your_illusion97 Posted April 7, 2012 Share Posted April 7, 2012 As my topic suggests, I am pondering something that has come up before. How common is it to be on two mood stabalizers? Before I switched to my NP who is a lot closer that my Pdoc was to me, he had brought up staking Lithum on top of my Lamictal. Now I am already on 400mg of Lamictal a day, which I consider alot. Not sure what the celing is on Lamictal dosing thoguh. So how many of you are on two mood stabalizers? Why? Do they work together well? Did it take a while to find a balance? I am just curious, as I am not sure what my NP will do wiith my meds when I see her Monday. My most recent changes were to go on Lexapro 5mg ( then d'c it when I went manic) and start Geodon at 120mg and then upped to 160mg when I went manic. I know with Lithium blood levels have to be watched carefully and it can cause weight gain ( something I DO NOT WANT, I have body Image issues). Anyway opinions and experiences are welcome. thanks. Link to comment Share on other sites More sharing options...
jt07 Posted April 8, 2012 Share Posted April 8, 2012 I take Lamictal and Tegretol which are both considered mood stabilizers. I am on the Tegretol because it keeps me from falling into really black and suicidal depressions, and I take Lamictal for its antidepressant effect (I don't respond to ADs alone). They do different things for me. I have not had a problem taking them both together. Link to comment Share on other sites More sharing options...
your_illusion97 Posted April 8, 2012 Author Share Posted April 8, 2012 I never think about Tegretol as a mood stabalizer, I guess I forget about it. My issues are mixed episodes, and now the Mania is back with a vengance. Link to comment Share on other sites More sharing options...
crtclms Posted April 8, 2012 Share Posted April 8, 2012 Depakote is supposed to be good for dealing with mixed episodes, and now some people on the boards have told me that sometimes they use a large dose of Depakote at once. I took Depakote for migraines. It never had any effect on my mood. So when I went back onto a mood stabilzer, it was Lamictal on top of the Depakote. You have to titrate up super slowly if you are on depakote, I think it took me 5 weeks to get to 100mg. Now I am on 300mg. 400mg is ostensibly the upper limit for BP patients. But my husband uses it for seizures, and is on 600mg. I came off the Depakote, as it stopped working. And because I was having a hard time with depression, my pdoc added lithium. So now I am on lithium and lamictal at the same time, and as far as I can tell, it hasn't even been a consideration. When I was taking tegretol as a mood stabilizer, it was before Tri-leptal, the "new and improved" Tegretol. But some people only have luck with one or the other. Anyway, I was also taking gabapentin for migraines at the same time. Gabapentin did not affect my mood, although it probably made me less anxious, and I just didn't notice. So depending on your situation, you may be on two mood stabilizers. Link to comment Share on other sites More sharing options...
your_illusion97 Posted April 8, 2012 Author Share Posted April 8, 2012 ok I am going to have to re research my mood stabalizers, I am either just plain forgetting things, which I am right now, or just didnt know about some drugs which is bad cause I am a pharmacy tech. Anyway I need to find something that is weight neutral as gaining weight would be a HUGE issue. Link to comment Share on other sites More sharing options...
bpladybug Posted April 8, 2012 Share Posted April 8, 2012 Just for your information, lots of people have NO wieght gain with Lithium. However, it might turn you into a blue smurfette!! Furthermore, you describe several episodes of mania and that certainly can be helped with Lithium. I enourage you to keep an open mind. Link to comment Share on other sites More sharing options...
your_illusion97 Posted April 8, 2012 Author Share Posted April 8, 2012 Just for your information, lots of people have NO wieght gain with Lithium. However, it might turn you into a blue smurfette!! Furthermore, you describe several episodes of mania and that certainly can be helped with Lithium. I enourage you to keep an open mind. ok, I will try to keep an open mind and keep Lithium as a possible option Link to comment Share on other sites More sharing options...
crtclms Posted April 8, 2012 Share Posted April 8, 2012 I didn't even know Lithium was supposed to cause weight gain. I've lost weight throughout the first few months I have been using it. Mostly from portion control. But the point is, I've lost almost 20lbs, and the weight loss actually began the same month as I started lithium. Link to comment Share on other sites More sharing options...
girl_interrupted Posted April 8, 2012 Share Posted April 8, 2012 Hi, I take Depakote and Topamax. The Topamax was prescribed for migraine but has made a difference to my mood. I have tried Tegratol and had no success. Link to comment Share on other sites More sharing options...
rowan77 Posted April 8, 2012 Share Posted April 8, 2012 I have taken 3 mood stabilisers together in the past, namely Depakote, Lithium and Lamictal. I was also on a Tegretol and Lithium combo. I now take Lithium along with Seroquel (which although is an AAP is also considered to be a mood stabiliser). To be honest Lithium has been the best for me and did not cause me to gain a lot of weight, unlike many of the other meds I've taken I gained very little on it. Link to comment Share on other sites More sharing options...
your_illusion97 Posted April 8, 2012 Author Share Posted April 8, 2012 ok this gives me a lot of ideas to take to my NP tomorrow. I need to make lists and take them with me. I have no idea whats going to happen with my appointment. Link to comment Share on other sites More sharing options...
