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Re: Amateur Shrinks and experienced Patients needed! Mr.Scott

Posted by Ritch on January 12, 2003, at 10:54:50

In reply to Amateur Shrinks and experienced Patients needed!, posted by Mr.Scott on January 11, 2003, at 20:34:05

> Please help me evaluate my situation so when I see my doctor on Monday who insists on emphasizing psychotherapy and offers the well known to be ineffectual neurontin for my bipolar 2 disorder I have some ammo.
> I am taking 2.5mg of Lexapro which painfully stiffens my muscles up. I also take 3.75mg of tranxene daily and 1500mg of EPA (fish oil). For the last few days I felt really good and revved up. I drank a good amount of coffee and was exercising like a champ. Going to classes and working and feeling anxious to but also about raising my hand in class. Was I normal or hypo? How would I know? Over the weekend I have crashed. My mood is irritable, negative, mildly dysphoric and I'm VERY tired. The muscle pain is now really a bother to me and I can't seem to push myself to do much even though I am forcing myself to go see a movie tonight anyways.
> Is this a cycle or can it be explained as normal? And if you think it's a cycle what do I need to do to get my shrink to realize these hypomanic blips may be preventing me from ever getting stabilized across the board. He doesn't see them or think much of them when I mention them. Other times I've been revved and feeling good I've made some poor decisions usually involving substances of abuse.
> I read a book on childhood bipolar disorder that in looking back I certainly could squeeze myself into. Once again it says AVOID ANTIDEPRESSANTS, and particularly if your not on Lithium, Depakote, or Trileptal/tegretol.
> Should I try Lamictal since I am primarily depressed?
> Once again folks..any input is appreciated..
> Scott

Scott, I've found Neurontin to be somewhat helpful. True, it doesn't do much for my hostility and is only mildly antimanic. But, it definitely helped anxiety and had a mildly antidepressant effect. As far as your questions about cycles go, you need to chart the things. If you don't chart them (esp. if you are rapid-cycler), you won't get a sense of what pattern you are dealing with. I've been rundown and tired the last day or two and I thought I was coming down with a cold or flu or something. Well, I looked at my mood calendar and I'm in the depressive last few days of my current 20-day cycle. It can be as simple as getting one of those desk calendars and just put a plus or a minus based on how you feel when you first get up and then at the end of the day before you go to bed to judge how remarkably up or down you were. Then look at the patterns after a few weeks. THEN you can have something to show your doctor-they like charts! The anxiety could be the citalopram. I found citalopram to enhance my "startle response" more than the other SSRI's. As far as the muscle pain goes, maybe you could whack that dose in half? I also found with Celexa that I could get just as good a benefit from it by taking it every other morning (instead of every day). I don't know how long you have been taking the Lexapro, but it may be the result of it accumulating and your blood level of it is high enough to make you feel kind of foggy-headed and rundown. Flulike-symptoms are common with SSRI. The choice of "mood stabilizer", that's probably the toughest. My first idea would be to try lithium (since it is 1st line) first, but there have been many here that are very happy with Lamictal. Maybe a combo of Lamictal+Neurontin? The N. might help with the "activation" that might result from the Lamictal. hope this helps some--Mitch




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