Posted by Emme on January 11, 2004, at 20:20:28
Hello All,
I'm trying to brainstorm on ideas for improving my meds. My pdoc usually has some thoughts, but I like to have some ideas percolating also.
Dx: Bipolar spectrum. Mostly evil hideous depression. Little hypomania - the excess energy turns up as anxiety, edginess, noise hypersensitivity.
I'm on 350 mg Lamictal, 25 mg atenolol (to control physical symptoms of anxiety), clonazepam and xanax (at the moment, low doses as needed. Occasional crumb of seroquel. Intermittent selegiline (5-10 mg).
I'm more level on the Lamictal - less bouncy, and partial remission from depression. I need to acheive better remission of depression. But medicating me is like trying to walk a tightrope between the sluggish "eeyore" depression and the anxiety. And I am sensitive to side effects. When I'm really depressed, I need perking up and *motivation*. But something too activating makes me jittery, so I need anxiety control that doesn't zombify me (alternatives to clonazepam?).
The Lamictal seems to be stimulating - I don't feel anxious per se, but my pulse is running high even with the atenolol. It would be nice to have new ideas for something to "balance" out the Lamictal and calm my system as well as ideas for improving depression.
The most optimistic-feeling/motivated days I've had have been on 5 or 10 mg selegiline. But I was also kind of revved - the stuff is stimulating. I've had awful days on it too - so I worry it may induce cycling. I may continue to use it on an as-needed basis when I'm immobilized, but I'm notdecided.
Have tried:
Li
SSRIs out of the picture
neurontin (great but dropped WBC count)
Effexor
Gabitril
Remeron
Trileptal.Others:
Standard MAOIs. I know they make pharmacologic sense for me. But I'm unwilling to assume the worry with the diet (I *know* I'd obsess). I'm a vegetarian and I eat too many questionable things, especially ethnic foods.Risperidol: Just trying a few days. I'm not sure it's doing anything that seroquel didn't do.
Provigil: low dose has helped sometimes when I'm really sluggish. Sometimes it sends me into orbit. Sometimes I don't even feel it.
Strattera: tried it briefly, neither bad nor good. Probably didn't try it long enough. (keep that as an option?)
Keppra: I didn't hate it. But it made me feel simultaneously emotionally edgy and apathetic. And my brain didn't produce any thoughts.
Topomax: seemed to make me more depressed. Of course I wasn't taking Lamictal then... revisit it....? Will it make my hair fall out?
Zonegran: Well, I was sleepless and very depressed on it after about 5 days. Scary. But then I was also very depressed a few days after stopping it. So maybe I felt awful by coincidence and I was premature on nixing that? Anyone find it helped depression? Anxiety?
That's probably most of it. I think my doc has stayed away from depakote and tegretol because of their side effect profiles and as I understand it, depakote is better suited for controlling mania.
Okay, if anyone has any thoughts, I'll be interested to hear them. Thank you.
Emme
poster:Emme
thread:299547
URL: http://www.dr-bob.org/babble/20040109/msgs/299547.html