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Old 04-30-2007, 09:52 AM   #1
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leomia HB User
Question BP II meds: Lamictal, Seroquel, Tegetrol or... any others?what will work best?

Hi everyone
I am doing my research because I have 2 more weeks to see the pdoc and my meds are so low right now that they barely work as I am ready to change to something that works for me, whatever that is.
I have been considering the following after talking with people here as well as doing my own research on it online.

Lamictal
Seroquel
Tegetrol
Topomax
Abilify
Geodon

anyone on these or a combo and what side affects, etc, as all the sites cant make up their minds it would seem!
I would really like to be on something that wont make me gain wieght or be dizzy which is why I am getting off Depakote and Klonapin.
I thought I would like Lamictal the best because everyone swears by it but I went to the actual site, and they say it is for type I BP.

Anyone with Type II on it and how does it work for you?

Also someone said Tegetrol was good for rage and other general madness irritability (which I definately have) so was wondering if anyone there has gotten to the full level of it and how you think it works for you.

I also realize we are all different, just trying to get a general opinion here!
Thanks for your help!
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Old 04-30-2007, 10:43 AM   #2
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Exclamation Re: BP II meds: Lamictal, Seroquel, Tegetrol or... any others?what will work best?

Quote:
Originally Posted by leomia View Post

Lamictal
Hi im not sure what type of BP I am, I just finally accepted that I even have it... My physician has put me on lamictal before and it really messed me up even more , I ended up punching my husband in the head and getting 2 pins surgically inserted into my hand due to it being broken
Im not usually that angry at all....

 
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Old 04-30-2007, 10:53 AM   #3
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Re: BP II meds: Lamictal, Seroquel, Tegetrol or... any others?what will work best?

Leomia ~ As you must already know....the meds with BP are custom picked according to how one responds to them. It is usually a matter of trial and error. Not everybody will have the same response to any given med.

My daughter is on Lamictal and Seroquel combo....those two meds work well for her in terms of addressing her depresssion and frustration/irritability levels.

As far as side effects....I hand picked these two meds because of most of te meds out there they have the least amount of side effects.

I have more info but and pressed for time so I will post more later if you have any further questions or concerns.

~ Goody

 
Old 04-30-2007, 11:10 AM   #4
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Re: BP II meds: Lamictal, Seroquel, Tegetrol or... any others?what will work best?

yes Goody please let me know more. With haven talked to you before, I already had these 2 on my list of choices as I would rather know about a med and ask then get stuck on a med I hate then be stuck trying to change again, ya know? what kind of BP is your daughter?

AcrylicMaster - how long were you on Lamictal for? Did you get to what YOUR personal best dose is supposed to be, the therapeutic level for you? and did it still make you have rage issues? Well I have punched hubby in the nose before so nothing new there! Jk. I mean I have thats true but I don't want to make it a habit as not good for a marriage as I am sure that is one reason you wanted to get off of it. Can you tell me a little more?

thanks Ladies!
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Old 04-30-2007, 02:42 PM   #5
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Re: BP II meds: Lamictal, Seroquel, Tegetrol or... any others?what will work best?

leomia - how is your doc with prescribing multiple meds?

Mine so far have been very into one medication only - they are against the idea of 2+ medications which is quite discouraging I think considering the stories I have heard here about multiple low combinations working.

Currently I am on Seroqueal (quetiapine) only. I'm at 175mg a day for two days now and soon will be at 200mg. 200mg is supposed to be the ultimate dose. But I see a psychiatric nurse this Friday for the first time. Maybe she'll switch my meds ? I'm still very agitated/clouded mind with multiple thoughts/bad energy. I'm just able to sleep without sleeping pills and can somewhat get through the day without having to drink/take sleeping pills.

 
Old 04-30-2007, 06:42 PM   #6
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Re: BP II meds: Lamictal, Seroquel, Tegetrol or... any others?what will work best?

I tried seroquel and didn't like it at all. I felt like a complete zombie and was more irritable. Now I'm one lamictil at 150mg, 200 made me a bit fidgety, and it has worked very well for me. Actually I feel better than I have in years. Tom

 
Old 04-30-2007, 07:54 PM   #7
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Re: BP II meds: Lamictal, Seroquel, Tegetrol or... any others?what will work best?

