Psycho-Babble Medication | about biological treatments | Framed
This thread | Show all | Post follow-up | Start new thread | List of forums | Search | FAQ

Re: Bipolar Disorder Question. Can You Help Me? » Mr.Scott

Posted by Emme on September 19, 2004, at 8:34:03

In reply to Bipolar Disorder Question. Can You Help Me?, posted by Mr.Scott on September 18, 2004, at 22:21:27

>
> I have a bipolar disorder. I also have a psychiatrist who is wishy washy and ambivalent to say the least.
>
> I am far more frequently depressed (like 85-90% of the time I'm unhappy but I believe some of that is due to the consequences of my mood disorder rather than the disorder itself), and I have never had a full blown Mania. My hypomania's have only been induced by antidepressants and stimulants and rarely debilitating except for the inevitable crash. It was hard to sleep and I was euphoric or agitated and impulsive on Nardil and Prozac and a little bit on Ritalin as well for a few weeks until they stopped working or actually made my depression worse! Tricyclics may me want to kill myself immediately. I may have experienced more pure maniclike symptoms when I was younger and then my first clinical depression was at age 16. I also have a seasonal component.
>
> After years of drugs (now in recovery) and meds my response to Antidepressants is generally a very quick hypomanic reaction (within 1 day for sure every time) followed in a few days by an enduring mixed state (lots of agitation, mood shifts, irritability, grandiosity, being a dick, and still being depressed and tired).
>
> The disappointing thing about all this is my doctor's essential throwing up of his hands. I can't take Lamictal due to rash. I currently take 25mg of Zoloft and .75mg clonazepam and when I tell you I suffer I'm not lying.
>
> Wouldn't straight lithium or maybe Depakote + Antidepressant make sense here?
>
> I'm asking for help with this matter because I can't seem to get it fixed on my own, and I don't really know what I want from my doctor, but obviously I'm not getting it.
>
> Surely someone who has had an unconventional or misdiagnosed bipolar disorder can share there experience with me...I hope.
>
> Scott

I agree with the above poster- sounds like BPII. Or BPIII. If your pdoc is throwing up his hands, you need a different doc. Badly. There are many options you haven't exhausted:

- MAOIs and Wellbutrin are not known for inducing cycling. Include a mood stabilizer.

- Try an AD plus Li.

- I'd be a bit surprised if Li or depakote alone did it for you. But, you never know.

- Consider the anticonvulsant Trileptal.

- Sooshi has great success with Zonegran, a newer anticonvulsant.

- Lamictal: Depending on what your rash was like and how quickly it resolved, you might think about a retrial. You can use 5 mg tabs for an ultra-slow titration. Not to be done w/o much thought, but if you can't find anything else that helps, at least discuss it. Don't be discouraged if you need extra AD on top of Lamictal.

- I have mostly depression, but like occasional seroquel for highly anxious states. I doubt you'd use it alone, but it might be helpful in combo w/ something else.

- Consider dopaminergic drugs for bipolar depression. My pdoc has had good luck with Mirapex. I think the jury's still out on memantine, but it's worth thinking about.

- If you're sluggish, a little provigil or selegiline might perk you up. Even a low dose of selegiline (5-10 mg) is good for some people. Other need higher doses.

- Consider swapping the clonazepam for xanax, which is supposed to have some AD properties.

Good luck.
Emme

 

Thread

 

Post a new follow-up

Your message only Include above post


Notify the administrators

They will then review this post with the posting guidelines in mind.

To contact them about something other than this post, please use this form instead.

 

Start a new thread

 
Google
dr-bob.org www
Search options and examples
[amazon] for
in

This thread | Show all | Post follow-up | Start new thread | FAQ
Psycho-Babble Medication | Framed

poster:Emme thread:392467
URL: http://www.dr-bob.org/babble/20040915/msgs/392554.html