Posted by Barbara Cat on June 6, 2003, at 11:42:06
In reply to Re: Should BP II's nix the AD's? - Depends » Barbara Cat, posted by nmk on June 6, 2003, at 10:56:52
Hi Nicole,
Happy to answer. You can scroll to the bottom for my dose info and skip the following if you want. I'm including my med history cause it puts my thoughts in order. I've had infrequent but very bizarre depressions all my life. Was on Elavil for a short time mid-70s but hated the side effects. Went on Zoloft and other SSRI's in 1984. They worked pretty good, but would always poop out after a few months and I had to keep going to higher doses. As time went on the depressions were cycling more rapidly with truly awful terror and angst mixed in. Nothing helped, and I had a 'breakdown' in 1999 and was hospitalized and off work for 5 months. The rest helped, no doubt, and I eventually felt better but still very shaky. Then 'it' started up again and I was put on Remeron 2 years ago. Worked great then same pattern. I also developed severe fibromyalgia during this time so had to deal with bad somatic pain as well. I was working in a very stressful high-tech job and falling apart. Things got so bad I truly in despair and stopped working. It was really, really baaaaad. I applied for disability and am currently on the last round in the process. I am very blessed to have a wonderful loving husband who was my rock of support during this time.My pdoc suggested lithium as an augmentor since Remeron was fizzling out and I resisted for months. I then began to recall times of intense hyperactivity all my life that I never associated with bipolar symptoms because it was such fun and so very productive. Plus the hyperactivity and depressions were separate. The hyperactivity unfortunately started getting jangled and intense, meshing with my garden variety major depression as I got older. It turned into what I think is bipolar mixed states, agitated and horrible symptoms that were fast becoming my predominant state. So I thought, OK, I believe I have classic bipolar signs and agreed to try lithium, 600mg a day.
Within 1 week it felt like a black veil had lifted. I was tapering off Remeron and still feeling a little weird even at 7.5mg, so went off it completely and only then felt great. Hated the weight I put on from inactivity and Remeron and tried Topomax for 1 month. Hated it, felt pissed off all the time.
Sure enough, major depression returned only thank God without the mixed states component so my pdoc added lamictal which seemed to help at first at 75mg (couldn't go any higher without anxiety). It was very nice, energetic and sparkly happy. Then it of course started pooping. I was holding my own until my Mother died in very tragic circumstances last fall and I fell apart and was really at the edge. My pdoc said "OK, let's go to good old tricyclics". I said ANYTHING! So I've been on nortryptiline at 75mg since January and am feeling very good. This is the longest I've ever gone feeling stable. So my doses are:
lithium 600mg (very low dose but working)
lamictal 75mg
nortriptyline 75mg
ambien 10mg to sleep
10-12 grams liquid fish oilNot many side effects from this low lithium dose, but when I added the nortriptyline I had annoying tremors and cotton mouth that lasted about 2 months and then decreased enough to not be so annoying.
I think the fish oil helps alot, as well as numerous 'state of the art' supplements. My thyroid medication had to be raised because lithium does clobber the thyroid. This is the major objection I have to it cause I already was hypothyroid. But being at the right level of thyroxine has made a HUGE difference. Whew, what a diatribe. - BarbCat
> Talked to my pdoc yesterday (before I read your post) and we decided to tinker with the AD's first and if I continue to cylce, we will raise the dose of Trileptal. I am currently at 1200mg but he stated that I could go up as high as 2800 mg. The thought of that freaks me out. The third line of defense will be to switch to a new mood stabilizer, in which I will discuss Lithium and Lamictal since I have also read so many positive experiences with both meds. I have no problem with Lithium.....at this point, I will do whatever works.
>
> Can I ask you a few questions??? What is your dose of Lithium? Do you take an AD to augment? Since you started Lithium, have you cycled at all or have things been pretty stable? Other than the weight gain, any negative s/e's for you?
>
> Thanks for all of your help and support Barbara, I really do appreciate it.
>
> Nicole
>
poster:Barbara Cat
thread:229544
URL: http://www.dr-bob.org/babble/20030604/msgs/231904.html