From topamax to trileptal

[llama44]

My pdoc really wants me on a good stabilizer like trileptal. He has his mind set on that one. Lithium didn't do much but flatten me, lamictal gave me a huge rash all over my neck, topamax does nothing for my moods, etc.

So, I plugged all my meds and trileptal into a drug interaction checker and trileptal seems to lower the clearance? of a lot of my other meds.

Is it a good choice to take then? I'm not sure what to do!!!!

[notfred]

One option is to adjust the meds doses for those effected.

[Eden]

Have you talked to your doc about this?

[gizmo]

I considered trileptal once, but my pdoc and I decided on depakote instead due to it's approval for first-line BP treatment. Good ol' Dr. Phelps at psycheducation.org doesn't seem to think trileptal is a good first-line treatment drug, but then again, he mainly deals with the treatment of BP II.

There are a lot of meds that affect the absorption of other meds. Sometimes it's a little, sometimes it's a lot - depends on the meds. But every med that has this possibility has the same warnings on a med interaction checker. So you would be best off to either search for information on the lowering of absorption for each individual combo of drugs, or discuss in detail your concern with your doctor. Making a written list of your specific concerns will help you on this, since you seem to have a communication issue with your particular doctor. But as notfred said, medication absorption issues are most often dealt with by the increase/decrease in the effected meds.

For example, taking ibuprofen can increase your lithium level by as much a 150%. Big deal, right? So I discussed it with my pdoc when I was taking lithium, and got permission to lower my lithium dose when I had to take ibuprofen that day. And that worked in my particular case.

[Cuttlefish]

I take Trileptal. Yes, it affects metabolization of a lot of other meds (though to a somewhat lesser extent than its parent drug tegretol). Meds that are affected often have to have their dosages increased and sometimes the med dosages even have to be increased above set guidelines. I take 400mg of Wellbutrin SR, but am likely only getting around 300mg effective dose because I'm taking it with Trileptal.

[jt07]

Trileptal is supposed to be the "new and improved" Tegretol. I take Tegretol, and yes, the dosages of my meds had to be adjusted upwards, but that is not a problem. If Trileptal is anything like Tegretol, you will either love it or hate it. Personally, I love my Tegretol and really can't live without it. I tried to go off it, but had to go back on. It is a good med for me, and it keeps me from becoming suicidal for the most part.

I suggest that you go in with an open mind. It could turn out to be one of the best meds that you take.

[steves]

i have taken both tegretol witch made me super sick had to go off. I was then put on Depakote and that made me gain 30 lbs . Finally i went on trileptal so im on it trying to loose some weight . My pdoc doesn't really like trileptal but I have to loose some weight somehow.

[bubblegirl]

I am BP1, rapid cycling (hourly), mixed episodes. I have been on oxcarbazepine for a year and a half. We are currently reducing my dose. I have just in the last two months started having some of the "less common" side effects. Severe yeast infection that will not go away, headaches, waking up at night. I have not decided what I will do next as far as changing AC's. I have been trying so many medications for the last few years that I am ready to stop taking any of them. I always get the "less common" side effects along with the "more common" ones. I have tried Lamictal, it didn't control my episodes. Trileptal does. I would probably recommend it even though I have had the side effects, since most people don't get them. Be prepared to work your way up through the dosage. It takes awhile. Less than Lamictal.

[crtclms]

bubblegirl, have you tried tegretol? Maybe it will not cause the same side effects? I know it is considered the lesser med, but if you can't take Tri-leptal, and Tri-leptal worked, it is the closest thing you will find.

Also, remember they use AAPs as mood stabilizers. I'm not saying run out and get yourself some AAPs, I am just saying don't give up yet.

[bubblegirl]

crtclms, No, I haven't tried tegretol. But I have tried geodon, seroquel, abilify, latuda, saphris, and zyprexa. All of the AAP's I have tried gave me serious cognitive impairment, incontinence, weight gain, deep depression, and made me a zombie - even at low doses. Zyprexa was the least offensive. So AAP's are not on my favored list to experiment with anymore. In fact I won't take one unless I become psychotic, and then it will be just long enough to get me out of the hospital and back on my feet. They make me miserable. I have thought about tegretol, I just think it will likely cause the same kind of imbalance since it is the parent drug. I've tried lamictal. I just got through with a failed try with wellbutrin. Obviously I am reluctant to try new drugs at this point, since my pdoc always says "we won't know until 'we' try it." I'm not ready to switch hamster wheels just yet.

Thanks for the suggestion though. If I do switch, it will likely be to tegretol.