Posted by Ritch on September 15, 2002, at 11:38:12
In reply to Need advice: meds for bipolar rapid cycling, posted by lorelai on September 14, 2002, at 22:25:12
> A little background: I was misdiagnosed early on (the docs tagged me with the dx "clinical depression" and no one noticed the full blown manic attacks complete with text book psychosis, etc., till much later--I'd had them for years and enjoyed the creative productivity, heightened sexuality and extreme shopping sprees--well, at least till I had to file bankruptcy). The first medication I was put on was Prozac. This of course threw me into even worse manic episodes (nearly got into a terrible car accident, lost a good friend whose husband insisted she stop seeing "that lunatic," and I spent money like it was water). Only positive thing was I lost 15 lbs.). From there I've been on Serzone, Effexor SR, Depakote and just lately had a terrible bout with Wellbutrin. The only good experience I've had with meds is the Ativan I take (occasionally) for anxiety attacks. Everything else has caused me no end of problems. Serzone and Effexor caused horrible memory loss. Serzone also caused me to gain weight and itch like crazy. Depakote seemed to work for a while and mellowed my moodswings, I guess, but then started to NOT work anymore as well as pack on more pounds. I also started losing handfuls of hair and my eyelashes on Depakote, which was scary! Wellbutrin was wonderful at first, as I lost weight. But then I experienced terrible, nonstop ringing in the ears, so bad I wanted to take a sledgehammer to my head! So now I'm back to taking nothing (except my occasional Ativan) and I'm worried because I've just gotten over a terrible depression (set off by the suicide of a friend in July). I know the manic stuff is eventually going to rear its head and then I'll have all sorts of problems. I'm one of those people who tends to make major life changing decisions while in the height of mania (my pdoc wants me to go back on Depakote. I've refused. She mentioned Lithium and I refused that too). I have to figure out something to take that's not going to cause me to gain weight again. I'm not even 5 ft. 1 and even a few extra pounds is too much. Not to mention the severe depression the weight gain sets into motion. I guess what I'm asking here is--are there any people with bipolar disorder out there who've had success with certain meds that DON'T cause weight gain??? My pdoc said something about neurontin the last time I saw her. Does anyone have any neurontin experiences they might share? Also, any idea on whether Topamax might be worth a shot? I'm just grasping at straws here, as you can tell. I'm tired of being a guinea pig for modern medical science, yeah, but if I could find something that works and doesn't cause me to go bald or lose my ability to have an orgasm or make my head ring like it's going to explode, then I'd be willing to give it a try. Thanks in advance.
> Best,
> LorelaiHi, Lorelai,
Topamax tends to cause some weight loss, and you can get away with once nightly dosing (which is what I like the best about it), BUT, the cognitive side-effects are kind of nasty for some folks, but many have reported them to slowly fade over weeks (once you reach a target dose). I got up to just 50mg/day and couldn't wait out the cog sfx because of my job (I was taking TOP for probably a couple of months total-and titrating the dose upwards, too). It seemed to be a pretty powerful antimanic agent, though. I slept like a log on it after a nightime dose, too. Maybe you could start 25mg at nightime and see how it goes? Neurontin didn't seem to cause weight gain or loss. It worked the best for anxiety associated with dysphoric hypomania/agitated bipolar depression. I don't like needing to take something 3-4x daily, though. If you take it less often than 3x daily, you may notice some agitative rebound/OCD-like effects when the med is leaving your system. If you don't crank the dose up too high at first-the cognitive sfx from it were fairly mild in my experience. It didn't adversely effect my work performance unless I was above 1200mg/day. You might find that going back on Depakote and adding thyroid hormone might prevent weight gain (but that's just a theory). I have a super-conservative thyroid-doc who doesn't like the idea (because of paranoia over bone-density loss), and my pdoc doesn't want that conflict with my internist, so no T4 for me. So, I have got to swap Tdocs. I rapid cycle every 3 weeks chronically, no full blown manias. I think it would be helpful.
hope this has been of some help,
Mitch
poster:Ritch
thread:119887
URL: http://www.dr-bob.org/babble/20020914/msgs/119907.html