Question:

Dear Coral,     Have you tried to set an alarm for when to take your meds.  I have my inhalers by my toothbrush that way I can take the flovent BEFORE I brush my teeth. When I had to take the inhaled steroid in the middle of the day I set my watch alarm to remind me.  I think they even make little med reminder clocks that you can set to remind you.  Hope this helps  Pam.

Response:

I don’t know if this applies to you, Coral, but I work in the computer industry, and I’m at a computer 8-10 hours a day. I’ve set reminders in Outlook that pop up so that I don’t forget to take my meds. Whatever you try, good luck! — Grant Thornley   "Do you like my mask? It brings thing back from the dead."     Giles, Season 3

Response:

Thanks for replying guys: Chris, yes, Im going to check that pill thing out in a while after I leave the computer, Pam, thats a good idea,and yes I ve tried an alarm but I share the alarm with my hubby, who needs it to wake him up for work, so thats no good. Grant, thats a good idea, didnt think about that. (in a rush) thanks Coral

Response:

I realize that I have to take my maintenance meds if I want to live, but my problem is that I constantly loose track of the time that I have to take them and end up skipping a night or two. Now, Ive been on Flovent and Serevent night and day for two months now and begining to feel like a crack head constantly inhaling on my areochamber.lol but seriously, sometimes I cant keep track of the time and I end up forgetting to take em. And after a while it feels like I going through some type of withdrawal.

At almost any drug store, you can get a pill box with a built-in alarm.  In almost any department store, you can get a watch with a built-in alarm.  Either will cost you less than $50, and be well-worth the expense if it helps you remember your meds. Chris Owens

Response:

I realize that I have to take my maintenance meds if I want to live, but my problem is that I constantly loose track of the time that I have to take them and end up skipping a night or two. Now, Ive been on Flovent and Serevent night and day for two months now and begining to feel like a crack head constantly inhaling on my areochamber.lol but seriously, sometimes I cant keep track of the time and I end up forgetting to take em. And after a while it feels like I going through some type of withdrawal. Coral

Response:

Question:

Actually, you would be better off using herbs.  I’m not saying you should stop using your asthma inhalants, but take the herbs in addition to… After about a month, you will notice that you don’t really need all of the medication that you are taking. I have had asthma for fifty-two of my fifty-three years.

Response:

currently, i am using flovent 110 mcg,2 puffs twice daily, serevent 2 puffs twice daily, and a nebulizer w/albuterol as needed. side effects from the flovent include sleeplessnes,  tremendous headaches that i am unable to remedy w/any medication, mood swings, and bruises that show up all over-with no injury to cause them. these occur when taking as little as 1 puff of the flovent 110 mcg, twice daily. my question is this, am i better off continuing the flovent and suffering the side effects; or, would i be better off avoiding all triggers, thereby curtailing the asthma attacks?

Avoiding triggers as much as possible is always a good idea.  So is going to your doctor, pointing out the side effects and lack of asthma control you are having, and trying another of the several medicines in the same class as Flovent to see if one of them works better. Chris Owens

Response:

      You mentioned using herbs…can you be a little more specific and mention the names of some of the herbs you have used, and what they help you with?       Thanks. *                                 *                         o                (((—O—)))   o         *                *                             *           * *                      *        *                                      O

Response:

Actually, you would be better off using herbs.  I’m not saying you should stop using your asthma inhalants, but take the herbs in addition to… After about a month, you will notice that you don’t really need all of the medication that you are taking. I have had asthma for fifty-two of my fifty-three years.

Let’s see, the difference between an herb and a formulary medication is:  The formulary is of known content, dosage, and purity.  The herb isn’t.  So, in addition to having a life-threatening illness, you are proposing that I play dosage/content roulette?  NO, thank you! Chris Owens

Response:

currently, i am using flovent 110 mcg,2 puffs twice daily, serevent 2 puffs twice daily, and a nebulizer w/albuterol as needed. side effects from the flovent include sleeplessnes,  tremendous headaches that i am unable to remedy w/any medication, mood swings, and bruises that show up all over-with no injury to cause them. these occur when taking as little as 1 puff of the flovent 110 mcg, twice daily. my question is this, am i better off continuing the flovent and suffering the side effects; or, would i be better off avoiding all triggers, thereby curtailing the asthma attacks? any information will be greatly appreciated. thanks! je meyer

Response:

Question:

I also brush my teeth after taking my flovent – I have yet to get Thrush Tim Washington State

– Hide quoted text — Show quoted text – : yeah, but don’t you want to avaoid getting thrush? Using an extender tube has greatly reduced my problem in my mouth and stomach from inhaled steroids. — Gordon    W5RED www.couger.com/gcouger "You miss 100 percent of the shots you never take."   – Wayne Gretzky

Response:

Because it’s on the insurance company’s list and Flovent isn’t?  More trouble to get you authorized for Flovent. – Hide quoted text — Show quoted text – I f Flovent works better, then why would my doctor want me to switch to Pulmicort? : Flovent tastes like crap… I hate that stuff…but it works. Flovent causes me a lot less troubles than pulmacort and works better. The tast is not nears as bad as a lot of things I remember. Witicha Falls, Texas water stands out in my mind for bad tasting things. — Gordon    W5RED www.couger.com/gcouger "You miss 100 percent of the shots you never take."   – Wayne Gretzky : : -J : : Hey, I’m using Flovent right now, but my doc wants me to switch over to : Pulmicort, but I don’t feel comfortable with it.  With Pulmicort, unlike : Flovent, you don’t taste the medicine.  How do you know for sure (short : of : an asthma attack) that you are getting the med? : : By the lack of asthma attacks. : : BTW, sometimes I can detect a faint taste of the medication. : : : : "Keep looking below surface appearances. Don’t shrink : from doing so (just) because you might not like what : you find." :    General Colin Powell : :

Response:

Because it’s on the insurance company’s list and Flovent isn’t?  More trouble to get you authorized for Flovent.

It is debatable which is better. Pulmicort has less systemic exposure due to rapid metabolism in the liver. Also the delivery device eliminates the need for a spacer. Personally, I use Flovent more because I think my patients are more used to the MDI and I try to get them to use the spacer for the other MDI’s as well. There doesn’t have to be an insidious reason for the recommendation to switch. If it is due to formulary reasons I think the doctor should be excused for not fighting a switch to a drug that is as good, if not better. — CBI, M.D. Please note: It is impossible to accurately diagnose medical problems without seeing the patient and reviewing the entire history. These posts are intended to be helpful and informative. Always check with your doctor before following any advice given.

Response:

yes, that works, but does it work with Pulmicort?

