Posted by Mitch on November 10, 2001, at 0:53:50
In reply to Re: Trileptal and topomax » Mitch, posted by Sue4 on November 9, 2001, at 15:34:23
> I've never been on Tegrotol, although I've been on Depakote. Side effects of weight gain and heart pains made me stop. I've been on Topomax for a long time and have been able to go up to 200 mg (slowly) w/o any apparent cognitive side effects...my pdoc thinks I cycle too much on addition of antidepressants (wellbutrin and prozac)and that the neurontin isn't really all that effective. Yet he thinks I could handle the antidepressants with the addition of another anticonvulsant. Have you tried Lamictal?? My Pdoc doesn't seem all that excited about that. Sue
Hi Sue,
Wow, that is amazing you have gotten to that level on TOP without any major cognitive sfx (no wonder you probably don't need an AD)! I would agree that Neurontin is a relatively mild mood stabilizer that needs an adjunct to work well. Never tried Lamictal-want to avoid that one. I have a history of hives-skin reactions to meds and have to take allergy shots (for molds/dust systemic reactions) to prevent that. I believe that Topamax shares a similar mechanism of action to Tegretol/Trileptal (could someone enlighten us to what that is?-I think it is voltage-dependent sodium channels??). I think he is onto something. I would go for the Trileptal add-on. I definitely had an AD effect from it. I just got nauseated easily. Just start low-go slow on it, who knows? I have had a lot of cognitive blunting on GABA-affecting AED's like Depakote/Klonopin/Gabitril, etc. Maybe the sodium/calcium ion-channel affecting meds would be less blunting? Neurontin's mechanism of action isn't really GABA enhancement it is selective calcium-channel antagonism in the hippocampus, FWIW.
poster:Mitch
thread:83661
URL: http://www.dr-bob.org/babble/20011104/msgs/83754.html