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Need to change my cocktail


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Hmmm.  Well, I have to take at least 1200mg of Trileptal in order to not slip back into depression, and that's even with an SSRI on board (I'm BP2 but AD's don't "bother" me usually, they all just poop out w/o a mood stabilizer).  So just from my personal perspective, 450mg seems really low.  Any way you can counteract the blood sugar problem and go higher?  Or maybe (groan) another MS?! I don't know the dosages on Cymbalta ... is there room to increase?  Or does that increase the potential for anxiety? 

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Opps....it's not blood sugar, it blood sodium.

Oooooh, the dreaded hyponatremia issue.  I get that.  Bad.  To the point where I had a couple of "drop down, black out" seizures when I was also taking a diuretic for blood pressure control a couple years ago.  The Trileptal works so well for my mood issues that I'm afraid to try a switch though, so nowadays I just make sure to eat salty foods and watch my fluid intake.  I also drink about 1/4 tsp. of pure sea salt (I found this stuff called "Real Salt" that contains trace minerals as well, and actually tastes good) dissolved in a cup of water every day.  Sounds disgusting, but when your body needs sodium, it's a good way to go.  I rarely have trouble with puffiness.  Of course your diabetes might complicate the fluid intake issue.  ??

Since I got pretty "up" with 150 Well, I'm not sure I can handle 300, but maybe it settles down after a couple of weeks.

Boy I dunno.  I was on a pretty high dose of Wellbutrin for a long time before I realized THAT's what was aggravating my anxiety.  But everyone's different.  Your "good" pdoc might have an opinion on whether that's worth a try  ;)

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