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Q: Urge Incontinence & Meds
18 year old daughter was diagnosed BPI with panic disorder abut 2 years ago.
Maintained on Neurontin and Effexor XR. Neurontin was
helping but she still had many ups and downs. 10 weeks ago she was switched to
Depakote along with the Effexor. Mood stabilized wonderfully, but immediately
started having problems with urge incontinence. Detropan has not helped.
Blood tests and urinalysis normal. This past week went off the Depakote &
onto Trileptal but the incontinence continues. Needless to say, this is
not a good thing for an 18 year old to be going through. Any experience with
this problem and what can be done? Leaves for college in 3 months and
certainly needs this resolved before that stressor begins.
Dear Ms. B' --
Haven't heard this one before. Lower dose and make up the difference with
lithium? (a very old, basic strategy). Begin to lower Effexor in hopes
that a lower dose of Depakote might be sufficient (obviously these strategies
hope that the effect is dose related).
Could Effexor be a cause and somehow Neurontin was
masking it? i.e. it's not really Depakote (or Trileptal)... or perhaps
it's something else that's a cause, not Effexor, but still not Depakote?
Probably her doc's have already done the appropriate head-scratching about this,
with the lab work you mention.
Sorry, beyond that, it seems like there's just more
switching to try.
Dr. Phelps
Published July, 2003
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