Verapamil Dosage
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Q:  Verapamil Dosage


Dear Dr. Phelps,

Thank you so much for the wealth and diversity of information you provide on your website and through this forum.  As a 48-year old bipolar woman, diagnosed and treated with varying degrees of success since age 20, I find educating myself is one of the most important tools to which I have access.

Over the years I have been on various combinations of all of the standard mood stabilizers as well as many of the newer possibilities.  One option I'd not heard of before reading about it on your website was verapamil, and I'd like to find out more.  I understand that in your experience you found the slow-release version didn't work well but the immediate-release version showed some impressive results as a mood stabilizer.  (My blood pressure is normal so it shouldn't be a problem for me to take the verapamil that way.)  I've searched the web...and your archives...trying to find information about what the dosage should be if used for this purpose but have come up blank.  Can you give me some guidelines or point me in the right direction? 

BTW, I'm on a limited income and already spend over $500 a month on maintenance medication for my disorder, even after getting what I can from Canada.  I'd love to try Trileptal but the cost is absolutely prohibitive and I'm just over the limit for pharmaceutical assistance.  Since verapamil is an older drug with an expired patent, it's very inexpensive.  Wouldn't it be terrific to find a mood stabilizer with some potential that is actually affordable!
 
Many Blessings,
Terry


Dear Terry -- 
Not to do this on your own, mind you, as there are some interactions and side effects to watch for; here are the doses we usually use:  80 mg pills, increasing to 3 daily as the standard target dose.  If you got a great result you could switch to the generic 240 sustained-release version and see if you lost the benefits.  Maximum dose I've seen used in studies is 480 mg, but it has been used as high as 720.  The few successes  I've seen with it have been at 240, didn't have to go higher.  Haven't used it all that much because of the mixed evidence about its effectiveness.   Good luck to you. 

Dr. Phelps


Published July, 2004

 

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