Hi, Leomia....to answer some of your questions my daughter has been diagnosed as Bipolar NOS (not otherwise specified). She presented with depression and had an induced hypomania while on an antidepressant but if I were to take a guess I would say that she seems to meet most of the criteria of having BP II.

With that having been said, I like the Lamictal because it is weight neutral and has a great side effect profile. If you can avoid that rash which is more common in kids or adolescents or when the med is introduced too quickly then you pretty much will not have any problems with it. It also seems to help out more with the depressive side of BP which seemed to be exhibited more by my daughter. The Seroquel is one of the atypical antipsychotics which helps with symptoms of mania as well as depression and is has a good track record for not causing the weight gain that the other atypical antipsychotics are known to do. It is known to help out with the irritability as well as the impulsivity that are commonly seen when one is hypomanic and it works rather quickly. It knocks you out at first but if introduced quickly and once up to it's therapeutic dose this will usually subside. My daughter started on 25mgs and the doctor said that whether it knocked her out or not to double it the next night for 4 days and then double it again to 100mgs for 4 days and then go to 200mgs. Eventually she went to 100mgs in the morning and 200mgs at bedtime....she got very dizzy the first day she increased to that and the doctor assurred me that it would improve within a few days and to give her salty things and fluids when that happened and sure enough she was right. My daughter was recently increased on the Seroquel when her hypomania increased and is now on 200mgs in the morning, 50mgs in the afternoon and then 300mgs at bedtime. She seems to be doing much better with the increase.

I hope this information will help you out. It is good that you look into each of the meds and know about each one so that when the doctor suggests the ones he feels will best help you out you can then discuss your concerns with him. But remember, not everything you read or hear is what you will experience but having a basic knowledge of the meds is important so that you can be actively involved in picking out the ones you will feel most comfortable taking.

Good luck with your appointment and please come back and let us know what meds you and your doctor finally decide upon.

((((HUGS))))) ~ Goody

 
Old 04-30-2007, 09:11 PM   #8
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Re: BP II meds: Lamictal, Seroquel, Tegetrol or... any others?what will work best?

Hi Leomia,

I'm not sure what you want me to tell you. My son is 25, rapid cycling BP1. I'm not sure when he started having symptoms because he did not tell us and was very good at covering. As I mentioned he smoked pot as it helped him feel like he had some control over his agitation, anxiety, etc. When he got serious about getting a handle on his situation, he had two pdocs in succession who tried one drug after another. Every month he was on a new med...lithium has been the one constant...and the others were added on to the lithium. He has always been able to take lithium. He has a buddy from high school who was diagnosed in 7th grade who also had tremendous problems finding the right meds. He had lots of trouble with lithium --physical symptoms concerning his digestive tract as I recall. But they kept adjusting the dosage and he still takes it.

My son finally got sick of being a guinea pig and really felt his pdocs had no idea what they were doing...so he found a new one who had additional training in neuropharmaceuticals. He is very talented at combining drugs and after a bit of trial and error, he was put on the sustained release lithium, and tegretol. He was feeling quite well but was still a bit agitated, so the pdoc added Lamictal. This proved to be the winning combination and he has been stable and well now for 2 years. He is very diligent about taking his meds on time every day and I believe he said he has only "missed" one time in 4 years. He has been drug-free for a bit more than 2 years and rarely drinks alcohol -- maybe one or two beers/month.

The philosophy of his pdoc (and others that have trained rather recently) is that you give medication to treat the disorder, rather than giving various medications to treat the various symptoms that present with episodes of mania or depression. For example, some pdoc prescribe a sleep aid to help with sleep problems; an anti-depressant to help with depression; maybe an atypical antipsychotic to help with anxiety, etc. The current thinking is that these are individual symptoms caused by the disorder; if you can control the bipolar disorder so that the patient is stable and no longer swinging between episodes of mania and depression, you won't need all those separate meds because the patient will no longer be feeling all those symptoms. I hope I'm explaining this ok. Anyway, our son is on 3 mood stabilizers, and as they work together, they keep him stable and free from episodes.

