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Bipolar 2, rapid cycling


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So, I finally got to see a pdoc for the first time and he's proposed some radical changes to my cocktail.

Previous cocktail: 1 mg clonazepam, 75 mg topamax, and 30 mg remeron.  I was still rapid cycling but the cycles were lasting days instead of hours.

The pdoc has recommended that I taper off of the topamax and the clonazepam entirely, he didn't really give any directions on how to do this.  I've done my research so I think I have a good idea but input would be appreciated:)

In place of my prior meds we'll be upping the remeron to 45 mg to hopefully get rid of lingering depression.  Hopefully, the risperdal at 1 mg (0.5 mg at bedtime to start then eventually 0.5 mg BID) will help with the anxiety and racing thoughts.  Then comes the valproic acid for a mood stabilizer.

The problem?  Well, the pdoc prescribed valproic acid in 200 mg capsules a formulation that doesn't seem to exist  ;) .  The pharmacist called but the pdoc has not returned their call yet.  His plan was to have me taking 600 mg of valproic acid, but I don't know what the new dose will be.

Any comments on the new cocktail?  It seems like  solid enough plan, but jumping straight to an AP makes me a bit nervous.

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depakote does not come in 200 milligram tablets....maybe he meant 250 milligram?

Valproic acid is depakene. Depakote is divalproex sodium. I'm not trying to correct you, hell, I'm still trying to figure out the differences, they're very confusing. I'm on depakote too, and yes, they're in 250mg increments.

Yes, my gp, thinking it was unipolar depression, put me on zoloft. I'm wondering if that's what's thrown me into suck rapid cycling. I'm finally settling down now. It takes time to find the right combo, I'm hoping this is it!

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I think that any med changes should be made gently and with full information/dosing info to the patient. Too many pdocs just shove pills at us and expect us to obey. They are the PhD, they are the ones who know, and we are just the crazy people. Well, not all of us are too crazy to care about what we put in our bodies! I'd bug and bug and bug the pdoc for a better explaination. I can't say to stay on the old meds until you know how to switch, but it seems that switching without a plan is serious. Maybe as a nurse practitioner or pharmacist? My uncle (pharmacist ) has been helpful to me when the pdoc isn't explaining things to my satisfaction. a 15-min session is not long enough to know you and your particular body and issues in my opinion.

loon

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