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Re: Need experiences w/ LITHIUM (and versus DEPAKOTE)

Posted by JohnX2 on March 7, 2002, at 2:17:59

In reply to Re: Need experiences w/ LITHIUM (and versus DEPAKOTE) » Janelle, posted by Ron Hill on March 7, 2002, at 0:13:09


Hi Janelle:

Just to create as much anxiety for you ;)

Here are my latest thoughts (you have 3 good bipolars
sharing there experience,).

You didn't indicate if you tried
an AD (anti-depressant) (Effexor) before Lamictal? But you
indicated the Lamictal may have been OK? This sounded positive
for Lamictal? A failed AD response before taking a mood
stabilizer for a bipolar is to be expected, just so
you know.

What would be most preferable would be to start
with a tolerable 1st line stabelizer, and Lamictal
is a good one which may avoid an AD ad on. If you
can push the Lamictal to a good dose, for a lot of people
it has a fairly good anti-depressant profile and can
really wipe out those bad lows. It does that for me.
Since I started Lamictal, no major lows. A few downturns,
but no big drops. After this I would explore adding on
anti-depressants and possibly the anti-psychotics if you
are becoming manic.

This is just my opinion to help *minimize* the number of
medicines in your body and understand what they do as you
add them in. Personally, I wouldn't slam in an anti-depressant
before getting up to a healty dose of any mood stabilizer.

But I guess it would be good to know how things went on
your last Lamictal trial.

These are all things to discuss and check with your
doctor. Sorry to overwhelm you with opinions. Just trying
to minimize the amount of medicine changeovers if possible.

PS. I do well on Serzone. I've taken it twice.
The 1st time without Lamictal it made me extremely
fatigued and dizzy. The 2nd time with Lamictal I
have had no fatigue or dizzyness.

Best wishes,
John


> Janelle:
>
> The general "rule" is that Bipolar I patients typically do better on lithium whereas Bipolar II patients typically do better on the AEDs (eg Lamictal, Depakote, etc). I personally am an exception to this very general rule.
>
> I am BP II and Lithobid works better for me than the AEDs. I liked Lamictal but it gave me a bad rash. The only thing good about Depakote was that it facilitated great sleep and dreams. On the down side, Depakote caused a rash (fairly severe), caused weight gain, and may have made my depression worse. Lithobid (600 mg/day) causes slight rashing but I can control it with a topical skin cream.
>
> A couple of days ago Cam posted a link to a bipolar document that you may find useful since it directly addresses the issue you raise (Li vs. AEDs). Here is a link to Cam's post:
> http://www.dr-bob.org/babble/20020301/msgs/96446.html
>
> IMHO, if Lamictal is working well for you as a mood stablizer, I'd be reluctant to switch to Lithobid if I were in your shoes. If it ante broke don't fix it! But I do not know your specific case history, so you of course would know better than I what course of action is best for you.
>
> Li does a fine job of keeping me out of hypomania but does very little for my depression. After several years and more ADs than I care to remember, my pdoc found something that works like a charm to treat my depression. I can not begin to tell you how happy I am to have my depression problem solved. It has worked very well for four months and I have every confidence it will continue to do so. What is it, you ask? SAM-e.
>
> If you want to find out more about SAM-e for depression, click to the following prior post:
> http://www.dr-bob.org/babble/20020301/msgs/96055.html
>
> --Ron
> ------------------------
>
> > The new pdoc is also having me go on LITHIUM (in the form of sustained release LITHOBID) -- I'd really like to hear anyone's experiences on LITHIUM.
> >
> > I'm currently not on a mood stablizer, although I had been on Lamictal with some success (or so it felt). However, I've heard that DEPAKOTE is a good choice of mood stablizer so if anyone has anything to say about Lithium versus Depakote or Lamictal, I'd appreciate that too. Thanks very much.


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poster:JohnX2 thread:96752
URL: http://www.dr-bob.org/babble/20020301/msgs/96844.html