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I finally got back in to see my Pdoc... He was glad that I did not wait for my normal appointment and came right in.. He told or sort of yelled at me for not listening to his expertise.. He told me that if I didnt want to take his medical advice that maybe I should stop coming...I kinda bowed my head and said sorry "master".

He was very concerned with the mania episodes breaking through. I told him that I tried things on my own.. I also told him that I was afraid of benzo addiction so I cut the Klonopin to the point of just using it when I needed it... He told me that my perscribed amount was 1mg twice a day.. So some of the espisodes could have been withdraw or anxiety attacks caused by stopping the klonopin.. He said how can he tell if I dont take the meds as perscribed.. This is really the first Pdoc that really seems to give a shit....

Well I am listening to his directions and feeling better.. He upped my Lamictal to 200mgs twice a day,, 60mgs of cymbalta in the morning because it does not make me sedative, and klonopin 1mg twice a day... I have been a good boy and have followed his orders.... I am really starting to level out and it sure feels great..

Sleep has been a little bad but that always happens to me when I go to a new level of Lamictal...

The reason I am posting is because I had posted a week ago about Lamictal toxicity.. My Pdoc assured me that I was no where close to the dosage of overdosing... Although the Lamictal leans towards helping manic depression,, at the higher dosages it has found to be my super drug for mania...I just thought I would bring this up in cast any one is in the same situation..

Thanx again to the boards for steering me in the right direction.......

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Heya icthus,

Glad things are better.

Sometimes it seems the psychs know what they're talking about.  I'm glad you have a good one.

Thanks for the update!

Hope things continue to improve, on the whole.



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I'm glad you're feeling better!  IMHO part of being a good pdoc is caring whether your patient is taking his meds.  My last pdoc's initial spiel included making a deal that I'd take whatever we decided I'd take.  Part of that was that my input was important, but if I wasn't willing to take my meds and his advice I'd have to find another pdoc.  He ended up being a little too inflexible for me (after over 5 years), but his firmness is part of the reason I stabilized.

And it's not surprising to me that increasing the lamictal helped with the mania.  The reason people say that lamictal isn't indicated for mania is that it's not good for acute mania; it's activating at low levels and it takes a long time to get to mania-controlling levels.  But once you're up to that level it works very well for mania for most of us.  I'm glad you can get some relief!

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