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Q: Trileptal & Depression
Hi,
I'll try to make this brief. I recently moved and got a new doctor. Prior to
seeing him I stopped taking my meds because I was no longer feeling better on
them. He talked to me and encouraged me to begin again. He started me on
Trileptal moving me up to 150 in the morning and 300 in the evening. The next
time I saw him I explained that I was extreemly depressed, so he increased the
trileptal to 300 in the am and 600 in the evening. I then read your article and
was confused as to why he was doing this as Trileptal does not pull one out of
depression like other mood stabilizers may. Anyway, I went to see him again
today and again, I was extreemly depressed. Christmas was awful. He then
increased the Trileptal once again to 450 in the morning and I believe 600 in
the evening. I told him what I read about Trileptal not pulling one out of
depression and he said I shouldn't believe everything I read on the internet.
My question is what should I do? Should I get a new
doctor or continue with this one? He also said that if I didn't improve he
would have to increase this medication or put me on something else. Please, if
you have time, answer me. I really don't know what to do.
Thand you for your time.
Dear Nancy --
Well, as long as you're working with this guy, you might try using some of the
ideas in my little essay on
talking with
doctors. If that or some such strategy doesn't work, then maybe a hunt for
a new doc' is a good idea.
You could wonder out loud about adding something with
some direct antidepressant potential (e.g. lithium, lamotrigine, or perhaps fish
oil; see more on this in my
list
of mood stabilizers, if you haven't been there already) indicating that you
understand the risks of an antidepressant as such inducing cycling and mania and
you appreciate his diligent efforts to make sure that doesn't happen to you.
You could ask very politely how he would determine when a strategy that targets
your depressive symptoms more directly would be warranted, in his view (so you
know if he'd ever do it). That kind of thing.
Good luck with that.
Dr. Phelps
Published April, 2004
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