any success with a combo of lithium and depakote?

[wemble]

after many failed attempts at anti psychotics and still cycling while on just lithium, my pdoc has put me on a combo of lithium (750mg and 900mg on alternating days) and depakote (500mg). we've just started on this, so he seems to think there'll still be some dosage adjusting to do, but wanted to get my initial levels first. eventually he wants to even out my lithium dose (taking JUST 750 or JUST 900) which would be nice and he's hoping that the depakote can pick up where the lithium leaves off (it takes care of the brunt of the work, just not all of it). we're hoping that my moods will stop cycling, my head will clear up (i'm in need of some cognitive glue, as he called it ), and that these left over psychotic symptoms i get from time to time will stop (they show up as soon as i cross over into the edges of an episode - esp. mixed or manic).

has anyone had any luck with this combo or a similar one (two+ mood stabilizers)? i actually feel hopeful about this (unlike how i was feeling with the anti psychotics) but of course it's a game of playing with the dose and wait and see. i'm just hoping we're moving in the right direction finally.

thanks!

[Anna]

I've combined depakote with neurontin only, which is not really a great mood stabilizer but the two play well together for me.

That said, many docs do find success combining with 2 mood stabilizers low dose, psycheucation.org has quite a bit of info on this, you may want to check it out.

As far as lithium/dep I have never been on the combination of the two but I can tell you my experience with depakote, as a somewhat rapid cycling mixed/maniky person who is highly highly unstable, usually, often (I just have a very nasty form of BP and am very sensitive to stress).

DEPAKOTE IS THE ONLY THING THAT WORKS FOR ME. Period. For the mixed/manicky/rage/wacko shit. I do augment with AAPs and I need to, but as far as actual mood stabilizers go, when I finally commited to depakote, period, for like 2 plus years, I was really stable. I was also on SSDI and the less stress may have played a part, but until I went back to work and some other life stressors PILED up, and stuff like that, it continued to work well.

I've pretty much accepted that depakote works, for me. And that I can only work part time. That's sort of where I am slowly but surely edging my life ATM. I'm working 30 hrs per week, thank god (supposedly, heh, but it does make my schedule easier) and going to intensive DBT and really, things are starting to improve.

I have a long way to go (stupid pdoc decision to try an SSRI after I told him that was a bad plan) but... it's getting better.

I love my depakote, and nothing will make me give it up at this point, I don't think. I've tried everything but topamax, and I just don't see that, uh, working for me?

Anna

[dedoubt]

That's pretty much exactly what I do. I can't take APs, and have spent years changing meds around and around. This is the first time I've come close to finding a good combination (though I did have a period of calm when I only took Neurontin & Klonopin). Of course every person will respond to different doses, but I am taking 900 of lith. and 500 of Dep., along with 1200 gabapentin (Neurontin), a TCA & levothyroxine + PRNs up the wazoo. I'm not entirely stable, but that is partly to do with my stupid thyroid being fucked up. My increase of levothyroxine hasn't really managed to help me feel better yet.

Though I am taking more meds, I am taking smaller doses than the usual, which makes sense to me-- use the smallest dose possible to avoid SEs. That method is working for me. I'm just pissed that my thyroid is so screwed up, because eventually I may have to stop the lithium if my thyroid doesn't chill out. AUGH!!!!!!!

[wemble]

As far as lithium/dep I have never been on the combination of the two but I can tell you my experience with depakote, as a somewhat rapid cycling mixed/maniky person who is highly highly unstable, usually, often (I just have a very nasty form of BP and am very sensitive to stress).

that's actually encouraging b/c it sounds like me. i always thought depression was my problem, but when i learned more about BP i realized they were awful mixed states (and i wondered why no one knew what i was talking about when i described "depression" to them). i deal mostly in mixed states followed by hypo/mania, and then "plain" depression. pdoc said depakote worked well for manias and mixed episodes. they were gonna put me on that in the hospital but opted for a lithium/saphris combo instead (which worked well until i had to stop the saphris). the lithium is awesome (esp. since nothing else has worked remotely before) but i'm still not functional on it (my therapist wants me to schedule eating/drinking times and prepare food that i can just grab and go because i can't even seem to get that right).

dedoubt: hope your thyroid issues are resolved soon. it must suck having to deal with that and the lithium.

thanks for your replies!

[Kasumi]

after many failed attempts at anti psychotics and still cycling while on just lithium, my pdoc has put me on a combo of lithium (750mg and 900mg on alternating days) and depakote (500mg). we've just started on this, so he seems to think there'll still be some dosage adjusting to do, but wanted to get my initial levels first. eventually he wants to even out my lithium dose (taking JUST 750 or JUST 900) which would be nice and he's hoping that the depakote can pick up where the lithium leaves off (it takes care of the brunt of the work, just not all of it). we're hoping that my moods will stop cycling, my head will clear up (i'm in need of some cognitive glue, as he called it ), and that these left over psychotic symptoms i get from time to time will stop (they show up as soon as i cross over into the edges of an episode - esp. mixed or manic).

has anyone had any luck with this combo or a similar one (two+ mood stabilizers)? i actually feel hopeful about this (unlike how i was feeling with the anti psychotics) but of course it's a game of playing with the dose and wait and see. i'm just hoping we're moving in the right direction finally.

thanks!

I like multiple mood stabilizers, certianly more than I like antidepressants and anti psychotics.

I did pretty well with the combination of Lithium and Depakote. I was on 600mg Lithium and 750mg Depakote ER. Very calming... It was great

at calming me without being too mentally flattening.

Another one is Lithium and Lamictal. This combination for me has more of an antidepressant effect as opposed to Lithium and Depakote

which did not have any at all.

[AnneMarie]

I was on Lithium, Depakote and Lamictal for a while. The Dep was added last and it did a lot to slow my rapid cycling.

[dedoubt]

I was on Lithium, Depakote and Lamictal for a while. The Dep was added last and it did a lot to slow my rapid cycling.

May I ask why you stopped taking it? I'm not sure it is doing anything besides making me fat (along with my hypothyroidism)-- the only times I have noticed an improvement in my moods is when my lithium has been upped. I have to assume the rest are doing something, but it's frustrating to take handsful of pills and not know if they make a difference.

[Karinthewind]

I was on Lithium, Depakote and Lamictal for a while. The Dep was added last and it did a lot to slow my rapid cycling.

May I ask why you stopped taking it? I'm not sure it is doing anything besides making me fat (along with my hypothyroidism)-- the only times I have noticed an improvement in my moods is when my lithium has been upped. I have to assume the rest are doing something, but it's frustrating to take handsful of pills and not know if they make a difference.