Trileptal

Hermes · 12-09-2010, 04:30 PM

Well Lyrica threw me for a loop so now we are trying TRILEPTAL. Has anyone taken this?

bruegger84 · 12-09-2010, 04:56 PM

Quote:

Originally Posted by Hermes

Well Lyrica threw me for a loop so now we are trying TRILEPTAL. Has anyone taken this?

yah i tried it, it is pretty bad. i got wicked bad headaches while on it. if lyrica was in any way helpful than trileptal will not be much better. lyrica and gabapentin have some anti-depressant effects. but trileptal on the other hand does not. There aren't many anticonvulsants out there to try with a low SE profile. Have you tried topamax? it actually is pretty good in terms of SE, and also works better than trileptal in my opinion. It does happen to give me wicked bad insomnia on the other hand.

But lamictal is one i wish to try, as it has more of an antidepressant effect than trileptal.

mrsD · 12-10-2010, 06:37 AM

Trileptal is a modified form of Tegretol. Both drugs can cause hyponatremia (low sodium), and so can SSRI drugs.

Combined you will have to be monitored closely for this side effect.
Cymbalta:

Quote:

Although infrequent, several cases of duloxetine-induced hyponatremia have been reported. In one case report, duloxetine-induced hyponatremia was confirmed after inadvertent rechallenge. It has been suggested that there is a dose-related effect in the development of hyponatremia with duloxetine.

Numerous cases of hyponatremia have been reported following treatment with a selective serotonin reuptake inhibitor (SSRI). Risk factors for the development of SSRI-associated hyponatremia including advanced age, female gender, concomitant use of diuretics, low body weight, and lower baseline serum sodium levels have been identified. Hyponatremia tends to develop within the first few weeks of treatment (range 3 to 120 days) and typically resolves within 2 weeks (range 48 hours to 6 weeks) after therapy has been discontinued with some patients requiring treatment (e.g., water restriction, dietary sodium). The proposed mechanism for the development of hyponatremia involves the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) via release of antidiuretic hormone.

Metabolic side effects have infrequently included hyponatremia

from http://www.drugs.com/sfx/cymbalta-side-effects.html

Trileptal:

Quote:

Oxcarbazepine (Includes Trileptal) ↔ Hyponatremia

Moderate Potential Hazard, High plausibility

Applies to: Hyponatremia, Renal Dysfunction, SIADH, Fluid Retention, Adrenal Insufficiency, Hypothyroidism, Polydipsia, Cirrhosis, Congestive Heart Failure

Clinically significant hyponatremia (Na < 125 mmol/L) can develop during the use of oxcarbazepine. In controlled studies, 2.5% of patients receiving oxcarbazepine developed hyponatremia at some point during treatment, generally within the first 3 months but as late as a year or more after initiating therapy. In most cases, the hyponatremia was asymptomatic and serum sodium levels normalized within a few days following withdrawal of the medication without additional treatment. Therapy with oxcarbazepine should be administered cautiously in patients with conditions predisposing to hyponatremia, such as SIADH, use of diuretics or drugs associated with inappropriate antidiuretic hormone secretion, adrenal insufficiency, hypothyroidism, primary polydipsia, and edema (e.g., due to liver cirrhosis, congestive heart failure, or nephrotic syndrome). Serum sodium levels should be monitored during maintenance therapy, and patients should be monitored for signs and symptoms possibly indicating hyponatremia such as nausea, malaise, headache, lethargy, confusion, obtundation, and increase in seizure frequency or severity. If hyponatremia occurs, conservative measures such as fluid restriction, a reduction in dosage, or discontinuation of therapy will usually suffice.

from http://www.drugs.com/disease-interac...trileptal.html

Trileptal is a much more common cause of hyponatremia than SSRIs, but it can be additive when used together.
More here:
http://www.drugs.com/drug-interactio...trileptal.html

So if you decide to use this drug, make sure you understand the signs to look for and report to doctor immediately. Blood electrolyte monitoring is a good precaution periodically.

Hermes · 12-12-2010, 01:04 PM

I checked for side effects on the NIH website. I was having some serious itching and started to develop a rash. These were list under the heading "Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately: " I called on Friday and will probably get a call on Monday. I stop taking the meds Friday night and the good news is itching and rash are gone and the tiredness is gone. Bad news pain is much more intense. I'll call the neuro and see what we try next.

bruegger84 · 05-17-2011, 04:52 PM

good thinking MrsD, yes i am prone to dehydration at times, is that the same as hyponatremia?, maybe i was hyponatremic. all i know is i had a bad headache and my spine/neck was really stiff like i couldn't move it around whenever i took the trileptal. and at a couple of points i was taking lexapro, this was early in january.

I always thought it didn't have as much side effects and since topamax and gabapentin worked well i thought, so why wouldn't this work. well it turns out they are different. I may either have to go back on topamax or try something else like lamictal(this has that nasty rash risk) but otherwise it seems pretty benign, especially when compared to those heavy antipsychotics, or ssri's. I need it for pain/depression.

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