The newer meds are developed to target one particular area of the brain. So something like Seroquel may work on part of the patient's symptoms, but maybe not on all of them. For this reason, it is usually given along with a mood stabilizer such as lithium, tegretol, depakote, etc. Lamictal and Seroquel seem to be a good combination for many people.

Anyway, take all of this with a grain of salt. I'm just reporting what I've found from my son's experience, what I've learned on the board and through a lot of research. Every brain is different and everyone responds differently. Also, most pdocs aren't too receptive to being told what you'd like to try!! So tread carefully!!

Let me know if I didn't answer your questions.
Tsohl

 
Old 05-01-2007, 04:19 AM   #9
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Re: BP II meds: Lamictal, Seroquel, Tegetrol or... any others?what will work best?

Tom how long have you had BP and what type? I have heard more people that like Lamictal so far... but some like seroquel and some dont. Who knows they may only give me one, so if I need any it would be the mood stabilizer.
Glad it is working for you and thanks for your advise!

Goody, I am BP II but from what I read on BP NOS it sounds like I fall somewhere in either... But I cant diagnose myself. I am glad to see the Lamicatal is weight neutral, I also have heard of the rash but I really would prefer to not gain weight as that would make more depressed! I also realize its a general thing because everyone's body reacts differently. what is atypical antipsychotics? as in I was on Klonapin but it makes me so dizzy! so I am now on barely a trace of it! is Seroquel sort of like that? Its good that is weight neutral as well. If they want me to try both I will but we will see how I get on with it.

Tsohl, thanks for your input too. WHat does tegretrol do I am wondering? I have heard it helps with rage and stuff like anger, is that true for your son? and yes, its better to get to the root of the problem then each symptom which can change. I like how he is on a few mood stabilizers maybe that would work for me. I didnt do well with what I have been on and Klonapin was the constant, but then if Depakote is a new Lithium maybe not so much.
I know they dont like to know what to be told to put me on, but I have to do my research and not blindly accept some random med that may not be the best for me.
I think for both you and Goody, its your kids and you guys get to sort of oversee. Goody handpicked the meds that had the least affects which is how I want it, because no one just wants lots of affects.
I did find all of this useful, I am just trying to find someone on Tegretol who can explain better what it does and any affects. Maybe your son can tell you, but then if he is on 3 he may not be able to say what he feels from that. I know I wouldn't.

So far I am thinking, Lamictal and maybe seroquel and maybe Tegretrol depending on which one they want to give me and how I react to it. I have to read my first few posts. Someone was saying something was their miracle drug and I dont know what it was....
Thanks everyone and if anyone else has any ideas for me let me know (as in how to approach a pretty old-school doc when it doesn't matter as I am not staying in UK for long!) so I would like to be on something better.
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Last edited by leomia; 05-01-2007 at 04:33 AM. Reason: added something

 
Old 05-01-2007, 05:26 AM   #10
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tsohl HB User
Re: BP II meds: Lamictal, Seroquel, Tegetrol or... any others?what will work best?

I'd bet that it is Lamictal that someone said was their "miracle" drug. Not all that many take tegretol (carbamazepine). Studies have shown that it is probably more effective in those individuals who have rapid cycling, mixed states or schizoaffective disorder. Lithium works best in those with a "classic" manic depression.

You do need to have bloodwork done with tegretol to be sure the liver is protected.

 
Old 05-01-2007, 05:32 AM   #11
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Re: BP II meds: Lamictal, Seroquel, Tegetrol or... any others?what will work best?