Becks Posted April 8, 2012 Share Posted April 8, 2012 I was on Lith and it caused no weight gain for me. If anything, it helped level out the weight gain I was having on the Seroquel. For awhile I was on 3 mood stabalizers but all for different purposes. Seroquel - Initally was prescribed as my main mood stabalizer. It also helped with my anxiety, psychosis, sleep issues and crushed my mixed states. Lithium - That was added in after I had the baby. I was terribly depressed and the Lith seemed to lift me out of that depression Lamictal - Was then added because the Lithium wasn't keeping the depression away as much as we would have liked. Since this time, I've switched around on a few med combos. Seroquel and Lithium have been completely dropped. Right now I'm on: Lamictal 150mg - I really think we need to go up on this, but I won't push it until next month. Invega 3mg - Being used to help squash my mixed states, help me sleep and control the psychosis. Klonopin 1mg - Lovely anxiety I don't think it's uncommon for those with BP 1 to be on more than one mood stabalizer, I think only being on one is actually out of the norm as it takes a few sometimes to get all the sx's treated and under control. I might be wrong and if I am, please, someone come along and correct me. I will take it gracefully I think being on Lamictal alone for BP1 isn't quite common. I haven't seen this happen with many people. It's great for controlling depression, but I'm not too sure about it controlling mania or mixed states. Good luck tomorrow. Link to comment Share on other sites More sharing options...
your_illusion97 Posted April 9, 2012 Author Share Posted April 9, 2012 hmm I've been On Lamictal starting out at 100mg since I went back to a pdoc in 2006 and got on meds. He never said anything about a second mood stabalizer till 2010, but then I switched to the NP I see now and it wasnt brought up. Link to comment Share on other sites More sharing options...
Becks Posted April 9, 2012 Share Posted April 9, 2012 Is your NP a pychiatric NP or a general NP?? In my experience.....pdoc's are the ones to go to when you need psych meds. All my GP's and OB's put me on AD's which either did nothing for my mood, sent me manic or into mixed states. It wasn't until I started seeing a pdoc for my issues that we were able to sort it all out and get on the right med combo. Link to comment Share on other sites More sharing options...
your_illusion97 Posted April 9, 2012 Author Share Posted April 9, 2012 she is a psychiatric NP and is overseen by her husband who is a pdoc. She, from the time I have been with her so far knows her stuff, and is super nice and genuinely concerned about her patients. Link to comment Share on other sites More sharing options...
gizmo Posted April 9, 2012 Share Posted April 9, 2012 I took Depakote for migraines. It never had any effect on my mood. So when I went back onto a mood stabilzer, it was Lamictal on top of the Depakote. You have to titrate up super slowly if you are on depakote, I think it took me 5 weeks to get to 100mg. Now I am on 300mg. 400mg is ostensibly the upper limit for BP patients. But my husband uses it for seizures, and is on 600mg. Are you talking about the lamictal or the depakote? I think it's the former, as I am currently on 1500 mg for mood stabilization and migraine prophylactics. I'm currently on one mood stabilizer and two AAP's, which work, in effect, like mood stabilizers. I'm having a good success run with the combination I'm on now. Link to comment Share on other sites More sharing options...
your_illusion97 Posted April 10, 2012 Author Share Posted April 10, 2012 For now I am adding Lithium ER 300mg twice a day to what I am already on, I havent taken it yet because she is waiting on my bloodwork to come back before she lets me take it. I saw her and got the bloodwork this afternoon, so I figure I will hear from her tomorrow about it.oh and wanted to add she mentioned if the Lithium worked maybe taking me slowly of the Lamictal and see what happens. Not like I cant go back on it if soemthing happened. Link to comment Share on other sites More sharing options...
crtclms Posted April 10, 2012 Share Posted April 10, 2012 Yeah, the Lamictal. He takes 600mg, with Lyrica and Trileptal. Link to comment Share on other sites More sharing options...
your_illusion97 Posted April 10, 2012 Author Share Posted April 10, 2012 Officially starting the Lithium today since my bloodwork came back a ok. Hope it helps Link to comment Share on other sites More sharing options...
wemble Posted May 7, 2012 Share Posted May 7, 2012 i take lithium and depakote as my primary meds and mood stabilizers. i can't tolerate AAPs or ADs, so it's kind of my only option and luckily one that has worked REALLY well for me from the start. i also take gabapentin as needed as a low dose for anxiety. Link to comment Share on other sites More sharing options...
melissaw72 Posted May 8, 2012 Share Posted May 8, 2012 When I took lithium and eskalith, I had to also be put on a diuretc because I developed nephrogenic diabetes insipidus. Link to comment Share on other sites More sharing options...
matthewmurphyj Posted May 16, 2012 Share Posted May 16, 2012 I'd think about starting a stronger course of antipsychotic therapy, most specifically a typical. Typicals tend to cause less weight gain and provide good symptom control when paired with an antidepressant or possibly the Lamictal you already take. I currently take Haldol and find it to be a good drug with unnoticeable side effects. Some good alternatives are Stelazine, Haldol, or Trilafon. Trilafon comes in a combination drug with amitryptiline called Etrafon which may reduce your pill load. Good luck and keep trying! Link to comment Share on other sites More sharing options...
neingesicht Posted May 16, 2012 Share Posted May 16, 2012 I'm on both Lithium and Lamictal, and I think it's a good mix. Both the lamictal and the lithium have certain anti-depressant qualities, I believe. Link to comment Share on other sites More sharing options...
Alien Navel Cord Posted June 7, 2012 Share Posted June 7, 2012 . I might be wrong and if I am, please, someone come along and correct me. I will take it gracefully I think being on Lamictal alone for BP1 isn't quite common. I haven't seen this happen with many people. It's great for controlling depression, but I'm not too sure about it controlling mania or mixed states. My mom is BP1 and only takes 100mg of Lamictal. Hasn't had an extreme episode since she began taking it, which was over 10 years ago. Link to comment Share on other sites More sharing options...
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