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Re: It's not to late to medicate!

Posted by fluffy on August 8, 2003, at 17:36:13

In reply to Re: To med or not to med? fluffy, posted by katia on August 8, 2003, at 17:11:52

Hey Katia--

You are probably not treatment resistant at this point. Maybe if you were like 50 years old or something. Besides--how will you know if a mood stabilizer will work or not if you don't try it? SSRI's and other AD's DON'T work on BP folks w/o the presence of a mood stabilizer.

For me, Lamictal has chased the blues away--it has a reputation for being an anti-depressant mood stabilizer. However, the risks of taking Lamictal ONLY involve still having a hypo-manic episode. Depending on the severity of your manic or mixed episodes, it may be recommendable to add another stabilizer on top (if you do the Lamictal thang). A lot of people who have only a problem with depression who haven't responded to AD's have responded to Lamictal. Also Lithium. I forget--are you the one who has a reaction to it? According to research, Li and Lamictal make great partners for lots of BP peeps.

You could try Lamictal first, and if it doesn't control the more agitated states, then you could add Li, Trileptal, Neurontin, Topomax, or Depakote (other anti-epileptics that control mania), or give a minor anti-psychotic a trial (like Zyprexa or Abilify). One of my friends who is BP responds well to Zyprexa and Wellbutrin. The important thing is to treat your SYMPTOMS. .

Another approach could be to try the depakote first, and if it only treats your "highs" or mixed states (as you fear) and not your lows, you could add an AD like Wellbutrin or Effexor (a non-seratonin related AD). There are lots of approaches, so it can seem daunting. But just try one thing at a time--add or subtract as you go.

Anyway--I know that I don't really know you, but I care anyway. Keep in touch, and let me know any thoughts.

Katy


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