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Re: Med Update - Cam and all » Greg

Posted by Cindy W on October 13, 2000, at 10:01:51

In reply to Re: Med Update - Cam and all, posted by Greg on October 13, 2000, at 8:30:36

> All,
>
> I really appreciate everyone's help with this. It gave me a lot to talk over with the new pdoc.
>
> After reviewing my history the new pdoc says that I definitely do have BP II. He gave me the option of three meds, Seroquel, Risperdal or Zyprexa. He said that the Zy has the lowest instance of negative side-effects. I told him to make the call as he is the expert. So, I've dropped all other meds except for a max of 1 mg Xanax per day as needed, and the 10mgs of Ambien to help me sleep. In a couple of days I'll start adding Neurontin in two day increments, 300 mgs at a time until I reach 900 mgs per day. He said that I'll probably find pretty quickly that the Ambien won't be needed as the Zy and the Neu will help me sleep much better. He says if the Zy doesn't do the trick, we'll try Seroquel next. I'll also start titrating off the Xanax in about a month, hopefully.
>
> Cam,
>
> If you post to Haven, I can read it but may not be able to respond. To explain what's going on, read my post below to Noa (NOA-Please Read)and it will explain what's happening. It's really good to hear from you and I hope everything is OK. Please say hi to the family for me!
>
> Greg
>
> > Gerg - Seroquel is sort of a different beast. At a conference I attended, Dr. Bill Wirshing from Berkley said that Clozaril™ (clozapine) was highly toxic and highly efficacious and that Seroquel™ (quetiapine) was incredibly safe, with few side effects; but it didn't work.
> >
> > I had thought this for quite a while, but experience has shown that Seroquel does work very well in a sub-group of people with bipolar disorder. For those for who it does work, it works like a damn. Dr. Roy Chengappa from the U of Pittsburgh has shown this. Some of the people are clear headed within a week (I've seen some dramatic improvements). In some of these people though, the effect seems to wane in 3 or 4 months, but many have been maintained for a couple of years.
> >
> > Just judging by side effect profiles, I would try the Seroquel first. Risperdal is very effective in many people, but the risk of EPS and hyperprolactemia (leaky boobs, even in you) would stop me from using it first. These side effects are not seen at doses below 4mg per day very often, though.
> >
> > Hope this helps - Cam
> >
> > P.S. - Greg, I will be posting in ASH tonight after 9pm (your time). I will give more info, then.

Greg, hope the new combo works well for you! Saw your note to Noa on Psychosocial Babble. Have checked ASH periodically but have seen very few new posts the past few days (and didn't make any). Don't know what's going on yet. Will try to post there and let you know.--Cindy W


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poster:Cindy W thread:46197
URL: http://www.dr-bob.org/babble/20001012/msgs/46270.html