Posted by Ron Hill on September 10, 2007, at 7:21:18
In reply to My Horrible Experience on Abilify, posted by AnneL on September 1, 2007, at 21:22:14
Anne,
I hope you are still checking this thread. I've taken the liberty of rearranging the order of your text but, of course, I did not change any of your words.
> What are the other mood stabilizer choices that don't make people gain a lot of weight?
Have you considered Trileptal? Trileptal is my “ace-in-the-hole” to reel in any breakthrough hypomania. If I get a little hypomanic, all I have to do is increase my Trileptal dosage somewhat. I can feel my hypomania subsiding within minutes of taking the dose. For me it is a great anti-manic moodstablizer.
I’ve had no weight gain due to Trileptal. But, as listed at the close of this e-mail, I also take other meds. Nardil packs on the pounds (i.e. "The Nardil 40"), but it is a great med for atypical depression, and the weight gain can be counter-acted with intense exercise.
> In addition to Effexor and clonazepam, my pdoc started me on Abilify 5 mg. daily, up to 15 mg. daily for symptoms of Bipolar (most likely BPII - overspending, not needing sleep, etc).
Anne, what in the world is wrong with your pdoc??!! It is completely inappropriate to prescribe an antidepressant (Effexor) before he has you FULLY ramped up to therapeutic levels of a good moodstablizer. The risks of inducing mania is one problem, but the HUGE risk is turning you into a rapid cycler for years to come, and maybe forever!!Please, PLEASE, read what Dr Phelps (pdoc who specializes in Bipolar disorder) says about the risks:
http://www.psycheducation.org/bipolar/controversy.htm
May I give you a brief summary of what a pdoc did to me in this regard? Was that a yes? Good. Here is the summary:
1996: Working as engineer and loving life. Advancing in my career. But I started having less motivation and less "Git-er-dun" energy. Went to pdoc not knowing ANYTHING about p-disorders or p-meds. Completely clueless and venerable.
Idiot pdoc misdiagnosed me as ADHD without any testing. He gave me Ritalin, and it caused erratic moods. I told p-doc that I have to stop taking it. He says "No, no. Let's add Paxil". Very reluctantly, I go along. WORST MISTAKE OF MY LIFE -- seriously.
In short order, I go full blown manic. Idiot pdoc still doesn't get it that I'm bipolar. Long story, short; I lost my career, and I lost everything I had (except my house).
But, even worse, without a fully ramped up dosage of a good strong mood stabilizer, Paxil turned me into an ultra-rapid cycler. It’s eleven years later, and I'm still cycling once every 15 days, as I have for the past 11 years. I never rapid cycled prior to taking Paxil.
For years, I used to spend 10 days in horrendous, completely debilitating depression, and 5 days in my normal mood state (10 depression + 5 normal = 15 day cycle, then repeat, repeat … for years and years and years).
Due to spending huge amounts of time reading medical journal articles, searching the archives on PB, talking to smart people on PB, and working closely with my current p-doc, I have made great gains. My current p-doc trusts my research completely and honors my medication requests, so long as I present the research, and justification for the medication trial.
Currently, I'm still ultra rapid cycling once every 15 days, like always, but I've greatly reduced the severity and duration of my depressive episodes such that I spend three days in comparatively mild depression, and 12 days in my normal mood state. PTL, and PTL for p-meds. However, my research continues because I’m still not quite there yet.
Anne, I've rambled a bit – okay more than a bit, but the ONLY reason that I took time to post to you, is in hopes that you will look into this issue thoroughly because the potential risk is HUGE, and it is not worth taking (IMHO). Please, PLEASE; 1) read Dr Phelps lengthy web page entry on the topic by clicking on the link provided above, 2)conduct further research (ask me if you need help), 3) march into your p-doc's office, with your research in hand, and demand that he put you on a good strong moodstablizer asap.
If you are BPII, use an anti-epileptic medication (AED) such as one of those that people above have suggested. BP1 patients tend to do better on lithium. I think Trileptal would be a great choice for you as a first try. Might work well for you, might not. But remember, the business of finding the right med for each individual involves a trial-and-error procedure. But the trial-and-error procedure is not conducted willy-nilly. Instead, it is conducted based on the best research you can find on the net.
And if you need the full text version of a journal article that you cannot gain access to for free on-line, go to the local library to gain assess to it. We have a good university library in our town, but I get the vast majority of my information right off the net.
Please note that most BipolarII patients often find it beneficial to have more than one AED on board in order to achieve optimal benefit. For example, I’m currently on three AED’s and I’m considering a trial adding a fourth AED; a low dosage of Topamax.
Antipsychotics (AP's) like Abilify are absolutely NOT first-line moodstabilizers for the treatment of Bipolar hypomania, and not even for full blown mania, unless the mania becomes a crisis situation and the patient is in danger. And even then, the AP is withdrawn asap.
Please do not misunderstand me. On-going low dosage use of AP's can be of great usefulness to some bipolar patients as an add-on medication. However, all I am saying with regard to AP's is that they are NOT first-line moodstabilizers for BPII patients. AED's are first-line for BPII patients.
Here is a link to the Prescribing Information document for Trileptal:
http://www.pharma.us.novartis.com/product/pi/pdf/trileptal.pdf
Sorry for the length of this post. If I did not care, I would not spend the time to post.
I wish all the best for you, Anne!
-- Ron
Bipolar II with ultra rapid cycling (15 day cycle), and mild Obsessive Compulsive Personality Disorder (OCPD)
600 mg/day Trileptal (AED)
200 mg/day Lamictal (AED)
875 mg/day Keppra (AED)
90 mg/day Nardil (MAOI)
poster:Ron Hill
thread:780264
URL: http://www.dr-bob.org/babble/20070831/msgs/781955.html