Posted by Just A Lurker on July 26, 2007, at 0:21:29
In reply to Re: Need some medication support, posted by linkadge on July 25, 2007, at 11:46:08
> Generally yes. Mood stabilizers can reduce the propensity of an antidepressant to cause destabilization. Remeron is probably less likely to cause destabilization than other AD's. Usually if the dose is kept low there aren't too many problems.
OK. I was on 10mg of Lexapro, maybe I need to ask my doctor about Remeron. (God, that sounds like a commercial.)
> >I'd like to reduce the Klonopin just because >benzos can be addictive and they tend to stop >working anyway.
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> Yeah. It can sometimes cause depression. The addictiveness and loss off effectiveness of benzo's with time varies from person to person.Generally I haven't had much problem with withdrawal - ambien of course caused insomnia if I stopped cold turkey, paxil was (accidentally) cold turkey and a real pain, but everything else has been fine.
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> >I have some but haven't tried them yet. My new >pdoc's theory is that (at least with the >Adderall) it made my manic symptoms worse, >notably the negative ones.
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> This is always a possability. Provigil is an alertness promoting agent, not necessarily an attention promoting agent. If you can't concentrate for lack of alertness (ie from other meds or daytime fatique) it may help, but true ADHD is not really a lack of alertness.Well, that's a good question, maybe this is some sort of sleep-attention-bipolar interaction and who knows what is causing what. Lack of sleep would make attention worse and moodiness. But sometimes I am sharp as a tack, sometimes not (either unfocused, depressed, or a combination thereof.) One reason why I was thinking of a SPECT scan or something to see if it could give me something with a bit more... certainty may not be the right word, but you get the idea.
> You could always try another stimulant. Sometimes they don't mix well with anticonvulsants. Somtimes certain stimulants can acually improve stability in certain bipolars.
I do have some Ritalin (long story) I could try. I'm going to give the Provigil some time to see how it works.
> A high quality omega-3 product is always a good idea as there is evidence of efficacy in both bipolar and ADHD.
Excellent, thanks. My pdoc even said I should take it.
> >He also suspects that I may not really have ADD >per se, but it could just be a mask for bipolar.
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> This is a possability too. It can go the other way around, ie bipolar symptoms can really be a result of severe ADHD. There is also high comorbidity between the two illnesses. Both illnesses seem to show deficits in prefrontal cortex activity.Yeah, I'm getting that impression. ADHD is no longer really such a bad word, thankfully, since everybody either has a kid with it or knows someone who does.
> >This pdoc is highly recommended (by some other >doctors who are, frankly, tops in the area), but >I'm frustrated that nobody knows what I have, >how I feel, and how to fix it.
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> It sucks. I am in kind of a grey area too. I personally didn't find lamotrigine to be of any use. It does't really have the same track record of other mood stabilizers.
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> Have you tried say lithium + omega-3 + low dose methlyphenidate?I haven't tried lithium yet, my pdoc was talking about trying a lithium + lamotrigine cocktail depending on how I was feeling. I think my mood HAS stabilized more since going up to 3 pills a day, judging from my mood chart, but that's my impression.
The worst part is that you really can't judge by yourself how you are doing, you have to ask others. Sigh.
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poster:Just A Lurker
thread:771805
URL: http://www.dr-bob.org/babble/20070719/msgs/772031.html