Posted by chemist on July 24, 2004, at 23:49:37
In reply to To Chemist (or anyone) re: Tegretol, posted by jay on July 24, 2004, at 22:09:48
> Hello Chemist..I am thankfull for the kind insight you bring to the board. I tried Tegretol about a year ago, and completely could not tolerate it, even in low doses. It made me *deeply* sad, and even though I am a sensitive guy, I *cried* and was feeling guilty about everything! So, no doubt, in chemical terms, it had a very depressive effect with me. I was also on 250mg's of EffexorXR, and 50mg's of nortriptyline.
>
> So, my question is, would Trileptal(sp?) more or less have the same effects, being that it really doesn't act differently, except through it's passage ways in the body?
>
> TIA,
> Best,
> Jayhello jay, chemist here....thank you for your kind words, i only hope something productive results. the deal with tegretol and trileptal is that it is the metabolite that is active, and this metabolite (MHD, monohydroxy derivative) pops out of your liver and into your blood and into the brain regardless of whether you take tegretol or trileptal. so, either way, you get the active metabolite. so, the immediate answer is that the results would be the same. however, tegretol is metabolized by an enzymatic pathway that is the major metabolic route for many other drugs (CYP). for instance, if you take tegretol with nortriptyline, the metabolism of nortriptyline is hastened, and thus the efficacy in antidepressant effect is lessened; this is not true with trileptal. similarly, tegretol auto-induces its metabolism via certain enzymes in the CYP group and decreased serum levels of effexor result. in short, tegretol was more than likely responsible for your continued depression. trileptal is worth trying, as is is not metabolized by the enzymes that metabolize nortriptyline and effexor and thus you should feel the brunt of the MHD without lessed AD activity. i do hope i have (accurately) addressed your concerns....please do let us know if trileptal is indeed the answer for you.....all the best, chemist
poster:chemist
thread:370132
URL: http://www.dr-bob.org/babble/20040724/msgs/370159.html