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Discussion Starter · #1 ·
So, I've been on Concerta (27 mg twice a day) and building up the Depakene, but I already notice Depakene is going to be too weak even in the maximum dose.

Does this combination sound like a good idea? All 3 in the maximum daily dose and for (treatment resistant) bipolar depression.
 

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Discussion Starter · #2 ·
Btw: Concerta is a lot smoother than long acting Ritalin, with less of a crash as well. Still not convinced on it's use for depression but I'm giving it some weeks at least.
 

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So, I've been on Concerta (27 mg twice a day) and building up the Depakene, but I already notice Depakene is going to be too weak even in the maximum dose.

Does this combination sound like a good idea? All 3 in the maximum daily dose and for (treatment resistant) bipolar depression.
How does concerta work for you ? I am in the process of being diagnosed with ADHD .. i am no yet diagnosed but there are many pointers... my psychiatrist is working with me right now .. i think i had to fill like 4 questionnaires.. 2 of them are ADHD questionnaires.

She mentioned concerta.. that si why i am asking you .. i actually have no answer for your question sorry :)
 

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Well it is definitely better than the rollercoaster-ride that was Ritalin LA, it's still not a good sustained release version though. I don't understand why they don't make something that works 16h, no more, no less. Concerta is supposed to last up to 12h but that is very much a fallacy. I'd guess it's duration of action at about half of that at best.

It's useful while it's working, but creates problems when worn off. You need to be very in control of yourself and recognize what's going on to not do something stupid during that period. But maybe we can still finetune it.
 

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Sounds fine to me, although Depakene isn't famous for being good for depression, more of an anti manic so idk. If its not lifting your mood, and you don't need it for mania prevention it would make more sense to swap it for lithium, rather than add that. I'm guessing you've tried Lamictal? Wellbutrin?

I'm in a similar situation. I take lithium 1g, Cymbalta 60mg, Concerta 36mg for bipolar depression. It kinda works. Not really.
 

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Well it is definitely better than the rollercoaster-ride that was Ritalin LA, it's still not a good sustained release version though. I don't understand why they don't make something that works 16h, no more, no less. Concerta is supposed to last up to 12h but that is very much a fallacy. I'd guess it's duration of action at about half of that at best.

It's useful while it's working, but creates problems when worn off. You need to be very in control of yourself and recognize what's going on to not do something stupid during that period. But maybe we can still finetune it.
How do yo feel on it ? .. i mena .. what positive effects is it bringing for your depression or anxiety or even attention ( in my case .. if i am diagnosed then this is what they want to try )
 

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Discussion Starter · #7 ·
Sounds fine to me, although Depakene isn't famous for being good for depression, more of an anti manic so idk. If its not lifting your mood, and you don't need it for mania prevention it would make more sense to swap it for lithium, rather than add that. I'm guessing you've tried Lamictal? Wellbutrin?

I'm in a similar situation. I take lithium 1g, Cymbalta 60mg, Concerta 36mg for bipolar depression. It kinda works. Not really.
I take the Depakene for that reason (mania, mostly long lasting rages) but it isn't going to be strong enough. I don't think Lithium on it's own will suffice neither.
 

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Discussion Starter · #8 ·
How do yo feel on it ? .. i mena .. what positive effects is it bringing for your depression or anxiety or even attention ( in my case .. if i am diagnosed then this is what they want to try )
It's mostly useful for motivation and attention, I don't see any real mood lifting possibilities and certainly no anti-anxiety action. (but not worse neither) Maybe indirect by improving one's focus?
 

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Discussion Starter · #11 ·
My psychiatrist wanted to add Seroquel XR to the Concerta instead of the Depakene (and Lithium). Would someone consider that a better option instead?
 

