Posted by satsumas on August 1, 2008, at 1:25:52
In reply to Best meds for Bipolar II?, posted by UGottaHaveHOPE on August 1, 2008, at 0:56:54
i am on lithium 450 and just starting to titrate up to nardil 45 but dont think that will be near enough dose for me given my weight and my current mood state (suicidal ideation, pretty bad cognitive / executive function impairment, goal/reward system shutdown..basically full blown full spectrum depression of type Satsumas.) dr seems to think that lithium is not the best long term solution for mood stabalizer and suggested lamictal last time, but iv'e been on lamictal before and it didn't feel like much of anything...if anything, it may have caused cognitive impairment and lack of desire...or that could have just been the fact that it didn't do anything for the depression itself. who the F knows. depending on how the nardil works out i'd be up for discussing lamictal again, but all i know is that i tried lamictal at 200mg +focalin after cymbalta at 60 wasn't working, and i was tired of SSRIs, and while i wasn't suicidal during those months, I have the distinct remembernce of being extremely blah about life, dispassionate, but for some reason a bit ambivalent about doing anything med-related for months. Finally doc suggested to try Esmsam...evil emsam. Kinda wished he had pushed the cymbalta up a lot higher to see where it would hit hypomania. in any event...
all i know is that lithium seems to have profound neurogenesis/protective effects in the prefrontal cortex so it would be wise to review whether lamictal does as well. and i heard that lamictal really isn't even that great of a hardcore mood stabalizer so unclear whether it will be effective if you're already pumping things up pretty good with nardil.
what about tianeptine? people seem to say it has mood stabalization effects. how about being a guinea pig and trying it with an MAOI (half kidding).
in my reading, lithium and depakote seem to be gold standards, and both have pro-neuroplasticity effects. i'm curious as to whether any pdocs ever prescribe both at the same time, potentially at lower doses, in order to get full spectrum mood stabilization + neuroprotective/genesis effects with perhaps less side effects. anyone know?
poster:satsumas
thread:843419
URL: http://www.dr-bob.org/babble/20080727/msgs/843424.html