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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by Sobriquet Style on February 5, 2006, at 13:46:37
When treating Bipolar Disorder, what do you feel is the best longterm maintenance treatment when comparing the old anticonvulsants vs the newer ones in terms of safety and overall effectiveness?
In Particular...
Valproate/Depakote
Carbamazepine/Tegretol
vs
Oxcarbazepine/Trileptal
Topiramate/Topamax
Also of interest, Gabapentin/Neurontin - Is any of the old school anticonvulsants known to work synergistically with this drug? I remember reading somewhere that sometimes in terms of effectiveness Gabapentin works best when combined with the older anticonvulsants rather than the newer ones. I cannot remember where I read this though, however I think it was written by a Neurologist.
Look forward to your responses.
:-)
~
Posted by rjlockhart on February 6, 2006, at 13:14:58
In reply to Old Anticonvulsants vs New Anticonvulsants?, posted by Sobriquet Style on February 5, 2006, at 13:46:37
All i know is Tegetrol reduces white blood cell count thats why its is monitered sometimes.
Trileptal is very same
My stepdad takes 600mg at night and 450mg in morining for Epilepsy.
Matt
Posted by Sobriquet Style on February 7, 2006, at 11:31:05
In reply to Re: Old Anticonvulsants vs New Anticonvulsants?, posted by rjlockhart on February 6, 2006, at 13:14:58
Thanks Matt.
Tegretol and Trileptal seem very similar in their actions as mood stabilisers and anticonvulsants from what I can gather.
The drugs also have unique advantages over some of the other drugs, as well as generally good side effect profile.
There is, unfortunately some serious side effects even with Oxcarbazepine (Trileptal) with hyponatremia (SIADH) I'm not sure how common this side effect is though.
With Carbamazepine I've read that in less than 1 in 100,000, it may cause aplastic anemia or agranulocytosis. Also very severe liver damage is very rare but has occurred with fatal outcome.
One of the benefits of this medication is, in certain types of bipolar disorder (the non-calssic type eg Bipolar 2) it can be better treatment than lithium.Oxcarbazepine as well has far less interactions with other drugs, which I've heard is the best choice in reserving this medication for those reasons. Also said to have fewer side effects, but again I've read that this might only be in first weeks of treatment.
Swings and roundabouts!
How does your dad like it, has it had any problems with Trileptal?
~
This is the end of the thread.
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