Posted by Golf4 on December 1, 2003, at 15:56:10
In reply to Clarification; Lamictal as monotherapy for BP II, posted by femlite on December 1, 2003, at 10:34:50
Hi,femlite
I agree with you 100%!
Your dwelling on this controversial issue is justified moreover that BP2 is one of the most complex maladies, difficult to treat,though possible provided that not only YOU have the patience and the intelligence to deal with it,but your doc.,too….as far as I observe, you do face a problem regarding your actual doc and I strongly suggest you to try and find someone who is intelligent and with a good willing (at least) as you are.
Concerning Lamictal which IS approved already by FDA for prophylactic BP treatment ,seems to be a promising(statistically obtaining quite high marks) med with some quite good mood stabilizing effects and even with some AD effects,too ,BUT certainly(according to my opinion and experiences) having not enough AD qualities to substitute a usual AD (in my case it has been once Celexa and now days Zoloft).
The consensus among 99% of the professionals is that a BP2 one must augment his AD with a Mood Stabilizer=a mania,or hypo mania blocker and one of these “mood stabilizers” is considered (now days already officially) being Lamictal,too
I can just strongly suggest you :DO not to stop taking an AD which works for you(for instance one of the SSRI’s),but rather add a mood stabilizer(as Lamictal,but staying on quite” reasonable” doses which should be between 50-125mg,depending?!...on your doc’s “philosophy”
Do not forget that the biggest difference between a BP1 and a BP2 is that the second has much more frequent and disabling depr.episodes which need a real ANTI depr.drug and not just a drug having “some “ AD qualities,too(like Lamictal)
All the best to you and DO NOT GIVE UP!
==========================================> I feel I need to clarify. Im looking at evidence of mono therapies (Lamictal included) that work for BP II. I don’t doubt the efficacy of Lamictal. I know If I’m truly BP, we're not going to get any where with out a mood stabilizer. I think Lithium is also a good option but I would choose Lamictal over Lithium .
>
> The part I’m struggling with is my pdocs lack of communication skills, (dont they teach that in psych school?) and someone telling me to take a psychotropic medicine and not explaining "what the point of this therapy is" is frightening for me.
> I don’t think it is wise for me to just drop the WB. So I am trying to titrate down on my own.
>
> I also fully aware of the need to titrate Lamicatal up slowly.
>
> What I don’t understand, is given my equal propensity for deep depression,(which dominates the balance of my mood swings) why my pdoc is not discussing with me the future possibility of a different AD.
> I hate being treated this way and forgive me, but that’s his problem. My doctor phobia is something he has to be willing to WORK with me on.
>
> He’s already indicated that he realizes I am frightened of big changes in my meds. I am also frightened of not knowing where we're headed.
> I realize he’s human and may not even be sure. But can’t he at least give me the consideration of respecting my intelligence and participation in a dialogue of those future possibilities.
>
> If his reason for not allowing me to be privy to the game plan is based on the "15 minutes for each patient" model of dr/patient relation, than I’m out of here. I can’t deal with that. I think there must be other doctors who operate with more respect for patient’s human failings.
>
> I’m sorry, but this cant be a one-way relationship. I do all the understanding, make all the allowances, take all the cr*p, and keep smiling, "I guess he's the doctor" nonsense".I come home from visits characterized by this antiquated notion ("me all knowing doctor - you passive docile patient") deeply depressed and filled with fear and hoplessness. Is it worth that?
>
> Do we sense I have an issue here? Darn right and I told him that from the start. It seems I didn’t explain it well enough, or he doesn’t get it or he doesn’t care. I m sure there are patients less troublesome than I, from whom he can collect his 50 -75 bucks, go home and the end of the day and not think about.
> So be it. It’s his choice.
>
> I’m sure Lamictal has a good chance of helping me and if the next Pdoc wants to mess with that, I guess Ill have some serious thinking to do. Each new pdoc almost comepletely changes my meds, which should give us a clue on the "all knowing doctor" model and be a possible basis for they're humilty,dont you think?None them agree on what to do with me. Im thr only unchanging variable and always will be. But how much respect do my views about my heath get?
>
> Thank you Leslie and all, esp. for letting me blow off some steam.
>
> I do want to hear from BP II patients. I don’t believe there are any out there doing well on Lam alone. Mono therapies arent often effective for "most" BPs.
> At least that’s what my reading indicates.
> If he has a different idea, it’s his responsibility to help me understand that.
>
> If any BPs have expereince with mono threrapies that work. Im am very willing to listen. Im not closed minded to evidence, just doctors who insult my intelligence and my humanity.
>
poster:Golf4
thread:284139
URL: http://www.dr-bob.org/babble/20031126/msgs/285609.html