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mood stabilizer » Nella

Posted by azalea on October 8, 2008, at 15:01:31

In reply to Bipolar II --) to azalea and phillipa, posted by Nella on October 8, 2008, at 1:18:20

You raise an excellent question about whether such a diagnosis would be helpful. If you (and your daughter) experience symptoms consistent with bipolar spectrum, it's likely you will respond well to a mood stabilizer. The traditional bipolar meds do have side effects, which is likely why you've been "willfully blind." You might consider a trial of Lamictal (lamotrigine). Originally developed for epilepsy, it is now used frequently for bipolar maintenence. Research studies show it has powerful antidepressant properties, but is less effective for mania. This makes it a good choice in my mind, as neither you or your daughter have experienced full-blown mania. I'll also mention that a trial of Lamictal takes a while because you have to start at a very low dose (12.5mg or 25mg) to minimize the risk of a serious side effect called Stevens-Johnson Syndrome. SJS is a life-threatening rash that Lamictal has caused in some people. The risk is quite low, but not something to ignore. 200mg of Lamictal is considered the goal therapeutic dose and it can take 6-8 weeks to get there, depending on the titration schedule your doctor recommends.

Another positive for Lamictal is that it has been studied and approved to treat children with seizures. Although not FDA-approved to treat depression or bipolar disorder in anyone under 18 years, there is evidence it is a safe compound to use in kids.

Any questions, just post.

Best wishes to you and your daughter.

Also, perhaps the enzyme you're thinking of is cytochrome P450 2D6?

> You two are making me broaden my perspective.
>
> Because I had early depression, I've devoted a fair amount of time to reading psych books in an effort to determine just how crazy I am/was. So I have a reasonable understanding of psych diagnoses. I've also had biases regarding bipolar distinctions and only paid attention to full-blown bipolar I -- which I'm certain I do not have, doubt my daughter has, and which a cousin undoubtedly has.
>
> So due to your comments, I've been reading about bipolar II. Had an initial knee-jerk reaction along the lines of "who doesn't have it?" -- but am starting to connect the dots.
>
> I now have no doubt both my daughter and I could easily be dxed with it -- especially me. I wasn't exactly looking for twin diagnoses, but certain pesky similarities are emerging.
>
> At this point, I'm most interested in determining whether such a dx would be helpful. I've been willfully blind to bipolar meds, so I have to get educated. Every respondent has agreed that psych meds can be worse than the disease -- and I agree. But if they help, that's a different story.
>
> I am also trying to sort objective from subjective criteria. Neither of us have ever had anything resembling a Kay-Jamison-type manic. But my daughter's spells of irritability that I've chalked up to PMS could easily be reframed. One of her Sophomore teachers mentioned concern about an episode of irritability, while acknowledging she is far more often regarded as an "easy" kid.
>
> My reaction to SSRIs is indisputable. The standard dose (or even half) guarantees instant trouble. I'm now looking for info about how robust a measure of bipolar that is. A while back I saw some fascinating info here about SSRI sensitivity and one's ability to metabolize a certain enzyme. (Anyone know what I'm talking about? Can't recall the name of the enzyme.) At the time, I concluded I was a non-metabolizer, but bipolar I could explain SSRI sensitivity as well.
>
> Sleep problems abound. I'm aware they're linked to all mood disorders. Long ago, I posited the theory that my internal clock runs on a longer-than-24-hour daily cycle: I can easily both stay awake and sleep longer than most people. Later, I read that is a bipolar trait. Kid has never been a sleeper. Most people would drop dead on her schedule. On the other hand, until recently, she's been uniformly far more stable and higher functioning than I was at her age -- far higher functioning than most kids.
>
> So thanks, I'll keep reading. The big question is whether bipolar I meds are a help or a hindrance: and I guess trial and error is still the only way to know. We are still in a mess, and I thank you all for your support.


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Psycho-Babble Medication | Framed

poster:azalea thread:855985
URL: http://www.dr-bob.org/babble/20081006/msgs/856430.html