– Hide quoted text — Show quoted text – : yeah, but don’t you want to avaoid getting thrush? Using an extender tube has greatly reduced my problem in my mouth and stomach from inhaled steroids. — Gordon    W5RED www.couger.com/gcouger "You miss 100 percent of the shots you never take."   – Wayne Gretzky

Response:

I used Maxair and Asthmacort successfully for 12 years. Last year at this time, my asthma started causing me trouble. And this has gotten steadily worse over the year. Question 1: Do these drugs become ineffective after long-term use?

Typically, no.  However if your asthma changes then they may no longer be adequate. Question 2: If Asthmacort is no longer effective for me, will Pulmicort do any good?

I stopped using Azmacort a long time ago.  I have been on Pulmicort for about a year now and have had great success. "Keep looking below surface appearances. Don’t shrink from doing so (just) because you might not like what you find."    General Colin Powell

Response:

I used Maxair and Asthmacort successfully for 12 years. Last year at this time, my asthma started causing me trouble. And this has gotten steadily worse over the year. Question 1: Do these drugs become ineffective after long-term use? Question 2: If Asthmacort is no longer effective for me, will Pulmicort do any good? -Daniel Before you buy.

Response:

Hey, I’m using Flovent right now, but my doc wants me to switch over to Pulmicort, but I don’t feel comfortable with it.  With Pulmicort, unlike Flovent, you don’t taste the medicine.  How do you know for sure (short of an asthma attack) that you are getting the med?

By the lack of asthma attacks. BTW, sometimes I can detect a faint taste of the medication. "Keep looking below surface appearances. Don’t shrink from doing so (just) because you might not like what you find."    General Colin Powell

Response:

Flovent tastes like crap… I hate that stuff…but it works. -J

– Hide quoted text — Show quoted text – Hey, I’m using Flovent right now, but my doc wants me to switch over to Pulmicort, but I don’t feel comfortable with it.  With Pulmicort, unlike Flovent, you don’t taste the medicine.  How do you know for sure (short of an asthma attack) that you are getting the med? By the lack of asthma attacks. BTW, sometimes I can detect a faint taste of the medication. "Keep looking below surface appearances. Don’t shrink from doing so (just) because you might not like what you find."    General Colin Powell

Response:

Hey, I’m using Flovent right now, but my doc wants me to switch over to Pulmicort, but I don’t feel comfortable with it.  With Pulmicort, unlike Flovent, you don’t taste the medicine.  How do you know for sure (short of an asthma attack) that you are getting the med? By the lack of asthma attacks. BTW, sometimes I can detect a faint taste of the medication. When I was on Pulmicort I knew that I was receiving med. because I had

thrush. think about it.  Pam – Hide quoted text — Show quoted text – "Keep looking below surface appearances. Don’t shrink from doing so (just) because you might not like what you find."    General Colin Powell

Response:

yeah, but don’t you want to avaoid getting thrush?

– Hide quoted text — Show quoted text – Hey, I’m using Flovent right now, but my doc wants me to switch over to Pulmicort, but I don’t feel comfortable with it.  With Pulmicort, unlike Flovent, you don’t taste the medicine.  How do you know for sure (short of an asthma attack) that you are getting the med? By the lack of asthma attacks. BTW, sometimes I can detect a faint taste of the medication. When I was on Pulmicort I knew that I was receiving med. because I had thrush. think about it.  Pam "Keep looking below surface appearances. Don’t shrink from doing so (just) because you might not like what you find."    General Colin Powell

Response:

: yeah, but don’t you want to avaoid getting thrush? Using an extender tube has greatly reduced my problem in my mouth and stomach from inhaled steroids. — Gordon    W5RED www.couger.com/gcouger "You miss 100 percent of the shots you never take."   – Wayne Gretzky

Response:

: Flovent tastes like crap… I hate that stuff…but it works. Flovent causes me a lot less troubles than pulmacort and works better. The tast is not nears as bad as a lot of things I remember. Witicha Falls, Texas water stands out in my mind for bad tasting things. — Gordon    W5RED www.couger.com/gcouger "You miss 100 percent of the shots you never take."   – Wayne Gretzky : : -J

: : Hey, I’m using Flovent right now, but my doc wants me to switch over to : Pulmicort, but I don’t feel comfortable with it.  With Pulmicort, unlike : Flovent, you don’t taste the medicine.  How do you know for sure (short : of : an asthma attack) that you are getting the med? : : By the lack of asthma attacks. : : BTW, sometimes I can detect a faint taste of the medication. : : : : "Keep looking below surface appearances. Don’t shrink : from doing so (just) because you might not like what : you find." :    General Colin Powell : :

Response:

I f Flovent works better, then why would my doctor want me to switch to Pulmicort?

– Hide quoted text — Show quoted text – : Flovent tastes like crap… I hate that stuff…but it works. Flovent causes me a lot less troubles than pulmacort and works better. The tast is not nears as bad as a lot of things I remember. Witicha Falls, Texas water stands out in my mind for bad tasting things. — Gordon    W5RED www.couger.com/gcouger "You miss 100 percent of the shots you never take."   – Wayne Gretzky : : -J : : Hey, I’m using Flovent right now, but my doc wants me to switch over to : Pulmicort, but I don’t feel comfortable with it.  With Pulmicort, unlike : Flovent, you don’t taste the medicine.  How do you know for sure (short : of : an asthma attack) that you are getting the med? : : By the lack of asthma attacks. : : BTW, sometimes I can detect a faint taste of the medication. : : : : "Keep looking below surface appearances. Don’t shrink : from doing so (just) because you might not like what : you find." :    General Colin Powell : :

Response:

Hey, I’m using Flovent right now, but my doc wants me to switch over to Pulmicort, but I don’t feel comfortable with it.  With Pulmicort, unlike Flovent, you don’t taste the medicine.  How do you know for sure (short of an asthma attack) that you are getting the med?

– Hide quoted text — Show quoted text – I used Maxair and Asthmacort successfully for 12 years. Last year at this time, my asthma started causing me trouble. And this has gotten steadily worse over the year. Question 1: Do these drugs become ineffective after long-term use? Typically, no.  However if your asthma changes then they may no longer be adequate. Question 2: If Asthmacort is no longer effective for me, will Pulmicort do any good? I stopped using Azmacort a long time ago.  I have been on Pulmicort for about a year now and have had great success. "Keep looking below surface appearances. Don’t shrink from doing so (just) because you might not like what you find."    General Colin Powell

Response:

Question:

hello, I was wondering if anyone had any suggestions as to which pranayama exercises are most appropriate for asthmatics. I.ve been practicing for about two years and have recently begun to explore pranayama.  I sometimes find, however, that this can antagonize my symptoms. Fortunately, when this happens, I’ve always been able to return to "normal" breathing but it can be rather frustrating.  Thanks in advance for your help. Namaste, Kyle

Response:

