Posted by Ron Hill on January 17, 2011, at 13:28:58
In reply to Re: Review my symptoms..., posted by SheilaC on January 16, 2011, at 17:03:38
We have talked in the past. May I throw out a couple of ideas? I'm certainly not an expert. I'm just a BPII pt who found wellness five months ago from my ultra rapid cycling and, as a result, my depressive phase does not occur any more.
My wellness is due to my addition of Valdoxan. Please review my med combo provided at the bottom of this post. Please note that I added a very small amount of Adderal XR because Valdoxan can make me a little sleepy during the day. However, I do not take the p-stim everyday and I may discontinue it soon because I do not think that I need it anymore.
> I am irritable first thing in the morning (especially when I have taken Seroquel or Geodon at night for sleep).
> Main issues are irritability, lack of motivation and slight, lingering depression.
Historical, when I experienced irritability it was always an indication of a serotoninergic problem. Irritability meant I was a quart low on serotonin. <[:-)}}
> Should I really be looking at mood stabilizers and anti-psychotics?
Personally, I have never taken an antipsychotic medication for fear of the possible long-term adverse health consequences. I use AED's for my mood stabilization. But, that's just me. Some pts need AP's.
> My diagnosis is BPII. I do tend to cycle fairly rapidly (feel like I'm on a roller coaster).
Refresh my memory, SheilaC; did you try Valdoxan?
If not, you might want to read the following link for Valdoxan and provide your p-doc with the link. Click on the Doctor button:
> I used to take Seroquel for sleep. Now I take Geodon as my mood stabilizer. No weight gain from it and it seems to work pretty good at keeping me stable. I've tried going up to a higher dose like 80mg, but it still doesn't really help with depression.
Have you ever considered trying Parnate as your antidepressant? Parnate does not work for me, but Nardil works very well. If Parnate does not work for you, then Nardil might. Nardil has weight gain tendencies and sexual side effects for some pts. Pts starting Nardil need to implement a proper diet and exercise program right from the start to avoid weight gain.
> My doc has mentioned to me several times Wellbutrin and I've been afraid of trying it again. I took it several years ago and it made me manic (but I wasn't on any sort of mood stabilizer).
My concern with the addition of only Wellburtin is that it may worsen your irritability. It will most likely give you more motivation due to the norepinphrine. But, the lack of serotonin may make you more irritable.
One of the good things about Parnate or Nardil is that serotonin, norepinephrine, and dopamine levels are all raised.
> Maybe Wellbutrin would be less de-stabilizing than Adderall?
Yes. You are correct.
Add 200 mg/day of Lamictal. Ramp slowly to avoid rash.
Discontinue Geodon and replace with an AED such as Trileptal.
Add 7.5 mg/day of Deplin taken with 5000 mcg/day of sublingual methyl B-12, and 25 mg/day of sublingual P-5-P:
Lastly, you might consider taking the vitamins and supplements listed below. Some of them are a little expensive, but most are not. If I don't take my vitamins and supplements for more than two days in a row, I experience some depression and extreme sleepy-tiredness. But, within a couple hours after re-starting, I become fully well again. It's interesting how profound the improvement is by taking the vitamins and supplements.
Just some thoughts.
dx: Bipolar II and mild OCPD
600 mg/day Trileptal (oxcarbazepine)
200 mg/day Lamictal (lamotrigine)
500 mg/day Keppra (levetiracetam)
90 mg/day Nardil (phenelzine)
12.5 mg at betime Valdoxan (agomelatine)
3.75 mg/day Deplin (taken with 2500 mcg/day of sublingual methyl B-12, and 12.5mg/day of sublingual P-5-P)
2.5 mg/day Adderal XR
45 ml/day of Carlsons Bottled Fish Oil
200 mg/day phosphatidylserene
One Multi-vitamin/day; Only 100% of all the usual vitamins; Look for good chelations. NO VANADIUM!!
2000 IU/day Vitamin D-3
850 mg/day of Mg 212% of RDA (as 5 grams of Mg Malate)
200 mcg/day GTF Chromium
600 mcg/day Chromium Picolinate
200 mg/day Co-Q10
1000 mg/day Cinnamon
480 mg/day Milk Thistle
2 g Vitamin C
Whats next to add?:
NAC, + 8 to 10 glasses of water, + Acetyl-L-Carnitine, + Alpha-Lipoic Acid