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Mental Health (Expert Forum)
can i trust tegretol?
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD) , bipolar disorder , dementia , electroconvulsive therapy (ECT) , learning disabilities, memory, obsessive compulsive disorder (OCD) , panic , personality disorders, phobias , post-traumatic stress disorder (PTSD) , schizophrenia , stress , transitions, and work problems.
can i trust tegretol?
by tanja__0, Apr 04, 1999 12:00AM
dear reader,
i am diagnosed with cyclothymia and borderline, taking tegretol to get my moodswings better under control. I take this medicine since about 1 1/2 years and I am better than before. Recently I went from 800mg to 1000mg. I was bleeding one month. It is normal to get bleedings in between and I "suffered" from this side-effect since I take it, but one month?? I am getting nervous. I don't like psychofarmaca that much. You will understand when I tell you that prozac triggered my first hypomanic episode instead of treating my depression. Since I took prozac for one month, my life changed tremendously. From depression I went into cycles. Because I was not myself anymore, because I went into promiscuity I tried to kill myself because like this I did not want to go on. Later on I heard and read that prozac very probably had a lot to do with this. Some month I did not take anything but went up and down and... which is energy kosting and destructive. Before I could go into a dayclinic for some months I had to start taking tegretol. By my own I could not manage my life anymore, there was no rest at all. I had to trust tegretol, there was no other way, and I did. They say that bipolars often stop taking their medicine... I never did and I was proud of this. Now this bleeding occurred I went on the internet again surfing and searching for information about tegretol. The last time I waa shocked to read that one day it may not work anymore. This time I read about problems concerning concentration and loss of IQ. It terrifies me. What am I taking? As far as I am concerned they still do not know how carbamazepine works. On the paper inside the box of pills nothing is said about treatment by bipolar disorders. At this moment, the first time since I started to take this stuff, I am asking myself whether it is wise to go on taking it. I am writing down a lot, making diagrams. Lately I was looking for combinations: mood/hours sleep. mood/punctuality of taking the medicine... and I realized that the last in my case is the most important thing. Missing one dosis (600mg) in the evening means depression in the morning (at first i am depressed, then I realize thta I missed a dosis). Now I realized that the hours in between are important. It have to be more ore less 12 hours, is it more, depression is waiting, is it less, I feel better. So this makes me believe that I really need the medicine. On the other hand, I also need my brains. I am still at University and I would like to doctorate after. I have concentration problems. Before being in the clinc it was a disaster and I could not study for more than a year, now I try but it goes slow and not continuously. I am afraid that tegretol beside keeping me somewhat in balance could harm me at the other hand. But what would be the other option? I could stop and have a look what happens. Unfortunately I am almost sure that I will go back into chaos...less sleeping, no structure, bad eating, exhausting myself during ups and forgetting myself during downs... ending in a disaster for me and my friends. But I don't know. Is it worth trying or is it dangerous? The other problem is that cycloyhymia and the borderline personality disorder are close to each other. There were docotors who strenghten the first and others who strenghten the latter. Probably it is a combination and tegretol works for both. I still get stressed very easily. I am almost 30, so I hope that there will be a lot of years more to enjoy life. Something making that my period stays durin a whole month, something of which others say that they use intellectual capacity with,... and my own experience with prozac, it makes me afraid. I trusted tegretol for such a long time, it became something like my friend, feeling what it does for me, but now I have questions which need to be answered. What more does this medicine with me without me feeling it and being aware of it? Do you know many cases of memoryloss? At this moment I don't have a psychiatrist anymore. My psychotherapist as well as my housedoctor do not know about this, so again I try to read and search on my own and finally asking you what to do. I hope you can tell me something about the side-effects of tegretol which they don't list on the medicine itself as they don't put promiscuity as a side effect on prozac.
I would be very happy to receive an answer from you.
Yous sincerely, Tanja.