I have asthma and I never though of pranayama as something that would relieve the symptoms or the disease.  It can’t hurt, after all asthma effects exhaling and pranayama, for the most part, concentrates on exhaling. I find that doing head and shoulder stands followed by bridge and fish are great.  You get to really stretch out the lungs and get to breathe deeply…expanding lung capacity is a good thing for asthmatics. I also take medication (Severent and Pulmicort) and exercise.  Combined with yoga I’m virtually symptom free. Good luck,

Response:

hello, I was wondering if anyone had any suggestions as to which pranayama exercises are most appropriate for asthmatics. I.ve been practicing for about two years and have recently begun to explore pranayama.  I sometimes find, however, that this can antagonize my symptoms. Fortunately, when this happens, I’ve always been able to return to "normal" breathing but it can be rather frustrating.  Thanks in advance for your help. Namaste, Kyle

Hello Kyle, it’s a long way – be patient. Especially breathing exercises for ppl with breathing diseases. I practice Yoga + Pranayama now for 12 years and slowly start to "understand" now how to meditate on the breath in a relaxed and joyful way. I wish I "only" would have Asthma – I have only 30% lung capacity – but it is possible to heal the relationship with the breath. But it needs patience – allways and a lot of love, forgiving understanding and patience – for your-self. Don’t give up + enjoy. Sat Nam – Hari Har Singh PS: There are many different ways of pranayama, working with the breath. Maybe you’ll also try something different.

Response:

yes – yes – yes – that is where it came from.  A manual with our human frailties listed in alphabetical order.  and things to do to facilitate healing. is this the one that says the "asthma will fly from your body like a crow from a clap of the hands"?

Yes, it is. Page 53 The exersise is 1-3 min. long we forgot to mention Sat Nam – Hari Har Singh

Response:

dear asthma sufferer, ask your healthcare professional if it is o.k. for you to do this stand up, heels together.  hands are overhead with palms together.  lean back as far as possible and do breath of fire for 1-3 minutes.  you can lean on back of sofa to avoid falling.  but lean back as far as you can. peace

Ah, you practice Kundalini Yoga? It’s one of the KY classics for the lungs – can be found in the book "Yoga for Health and Healing" ISBN 0-940992-01-9 For additional copies of that manual write to: Alice B. Clagett P.O. Box 3142 Santa Monica, CA 90408 Phone: (310)393-8167 Sat Nam – Hari Har Singh PS: If you have problems with breath of fire you can also practice this exercise with long deep breathing.

Response:

Question:

Thanks for the help. Brian’s chest specialist is planning to substitute Singulair for Flovent. My husband and I are still deciding whether to stop the Flovent and change to Singulair or put up with the behaviour changes and leave him on Flovent. The Flovent does work.         I’ve been using the other powerful effective steroid Pulmicort for some nine months and it’s done me a whole lot of good.           Last month I started taking Singulair. Didn’t notice any effect for a few days.  But now, thirty days later, I’m using a whole lot less of the rescue inhaler (albuterol) And from time to time, I’m  forgetting to take the Pulmicort.          I can’t believe your doctor want’s to stop the Flovent before seeing what effect the Singulair may have. (From the point of view of "If it works, don’ mess with it."  Are you sure you read him right?

Response:

I may be a little late with this response. My son has been sporatically on Singular since he was 3 y.o… The reason for only being on it once in a while is because it gave him headaches.  It took me a while to figure out they were related to the Singular, but it is listed as a side effect.  Our doctor initially had given him a 5mg chewable.  Then had us break it in half when the headaches started.   The headaches continued so I gave up on it until recently I’ve tried him on 1/2 tablets again (he is 5 now) and he seems to do better on them. Just FYI …keep it in mind that there are side effects to the Singular. Marina – Hide quoted text — Show quoted text – Thanks for the help.  Brian’s chest specialist is planning to substitute Singulair for Flovent.  My husband and I are still deciding whether to stop the Flovent and change to Singulair or put up with the behaviour changes and leave him on Flovent. The Flovent does work.  He has gotten sick this week with the flu and his asthma has not flared yet (yay!!!). I have talked to other parents who have had the same experience we have with using flovent.  I haven’t seen any studies that say flovent causes behaviour changes but can only go by what I am seeing. Debbie If you haven’t already tried it, you might be surprised about your son’s reaction to Singulair. It tastes _so_ pleasing to children that I’ve read (sorry, can’t recall the source) that there is pressure on the maker to change the flavor to something less palatable. There’ve been incidents of children overdosing on it, perhaps seeing it more as It’s small, cute, pink and tastes great. Even my 10-year old, for whom Singulair proved ineffective, whined the other day he wishes he could take it again, it tasted so good. Crushing it and sprinkling it in something should be no problem for him. ~Jacy

Response:

Thanks for the help.  Brian’s chest specialist is planning to substitute Singulair for Flovent.  My husband and I are still deciding whether to stop the Flovent and change to Singulair or put up with the behaviour changes and leave him on Flovent. The Flovent does work.  He has gotten sick this week with the flu and his asthma has not flared yet (yay!!!).   I have talked to other parents who have had the same experience we have with using flovent.  I haven’t seen any studies that say flovent causes behaviour changes but can only go by what I am seeing. Debbie – Hide quoted text — Show quoted text – If you haven’t already tried it, you might be surprised about your son’s reaction to Singulair. It tastes _so_ pleasing to children that I’ve read (sorry, can’t recall the source) that there is pressure on the maker to change the flavor to something less palatable. There’ve been incidents of children overdosing on it, perhaps seeing it more as It’s small, cute, pink and tastes great. Even my 10-year old, for whom Singulair proved ineffective, whined the other day he wishes he could take it again, it tasted so good. Crushing it and sprinkling it in something should be no problem for him. ~Jacy

Response:

If you haven’t already tried it, you might be surprised about your son’s reaction to Singulair. It tastes _so_ pleasing to children that I’ve read (sorry, can’t recall the source) that there is pressure on the maker to change the flavor to something less palatable. There’ve been incidents of children overdosing on it, perhaps seeing it more as It’s small, cute, pink and tastes great. Even my 10-year old, for whom Singulair proved ineffective, whined the other day he wishes he could take it again, it tasted so good. Crushing it and sprinkling it in something should be no problem for him. ~Jacy

Response:

Hi, I’m on flovent since 1999, i’ve never had behavior and personality affects and never heard of some in children. You may try to check other places than flovent side effects. It’s working well, for singulair, headache can occur, if it doesn’t disappear after 2-3 days see your MD to quit singulair. Singulair work well in 1/3 of the peoples, there’s majority of children in this 1/3, another 1/3 get some result, and finally 1/3 don’t get any benifit. You can see result 2-3 days after the first treatment. Don’t quit flovent, for your child don’t worry you’re in the "terrible 2 years" period, they always say no, it like the small angel tranform itself in a little devil! Good luck! AT – Hide quoted text — Show quoted text – My 2 1/2 year old son is currently using flovent as his preventer medication.  We have found that this affects his behaviour and personality.  When I discussed this with his chest specialist he claims that flovent should not affect his personality.  He suggested that we try singulair with him. Two questions immediately come to mind. One, how do you give a chewable singulair tablet to a child who will refuse to chew it?  (He will not chew anything hard). Two, does anyone have experience with giving singulair to a child this young?  I was told that there should not be any side effects but my husband and I are concerned about using this drug.  We are considering living with the flovent because we know it works. Thanks in advance.  Debbie

