About Lemas Mitchell Expertise I can answer give first hand experience with anti-psychotic and anti-convulsant medications. Currently, I take the magic combination of: Seroquel and Zonegran. In the past, I`ve taken Trileptal, Risperidal, Depakote, and Lithium. I`ve also learned (the hard way) about what it`s like to be manic and how to gauge your degree of mania from subtle environmental cues.
Question Thank you for your response...My only real question was the dosage of zonegran, since it is relatively new in terms of its effect on mania, even though the article from Japan came out in 1994. It does not go into detail about starting dose, maximal dose, etc. My daughter started on 100mg, and I increased it to 200mg after week 2. Initially, she had more clarity of thought, but no real difference(maybe slightly worse) at the 200mg dose.
I am a physician, Board Certified in Internal Medicine. As a physician, I learned to listen to patients about their experiences with medications, not just what the PDR says. As a parent, it is often difficult to ask a 15 year how she is feeling to guage that as a clinical response. So I was hoping that this forum would help me understand what these medications are doing to people who are atleast competent and articulate enough to write about them.
Sincerely,
Janet
Answer I'm sorry for not being clear enough in the last letter. To come directly to the points:
1. I myself took 200 mg of Zonegran and at a visit to the psychiatrist, he thought that I was still hypomanic at that dose. When I went up to 300mg, it felt like I had been smoking joints at regular intervals throughout the day. Keep in mind that that may have been the desired effect, as I cannot see myself as hypomanic when I am actually that way. It is very possible that my feeling "stoned" or "out of it" was the feeling that I was supposed to get when my mouth was running no more than necessary.
2. Since you'll have the access to the appropriate journals (Pub Med), I'd recommend that you look at an article called "Quetiapine in the treatment of rapid cycling bipolar disorder.
Bipolar Disord. 2002 Oct;4(5):335-40.
PMID: 12479667 [PubMed - indexed for MEDLINE]" If you get a paper copy of that article, you'll see at the end that there is at least one article cross referenced that discussed the use of Zyprexa as a monotherapy in rapid cycling bipolar.
If you've not tried Seroquel, I can't tell you enough good things about it. I hadn't had a good night of sleep in years before I started taking 200mg of it per night (I am 190cm/ 95kg) . It (as suggested in the article) does seem to have some mood stabilizing properties.
I hope that this answer was clearer and to the point.