i am diagnosed with cyclothymia and borderline, taking tegretol to get my moodswings better under control. I take this medicine since about 1 1/2 years and I am better than before. Recently I went from 800mg to 1000mg. I was bleeding one month. It is normal to get bleedings in between and I "suffered" from this side-effect since I take it, but one month?? I am getting nervous. I don't like psychofarmaca that much. You will understand when I tell you that prozac triggered my first hypomanic episode instead of treating my depression. Since I took prozac for one month, my life changed tremendously. From depression I went into cycles. Because I was not myself anymore, because I went into promiscuity I tried to kill myself because like this I did not want to go on. Later on I heard and read that prozac very probably had a lot to do with this. Some month I did not take anything but went up and down and... which is energy kosting and destructive. Before I could go into a dayclinic for some months I had to start taking tegretol. By my own I could not manage my life anymore, there was no rest at all. I had to trust tegretol, there was no other way, and I did. They say that bipolars often stop taking their medicine... I never did and I was proud of this. Now this bleeding occurred I went on the internet again surfing and searching for information about tegretol. The last time I waa shocked to read that one day it may not work anymore. This time I read about problems concerning concentration and loss of IQ. It terrifies me. What am I taking? As far as I am concerned they still do not know how carbamazepine works. On the paper inside the box of pills nothing is said about treatment by bipolar disorders. At this moment, the first time since I started to take this stuff, I am asking myself whether it is wise to go on taking it. I am writing down a lot, making diagrams. Lately I was looking for combinations: mood/hours sleep. mood/punctuality of taking the medicine... and I realized that the last in my case is the most important thing. Missing one dosis (600mg) in the evening means depression in the morning (at first i am depressed, then I realize thta I missed a dosis). Now I realized that the hours in between are important. It have to be more ore less 12 hours, is it more, depression is waiting, is it less, I feel better. So this makes me believe that I really need the medicine. On the other hand, I also need my brains. I am still at University and I would like to doctorate after. I have concentration problems. Before being in the clinc it was a disaster and I could not study for more than a year, now I try but it goes slow and not continuously. I am afraid that tegretol beside keeping me somewhat in balance could harm me at the other hand. But what would be the other option? I could stop and have a look what happens. Unfortunately I am almost sure that I will go back into chaos...less sleeping, no structure, bad eating, exhausting myself during ups and forgetting myself during downs... ending in a disaster for me and my friends. But I don't know. Is it worth trying or is it dangerous? The other problem is that cycloyhymia and the borderline personality disorder are close to each other. There were docotors who strenghten the first and others who strenghten the latter. Probably it is a combination and tegretol works for both. I still get stressed very easily. I am almost 30, so I hope that there will be a lot of years more to enjoy life. Something making that my period stays durin a whole month, something of which others say that they use intellectual capacity with,... and my own experience with prozac, it makes me afraid. I trusted tegretol for such a long time, it became something like my friend, feeling what it does for me, but now I have questions which need to be answered. What more does this medicine with me without me feeling it and being aware of it? Do you know many cases of memoryloss? At this moment I don't have a psychiatrist anymore. My psychotherapist as well as my housedoctor do not know about this, so again I try to read and search on my own and finally asking you what to do. I hope you can tell me something about the side-effects of tegretol which they don't list on the medicine itself as they don't put promiscuity as a side effect on prozac.
I would be very happy to receive an answer from you.
Yous sincerely, Tanja.
Doctor's Answer
by HFHS.MD-AJ, Apr 04, 1999 12:00AM
_
Tanja,
I can understand your concern and frustration about your diagnosis and medications. I must also commend you on your ability to maintain compliance with your medication.
It may be difficult to differenciate between cyclothymia, bipolar disorder, and borderline personality disorder, because these psychiatric disorders may share symptoms (such as mood swings, irritability, sleep and appetite disturbance, and impulsive sexual behavior).
Cyclothymia is essentially a mild form of bipolar disorder, characterized by alternating symptoms of hypomania and depression. It coexists with borderline personality disorder in about 10-20 % of patients. People with mood disorders such as cyclothymia have increased susceptibility to antidepressant-induced hypomanic or manic episodes, which may explain why you developed impulsive sexual behavior when taking Prozac.
Tegretol (Carbamazepine) is prescribed primarily as an anticonvulsant. A number of studies now support its use in the treatment of bipolar disorder, cyclothymia, and impulsive or aggressive behavior associated with borderline personality disorder. Tegretol can be used alone, but is more commonly used as an adjunct to treatment with Depakote or Lithium, the two most accepted mood-stabilizers. Different physiological and biochemical theories have been proposed to explain how Tegretol works.
The most common side effects of Tegretol are nausea, vomiting, drowsiness, dizziness, unsteadiness, rash, and impaired concentration. It is not commonly associated with memory loss or decreased IQ. People taking Tegretol may rarely develop decreased platelet counts, which could lead to bleeding problems. However, it would be unusual for heavy or prolonged menstrual bleeding to be the only manifestation of this. Because of Tegretol's possible side effects, treatment with Depakote or Lithium are recommended before Tegretol is considered.
Prior to starting treatment with Tegretol, a thorough medical evaluation is recommended. During treatment with Tegretol, blood cell/platelet counts and liver function tests should be monitored. Monitoring the blood level of Tegretol is also essential for ensuring safety and preventing drug toxicity. It is important that you are evaluated by a psychiatrist who will work with your psychotherapist and primary care doctor.
For an appointment with a psychiatrist at Henry Ford Behavioral Services, please call (313) 874-6680.
This response is for general information only. Always contact your physician for any health concerns.
Keywords: borderline personality disorder, cyclothymia, Tegretol