Response:

My 2 1/2 year old son is currently using flovent as his preventer medication.  We have found that this affects his behaviour and personality.  When I discussed this with his chest specialist he claims that flovent should not affect his personality.  He suggested that we try singulair with him. Two questions immediately come to mind. One, how do you give a chewable singulair tablet to a child who will refuse to chew it?  (He will not chew anything hard). Two, does anyone have experience with giving singulair to a child this young?  I was told that there should not be any side effects but my husband and I are concerned about using this drug.  We are considering living with the flovent because we know it works. Thanks in advance.  Debbie

Response:

Question:

Yes, but being a ‘learned scholar’ in one particular area does not mean that your ADVICE will help everyone…which ends up giving out misinformation to patients who are suffering. So instead of expounding on what your career ‘used to be’ and college degree, just try and be compassionate to share what works for you…. it may NOT work for others. The mouthwash DOES NOT do a thing for my thrush….good old mycostatin, and meds does it for me…. I  was a Med/Tech writer editor for 20yrs. but in Radiation Oncology, does that mean I can give advice on curing cancerous lymphomas? I also went to the garage several times, does that make me a mechanic?    LOL Just trying to lighten the mood. thanks

Response:

try using mouth wash( the kind that kills bacteria).  take a swig and hold it in your mouth for as long as you can then spit it out.  this will be a little uncomfortable but it helps

Response:

Dear Carrie,  I had the same problem with the pulmocort and I think you are right about the delivery system.  I rinsed my mouth out faithfully after each use and still had thrush.  I would go off the pulmicort and get the thrush cleared up and go back on it, the thrush would be back within a week.  I finally changed to flovent with the airchamber and have not had any problems.  Pam – Hide quoted text — Show quoted text – I use a MDI and aerochamber and I rinse my mouth out with water after using my Flovent inhaler.  Ever since I started doing that, I haven’t gotten thrush since.  I don’t know if you have been doing the same, but it has helped me. Carrie I am very upset and miserable. I have thrush again, due to my inhaler. I am on Pulmicort Turbo inhaler. I don’t know if my theory holds any water, but I wondered if I switched to a different mode of delivery….back to a metered dose inhaler…I might not get this thrush as often. With the aero-chamber and a metered dose inhaler I might be able to get it past my tongue better. I have only been on Azmacort and Pulmi-cort. Does Pulmicort come in a metered dose Inhaler? If not, which one would you recommend? Thanks so much DOn * Sent from RemarQ http://www.remarq.com The Internet’s Discussion Network * The fastest and easiest way to search and participate in Usenet – Free!

Response:

do not use a mouth wash that kills bacteria. Thrush is caused by a fungus if you kill the bacteria that normally live in your mouth the naturally occurring fungus will be able to gain a stronger hold on the mucousal surfaces of your mouth and the thrush will become worse.

This information is correct. Antifungal therapy, spacers, mouth rinsing/gargling with water-(try warm water not cold- could solubilize it better), weeker steroid inhalers (I was switched from flovent to  azmacort even though i hohum about it for many reasons)..these are ways to avoid/get rid of thrush. Chilla (the Candida biologist turned science writer)

Response:

I know this information is correct. I’m a microbiologist as well;-)

BTW, hansen’t a gene been identified that produces a susceptibility to yeast infections?  I wonder if (assuming an easy and inexpensive test were available) we could identify if any particular person was more likely to develop thrush? "Keep looking below surface appearances. Don’t shrink from doing so (just) because you might not like what you find."    General Colin Powell

Response:

I know this information is correct. I’m a microbiologist as well;-)

– Hide quoted text — Show quoted text – do not use a mouth wash that kills bacteria. Thrush is caused by a fungus if you kill the bacteria that normally live in your mouth the naturally occurring fungus will be able to gain a stronger hold on the mucousal surfaces of your mouth and the thrush will become worse. This information is correct. Antifungal therapy, spacers, mouth rinsing/gargling with water-(try warm water not cold- could solubilize it better), weeker steroid inhalers (I was switched from flovent to  azmacort even though i hohum about it for many reasons)..these are ways to avoid/get rid of thrush. Chilla (the Candida biologist turned science writer)

Response:

Yes, the mouthwash helped me a bit, temporarily,,,but didnt relieve the horrible pain, peeling, and tenderness of MY thrush; so always end up telling my doc to call in a prescription of "Nystatin" (mycostatin) oral rinse….swish and swallow, boy, does it do the trick for me in two days!!! Just thought this may help those that dont get relef from the home remedies. thanks.

Response:

I am very upset and miserable. I have thrush again, due to my inhaler. I am on Pulmicort Turbo inhaler. I don’t know if my theory holds any water, but I wondered if I switched to a different mode of delivery….back to a metered dose inhaler…I might not get this thrush as often. With the aero-chamber and a metered dose inhaler I might be able to get it past my tongue better. I have only been on Azmacort and Pulmi-cort. Does Pulmicort come in a metered dose Inhaler? If not, which one would you recommend? Thanks so much DOn * Sent from RemarQ http://www.remarq.com The Internet’s Discussion Network * The fastest and easiest way to search and participate in Usenet – Free!

Response:

As far as I know, Pulmicort does not come as a MDI, which is why I’m resisting agains my Doc switching me over to it. I believe that Flovent is just as good, but you would have to ask a doc about that. – Hide quoted text — Show quoted text – I am very upset and miserable. I have thrush again, due to my inhaler. I am on Pulmicort Turbo inhaler. I don’t know if my theory holds any water, but I wondered if I switched to a different mode of delivery….back to a metered dose inhaler…I might not get this thrush as often. With the aero-chamber and a metered dose inhaler I might be able to get it past my tongue better. I have only been on Azmacort and Pulmi-cort. Does Pulmicort come in a metered dose Inhaler? If not, which one would you recommend? Thanks so much DOn * Sent from RemarQ http://www.remarq.com The Internet’s Discussion Network * The fastest and easiest way to search and participate in Usenet – Free!

