To Hell With Titrations. Let’s Get the Party Started!!!

I got a call from my pharmacy today saying they had some medication to deliver to me.  Huh? Then they asked if it wasn’t me who called them yesterday? Uh…no.  Then they said, “Nobody called you?”

Clearly not.

All of my med refills were done a short while back.  I fumbled around about some discussion between my doctors making changes and increases and this and that.  I was too terrified to ask what the hell the girl was talking about.  Indeed, there has been a lot of discussion but…

…I was still awaiting “the final outcome.”  Well, let me tell you.  If Dr. PA didn’t get what she wanted? It would NOT have been the FINAL outcome at all. *looks at you all with menacing frown*

I got a migraine last night or was it the night before or who cares. That tells you where my head is (or isn’t.)  The girl brought over a sheet with all the “changes.”  My worst fear was that whoever was doing this would lower my Biphentin.  NO GODDAMN WAY. It’s the only thing that gives me an ounce of concentration when I’m sick–if I’m lucky.

What I wanted was to have my ACs (Topamax and Lamictal) increased.  This was necessitated because I was shooting through the stratosphere or even further (I had no clue at times) with Manic episodes.  And we’re talking Bipolar I.  I’m Bipolar II.  I only get hypomanic and really, depression and more of the icky anxiety and low stuff were my problems.

I also had a thought about my moods and how they change since losing the Clobazam two years ago for the Typical Absence Status Epilepticus.  Indescribably brutal.  However, there are two states that were utterly horrific and so foreign to me, it made me look as if I didn’t have Bipolar at all! But they made me happy.  Wot?

“Utterly horrific.”
“So foreign to me.”
“Made me look as if I didn’t have Bipolar at all!”
“But they made me happy.”

SHIT.  I could have been cycling non-stop from the beginning! For two full years now–and those two states were BP I Manic Episodes! Look at the list! It’s just now everything is coming to the fore.

One good thing about Topamax and Lamictal is they are two of few that can help with Typical Absence Status Epilepticus.  Oh, wouldn’t it be ridiculously amazing if this ridiculous (not-at-all-a-titration) increase helped with that?

I had to keep staring at my current bottles and my “new” ones.  I couldn’t believe my eyes.  Then when I focussed a bit better, I started maniacally laughing like crazy.  I think I probably sounded like a seagull choking on my new doses and all pills I’ll now have to take.

So here’s the deal:

Current Doses:

1 100mg Topamax 3x daily
1 150mg Lamictal 2x daily

The “Hang On To Your Hats New Doses”

3 100mg Topamax 3x daily
2 150mg Lamictal 2x daily

I seriously cannot believe Non-Arsey Neuro went that bloody high! And no titration.  But I think I know why this happened.  I called up Sweetie GP and freaked out.  She must have seriously kicked someone’s ass.  It’s also so insane as I wasn’t even consulted! He just faxed the new scripts to pharmacy! This whole thing keeps getting better and better, you know?

I’m gonna be pretty messed up for a few days *laughing so hard* Oh, yeah!!! I’m so hyper-assed crazy right now!!!!!!!! I was feeling sick because I have my period, the migraine was catamenial (so I’m in Typical Absence Status Land right now.)  Just GETTING the new meds has now turned me into a Bipolar Rocket again, shooting through the sky! That’s why I need the pills! Presumably they’ll help with the lows as well.

I have to see my Therapist on Monday too.  That will be “interesting.”  I’ll also start tomorrow and not tonight.  An even and full day to begin going completely off the wall.

I’ll be okay.  I’ve been on these meds for years.  I’ll get a good brain bashin’.  Probably like it’s in the ring as a featherweight vs. the biggest guy in heavyweight, undefeated for 10 seasons.  Never a problem with SJS either but I know what to look for if something’s not right.

CODA: I actually have done a doubling/no titration of my Topamax before. *winks*


  1. That’s a lot of lamictal!


  2. Hi darkentries. *jumps all over you with hugs and kisses* Well, you might have to pick me up to do it right now? *laughs*

    Indeed, it is a lot of Lamictal and a lot of Topamax too! But you know Dr. PA! Ever the faithful of Medical WTF.

    I was rather surprised to see what I found. Lamictal first.

    So, I was on 600mg. They did some efficacy tests (quite conveniently with Topamax) double blind, placebo etc. and 600mg on the table! The testing even went to higher doses than that!

    However, I’ve now plopped myself at 450mg. That is NOT unreasonable at all.

    Topamax. 900mg. *laughing so hard* Now THAT one I could not believe. Indeed, as per post with hospital pic, I was wondering if the fucking pharmacy made a mistake!

    But in looking, studies only done up to 400mg. Then came the wind that blew me away so far, I almost wouldn’t need to get on a plane to see you guys! Testing up to 1,600mg just hadn’t been done. So, WOW. I’m totally safe with everything!

    The last curiosity was Drug-Drug Interaction. What might one do to the other and vice versa?

    Get out the dice and prepare to roll, my dear.

    Lamictal increases my Topamax Concentration by 15%. Topamax increases my Lamictal Concentration by 13%.

    So, it’s all about tweaking. And I mean “tweaking” as in adjusting the meds, not “tweaking” as in…well, maybe I mean that too!

    Lots of love to you, and Aik as well of course,


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