Med question(s), advice/experiences greatly appreciated

caz23 · 11-08-2011, 09:05 PM

So as the title suggests, I could do with some advice regarding medications; Lofepramine, Lamotrigine, Valproate & Quetiapine.

Just to give some background; I'm currently prescibed Lithium & Trazodone and have been on this combination for around 18 months or so. I have been doing quite well on this combination on the whole and am much more stable in that I'm in full time employment and can look after myself etc. However, I am still struggling somewhat, primarily with low mood. I spend most of my days feeling tired out, unmotived and generally only really do what is absolutely necessary. This low mood though is sometimes interspersed with periods of "wellness" I guess. I need less sleep, have more energy, am more productive etc, but then inevitably crash back down into depression again, which is where I am now, just feeling constantly below par.

In a recent appointment with my psych (who has now unfortunately left) we discussed some different med combinations that I could try if things didn't really improve, and I'm now getting to the stage where I'm beginning to consider my options.

Basically, I was given two choices;

Keep the Lithium and swap the Trazodone for Lofepramine and then possibly add Quetiapine if the isn't much improvement after time.
Again, keep the Lithium but ditch the Trazodone for either Quetiapine, Lamotrigine or Valproate.

I am adamant that I want to keep the Lithium as I feel as though it has been quite beneficial. I'm slightly cocerned about ditching the Trazodone as it really helps me sleep, so with that in mind I thought about trying Quetiapine as it's quite sedating. However, as far as I'm aware weight gain is fairly common with it which is quite off putting for me.

I am actually quite keen on the idea of trying Lamotrigine as I've read quite good reports about it's anti-depressant qualities, but I have also read that it's not the best of friends with hormonal contraceptives and given that I'm happily on the pill, that could be a problem.

I don't know a great deal about Valproate to be honest but from what I'm aware it's more effective against manic symptoms rather than depressive ones, so if that is the case it's probably not ideal for me.

If anyone could give me any kind of advice relating to the above meds or share their experiences with them (primarily for treating depressive symptoms) I would be really grateful. I am seeing my GP in a fortnight and will discuss this with her but I just thought I'd try and gain a little more insight before then if I can.

Thanks in advance

Rhea-Billie-Tate · 11-08-2011, 10:20 PM

I'm afraid the only one of those medications that I have experience with is Quetiapine so I can't offer any hugely useful advice. It is quite sedating, I used to have to be physically carried to bed if I didn't get myself there within about half an hour of taking it. The effect reduced over time, but it does still help me to get to sleep. As far as the weight gain is concerned, it's a risk with a lot of those types of medications, but as with all side-effects different people tolerate it differently so don't let that put you off trying it because it may not be an issue for you at all. I personally didn't experience any weight gain on it. I gained weight really rapidly on Olanzapine but had a friend who didn't, they definitely have different effects on different people. Quetiapine for me has been pretty good on the side effect front, it gives me a really stuffy nose (took me months to figure out that was a side-effect) but that's about it.

I hope they find a combination for you that works, psychopharmaceuticals is more art than science so I think it can be a matter of trial and error to find what suits you.

caz23 · 12-08-2011, 02:52 PM

Quote:

Originally Posted by Rhea-Billie-Tate

psychopharmaceuticals is more art than science so I think it can be a matter of trial and error to find what suits you.

Yep, it certainly is a bit of a lottery isn't it. It always tends to be somewhat of a stab in the dark when it comes to choosing meds in my experience!

Thank you for sharing your experience with Quetiapine though, and as you say, just because something is listed as a side effect it doesn't necessarily mean that I will experience it. Did you find that the Quetiapine helped with depressive symptoms?

RiverSong · 12-08-2011, 07:42 PM

Lamotrigine is best for treating the Depressed mood in the bipolar illness.
It is quite a good med when it works, with myself it keeps wearing off, but there has been no weight gain. Of course there is usual side effects like blurred vision and others that most people get that can be over come with. I can get tremours at time with this med but its nothing that cannot be sorted out.

Quetiapine is good for treating the Mania in the bipolar illness and is effective for helping sleep at night. It is sedating. This med i have got on very well with in terms of mood, stabilising etc and have been up and down on all the doses.

If you happen to end up having both Quetiapine and Lamotrigine as an evening dose, take them seperate, ie lamotrigine 6pm and quetiapine 10pm. Because i have found everytime i have taken those two together it has given me very painful eyes in the morning.
So i would advise taking them apart with a 3-4hr gap, if you did end up with those two together, or coming off one to go on the other, incase you found the same side effect.

Valproate [sp] It can cause weight gain which is why i have avoided it and been on other meds. However, every individual is different. It may/may not do that for you.

I haven't experienced the other meds you have mentioned.