Response:

I use a MDI and aerochamber and I rinse my mouth out with water after using my Flovent inhaler.  Ever since I started doing that, I haven’t gotten thrush since.  I don’t know if you have been doing the same, but it has helped me. Carrie – Hide quoted text — Show quoted text – I am very upset and miserable. I have thrush again, due to my inhaler. I am on Pulmicort Turbo inhaler. I don’t know if my theory holds any water, but I wondered if I switched to a different mode of delivery….back to a metered dose inhaler…I might not get this thrush as often. With the aero-chamber and a metered dose inhaler I might be able to get it past my tongue better. I have only been on Azmacort and Pulmi-cort. Does Pulmicort come in a metered dose Inhaler? If not, which one would you recommend? Thanks so much DOn * Sent from RemarQ http://www.remarq.com The Internet’s Discussion Network * The fastest and easiest way to search and participate in Usenet – Free!

Response:

do not use a mouth wash that kills bacteria. Thrush is caused by a fungus if you kill the bacteria that normally live in your mouth the naturally occurring fungus will be able to gain a stronger hold on the mucousal surfaces of your mouth and the thrush will become worse. For what it’s worth I very rarely have trouble with thrush, despite being permanently on oral steroids as well as very high dose inhaled and when I do get it eating natural yoghurt helps heaps.

– Hide quoted text — Show quoted text – try using mouth wash( the kind that kills bacteria).  take a swig and hold it in your mouth for as long as you can then spit it out.  this will be a little uncomfortable but it helps

Response:

Question:

Good post, man.  Tnx. ALSO tnx for the Michael Moore quote !!!   So TRUE !  The media do such a great job of distorting reality.. Norbi

Response:

Hey folks: Well..it’s been a few days now..but my psychiatrist has me starte on this interesting (but..a bit expensive!!) combo of meds. Besides taking Depakote and Clonazepam 3x a day, he has set me up with a script for 37.5mg of Effexor XR, and 50mg of Zoloft. He was pretty good in explaining his rational, plus he knew that I was pretty knowldegable of medications. Basically, he thought a mild uptake inhibition of dopamine and norepinephrine combined with a bit stronger uptake of serotonin might possibly do the "trick" for me…as these are the only two meds I have EVER responded at least a bit well too. So, the Zoloft is the SRI, of course, and the Effexor provides that mild boost not to just serotonin, but also to norepinephrine and dopamine. The other meds seem to help smooth out the 1)anxiety and 2)insomnia. I know some people on here have been asking about this combo. If you can, and are looking at trying some augmentation of meds due to many past failures, you may want to talk to your doctor and psychiatrist about this. They may find it a bit odd…but as mentioned above, there is A BIT of logic behind it. Of course…monitor yourself very carefully on the first while of the meds..and make sure you get your bloodwork and tests done, as this is still fairly unknown territory. As always..YMMV…IMHO..etc. I was on just Effexor and Clonazepam before, but at no matter what dose of Clonazepam, I had a very hard time with a feeling of "depersonalization", and the Effexor XR just didn’t feel it was working completely right. Now..one other thing, is that my sleep pattern has seemed to fall well into place (except tonight..I just got home from work..heh) But, I sleep like a baby, and wake up feeling very refreshed. I know others have found Welbutrin to be a good combonation with any of the SRI/SNRI’s, but Welbutrin is WAY too stimulating for me. I you would like to email me with any thoughts, questions, etc, I would be more than happy to give M personal account. BUT, please, before embarking on such a med change, make SURE you discuss it thouroughly with you doc or psychiatrist. To help keep costs down…I shop around ALOT for the best prices on the medication. There are some excellent on-line pharmacies (NOT the "illegal ones) but places like Rxlist.com, who offer great prices, and free shipping on your meds. Once you and your psychiatrist figure out what works best (you..most of all,,MUST know..) s/he can usually give you up to months supply of your meds, in which you fax your prescription, or have your pshychiatrist phone it in, and it can save you a REAL bundle: NOT ONLY in the "so-called" dispensing fee’s, but also in the actual cost of the medication. As usual, also, there are free medications for those in need, with a low income. You can find them through any of the search engines. Best of luck..and remember…there is ALWAYS different paths to hope. James MacLachlan — "I’ve used up all my sick days…so I’m calling in dead!" -Anon "I’d like to know where shareholders get their power from?? I am wondering where the hell the word "shareholder" is in the American Consitution?" "Let us pause for a moment to recover from the sad news this week that Dan Quayle will not be running for President next year. Potatoe lovers all over America are feeling a sense of loss and I can only say that with Quayle out of the running, all we have to look forward to now is the day when we get to hear more than a sound bite from George W. Bush and realize he’s even dumber than Quayle. There is a reason you have not heard Bush Jr. speak on television for any length of time. The media knows he’s as dense as oatmeal and because they have been so busy touting him as "the front runner" to actually put him on to speak for ten minutes would reveal how not on top of things they really are." Micheal Moore, "The AWFUL Truth"

Response:

Question:

I noticed the clusiness and dizziness with Zoloft, though none of the other side effects but not until I got to the higher doses, at 200 mg and 250 mg. You may be more sensitive to the drug than I was. The only other side effect I noticed was that I couldn’t remember dreaming and I have always been a vivid dreamer. Interesting… Regards, JaneG

I’ve been the opposite — generally I don’t remember my dreams, but since starting Zoloft I’ve had more vivid dreams. Go figure! I’ve always been sensitive to drugs in general — I’m allergic to about half of every antibiotic there is, and I’ve had adverse reactions to the other half! The one time I took Ambien, it gave me hallucinations and violent nausea within 15 minutes. Bleh. Thanks for your response! It makes me feel better to know that someone else has experienced the clumsiness. Souris

Response:

What I am experiencing is trouble with my handwriting lately.  I can’t even read, so I have been printing.  I am only on 37 1/2 mg.  I have been on Zoloft for about 8 months.  It is hard sometimes to make o’s.   It really is strange. The intestional stuff was awful the first 2 months, then it went away.  I think I am going to mention this to my doctor.  I never really thought about it until I read your post.  Thanks.  Good Luck

Response:

What I am experiencing is trouble with my handwriting lately.  I can’t even read, so I have been printing.  I am only on 37 1/2 mg.  I have been on Zoloft for about 8 months.  It is hard sometimes to make o’s.   It really is strange. The intestional stuff was awful the first 2 months, then it went away.  I think I am going to mention this to my doctor.  I never really thought about it until I read your post.  Thanks.  Good Luck

I had trouble writing too for some time and occasionally still have. With me it’s an anxiety symptom, I think. Anyway, handwriting is getting obsolete ) Philip

Response:

I’ve been taking Zoloft for about two months now at a dosage of 75 mg. a day. I was wondering if anyone else had experienced side effects related to motor skills and memory? I find myself being clumsier — it’s harder to grasp things — and a lot more forgetful. Shouldn’t these side effects have gone away after two months? Because I’m taking Zoloft for depression brought on by health-related anxiety, these side effects have just served to give me new illnesses to worry about! I’ve also experienced a lot of intestinal discomfort, but I know that’s fairly common. Thanks! Souris

Response:

