Expert: Ivan Goldberg, M.D. - 3/27/2006

Question
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Followup To
Question -
I am taking Depakote (2x500 mg.), Effexor (3x75 mg.), Gabapentin (3x600 mg.), Trazodone (2x100 mg.) for a bipolar condition for about 4 years now. I'm feeling "bland" rather than the free spirit I was without treatment. Of course this is much better than the "wild" me back then. My problem is that I don't feel "myself". Now I realize the me that used to be was the me that was destructive, but the new "bland" me feels much more alone and lost since my basic personality was gregarious and extroverted. I'm now waiting to live again without a sense of self I once had. How does one get used to feeling dull inside. I have tried less Gabapentin, but then I get manic. I'm a gay 56 year old retired teacher who has lost the sense of "me" that I once had, and am not at all comfortable with how I feel. Any suggestions on how to live "normally" instead of this "controlled" feeling of numbness?
Answer -
Hi . . .

I may be better able to answer your query if you tell me the amount of the reduction in gabapentin that lead to your becoming more manic.

Also do you happen to know what the Depakote blood level is
when measured exactly 12-hours after the last dose?

Best regards . . .

Ivan
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We tried two - no change in 4 weeks, then only one a day and i went out and did the town - picked up a male hustler downtown cincinnati, brought hime home and got drunk with him. Much regret the next day. This was four days on just one at the same time am) as usual. My Depakote level is OK i guess as is my liver test. I get them twice a year. Wat else do you need. I can get the exact level if i need to call the office.

Answer
Not knowing your depakoet levcel puts me at a great disadvantage when ti comes to trying to say anything useful. When it comes to the gabopentin it seems as if you lowered it from 3 X 600 mg to just 600 mg a day. If I had been trying to lower your gabapentin, I would have reduced it in steps of 300 mg/day and not more often than one such change per 10-14 days. I think you need to have a long talk with your psychiatrist or a consultation with one of the experts listed at: http://www.psycom.net/depression.central.psychiatrists.html

Best regards . . .

Ivan
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