Jump to content
CrazyBoards.org

Recommended Posts

My P-Doc changed my meds around again (thank God or Oh, no.....I don't know which one).

It seems to have alot of overlapping:

Effexor XR 150mg

WB SR 300mg

Lexapro 10mg

Topamax 100mg

Does anyone have any insight? I told her that the effexor has killed my anxiety but I am supper depressed. So she left me on the WB and Effexor and added Lexapro? Huh?

The Topamax was added because I got the funky rash from the Lamictal....which really seemed to help me.

I hate meds.

N.J.

Link to comment
Share on other sites

Um... I don't know. Topamax is a pretty weak mood stabilizer, and that's an awful lot of AD's you're on now. Do you know why your pdoc wanted to go with Topamax to replace the lamictal, rather than some other mood stabilizing option?

Have you talked to him about having an emergency/back up plan in place, in case of breakthrough symptoms during the topamax titration? (I'm a big fan of back up plans during any and all med switches, just because, you know, meds are wierd, and wierd stuff can happen during changes, and I always like knowing that I know what to do, in case I find myself flipping out whilst titrating up or tapering down on this or that, at 3 am or something).

Link to comment
Share on other sites

Um... I don't know. Topamax is a pretty weak mood stabilizer, and that's an awful lot of AD's you're on now. Do you know why your pdoc wanted to go with Topamax to replace the lamictal, rather than some other mood stabilizing option?

Have you talked to him about having an emergency/back up plan in place, in case of breakthrough symptoms during the topamax titration? (I'm a big fan of back up plans during any and all med switches, just because, you know, meds are wierd, and wierd stuff can happen during changes, and I always like knowing that I know what to do, in case I find myself flipping out whilst titrating up or tapering down on this or that, at 3 am or something).

I took lamictal and it helped me so, so much. I had never had anything help me that much before. Of course, I got the rash with it. They were going to put me on Depokote but I am super anxious about the side effects on that one (hair falling out (I am already having massive amounts of hair falling out due to stress) and weight gain (I have bulimic tendencies)). That is how she came to the conclusion that topomax or neurotin would be my next step.

It is a good idea, to have a back up plan. I am going to call her tomorrow about that. I am infamous for going to nutsville at 3am.

;)

Link to comment
Share on other sites

My P-Doc changed my meds around again (thank God or Oh, no.....I don't know which one).

It seems to have alot of overlapping:

Not really.

Effexor XR 150mg

WB SR 300mg

Lexapro 10mg

Topamax 100mg

Topomax is an anticonvulsant/mood stabilizer, and doesn't work at all like the three antidepressants. It's also a good backup plan for reducing bipolar cycling from Effexor or countering a reduced seizure threshold from Wellbutrin.

The Effexor dose is probably not high enough to inhibit noradrenaline reuptake, but Wellbutrin does primarily affect NA transport. Killing off your anxiety is a pretty good indicator that the serotonin reuptake inhibition that the Effexor does perform at the dose is working.

But, increasing Effexor much more may not improve serotonin levels and is likely to start jacking NA levels up (on top of the WB, and a good way to bring anxiety back.)

My impression is that the doctor is nudging serotonin levels up to see if that improves your depression symptoms. Lexapro is pretty darned selective for doing just that. If it doesn't work out, it's easy enough to drop the Lexapro and increase Effexor to see if NA levels can be safely increased (juggling depression and anxiety is probably far harder than it sounds like).

I wouldn't be surprised to find the Wellbutrin being kept in to help mitigate the cognitive effects many people complain about on "Dopamax" (Wellbutrin often gets prescribed when ADD is comorbid with depression.) Nah. That makes too much sense for it to actually work, what with two medications known or suspected to have temporal lobe effects.

And if you do manage to get knocked into a manic or hypomanic state, it *should* be easy for the doctor to drop the Lexapro and increase Topomax to deal with it.

Link to comment
Share on other sites

Topamax does, though, seem to be one of the anticonvulsants to which different people do have pretty varied responses (when used for mood stabilization, specifically, no clue about when it's used for seizure issues or migraines). YMMV is maybe a little more true for this than some of the others?

Link to comment
Share on other sites

  • 2 weeks later...

my first reaction in looking at it was that they work on different neurotransmitters. cymbalta is hitting differently than wellbutrin, for example.

AM had a much better explanation. my scientific explanations suck, so i won't go there!

it does look like he's trying to boost seratonin.

topa over lamictal? there are a lot of types of bipolar, and just because topa is weak in some people (or makes them dysphoric manic, like me, and gives them weeks of insomnia, like me) doesn't mean that others don't benefit a lot from it. a lot of people on this board love the stuff. i'd give it a go. the worst that could happen is a dysphoric mania ;)

no, really, you might have the brain architecture and chemistry that would respond to topa. have an open mind and give the new line-up a go. it doesn't look like it will hurt you.

sorry about the rash. lamictal is really a wonder drug for me. it does the job like nothing else and is the most important drug for me in my cocktail.

Link to comment
Share on other sites

Hey, guys!

The new mix didn't exactly work, the lexapro made me feel kinda drunk: dizzy and stuff. So she upped my wellbutrin and discontinued the lexapro (I hope it doesn't increase my anxiety like suggested above) and kept me at a small dose of topamax because it seems to be working at a small dose. I have found patiences with my children. I have word finding problems but now I can find my way home when I get lost! Seriously! I have found directional/spacial ability that I didn't have before, LOL!

So my new cocktail is:

Wellbutrin 300mg

Effexor 225

Topamax 50mg

At least I am down 1 pill a day!

Link to comment
Share on other sites

Archived

This topic is now archived and is closed to further replies.

×
×
  • Create New...