Posted by JohnX2 on April 16, 2002, at 0:44:14
In reply to Re: Help,Li vs. Zyprexa vs Lamictal for manic symptoms » JohnX2, posted by Ritch on April 15, 2002, at 23:37:20
> >
> > I was wondering how lithium stacks up against Zyprexa and Lamictal for particular (hypo)manic symptoms.
> >
> > particularly (more mild symptoms):
> >
> > - psychomotor agitation
> > - anxiety
> > - anger
> > - racing thoughts
> >
> > more severe symptoms (fleeting):
> > - paranoia (feelings of conspiracies, etc)
> > - derealization/depersonalization/detachment
> > - grandiose thought patterns
> > - bad insomnia
> > - intense rage
> > - violent mood swings
> >
> >
> > I like to just take zyprexa with my Lamictal/Topamax/Serzone since Zyprexa fixes the lingering problems quite nicely and closes the book. But I got the TD (dystonia) in my hand (a clenching) and restless legs so I try to avoid zyprexa, despite how wonderful it is. BTW, the residual TD symptoms from prior high dose Zyprexa administration have all but disappeared.
> >
> > I'm in the process of getting some lab testing done in preperation for Lithium trial, so i was wondering what I may expect.
> >
> > One thing I think is happening is that the Topamax is the culprit in these wild manic swings, as lowering the dose has decreased the symptoms substantially. I was thinking maybe I could dump or lower topamax, raise Serzone (because either med is to treat myofacial pain and depression, and I *don't* think Serzone of the 2 makes me (hypo)manic), and possibly bump Lamictal dose up.
> >
> > Previously bumping Lamictal above 150 mg would make the myofacial pain worse (is Lamictal a SRI at higher doses, SRI activity this seems to correlate to my pain)? But maybe with the strong Serzone (blocks bad serotonin receptors), then I can tolerate stronger Lamital (knock out the bad cycling).
> >
> > I think the stronger dose of Serzone has some of the beneficial anti-serotonin 5-ht2 receptor qualities that the additive Zyprexa was giving me.
> >
> > As you can see I am grasping to avoid Li. I don't know why???, Maybe I just don't think I can deal with side effects. Pooped out from medicine trials. Are the LI side effects really that bad? The PDR scares the shit out of me.
> >
> > These bad (hypo)manic symptoms are out of line for me and I really think they are Topamax related.
> >
> > Sorry for the ramble.
> >
> > Thanks for any input.
> > John
>
>
> Hi there RipVanWinkle! I was fixin' to post something to you about whether you had already started the lithium-given your quietness lately. I am glad you are as sparky as ever.
>
> Lithium is good and fairly reliable for the things you listed:
> > - psychomotor agitation
> > - anxiety
> > - anger
> > - racing thoughts
>
> You mentioned some more serious thingies:
> > more severe symptoms (fleeting):
> > - paranoia (feelings of conspiracies, etc)
> > - derealization/depersonalization/detachment
> > - grandiose thought patterns
> > - bad insomnia
> > - intense rage
> > - violent mood swings
>
> I found it to be a fairly decent anti-psychotic for paranoia and fairly decent for sleep, however I think the remainder of things on the "fleeting" list respond much better to Depakote-primarily the rages and rapid mood flips. Also, derealization/depersonalization tend to be worse with GABA meds (IMO). Perhaps a *combo* of Topamax (which affects GABA) at a lower dose, combined with a low dose of lithium, AND Lamictal at your "sweet spot" of 150mg would be the trick. Forget the Zyprexa altogether.
>
> Go for the Li trial,
> what the heck.
>
> MitchLately I'm getting pins and needles in my hands.
I think it is the topamax. I'm getting nervous about being on too many meds.
Last time I took Serzone at a stronger dose it had a substantial anxiolytic response with absolutely no hypomania (very stable response), I was on no mood stabilizer at the time. Good AD response, and it completly alleviated my myofacial pain. No other AD pre mood-stabilizer did this (they all were non responders, or hypomanic response followed by poop-out). This time Serzone is not making feel the least bit drugged out (no cognitive impairment). Last time I felt drugged out and got into a fender-bender, so i quit the med.I'm just wondering if I can get my meds down to:
Lamictal + Serzone
before trying:
Lamictal + Serzone + Topamax + Lithium.
*Before* I added Serzone I had some wild hypomanic swings, this was shortly after topamax augmentation and during klonopin taper.
I wish I could take Depakote, but it is a placebo for me. Trileptal gives me crushing myofacial pain, but a nice AD response.
John
poster:JohnX2
thread:103174
URL: http://www.dr-bob.org/babble/20020408/msgs/103201.html