I’ve been taking Zoloft for about two months now at a dosage of 75 mg. a day. I was wondering if anyone else had experienced side effects related to motor skills and memory? I find myself being clumsier — it’s harder to grasp things — and a lot more forgetful. Shouldn’t these side effects have gone away after two months? Because I’m taking Zoloft for depression brought on by health-related anxiety, these side effects have just served to give me new illnesses to worry about! I’ve also experienced a lot of intestinal discomfort, but I know that’s fairly common. Thanks! Souris

Souris, I noticed the clusiness and dizziness with Zoloft, though none of the other side effects but not until I got to the higher doses, at 200 mg and 250 mg. You may be more sensitive to the drug than I was. The only other side effect I noticed was that I couldn’t remember dreaming and I have always been a vivid dreamer. Interesting… Regards, JaneG

Response:

Hello, I’ve tried Zoloft  off and on, the longest I’ve been on it for was 8 months.  Things got really weird for me, and I  lost the ability to feel sadness of any kind at all.  For instance if I say a dead cat on the side of the road, I wouldn’t even think  momentarily "poor kitty".  I was doing a lot of paper work at the time, and it made analyzing and writing about problems and their solutions a lot more difficult.  I just didn’t "get things" that I knew I should be able to grasp, and I couldn’t go on taking it feeling so clueless.  I tried Serzone too, but it seemed to make the depression worse, even though it did help the anxiety.  Good Luck. Blessings, Chrissie I’ve been taking Zoloft for about two months now at a dosage of 75 mg. a day. I was wondering if anyone else had experienced side effects related to motor skills and memory? I find myself being clumsier — it’s harder to grasp things — and a lot more forgetful. Shouldn’t these side effects have gone away after two months? Because I’m taking Zoloft for depression brought on by health-related anxiety, these side effects have just served to give me new illnesses to worry about! I’ve also experienced a lot of intestinal discomfort, but I know that’s fairly common.

– For more information about this service, send e-mail to:

Response:

I’ve been taking Zoloft for about two months now at a dosage of 75 mg. a day. I was wondering if anyone else had experienced side effects related to motor skills and memory? I find myself being clumsier — it’s harder to grasp things — and a lot more forgetful. Shouldn’t these side effects have gone away after two months? Because I’m taking Zoloft for depression brought on by health-related anxiety, these side effects have just served to give me new illnesses to worry about! I’ve also experienced a lot of intestinal discomfort, but I know that’s fairly common. Thanks! Souris

I’m no expert on Zoloft but I’d say that if you experience no significant improvement but rather serious side effects instead, you’d better try another, milder med. If you want to try another SSRI you might want to take Luvox or Prozac, which are weaker and more benign than Zoloft or Paxil. YMMV of course. Philip – Hide quoted text — Show quoted text –

Response:

Question:

PS……if you couldn’t tell by the X-File sig.

NIK!  You’re not Gizzie from the X-Files newsgroup, are you?!  I haven’t read that group for a long time, but I sure remember Giz! — Bunny

Response:

NIK!  You’re not Gizzie from the X-Files newsgroup, are you?!  I haven’t read that group for a long time, but I sure remember Giz!

No hon…….haven’t really posted there (although I have lurked).  I just had changed from NikNik7 to MycatGiz cuz I was getting tired of 50 spam e-mails and 1 personal one. Plus I got paranoid that people might find me here and use it against me.  Of course, now that I have made it common knowledge and got over my little incident of paranoia I can say….. NIKNIK7 is also MYCATGIZ. Nik They say, "she’s crazy as anyone can be" That’s what they say, they say of me…….Sheryl Crow "On the Outside"

Response:

Gee, can you say…….Frivolous Lawsuits. I’m not sure, let me try… Frivvawassa roosuts.

You’re singing backup for Baba Wawa these days? — Bunny

Response:

Did I hear you say law suit?  Don’t just stand by and do nothing about it.  You know what it takes for evil to prosper … oh, give me a break!  I went thru it too but I hardly think it warrants a friggin lawsuit. Gee, can you say…….Frivolous Lawsuits. Nik

o.k., granted this *would* be a frivolous lawsuit, imho… but just barely.  i don’t know how bad your withdrawal was, but with mine had i had a steady job at the time (i was a student, and still am, actually) i would have missed about a week’s worth of work…and i like to think of myself as pretty hardy.   anyway, comisseration to any who have had to deal with coming off effexor. not anything i’d ever want to do again…i actually still have the occasional side effect (did something get permenantly fucked in my brain?) even though i’ve been off the stuff for over 2 years.  fun, fun, fun. -m.

Response:

PS……if you couldn’t tell by the X-File sig. Hope it isn’t too long for you Mark…..I tried to keep it short just for you but am thinking of adding the entire lyrics to Stairway to Heaven and the 13 think? Nik They say, "she’s crazy as anyone can be" That’s what they say, they say of me…….Sheryl Crow "On the Outside"

Response:

Hey, Nik, you’re not "niknik" of old, are you?

Nik They say, "she’s crazy as anyone can be" That’s what they say, they say of me…….Sheryl Crow "On the Outside"

Response:

Did I hear you say law suit?  Don’t just stand by and do nothing about it.  You know what it takes for evil to prosper …

oh, give me a break!  I went thru it too but I hardly think it warrants a friggin lawsuit. Gee, can you say…….Frivolous Lawsuits. Nik They say, "she’s crazy as anyone can be" That’s what they say, they say of me…….Sheryl Crow "On the Outside"

Response:

I could go on and on about the interesting and and accute withdrawal symptoms I have been experiencing, but if you are taking Effexor, or thinking about it you should try to search AltaVista for "effexor withrdrawal" and look at the nearly 200,000 hits that come up.  No you won’t find any warning listed with your prescription. Most of the doctors who prescibe this stuff don’t know about this side effect.   Did I hear you say law suit?  Don’t just stand by and do nothing about it.  You know what it takes for evil to prosper … These statements are my personal opinions, and should not be considered medical advice or a call for any illegal or improper actions.

Response:

Don’t start taking this drug, you will be *sorry* when you stop.

It isn’t like that for most people that take the drug, for most it has very few side effects and withdrawal only has minor ones if any.  The three weeks of suffering you will go through are not worth it.

I had a lot more than three weeks. I had trouble all the while I took it and then coming off I had to go so slow that it took eight weeks just to get off it and some of the side effects persisted for six more weeks after that. Still though, for a lot of people Effexor is an effective drug with few side effects. I think that the difference in people’s reactions to it may indicate differing etiologies or pathologies or both for clinical depression. — bev . . . . . . . . . . . . . . . . . http://members.tripod.com/~Veb

Response:

Don’t start taking this drug, you will be *sorry* when you stop.  The three weeks of suffering you will go through are not worth it.  Find and ask someone better informed that the doctor who gave you this idea.

