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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by Sheilac on April 9, 2014, at 4:59:09
Looking back over my personal notes I've taken Trileptal on and off since 2006. I never had any painful swelling until the past year and I quit Trileptal in December.
Geodon is good, but since I missed Trileptal for the great sleep, as well as keeping me even, my doc allowed me to try 150mg at bedtime. And it's working for sleep.
I didn't like taking Seroquel & Geodon (Seroquel for sleep). 2 AAPs. Yuk.
So far, no painful swelling, no side effects with Trileptal. My goal is to get back on Trileptal. But I'm a low dose gal.
Pdoc thinks if we go really low and slow maybe we can find the right dose without the side effects (slow like Lamictal), or maybe if we move up slow enough I won't get the side effects.
I love Trileptal and want this to work, then I could drop my Geodon dose down.
I'm guessing if I start to have the swelling, I need to go to my regular doc and get my sodium tested? I never use salt, ever, unless it's already in the food I eat. Plus, I do drink a lot of water. Could that be what causing the swelling? Not enough salt? Do I need to start drinking Gatorade everyday?
Is there anyway to avoid the swelling? Do I need to add a little salt to my diet to avoid the possible hyptotremia?
I can't stress enough how much I want this to work.
Posted by Phillipa on April 9, 2014, at 9:48:32
In reply to Reintroducing Trileptal..., posted by Sheilac on April 9, 2014, at 4:59:09
Swelling based on water consumption without salt I've not heard of. Only when one has a physical condition such as heart disease or kidney problems? I also always have had a low sodium level for same reasons as you state. low sodium level would mean that you have too little salt. I am starting to feel maybe a good physical with a doc you trust? Phillipa
Posted by Sheilac on April 9, 2014, at 11:35:17
In reply to Re: Reintroducing Trileptal... » Sheilac, posted by Phillipa on April 9, 2014, at 9:48:32
I wonder if low sodium would cause swelling or be a symptom of the hypnotremia.
Posted by ed_uk2010 on April 9, 2014, at 15:31:31
In reply to Re: Reintroducing Trileptal... » Phillipa, posted by Sheilac on April 9, 2014, at 11:35:17
> I wonder if low sodium would cause swelling or be a symptom of the hypnotremia.
Not really, no. I suspect the swelling was caused by something else.
Good luck with Trileptal this time.
Posted by SLS on April 9, 2014, at 17:26:58
In reply to Re: Reintroducing Trileptal..., posted by ed_uk2010 on April 9, 2014, at 15:31:31
Trileptal can cause swelling of the ankles. I believe that this is a symptom of hyponatremia. I was told to increase my salt intake while taking Trileptal. I have no idea if this actually mitigates the problem, though. Hyponatremia as a side effect of Trileptal is dosage-dependent.
- Scott
Posted by SLS on April 9, 2014, at 17:42:02
In reply to Re: Reintroducing Trileptal..., posted by SLS on April 9, 2014, at 17:26:58
> Trileptal can cause swelling of the ankles. I believe that this is a symptom of hyponatremia. I was told to increase my salt intake while taking Trileptal. I have no idea if this actually mitigates the problem, though. Hyponatremia as a side effect of Trileptal is dosage-dependent.
Try not to drink too much water.
Have your blood tested.
- Scott
Posted by baseball55 on April 9, 2014, at 19:41:33
In reply to Re: Reintroducing Trileptal... » Phillipa, posted by Sheilac on April 9, 2014, at 11:35:17
> I wonder if low sodium would cause swelling or be a symptom of the hypnotremia.
>
>Hyponatremia does not cause swelling. Hypernatremia (high sodium blood levels) causes swelling.
Posted by SLS on April 9, 2014, at 20:16:20
In reply to Re: Reintroducing Trileptal..., posted by baseball55 on April 9, 2014, at 19:41:33
> > I wonder if low sodium would cause swelling or be a symptom of the hypnotremia.
> >
> >
>
> Hyponatremia does not cause swelling. Hypernatremia (high sodium blood levels) causes swelling.Are you absolutely sure that swelling is not a symptom of hyponatremia?
- Scott
Posted by Phillipa on April 9, 2014, at 20:22:41
In reply to Re: Reintroducing Trileptal... » baseball55, posted by SLS on April 9, 2014, at 20:16:20
Only one way to find out that is quick google. Phillipa
Posted by SLS on April 9, 2014, at 20:26:48
In reply to Re: Reintroducing Trileptal... » baseball55, posted by SLS on April 9, 2014, at 20:16:20
> Only one way to find out that is quick google. Phillipa
:-)
Let me know what you come up with.
I can't afford to get hyponatremia. My head is swollen enough as it is.
- Scott
Posted by Phillipa on April 9, 2014, at 20:28:34
In reply to Re: Reintroducing Trileptal... » SLS, posted by SLS on April 9, 2014, at 20:26:48
So you also googled since I do have low sodium and drink a lot of fluids get headaches & muscle cramps. Excluding trileptal found this quickly. Phillipa
http://www.mayoclinic.org/diseases-conditions/hyponatremia/basics/causes/con-20031445
Posted by Sheilac on April 10, 2014, at 4:53:55
In reply to Re: Reintroducing Trileptal... » SLS, posted by Phillipa on April 9, 2014, at 20:28:34
Well, I definitely have low salt and drink too much water throughout the day, and I guess that contributes to the swelling (hynotremia).
If I'm going to try Trileptal again, I probably need to try and sprinkle a little salt. Since I never use salt! No doc has ever told me this. Maybe this will help my blood sodium level come up. If I start to get swelling I'm going to get my bloodwork done!
