Urge Incontinence & Meds
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Q:  Urge Incontinence & Meds

18 year old daughter was diagnosed BPI with panic disorder abut 2 years ago.  Maintained on Neurontin and Effexor XR.  Neurontin was helping but she still had many ups and downs. 10 weeks ago she was switched to Depakote along with the Effexor. Mood stabilized wonderfully, but immediately started having problems with urge incontinence.  Detropan has not helped.  Blood tests and urinalysis normal.  This past week went off the Depakote & onto Trileptal but the incontinence continues.  Needless to say, this is not a good thing for an 18 year old to be going through. Any experience with this problem and what can be done?  Leaves for college in 3 months and certainly needs this resolved before that stressor begins.

Dear Ms. B' -- 
Haven't heard this one before.  Lower dose and make up the difference with lithium? (a very old, basic strategy).  Begin to lower Effexor in hopes that a lower dose of Depakote might be sufficient (obviously these strategies hope that the effect is dose related). 

Could Effexor be a cause and somehow Neurontin was masking it?  i.e. it's not really Depakote (or Trileptal)... or perhaps it's something else that's a cause, not Effexor, but still not Depakote?  Probably her doc's have already done the appropriate head-scratching about this, with the lab work you mention.  

Sorry, beyond that, it seems like there's just more switching to try. 

Dr. Phelps

Published July, 2003


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