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Need to sleep!
An_243012 posted:
Hi, I am bipolar and have epilepsy. i currently take lamictal xr, saphris, , topomax, and vimpat I am having the hardest time sleeping. i'm afraid it will make me go manic. my psychiatrist is aware and she raised my dose of saphris at night, she knows that didnt help (saphris doesnt make me tired at all) and she hasnt/wont do anything yet.. ive tried melatonin, valerian, yoga,meditation., you name it. trazodone doesnt work on does the opposite. so that is not an option. i was wondering what is most commonly taken as a sleep aid. but keep in mind I need something that doesnt lower the seizure threshold too much.
bpcookie responded:
Hello, Im sorry that its taken so long for your post to be replied to. I have difficulties sleeping as well and if I dont get a good nights sleep it really messes with my emotions. I take Lunesta and it puts me right out but if I wake during the night I still have problems getting back to sleep. Im not sure if your able to take Lunesta since you have issues withe seizures. Perhaps you can ask your Dr. if taking Lunesta will be ok. Good luck
I HATE being Bipolar. Its AWESOME!!!!
jd0026 responded:
I've been looking for someone with similar DX as me. I have been dealing with my bipolar disorder for 14 years now. I was DX with epilepsy due in part to exteme head trama. I believe the seizures and my bipolar disorder are related. Why are the meds for bipolor also for seizures then if they aren't related? Currently I'm taking Neurotin, Lamictal and Zanax for my symtoms if this helps.
bpcookie replied to jd0026's response:
Hello jd0026, nice to meet you and welcome to the board. I think your question could be better answered by Dr. Goldberg. If you write a post and title it to him, I'm sure he will answer.
You may go through life hearing a 1000 NO's but don't give up because your YES is out there waiting for you.- (Something my father told me.)
Joseph F Goldberg, MD replied to jd0026's response:
Dear jd0026,

Lamictal has value for preventing mood episodes, especially depressions (more so than manias) in bipolar disorder. Neurontin has no known value in bipolar disorder. Some years ago, after Depakote received its FDA indication in mania, interest grew in the theory that at least some antiseizure medicines that raise the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) like Depakote or block the excitatory amino acid glutamate (like Lamictal) might help regulate mood, though no one knows exactly why. It's since turned out that most anticonvulsants have no clear benefit for mood (eg, Neurontin, Topamax, Keppra, Gabitril) with Depakote and Tegretol the sole exceptions in mania and Lamictal the main exception for preventing depression in bipolar disorder.

Some antiseizure drugs are also used to treat migraine headaches (eg, Topamax, Depakote) but migraines and epilepsy aren't related, and some antiseizure medicines are also used to treat pain (eg, herniated disks), like Neurontin or Lyrica, but neuropathic pain and epilepsy also aren't related. Some blood pressure medicines (eg, propranolol) are used to treat migraine or tremor but migraine and tremor are not related to blood pressure. Monoamine oxidase inhibitors were first used to treat tuberculosis, and then depression, but those 2 things aren't related either. Lithium is sometimes used to treat gout! Topamax treats alcoholism and binge eating, regardless of whether or not someone also happens to have epilepsy. Wellbutrin helps people stop smoking, regardless of whether or not they're also depressed. Aspirin is used to treat heart disease as well as headaches, but those conditions are also unrelated...

So, a medicine may have value for multiple different uses without those different uses necessarily having anything in common.

Head trauma can cause seizures and head trauma can also sometimes cause secondary manias or depressions (secondary to the trauma). Drugs like Depakote may be useful both for managing mania as well as preventing seizures through independent effects on each disorder.

Dr. G.
CanadianDyanne replied to Joseph F Goldberg, MD's response:
Beautifully stated Dr G.

fyi for others: I for one found Depakote
1. horrible for my waist lol 2. does nothing for my migraines BUT 3. it has been remarkable for regulating mood. When I was put on it many years ago, I was desperate, and it was 'just what the doctor ordered"

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Joseph F. Goldberg, MD, is a Clinical Professor of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY. He also maintains a private prac...More

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