Thank you!

Tegretol gave me rash exactly a year ago, within a few days of taking it. I was on 100 mg, extended release - I just phoned the pharmacy to confirm my recollections and they did.

The side effects have often been brutal. I forgot to mention severe akathisia that was torture-like, in 2009, when I used high doses of Seroquel without Atarax or Gabapentin - atenolol did not work well to ameliorate the akathisia. In 2017 I tried again, this time with Gabapentin or Atarax, and both worked, and it seemed like a miracle, but then I was hit with QT-prolongation. It was my first borderline EKG ever. MY QT would have been too long for a male and was borderline for a female, but it was clear that if I were to continue, it would become too high for a female, too. So we tapered if off but asenapine caused rapid weight gain. At this point ECT seems so attractive and I am glad in Australia it is used for both ends of the range of moods. My long term memory is extremely good - I am a synesthete and such people have unusual memorial abilities - but after Abilify I have trouble recalling words. In the past I had such trouble on both Zonegran and Topamax, but it went away as soon as I stopped the drugs.

My hesitation with first generation is the higher risk of extrapyramidal side effects to which I am already predisposed, both by my own history and by how my mother had EPS and tardive tic. It can be genetic. My family of origin hid her EPS and tic from me (my father confirmed it to me in spring of last year when I asked, and by then I had figured things out by myself and he just uttered "thorazine" (aminazine in Russian) so I now know which drug caused it but I figured everything out after my episode of acute facial dyskinesia) - so they hid it from me and people who cared for me when they were asked, in 2009, and I was put on Risperdal, which is very similar to Haloperidol and other first generation AP's in how it causes EPS and Parkinsonism, much more so than 2nd generation AP's - I had, without myself being able to identify them, Parkinsonian mask, stiff Parkinsonian gait, and later was able to identify small motor difficulties in that I was not able to type on the laptop's keyboard) - so what went in with Risperdal is there in my system and I cannot undo it. The risk of tardive dyskinesia, dystonia and dysphonia goes up after menopause since estrogen is protective. The risk is especially high in women over 60. I am 47. I have some time to figure it out, but given my generally good memory I would rather suffer some memory loss but not up the risk of tardive dys-effects later in life.

So it sounds to me that I should do a Trileptal trial, hoping for the good part of Tegretol without the rash, and if that fails, go for ECT. The good thing is that I live close to Stanford hospital, have been there many times, know all the nursing staff, drs and occupational therapists, feel comfortable there. The food is quite decent and they allow cell phons and laptops (unlike some other hospitals I have been to). And they have lots and lots of experience administering ECT.

How does it work in the US when you have planned rather than ER-route ECT? I have only had emergency medical admissions at Stanford.