I do think it is dose dependent too.
Posted by baseball55 on April 10, 2014, at 19:55:25
In reply to Re: Reintroducing Trileptal... » baseball55, posted by SLS on April 9, 2014, at 20:16:20
>
> Are you absolutely sure that swelling is not a symptom of hyponatremia?
>
>
> - ScottI'm not medically trained, but I know enough A&P to know that sodium attracts water and causes water retention. Low sodium reduces water retention. That's why docs prescribe low sodium diets for people with high BP (less sodium means less fluid retention means less blood volume and lower BP).
So when Sheila connected low sodium to edema, that seemed counter-intuitive, so I looked it up. According to sources on the web, edema is not a symptom of hypo-natremia. It is a symptom of hyper-natremia.
Posted by SLS on April 10, 2014, at 23:56:28
In reply to Re: Reintroducing Trileptal..., posted by baseball55 on April 10, 2014, at 19:55:25
> > Are you absolutely sure that swelling is not a symptom of hyponatremia?
> I'm not medically trained, but I know enough A&P to know that sodium attracts water.
Thanks.
Water molecules diffuse osmotically across a semipermeable membrane according to a concentration gradient, right?
What if the sodium is retained INSIDE the cell (which it is)? Where is the excess water in the blood stream attracted to? Is cerebral edema (brain swelling) dangerous enough to be concerned with? Trileptal causes hyponatremia. Hyponatremia causes brain swelling. Brain damage is a possible result if the onset of hyponatremia is acute enough. Swollen ankles is also a symptom of hyponatremia, and will hopefully dispose one to having a blood test for electrolytes before more serious symptoms emerge. Intracellular and interstitial fluid accumulations both cause swelling, but for different reasons. They are not "opposites".
- Scott
Posted by Sheilac on April 11, 2014, at 4:42:31
In reply to Re: Reintroducing Trileptal... » baseball55, posted by SLS on April 10, 2014, at 23:56:28
In my case I had swelling in my ankles and feet. More painful in feet because you have to walk on them :)
So far, I'm using 150mg at night for sleep instead of adding Seroquel, which would be an additional AAP to my Geodon.
We may move up to 300mg to see how I react. I know at 600mg I had painful swelling.
So far the 80mg of Geodon is keeping me stable, even with a recent bout of bronchitis for which I had to use steroids. Usually, the steroids would have pushed me over into hypomania or mania. Geodon has kept everything even.
My concern is that there are so many interactions and side effects, mainly with the heart rhythm with Geodon.
For this reason, I was hoping to rely more on Trileptal (I think it might be a safer med) and less on Geodon.
Not sure this will happen. But I'd like to keep my heart safe given my family history of atrial fib, for which Geodon can cause.
I used to use Geodon main for its AD effects. I wish there were an alternative AD I could use. The only one that didn't bother my cystitis was Pristiq, but it's not generic. Effexor did bother my cystitis (at 75mg), but I never got up to 150mg, where I think it effects different neurotransmitters. Not sure if you can just start taking Effexor at 150mg. Plus, what a nightmare drug to withdrawal from!
I know I worry too much, and if it ain't broke, font mess with it, but I do worry about future heart issues and Geodon.
Posted by SLS on April 11, 2014, at 11:55:24
In reply to Re: Reintroducing Trileptal... » SLS, posted by Sheilac on April 11, 2014, at 4:42:31
Do you have limitations in resources that prevent you from taking newer drugs like Brintellix or Latuda?
Have you thought to try Remeron for sleep? It might even help the Geodon to work better for depression.
- Scott
Posted by phidippus on April 11, 2014, at 14:21:41
In reply to Reintroducing Trileptal..., posted by Sheilac on April 9, 2014, at 4:59:09
A low dose of Trileptal will work with a high dose of Geodon. Conversely a high dose of Trileptal will work better with a low dose of Geodon. Of course, high doses of both medications might be peachy keen as well. But, once again, I have to discourage you from doing low doses on both medications. Where is it you learned that low doses of a medication were the desired thing?
This issue of hyponatremia would best be discussed with a doctor.
Eric
Posted by Sheilac on April 11, 2014, at 15:13:20
In reply to Re: Reintroducing Trileptal... » Sheilac, posted by phidippus on April 11, 2014, at 14:21:41
I've been told I'm a slow metabolizer, which could be why I develop side effects at "therapeutic" doses. I also tend to experience the opposite effect of the drug at therapeutic doses.
I can tell a huge difference between 40mg of Geodon and 80mg of Geodon. At 80mg there is a switch to calmness.
I am low on the BP scale, so that might also explain why a little goes a long way with me. If I took 1200mg of Trileptal, 120mg of Geodon and 3-4mg of Klonopin I'd sleep 24 hours a day.
Posted by Phillipa on April 11, 2014, at 18:33:41
In reply to Re: Reintroducing Trileptal... » phidippus, posted by Sheilac on April 11, 2014, at 15:13:20
Back to hyponatremia and brain swelling. Premenopausal females complain or suffer from water retention & a lot as I did once also get headaches during the time before menstruation occurs. I had an ob-gyn who gave me diazide for the days before. And I stopped getting headaches as I did always figure if some got a swollen belly or elsewhere why not a swollen brain also? The diazide worked as well as B6 also worked. I fear the reason I now have always had a blood level of 134 for sodium is cause I still take 20mg of B6 a day. I will now stop this practice. Also the low sodium could be familial with the QT levels you mention and maybe cystitis? Dilute urine? Get your GP to run blood work. Phillipa
This is the end of the thread.
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