Response:

Don’t start taking this drug, you will be *sorry* when you stop.  The three weeks of suffering you will go through are not worth it.  Find and ask someone better informed that the doctor who gave you this idea.

I didn’t have any joy going thru the withdrawal of Effexor however I would hardly say I regret being on it for 2 1/2 years.  It *did* work and the only thing I told my pdoc was that I wished I had known how bad the withdrawal was….something he didn’t know of yet, either. If Effexor works for you or your doc thinks it might…don’t judge the medication just because of what it is like to go off of it.  Some people may be fortunate enough to find it works for them and even if for a couple years….isn’t that better than being depressed for a couple more years….even if it mean a couple months of being uncomfortable? Nik They say, "she’s crazy as anyone can be" That’s what they say, they say of me…….Sheryl Crow "On the Outside"

Response:

Effexor is a mood elevator. When you go off this drug,

I got dangerous side effects while on the drug. Hell, we even increased the dose after they started; thought it had more to do with a situational problem than internal workings of the neural system. The side effects worsened during withdrawal but were present before withdrawal. — bev . . . . . . . . . . . . . . . . . http://members.tripod.com/~Veb

Response:

Some questions: How much does Effexor cost in California if you have to buy it yourself?

I paid $80.95 for one months supply of Effxor ER  150 mG at a store called "The Medicine Shoppe" in California.  Prices vary, call around to different stores. Welcome to California, the land of fruits, nuts, and flakes. Charles

Response:

I have very mixed feelings about Effexor…it was very helpful to me while on it, but insurance problems prevented me from continuing on the medication, and not having anything to fall back on I had to quit taking it. I did this in a phased withdrawl but it was still very difficult. I would only recomenned Effexor if a person knows that they will be covered by insurance and will always have access to it. Otherwise go with something that is cheaper (it’s VERY expensive) and you know you can get with no problem.

Oh dear. Effexor has been an absolute life-saver for me (literally).  In the UK, we pay the same whatever our medication, so that’s okay.  But I’m now moving to the US (getting married), and I’ve no idea what my insurance situation will be.  I can get 3 months worth of Effexor from my GP to take with me.  I am sure I can safely halve my dose and make that last for 6 months.  But I don’t know what I’ll do then. Some questions: How much does Effexor cost in California if you have to buy it yourself? Does anyone by any chance have an insurance company they can recommend, who will cover ADs? Has anyone mixed Effexor with any herbal ADs? Christine  Christine Daae on the Web   http://easyweb.easynet.co.uk/~cdaae/

Response:

                             Effexor withdrawal Hello there.  You guys talk a lot about effexor and withdrawal but provide few details, and I am CURIOUS… Could you please enlighten me? Thanks

Sorry…several of us have been through it and you forget there are others here whom are unfamiliar with the drug. Effexor is a mood elevator. When you go off this drug, and this is especially true if it happens suddenly (though in a phased withdrawl bad things can happen too), you can drop into some very frightening and VERY dangerous depression. If you have already had problems with suicidal thoughts they come back with a vengeance, and in my case I spent entire days either weeping or unable to do anything apart from lie in bed and feel terrorized. I have very mixed feelings about Effexor…it was very helpful to me while on it, but insurance problems prevented me from continuing on the medication, and not having anything to fall back on I had to quit taking it. I did this in a phased withdrawl but it was still very difficult. I would only recomenned Effexor if a person knows that they will be covered by insurance and will always have access to it. Otherwise go with something that is cheaper (it’s VERY expensive) and you know you can get with no problem. Jeff (Drop the x to e-mail)

Response:

Question:

Thanks for the information David.  I suggest you visit this site for more information on Lamictal (lamotrigine)  Depression Central:             http://www.psycom.net/depression.central.html There’s some great infomration there!                                             Juliet                                   Ring the bells that still can ring                                   Forget your perfect offering.                                   There is a crack in everything.                                   That’s how the light gets in.                                   – Leonard Cohen, "Athem"-

Response:

Hi Surfs Edge/ Juliet: I’ve been on lamactal for about 3 months. I am a very rapid cycler (I have cycled three time a day.), however lamictal was help to stop my mania. The only real problem that I have is that I am resistant to these meds. Over the last three years I have been on over a 100 different combinations of meds.  One combination lasted nine months until it broke down (frustrating). the lamictal has work very well for me until this week. I was up to 300mg per day plus 300mg of lithium.  I was previously on 1200 mg of lithium until I started lamictal. I have not experienced any side effect from lamictal. But, as you were told in a previous letter, each of us is unique and reacts differently to various meds. Good luck to you. Arne – Hide quoted text — Show quoted text – Has anyone had first hand expierence with lamotrigine (lamictal)? I am considering taking this med and am trying to learn more about it. I have found about the stats, etc but haven’t spoken to someone who takes this med.  Any information would be appreciated.         Thanks.                                           Juliet                                   Ring the bells that still can ring                                   Forget your perfect offering.                                   There is a crack in everything.                                   That’s how the light gets in.                                   – Leonard Cohen, "Athem"-

Response:

Hi, I’ve been on Lamictal for a month and a half with no problems and some benefit, see my post in alt.support.depression.manic, which just goes to show what sucks about this illness .. The only way to find out how you are going to react to a medication is to take it. Rapid cyclers seem to be particularly problematic. In my case over the summer I was on Paxil an SSRI anti depressant similar to Prozac. It made me depressed and sleepy.  When I went off it I went slightly manic for several weeks. Go figure. Try to be philosophical as you experience the adventure of taking a new medication(See my posting to MoiraArwen Re Depakote in alt support depression.manic) In any case hang in there everyone. David – Hide quoted text — Show quoted text – Has anyone had first hand expierence with lamotrigine (lamictal)? I am i just switched off it. in my experience: good antimanic. supposedly has AD effects, but i went into a long depression on it, even though i’m usually a rapid-cycler. made me very drowsy. required me doubling my effexor dose, and i had to add atenolol for the tremors. and it’s not coated, so it tastes icky, if anyone but me cares. brooke — the further i get from the things that i care about, the less i care about how much further away i get (cure)

Response:

An FAQ on lamotrigine (Lamictal) may be found at:        http://www.psycom.net/depression.central.lamotrigine.html Best regards . . . Ivan

: Has anyone had first hand expierence with lamotrigine (lamictal)? I am : considering taking this med and am trying to learn more about it. I have : found about the stats, etc but haven’t spoken to someone who takes this : med.  Any information would be appreciated.         Thanks. :                                           Juliet :                                   Ring the bells that still can ring :                                   Forget your perfect offering. :                                   There is a crack in everything. :                                   That’s how the light gets in. :                                   – Leonard Cohen, "Athem"- — —                                                         \\           ||                          Ivan Goldberg, MD                ~          || || V: 212 876 7800  /  1346 Lexington Ave NYC 10128  /  F: 212 737 0473 || ||             http://www.psycom.net/depression.central.html            || ||                   http://www.psycom.net/ijppp.html                   ||

