Posted by desolationrower on April 27, 2010, at 2:09:58
In reply to Re: Severe anxiety and other problems, posted by Lisa2712 on April 25, 2010, at 12:44:05
> I had tried Lamitrogine for a few days only- it was too stimulating for me; maybe the brand name Lamictal is different? I haven't tried the brand name yet but I found the generic to be very stimulating for me. I don't know if there would be any difference.
> I tried Tegretol for a few months a few years ago and I remember feeling sick the whole time I was on it. I recently tried generic Depakote for about 4 months and it made me extremely tired and I gained a lot of weight on it. I also tried Trileptal in the past- I don't remember it helping me. Yes, with the Depakote my mind wasn't as racy. I was on the lowest dose with Depakote- 500 mg's I think.
> I was told by a few people that lithium causes weight gain and I'm already really overweight so I'm really hesitant to go on it.
> Yes, I had a lot of scary side effects from the 36 mg Concerta I just tried, especially with the heart pain and racing, and I think that dose was too high, my psydoc should have tried me on the lowest dose first, which is 18 mg.
>
> Thank you,
> Lisaso is it the social anxiety the only symptom that is actually bothering you? or do the symptoms of bipolar bother you, outside of social interactions?
tegretol and trileptal are similar, so if one didn't help its not unusual for the other not to either.
Most things that help anxiety/racy thoughts also make you fat. fish oil and topiramate are probably the only things that are good for weight loss and reducing mania both. So I think increasing a benzo for the anxiety once you find something to help with agitation is the best approach.
you haven't tried topiramate? That tends to cause weight loss, so i'd do that, and lithium might be the second option.
Lithium is more often the best for classic bipolar, with clear mania and depression. it sounds like you have most mixed states; depakote is usually the best for that, but it sounds like it didn't help you much. for thinking about what to try, it helps to separate side effects of a medication from how helpful it was. did you find it actually helpful (like, less anxiety, easier to talk to people, good for being productive, etc) and just not worth the side effects, or was the less racing thoughts not actually useful?
i think i would try lithium (after topiramate), at least a moderate dose.
This study indicates lithium causes thirst which causes liquid calories intake, which is what causes hte weight gain. http://www3.interscience.wiley.com/journal/120064093/abstract
but maybe it will be neutral for you. did the depakote not help you much? that is, if it didn't have side effects, would you have been doing well? or did it not really make a big difference.a low dose antipsychotic could help with agitation and negative thoughts, probably risperidone (not over 1mg)
Thats a lot of things to try, i think. i' probably rank them
switch to alprazolam
switch to or add gabapentin/pregabalin
add topiramate
add lithium
maybe try risperdone here
try nardil (this probably will cause some weight gain. if you didn't find depakote much help, maybe try tranylcypromine, which isn't quite as strong against social anxiety)getting enough omega-3, magnesium, and zinc can be done right away
-d/r
poster:desolationrower
thread:944443
URL: http://www.dr-bob.org/babble/20100425/msgs/945237.html