Posted by Ron Hill on May 31, 2003, at 15:28:10
In reply to OOPS - didn't state original post quite right! » Paulie, posted by Janelle on May 30, 2003, at 21:41:55
> Oh gosh, I think I did not phrase my post properly! I am on an a-d (Celexa) which knock on wood IS working - what is NOT working is mood stabilization - meaning I swing from hypomanic (lots of energy, anger, impatience, aggressiveness) for quite some time until my body can no longer sustain that kind of prolonged angry energy and I crash into depression where I head to bed and remain there for days. Then the cycle starts again - I have re-energized my battery, go hypomanic for a spell, get depressed, etc. ACCCCCCCK.
--------------------------Hi Janelle,
Sorry to hear that you are cycling. :-(
I can totally relate to the hypersomnia during the depressive phase of the cycle. I believe that the hypersomnia is one of the symptomatic components of atypical depression.
Is it possible that the Celexa is causing (or contributing to) your mood instability? Please read the following information. It is on Dr. Phelps' web site and it discusses the controversy surrounding BP patients taking antidepressants:
http://www.psycheducation.org/bipolar/controversy.htm
Over the years I tried almost all of the SSRI/SNRI's as an add-on to a moodstabilizer for treatment of the atypical depressive side of my BP II. Unfortunately, each and every time the AD eventually left me in worse shape than I was without it.
This put me in a difficult place for several years. I struggled with depression when using just a moodstabilizer, but the situation would become even worse shortly after adding-on an AD. Therefore, I turned my attention to supplements for treatment of my depressive side. About 18 months ago, I had good success using 200 mg/day of SAM-e. However, out of the blue after five months of very good results, SAM-e started to induce severe irritability and I pulled the plug on it.
The good news is that, with the help of others on this board, I have found a medication/supplements combo that is currently working incredibly well. I take 600 mg/day of Lithobid for my hypomania, 2.5 mg twice a week of Enada NADH in conjunction with 250 mg/day of TMG to treat the atypical depressive phase of my BP II disorder, and 250 mg/day of niacin to control my dysphoric mood states (irritability). I think the niacin is also helping my depression, but its main function is to control my irritability which it does exceedingly well.
I'll not bore you by listing all of the vitamins, minerals and supplements that I take since they are numerous. However, the ones I mentioned above are the heavy hitters and they are the main contributors to my current good mental health. Magnesium, fish oil, and phosphatidyl serine, are definitely worth honorable mention.
Janelle, I took the liberty of reproducing some of the above information from one of my previous posts. It's not that I don't care enough about you to draft an original message, but instead it's that I'm cramped for time and I think that what I posted previously may also be applicable to your particular situation.
Specifically, I wonder if supplements could play a more central role in the treatment of your atypical depression and anxiety/irritability. If I were in your shoes, I’d keep and slightly increase the Depakote and lithium. Since SSRIs induce mood instability for so many bipolar patients, I’d slowly discontinue the SSRI and simultaneously try various supplements that might serve to treat the depressive side of your BP. Clearly, I’m biased since this approach has worked so well for me. Further, if I were in your shoes, I’d wean off of the benzo and try to use a supplement(s) to treat the anxiety/irritability.
This approach will require you to do some homework to find the supplements that will work for you. For depression, I recommend that you start your search by considering Enada NADH, TMG, and niacin. Other supplements for possible consideration for depression would include SAM-e and St John’s Wort. For anxiety/irritability, I recommend that you consider niacin, niacinamide, and/or picamilon. Here is a link for the later one:
http://www.smart-drugs.com/picamilon-article.htm
Further, I find that fish oil provides a good mood stabilizing effect and has some antidepressant properties. I take about 20 ml (4 tsps) per day of Carlson’s Fish Oil. I go through three of the 200ml bottles each month and at $19.90 (retail) per bottle it is kind of expensive (about $1.50 per day). Also, magnesium might help you. I take 800 mg/night (400 mg of Mg citrate and 400 mg of Mg malate) at bedtime. It’s a great sleep aid and I’m convinced that it improves my brain chemistry.
Please take what I’ve said with a grain of salt. You know your particular situation way better than I do, of course.
One final note. If I ever find myself in need of a prescription antidepressant in the future, I’ll try an MAOI (e.g.; Nardil) because I’m convinced from what I’ve read that MAOIs work better for bipolar patients than SSRI/SNRIs.
One thing about us bipolars, we sure are opinionated, aren’t we?
I send to you my best wishes, Janelle.
-- Ron
poster:Ron Hill
thread:230335
URL: http://www.dr-bob.org/babble/20030530/msgs/230448.html