i lactated

i take lamictal. i've found it to be a super anti-manic. once i went off of it because my community health clinic ran out and i didn't have any, and i had a horrible manic episode and caused a lot of trouble. clearly the lamictal was holding that back. even when i'm not on an atypical (which i usually am, my pdoc likes them for mania prevention), lamictal holds down the fort.

have you tried abilify? abilify seems to be doing a good job with me and feels, for lack of a better way to put it, like it is gentle compared to risperdal and the other drugs. it has a rep for being actually a better drug for bp than for schizophrenia.

[sdjeff]

Thanks for the feedback.

I weigh actually a little over 300 lbs, thanks mostly to Zyprexa and Risperdal to a degree. My dosages are low because of med tolerance issues. I've never been able to hit the established theraputic level on anything. Abilify caused major akathesia.

I still have a starter pack of Lamictal, when my pdoc calls back I'll ask him about using it.

[Maddy]

Have you ever tried Topamax? Considering your headaches and all and the whole migraine thing with the Topamax thing it might be something to try? (although I don't know a damn thing about how it may interact with your MAOI)

All I know is that Topamax was the bomb for stopping my mood swings and rage, but then again if you don't have those particular brain cooties it won't do a damn bit of good for you. Just a thought.

I <3 my Topamax and my Keppra!

[DMF]

I have to throw in my two-cents on Topomax.....it was only after starting Topomax, and having been on it only two days, did virtually all of my dd's problems, including hallucinations, start. Coincidence...maybe...but everyone agrees that it was a really weird coincidence considering there were virtually no signs and then everything fell apart. Of course, we have also found an anomoly in DD's brain that was not there about a year prior to the onset of the psychosis and mood changes and are thought to be attributable to concussions related to sports participation so it is anyone's guess what exactly it is, if even either of the two possibilities described above or maybe just a combination of lots of things. DD is positive it was the Topomax - me, I don't know except if you start doing some serious research you will find that Topomax has many more clinical trials in Great Britain than it does here in the US and there is definite evidence in a good percentage of patients that Topomax causes psychotic side effects that did not go away once the drug was discontinued. I will truthfully tell you that if I knew that before she was prescribed the meds I would not have allowed her migraine specialist to prescribe the meds. Even once I provided the clinical studies off of the web, he said that those findings had not been repeated in the US and he was not convinced that the findings were accurate the the GB studies. It's been two years since I did that research and I honestly don't know the sites but it def took some digging to find on the internet......but if your interested or concerned......

[sallie21]

Hi

I'm sorry to hear things are so rough for you, too. I just wanted to add a couple things...

First, I have had very good results with Topamax, too. It is good for mood swings...especially when they involve rapid cycling...and it is good for impulsivity (which could help with things like self-injury issues or any others)...and it would also likely help you lose some of the weight you mentioned that you gained from the Zyprexa. Oh, right, it's also good for migraines if those are the types of headaches you're having.

But for me, Topamax put a serious lid on the rapid cycling mood swings. A life saver.

I'm on Lamictal, too, but I don't know that it's really something that's known to "knock out" mood episodes that include mixed or manic components. It's more preventative on that front, from what my pdoc told me.

good luck

sallie