Response:

Has anyone had first hand expierence with lamotrigine (lamictal)? I am considering taking this med and am trying to learn more about it. I have found about the stats, etc but haven’t spoken to someone who takes this med.  Any information would be appreciated.         Thanks.                                           Juliet                                   Ring the bells that still can ring                                   Forget your perfect offering.                                   There is a crack in everything.                                   That’s how the light gets in.                                   – Leonard Cohen, "Athem"-

Response:

Greetings Juliet: Below is some information that I found about Lamictal on the www. I’ve been taking it for 6 weeks so far. I’ve gradually been increasing the dose. I am up to 37.5 mg/day along with 500 mg/day Depakote. I think the lamictal is helping me. It is making a depression that I am going through now less severe than it would be otherwise. I am at a rather low dose as yet. People typically take 3 times the dose that I am taking. The only side effect that I have had is a slight headache for the first day when I increase the dose each time. I started taking only a half a 25mg pill every other day. I found out about this medication on my own via the internet and my Dr. got more information from the drug comany. It seems to be safe and has been used outside of the us by a lot of people. Anti depressants have never helped me. Lithium has never helped me. Depakote seems to make my cycles less extreme but mainly helps with mania. I’ve used that for several years. I am guardedly optimistic about Lamictal. If you have other information besides what I’ve attached and what is in the PDR, I’d be interested in hearing about it. If there is anything else you’d like to know please feel free to ask. In any case hang in there, David David Vogel Hackensack NJ Online Coverage from the 149th Annual Meeting of the American Psychiatric Association Lamotrigine in Treatment-Refractory Bipolar Disorder Robert M. Smith, MD Lamotrigine was effective in both phases of bipolar disorder in an open trial, with its most significant role anticipated for treatment of the depressed phase. Joseph Calabrese, MD, of Case Western Reserve Medical Center reported on the first 6 months of a 12-month, multicenter, open inital study of lamotrigine in treatment-resistant or -intolerant bipolar patients. Lamotrigine is an anticonvulsant derived from an antimalarial agent which has now been used in over 200,000 patients. Initial case reports in patients taking the drug showed it was effective in rapid-cycling patients with severe, refractory depression. It is well known that the depressed phase of bipolar disorder is particularly difficult to treat. The study reported on by Dr. Calabrese included 218 patients with bipolar disorder I or II, in any phase except euthymic; patients with epilepsy or active substance abuse were excluded. Positive response to lamotrigine was seen in 64% of depressed patients, and 76% of hypomanic/manic/mixed patients, as reflected in standardized measures. The study included some patients who received lamotrigine alone, and others who had a combination of antimanic agent(s) plus lamotrigine. The most common side effect and reason for discontinuing the drug was development of a rash. Lamotrigine was generally well tolerated and the results suggest efficacy in both the manic and depressed phases in bipolar disorder. Dr. Calabrese stated that the guidelines listed in the PDR may be used as a reference for dosage and estimated that the average required dose will be approximately 150mg. The drug must be titrated slowly, especially if given concurrently with medications that inhibit hepatic metabolism, such as valproate. A double-blind study is currently being conducted. Robert M. Smith, MD Robert M. Smith, MD is Attending Psychiatrist at St. Lukes/Roosevelt Hospital Outpatient Psychiatry Clinic; Candidate at The New York Psychoanalytic Institute; and Medical Director of the Villa Outpatient Substance Abuse Center. Dr. Smith was Chief Resident in Psychiatry from 1992 to 1993 at NYU Medical Center.                     http://www.medscape.com Antidepressants that once induced mood-cycling do not do so when administered along with lamotragine (Lamictal). It seems that this newly released (in the USA) anticonvulsant will play at least as large a role as valproate in the treatment of pholks with bipolar mood disorders. See also: general info on lamotrigine and its use in seizure disorders. I have found lamotrigine often to be effective in the treatment of patients:     with rapid cycling bipolar disorder     with hard-to-treat mixed states     with depression in whom     antidepressants cause mania or cycling Lamotrigine is tolerated best when introduced slowly. A rash that may necessitate discontinuation is more likely to develop in patients started on too high a dose or in those patients in whom the dose is increased too rapidly. There are some pharmacokinetic interactions of lamotrigine that should be kept in mind. Carbamazepine levels are increased by lamotrigine, and valproate levels are decreased somewhat by lamotrigine. Enzyme inducers such as carbamazepine decrease the t-1/2 of lamotrigine to the point where it should be administered q12h rather than q.o.d. In a patient not taking carbamazepine I usually initiate tx with 25 mg h.s. and increase the dose by 25 mg per day per week until a dose of 100 mg h.s. is reached. If a response is not seen after one week at this dose, I then increase the dose to 200 mg h.s. With a few patients I have had to go higher. Most impressive have been the results with rapidly cycling bipolar individuals who have not responded to valproate and/or carbamazepine. Also, the protection against antidepressant-induced cycling and mania has been very useful. I have also had good experiences using lamotrigine to treat the mood lability of so called "borderline" patients. There are no double-blind placebo-controlled studies to confirm the observations above. Charles Bowden has reported worthwhile preliminary results with lamotragine in bipolar patients, N = about 50, not published yet… Manufacturer reportedly somewhat concerned about high incidence of rashes and isn’t sure if they are comfortable investigating it for new use until there is more post-marketing data. At 07:30 AM 4/28/96 -0400,

    You mention that you begin with     a dose of 25 mg h.s. on patients     not taking carbamazepine. How     about patients on valproate? The     PDR suggests that one begins     with a dose of 25 mg every other     day for two weeks. Other     questions: Do your patients end     up only on lamotrigine? How     frequently do they end up on a     combination of lamotrigine and     carbamazepine? With patients on valproate I begin with 1/2 of a 25 mg tablet at bedtime and slowly increase the dose from there. As I see few people on carbamazepine these days, I have few who end up on the combination of carbamazepine + lamotrigine. Those who are asked for a reference regarding the innovative use of lamotrigine with patients who have treatment-resistant mood disorders may find Lamotrigine in Treatment-Refractory Bipolar Disorder useful. (EDT) "Start low and go slow" to minimize the risk of rash or other significant adverse events. – Hide quoted text — Show quoted text -Has anyone had first hand expierence with lamotrigine (lamictal)? I am considering taking this med and am trying to learn more about it. I have found about the stats, etc but haven’t spoken to someone who takes this med.  Any information would be appreciated.         Thanks.                                          Juliet ***                                  Ring the bells that still can ring                                  Forget your perfect offering.                                  There is a crack in everything.                                  That’s how the light gets in.                                  - Leonard Cohen, "Athem"- ***

Response: