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Re: MAXIMUS AND RON..............................

Posted by starlight on March 13, 2003, at 15:52:16

In reply to MAXIMUS AND RON.............................. Ron Hill, posted by Krissy P on March 13, 2003, at 13:53:14

Krissy P,
I too am Bipolar II and really struggle with depression. I'm not sure that Lamictal by itself is enough to stabilize mood. I am on both Trileptal and Lamictal because the Trileptal wasn't enough to keep me away from the depression. He wasn't dissing you, and it appears that you had a classic defensive reaction to what I thought was some thoughtful advice. He probably suggested Lithium because it's a front line mood stabilizer - makes sense to me. He wasn't saying that you should take it - just that you should think about it and perhaps inquire which you did - so congrats.

Any antidepressant is enough to cause mania over time in Bipolars. I took wellbutrin for over a year and thought it worked great, and by the end, I was definitely manic. I loved that aspect though and luckily I have a very good Pdoc who was patient with me and even though I was in denial, I eventually came around. I didn't see his post as attacking you. Only offering some advice that you can leave or take, or just think about for awhile. I totally agree on the self medicating though. I strongly believe in being patient and not using every little daily up and down as a reason to up or drop your dose - I think it's something to be reviewed over time - like every few weeks or so so you can establish a baseline and then decide how things are going. I too have a few side effects with the lamictal, but so what..., I know I'm going to have them, so I'm just patient with that too and give my body a chance to adjust. Starlight

> Thanks Ron, Yes, I hear you! I AM on a mood stabilizer-yes, Lamictal. What you don't seem to understand here is that 50mg works for me-even though, IYO, my dose of Lamictal is nowhere near the therapeutic dose range. I have posted before that I need VERY low doses. Example-A pdoc told me years back that 75mg of Effexor QD wasn't a therapeutic dose either BUT it worked for me. Please understand that before you suggest something, that some people, including me, do not need high doses of medication to function/feel "normal". Yes, I can see that I am cycling. Other things come into play here when I get depressed also-not just the meds. I found, after talking, and changing my attitude that I got passed the cycling last night, slept well, and took only 50 mg Lamictal. My body, at this moment, can only handle 50mg Lamictal-I will not put my health or others' at risk just because I am only taking a "non-therapeutic dose" of Lamictal-IYO. Why would you suggest Lithium when you know I am just now re-introducing 1 MS back into my system and, after several posts, am having a rough go????
> As far as taking an SNRI that can be very destabilizing to a BP II-I have been on Effexor for a year before I went off, and it worked GREAT. What makes it any different now???? I know my body better than anyone, and I would appreciate it if you understood this. Your post, however gently you meant it to be, put a stitch in my side, and MAXIMUS' post didn't help things. Just because your opinions aren't taken there is no need to dis me with a "couldn't of said it better" post -MAX.
> Thank God Jay already posted to me-that Lamictal must be ramped-up very slowly and carefully. I was told that, and I heard.
> As far as Lithium-I called my pdoc today and she said no-while you're on Lamictal and are still getting used to it, I will not add Lithium, your body is and has doen okay on Starting back on Lamictal" So I did what you said here k! From your post, I feel you haven't listened to me very much concerning this matter.
> At this point, I'm wondering if you DO care.
> I appreciate you trying, but do you see my points here guys?? ( Ron nand MAXUMUS)????? There is A LOT left to be said..............
> a quite disgruntled Kristen that WILL get over it-I had to respond
> ==================================================================================================
> Krissy, I'm going to say this as gently as I can and yet be stern enough so that you will hear me. Your pdoc has tried to convince you that you need to be on a moodstabilizer, I have told you that you need to be on a moodstabilizer, Maximus has told you that you need to be on a moodstabilizer, and others have said the same. A few days ago you were experiencing mania (or hypomania) and now you are feeling depressed. Can you see that you are cycling?
> >
> > You've told me that your dx is BP II, and yet the only medication in your cocktail that even resembles a moodstabilizer is Lamictal. And your dose of Lamictal is nowhere near the therapeutic dose range. You have virtually no mood stabilization in your cocktail. And to add insult to injury you are taking an SNRI that can be very destabilizing to a BP II. Is it any wonder that you are cycling?
> >
> > Call your pdoc and tell him/her that you have decided that he/she is right regarding your need for a first-line moodstabilizer. I personally do not think that Lamictal would provide enough mood stabilization to keep you from cycling even if it were fully ramped-up to the typical 300 mg/day range. Instead, I think you need to bring a first-line moodstabilizer on board. And since you did not respond well to Depakote, that leaves lithium. I know you are afraid that lithium will cause weight gain, but as I read your posts, it appears to me that you have never tried it.
> >
> > As an aside, Lamictal must be ramped-up very slowly and carefully, if that is what you end up trying.
> >
> > I care about you, Krissy. Please stop trying to self-medicate and call your pdoc.
> >
> > -- Ron
> >
> >




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