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It's mostly useful for motivation and attention, I don't see any real mood lifting possibilities and certainly no anti-anxiety action. (but not worse neither) Maybe indirect by improving one's focus?
Can you give me examples of how it help with motivation and attention or focus.. because frankly speaking these are areas that i have problems with !! is it like a marked feeling or mor eof a placebo slight feeling? like how it affect your daily routine?

again really thank you
 

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Do you have ADHD? Or did you get Concerta exclusively for treatment resistant depression? I have to ask because getting in for depression alone really sets you apart, making you one of only a handful of people I know of to ever accomplish such a task.

My experience with Concerta is quite limited, though I thought it lasted perhaps 10 hours at most. Certainly doesn't cover a whole day unless you sleep most of the day. Definitely no risk of the effect lasting too long.
 

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Discussion Starter · #14 ·
Can you give me examples of how it help with motivation and attention or focus.. because frankly speaking these are areas that i have problems with !! is it like a marked feeling or mor eof a placebo slight feeling? like how it affect your daily routine?

again really thank you
I haven't been on it for very long, but it does make you feel like doing things, things you'd be less likely to do without being on it. Examples: everything? :)
 

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Discussion Starter · #15 ·
Do you have ADHD? Or did you get Concerta exclusively for treatment resistant depression? I have to ask because getting in for depression alone really sets you apart, making you one of only a handful of people I know of to ever accomplish such a task.

My experience with Concerta is quite limited, though I thought it lasted perhaps 10 hours at most. Certainly doesn't cover a whole day unless you sleep most of the day. Definitely no risk of the effect lasting too long.
More like 6-8h for me but I take it twice a day to get more coverage. For treatment resistant depression yes. I don't think it's that hard to get once you've done ECT?
 

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More like 6-8h for me but I take it twice a day to get more coverage. For treatment resistant depression yes. I don't think it's that hard to get once you've done ECT?
I can see how it should be pretty easy to get stimulants after ECT, seeing how ECT is already a last resort that wouldn't have been tried if not for severe depression and a great many prior med failures. After ECT the choices are pretty limited, and suicide it a leading choice by that point, so stimulants look very safe in such context.

Have you tried other stimulants? If so, how does Concerta compare to various amphetamines?

Also curious about the Depakene & Lithium. Is this for unipolar depression? Normally I think of those drugs being used for bipolar, though I could imagine there being exceptions like your case which is clearly out of the ordinary.

Thanks for any information you can provide.
 

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I wanna ask for concerta now.

How your bloodpressure inshallah you still having problems?
 

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Lamictal added to Depakote/Depakene seems to enhance efficacy for bipolar depression in studies:

In a study comparing valproate monotherapy with the combination of lamotrigine and divalproex (Valproate) extended release (ER), the combination appeared more effective in bipolar depression. At the American College of Neuropsychopharmacology meeting in December 2009, Vivek Singh, Charles Bowen, Richard Weisler, and colleagues from The University of California, San Diego reported on the randomized, double-blind, eight-month maintenance study of bipolar depressed patients.

Patients who could be stabilized for two consecutive weeks on the combination treatment of both lamotrigine and divalproex were then randomized to either lamotrigine alone or the combination for the duration of the study. Most of the data collected about these 87 subjects favored the treatment with the combination (lamotrigine plus divalproex) compared with lamotrigine alone. Combination therapy was superior for manic symptomatology and resulted in lower rates of unanticipated worsening of depression (greater than 20 points on the Montgomery-Asberg depression rating scale (MADRS)) that led to termination from the study than lamotrigine monotherapy did.
Lamotrigine plus Valproate: Better than Lamotrigine Alone for Bipolar Depression
 

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My psychiatrist wanted to add Seroquel XR to the Concerta instead of the Depakene (and Lithium). Would someone consider that a better option instead?
It has more evidence for use in bipolar depression than Depakene so if that's what you're experiencing at the moment it might be a better choice. Usually its added to a stabiliser though, rather than taken alone. Lithium is generally preferred over Depakene as the primary stabilizer. Have you ever taken that before?
 
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