Posted by Ron Hill on July 23, 2002, at 16:27:07
In reply to Depakote tantrums..., posted by colin wallace on July 23, 2002, at 14:10:22
Hi Colin,
Sorry to hear about your mood swing problems. Let me briefly comment on two topics. First, lithium vs Depakote and, second, SAM-e induced irritability.
> Also, would I be wrong in thinking that lithium (in a low dose range)has a more benign side effect profile than valproate? I find the liver thing worrisome to say the least.
I took Depakote for a year or so. On the plus side, I slept like a baby with very vivid dreams. On the other hand, however, it caused weight gain and it seemed to make my depression worse. YMMV. I didn't concern myself regarding liver issues. Ignorance is bliss. However, my pdoc ordered periodic blood level tests.
In contrast, although 600 mg/day of Lithobid does not seem to provide much (if any) antidepressant effect for me, at least it does not seem to make my depression worse than baseline. Lithobid causes a slight weight gain above my no-medication baseline weight.
> Incidentally, I've now stopped ALL meds, with the exception of 2mg diazepam-the angry mood
> swings are lessening now too.And my mood is SO much more manageable than when I was on AD's.Did you also discontinue your SAM-e? I had to quit SAM-e because of irritability. I feel really sheepish about having posted frequently regarding the wonderful benefits I was experiencing with SAM-e, and now it turns out to be extremely detrimental to my mood in the long term. My hope is that any and all people that read my earlier posts would stumble across this post to get the rest of the story.
Let me block and copy three paragraphs from a post that I wrote to you prior to you going on holiday. I'll paste the three summary paragraphs immediately below and continue from there:
Colin, recall that I had roughly five months of excellent results with 200 mg of SAM-e. Then I began to experience extreme irritability/flash rage problems and I did not know why. As a last dig effort to identify the culprit causing the foul mood, I discontinued all vitamins and supplements (including SAM-e) but continued taking my Lithobid. The irritability continued.
I slowly began to re-add vitamins supplements to my daily intake and when I added 400mg/day of chelated magnesium, the crises state of my irritability subsided. I still have ongoing bouts of irritability (I think all bipolars do) but nothing like what it was without the magnesium.
I then resumed my 200 mg/day SAM-e intake, but it did not provide the same beneficial effect that it had during the first five months of use, so I increased to 400 mg/day. At 400 mg/day, SAM-e currently provides some benefit and I deem it worthwhile, but it has lost a lot of its effectiveness compared to what it once did for me. I do not know whether or not SAM-e was at least partially to blame for the initiation of the extreme irritability, but the current 400 mg/day does not cause irritability.
Okay, back to real-time. Within about a week or two after restarting SAM-e, I became VERY IRRITABLE and began to re-experience what I call flash rage. Four days ago I quit SAM-e and the irritability slowly subsided. But my brain chemistry got all screwed up; low motivation, difficulty concentrating, etc. My wife and I just closed on a new house so I need to have my brain in working order to get us moved. Therefore, in desperation I took 200 mg of SAM-e yesterday and sure enough my thoughts briefly became more focused and some motivation returned. But, within an hour of taking the SAM-e the irritability began to return. Even today I feel more irritable than I would have otherwise if I had not taken the small dose of SAM-e. I can no longer take SAM-e. Also, the perceived benefit of magnesium that I spoke of earlier may have just been coincidental. Maybe the SAM-e was just getting out of my system.
Sorry to ramble.
-- Ron
poster:Ron Hill
thread:113419
URL: http://www.dr-bob.org/babble/20020718/msgs/113431.html