Thanks Tsohl!
don't you need liver blood taken with Lamictal as well? I have done it with Lithium and Depakote so I am not shy of needles. (although no one wants them!
I bet it was too. (Lamictal) That reminded me to go and look for it. See how off track I get? I cant even remember what I was doing then I start downloading stuff for the ipod.... I cant stay on one train of thought for very long.
Has your son experienced this, to go to the docs, for me, I find it hard because I am afraid it will not be productive unless hubby comes because I forget what happened and what to say about how I feel because I honestly don't know or cant remember? I should know its me they are talking about right? Its very frustrating!!!
Spring allergies are still being a royal pain to me.... I cant sleep because when I lay down my head fills up and gets clogged but in USA they said I need allergy shots with zyrtec neither of which they have here. zyrtec was the absolute best allergy med and I miss it. At least that one I was sorted out on!
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Old 05-01-2007, 06:34 AM   #12
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Re: BP II meds: Lamictal, Seroquel, Tegetrol or... any others?what will work best?

No, Lamictal is one that does not require a blood draw.
Seroquel isn't really a mood stabilizer. I guess some people take it alone, but more commonly it is combined with a mood stabilizer such as Lamictal. There is no generic med for Lamictal so it may be that it is not widely prescribed in England at the moment.

I think it is always a good idea to take someone along to a doctor's appointment...particularly in your case. You might need someone to translate!! Just kidding. I have a cousin who was working in London, met a guy at work, married and has lived in England now for about 20 years. She has two little girls that I met for the first time this past summer. It was so weird to have them open their mouths, and out came this very, very British talk -- with lots of words that we just don't use!! Cracked me up!

Anyway, back to the topic: until you get your meds stabilized, I think problems with concentration are an issue for most people to some extent.

 
Old 05-01-2007, 06:46 AM   #13
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Re: BP II meds: Lamictal, Seroquel, Tegetrol or... any others?what will work best?

that is true, I am having all the symptoms because I am not stable and it is just a hard issue. I think the generic is lamotragine or something. I hope they have it, I will try to see if any UK sites say anything about it.
Since I will only be here a little its easier to get stable on something they would have put me on back home.
Actually I do need someone to translate! My doc is Indian I think, (not that I am racist not at all!!) I just don't understand what she says as she talks really fast and a thick accent.
I use a lot of British words but it sounds funny with my American accent. Ya know, if you are around a person you pick up each others sayings....
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Old 05-01-2007, 08:02 AM   #14
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Re: BP II meds: Lamictal, Seroquel, Tegetrol or... any others?what will work best?

Quote:
Originally Posted by leomia View Post
Hi everyone

I thought I would like Lamictal the best because everyone swears by it but I went to the actual site, and they say it is for type I BP.

Anyone with Type II on it and how does it work for you?

Also someone said Tegetrol was good for rage and other general madness irritability (which I definately have) so was wondering if anyone there has gotten to the full level of it and how you think it works for you.


Hi leomia,
That'll be me that swears by Tegretol. I am BP2 and it has stabilised me rightly. I am also on a fairly high dose (for BP) of 800mg daily. Above 600mg daily it affected my short-term memory - so I was changed over to the extended release (Tegretol Retard) formula. I still swear by it - no side effects for me.

I don't think Lamictal has been licensed in the UK leomia - so you might be hard pushed to get a pdoc to prescribe it. If I become unstable again my pdoc would like to change me over to Seroquel (quetiapine) due to it's farily neutral side effect profile. You may like to research this one. We also looked into risperdal (risperidone) but being a recovering anorexic the possibility of weight gain on this one was too risky for me. Also check out the NICE guidelines for UK treatment of BP - that gives you a systematic approach as to what drugs should be tried in what order within the UK... it's very comprehensive and eliminates any 'guessing' about what meds would be both suitable for your needs and are licensed in the UK.

Nut.

 
Old 05-01-2007, 08:15 AM   #15
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Re: BP II meds: Lamictal, Seroquel, Tegetrol or... any others?what will work best?

Nut, thanks for the info. Where do I find these NICE guidelines? is that just what its called or does it stand for something? I think if I cant get on Lamictal I would like Tegretol and when in 6 or so mos I get back to the states if I need to I can ask about lamictal. And I have looked into seroquel it seems to be good but mixed reactions here so I guess we have to wait and see but nice to know at least 2 of my top 3 even though if not my first choice is possibly available. I will see if I come up with anything on NICE if I search it. Take care!
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