Posted by jay on November 12, 2002, at 23:53:25
This is kinda long..sorry...but I think may help some folks who feel rather frustrated with their treatment. If I can do *anything* to offer some kind of hope to anyone, nothing else makes me feel quite as good.
I am currently on Effexor and Risperdal, and have been for sometime since I was on Effexor and Zyprexa before. I cannot take the Effexor by itself, as it will lead me into dysphonic mania, as I truly (and so does my doc..thankfully) feel I am in the 'soft' bipolar category..the one Dr. Jim Phelps at www.psycheducation.org (I'd STRONGLY encourage ANYONE who has not gotten relief from just antidepressants to visit this site...and even take some of the tests on the site. Dr. Phelps even has a 'form' letter you can print to give to your Dr.). My 'mania' (even off meds) consists of extreme anger, over-blown arrogant, aggressive personality, and anxiety that feels what I imagine having a drill bore through my skull would feel like. My experience is not just over a short time..clinging onto 'fads'. It is over a decade, and now I am finally getting the right diagnosis and treatment. I started off in the days with Elavil and Valium, (my first two meds) and the SSRI's where just coming around here in N. America. Elavil was either *really good* (a sign of inflated hypomania..often tempered by Valium), or *really bad* (the dysphonic mania.)
Effexor is the *only* antidepressant that works for me. Over a twelve year period, I have tried almost every other a.d. out there with little to no success, and often some very negative experiences. I've had individual mood stabilizers added and such, also with negative experiences. The only 'good' experience I have had is with Effexor + an atypical antipsychotic (the one being Risperdal. Zyprexa was very unpredictable.) I tried Zoloft with Risperdal about a year and a half ago, and I almost ended up in the hospital from a very, very dysphonic rage. Besides a few breaks, I have been mostly on Effexor (augmented with other meds too) over a 5 year period.
I am also writing this in hopes others out there can maybe relate, and feel there *are* options..even when you are laying in bed for a 300 day period, in the fetal position, unable to talk, eat, or even take a bath...sleeping for 20 hours a day..even if this has happened many times over a decade. Like many others have said, the 'establishment' has pushed the singular use of antidepressants, that many with more complicated forms of depression/bipolar/schizo-type illness have had our illness antagonized and made worse by monotherapy with antidepressants.
My current regiment of Risperdal and Effexor has been the best treatment for my 'agitated' as well as anergic symptoms. It helps with the balance of energy and calmness. But, the symptoms are still quite unpredictable, and my mood is better, but I still have outbursts, and especially some deep sadness and crying. I was on the combo of both Depakote (Epival in Canada), Topomax, and Effexor, at one time last year. I was put on it by a doctor at an emergency clinic, when the Depakote/Epival and Effexor where not working well. The Topomax added a much stronger stability to the Depakote. The Effexor kept the spirits up...the Topomax/Depakote combo kept the ceiling on that. Rather then having my normal 'up and down 20,000 times a day experience' when NOT on medication, I was in a very comfortable zone of comfort and some positive energy.
So, I asked my regular doc about using the two mood stabilizers, and he wanted to wait to try a few other meds. See, I deeply respect and like my doctor, even if he is a GP, because all my other psychiatrists would ONLY let me use benzos and a.d.'s. My GP felt it was deeply sad and limited treatment, and we have worked together trying reputable meds for my BP/Depressive condition. My GP also has a number of people with brain injuries as part of his practise, and has a LOT of experience with psychiatric meds. Plus..he *listens* to me...and doesn't make me feel like some dumb 'stump' that the psychiatrists did, and believe me, I have a VERY co-operative, easy-going temperament when dealing with doctors of any kind. But, a degree in Psychiatry does NOT mean a psychiatrist is a GOOD one...or even just a good one for *you*.
So..to end this for now...I am going to my next doctors appointment (I have to make tomorrow...will likely get in tomorrow too), and suggest it is time to give the Topomax/Depakote/Effexor combo a try. I also have some other reasons for switching away from Risperdal. I have been on it for a long time, and the massive weight gain...which now at 33, I don't need (way more than Depakote or Effexor), and the total blockade of my sex drive (again, worse than just Effexor/Depakote), and fundamental reasons. Also, my day-to-day response and my mania/depression chart is still quite all over the place. I may not be afraid now to walk into a public place, but I have a career in social work (which out of most professions, requires your mood-state to be absolutely even-tempered), and I *know* I can do better with further symptom reduction.
Anyhow...thanks for reading..and any comments welcome. I am sorry that I don't post a lot of 'advice', but sometimes I am just not comfortable with doing so. I do try to help as much as possible, with some of the more factual points on medication. Hope is really one of the fundamental things that keeps most of us going. I know going back to a doctor for a med change so *many* times can be demoralizing. But when you strike that 'balance', often in two or more meds, and the feeling of stability with some clarity hits you, you end up coming out feeling like even a better person then you where in the past.
/ramble/rant :-)
Jay
poster:jay
thread:127454
URL: http://www.dr-bob.org/babble/20021108/msgs/127454.html