New meds

So I saw a psych finally (after three months) today

He agreed the Seroquel was excessive. And he also said the rash is definitely from the Lamictal.

So...he's having me taper off of Lamictal and Seroquel. He said I can just do what works with it for sleep.

He put me on:
Neurontin 300mg x3
Wellbutrin 100mg x2
Vistaril 50mg x4

I won't take that much Vistaril but he wrote it that way so I can have it for anxiety *and* to get to sleep during the weaning off of Seroquel period. I'm not sure if I'll continue the HCTZ (diuretic w/potassium) or the Inderal (blood pressure med - I don't have blood pressure issues but this was written for anxiety, to physically keep me from attacks...but I don't believe it has helped much at all).

Any thoughts on this med combo?

so glad you finally got to see someone! glad you are getting off the seroquel too. that stuff is rough. as for the med combo, someone on here once said neurontin is ineffective by itself, but I don't know much about it - just that i was on a similar combo at one point and at the very least didn't have any side effects from it. I think it helped but i can't remember. that was when I was a teenager.

Used to take vistaril for anxiety. Was great for that and for sleep.

Hope your meds end up working for you!

When a Dr. finds out you have a rash from lamictal he's supposed to send you to a dermatologist asap because you can die from it. And neurontin isn't approved for manic-depression. My Dr. told me when neurontin first came out it was marketed as a wonder drug and it was used for many problems including BP but over 10-12 yrs ago it was discredited for BP treatment. I was prescribed neurontin from a Neurologist in early 2000s for chronic headaches (which only helped for a short period and as I increased it to a very high dose ~2000 mg).

Neurontin works on GABA (def: The GABA receptors are a class of receptors that respond to the neurotransmitter gamma-aminobutyric acid (GABA), the chief inhibitory neurotransmitter in the vertebrate central nervous system.)

My Dr. told me (in 2005) that seroquel is the least effective atypical anti-psychotic behind zyprexa, risperadol, etc. I guess you're taking it for severe agitation?

PsychEducation.org (http://www.psycheducation.org/depres.../neurontin.htm) - "Gabapentin (U.S. Neurontin) is a great example of how initial excitement about a medication can be misleading."

"And yet, gabapentin clearly helps some people. The results can be dramatic. One of my patients said "after 15 minutes following the first dose, my joy receptors turned back on". But within about 6 months it was clear that Neurontin was causing the same rapid cycling that he had experienced on antidepressants. Overall, this is my main concern about Neurontin."

"The rise and fall of gabapentin for bipolar disorder: a case study on off-label pharmaceutical diffusion" (http://www.psycom.net/depression.cen...abapentin.html)

Do you have a pain condition as well? Maybe he put you on the Neurontin hoping it would help with both? Have you tried all the other mood stabilizers and they didn't work -maybe that's why?

Did he refine your diagnoses (tell you if he agreed with all of them, some of them, etc.)?

I'm glad you finally got in to see him and I hope it works out!

Wellbutrin is great for depression

He was at a transitional clinic and saw me because I can't get in with the psych at my therapist's office until July 2nd and I had been on drugs that were causing me horrific side effects. He put me on Neutontin because I had taken it before (at a much lower dose for sciatica) and he knew I tolerated it. Same thing with the Wellbutrin, I had taken it before and had much better results than the other SSRIs I have taken (Paxil, Zoloft, Celexa, Effexor, Prozac, Remeron, etc.). Plus Wellbutrin is an NDRI. He put me on a higher dose than I was on before.

I had already seen an ER physician for the Lamictal rash but they would only treat the rash (with Prednisone) but not adjust my meds. So the fact that he agrees I should stop it and told me how to taper off is great. Same with Seroquel, it was causing hallucinations and panic attacks at night. I couldn't breathe, I could not swallow, I was paralyzed but awake, dear Lord it was horrendous. So he gave me some pointers on how to wean off that as well. Today I got a Depo shot and I go back in 3 months for another one and then 3 months after that I am getting an Implanon implant. I think it's best to be on BC until I've stabilized and got a med regimen that works. Sometimes that takes years. The Implanon isn't permanent and it's not 'one more pill to take,' there's no work involved. And if/when we decide to have another child it can be removed and we can conceive shortly thereafter. The psych at the transitional clinic said hormonal BC might help me. I'm willing to go through trial and error to figure it all out. I'm on my second round of meds to treat my BP, BPD, PTSD, OCD & Anxiety.

I see my doc this coming tuesday and want him to lower my seroquel as well I think it is way excessive I take 400 at bed 200 in the morning and 200 in the afternoon. It isn't the only med I am on but it is the one I think is overboard. I am so glad you found a doc that listened and worked with you, good luck in the future.

I'm a bit surprised he didn't put you on a mood stablizer.

He made it sound like the Neurontin would be the mood stabilizer...???

Neurontin is not a mood stabilizer. I take it for my Fibro pain.

probably because he's just transitional, christina. neurontin is supposed to act as a mood stabilizer but recent evidence suggests it does not. i was not put on a mood stabilizer either (just abilify) and I am going to request one when I start IOP soon.

HB, as i'm sure you know, the bipolar can be controlled with medication but the rest of your dx's need to be addressed with therapy. I know you got the DBT workbook - so did I. I am finding it very insightful and helpful. I hope you find the help you need. I know it's been a rough ride for you for a long time!!

I was in therapy until my T said he wouldn't do anything more than CBT until my sister moves. So I quit going and I'll go back once my sister moves away. Its a waste of money to sit and cry an hour a week.

oh i agree especially with no insurance. just keep coming here and working that workbook. that will help at least a little bit :-)

No, it's prescribed for nerve pain (like your sciatica) and fibro.

What did he say he would do instead of CBT after your sister moves? I don't think I understand --was there something about that modality that made you cry during the sessions?

That sounds terrible. I had bad side effects with high doses of depakote, lithium and akithesia (THE worst side effect I've had) with haldol, loxitane, stelazine.

The anti-psychotics (ie Seroquel) are also labelled as "mood stabilizers" along with lithium, depakote, lamictal (also an anti-convulsant).

Hope you get some better advice. Neurontin is not used by Psychiatrists for manic-depression nowadays (nor was it ever very popular among Psychiatrists). First line of defense has always been depakote or lithium then add other meds for anxiety, agitation, psychosis, etc. (You can find BP treatment flow charts in literature and maybe online which are used for training purposes.)

I read tonight that Depakote (Valproic acid, I think it is) has as a side effect causing
the loss of Vitamin B6, so it's recommended by one doctor that Vitamin B 6 be added to the diet of a patient taking Depakote.

I really liked that medicine, but it causes hair loss, too, and it took some time to get
that back once I stopped taking Depakote.

Lithium is still, I think, the benchmark for treatment in bipolar illness, but be sure to
have routine bloodwork checks if you're taking it. Your psychiatrist will know all about that for you, definitely.

This is correct. The first med I was put on was Lithium, then others were added. At the same time I went to a psychiatrist and not a GP.

I wonder about Neurontin as well. My Pdoc said it was a mood stabilizer but my pharmacist said it was used for anxiety.