![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 10 to 34 of 60. Go back in thread:
Posted by beardedlady on March 23, 2002, at 6:18:23
In reply to Re: sleeping pills--Bekka, Hattree look!-Beardy, posted by Bekka H. on March 22, 2002, at 20:44:40
No doubt you're correct! I have a DSL for my company (which is at home), so I skip by here a few times a day. That'll have to stop.
But I also love words, and I think Hattree is such a great word because I call my husband "Hair Tree." And since I usually see your name in association with Hattree's, the two naturally went together.
beardy : )>
Posted by jazzdog on March 23, 2002, at 12:34:50
In reply to Re: Lamictal problems already -- any advice?-Jazzd, posted by Bekka H. on March 22, 2002, at 20:37:29
I also take 25 mg of zoloft - was 50, but I'm tapering down and hope to discontinue it altogether. I've been on zoloft for ten years, and I'm sure it contributes to numbing and general malaise. I started out splitting my lamictal evenly between day and night to minimize the rash possibility, but at 100 mg, I started increasing at night only. So now I take 50 mg in the morning and 150 at night. I plan to go up to at least 250, and I hope to switch it all to nighttime for simple ease of remembering.
- Jane
Posted by Emme on March 24, 2002, at 10:14:57
In reply to Re: Lamictal problems already -- any advice?-Emme, posted by Bekka H. on March 22, 2002, at 20:34:32
Hi Bekka,
I feel like a walking pharamacopia. We're using the stratgey of lowish doses of various things because I tend to feel side effects easily. In addition to 75 mg Lamictal I take :
Neurontin, currently 900 mg, though during calmer times, I have slid down to 600. It makes a good subtle background anxiolytic.
Klonopin/clonazepam, which I really like. 0.25-1 mg, but usually around 0.75. I can easily alter the dose depending on need. On those (rare) occasions when I'm really relaxed, I need very little.
Atenolol 25 mg. No side effects for me and great for short circuiting the adrenaline/jitteriness associated with my anxiety.
Seroquel a small dose of 12.5 mg seems okay for me. Though I think I will try it at 6.25 mg and see if that's still enough - it might be. 25 mg is too high - I'm a zombie till noon. :) YMMV
I think the klonopin and the neurontin probably help a bit overall to offset insomnia and jitteriness from the Lamictal, but the seroquel pretty much guarantees some solid sleep. Taking klonopin at night didn't seem to help enough, but if I weren't using seroquel, then I suppose my next strategy might be to bump up my overall klonopin dose by trying extra at night and see how that worked.
Emme
> Hi Emme,
>
> Thank you for your advice. May I ask whether you take anything else besides the Lamictal and Seroquel? How much Seroquel do you take?
>
> Bekka
Posted by Cindylou on March 24, 2002, at 14:55:24
In reply to Re: Lamictal problems already -- any advice?-Emme » Bekka H., posted by Emme on March 24, 2002, at 10:14:57
Hi fellow Lamictal takers!
I've been on a psycho-babble holiday, but just checked back in.First, Bekka, like the others mentioned, I also experienced agitation every time I titrated up on the Lamictal (this included difficulty with sleep). For me, a small dose of Serzone helped (just 50 mg), and a very small dose of Klonapin helped me sleep -- still does when I need it. (I only take a quarter of a .25 mg tablet.) I am extremely med-senstive, so all my doses are very low. Anyway, the agitation went away for the most part once I stabilized on the Lamictal.
NOW, however, my depression is back, so is anxiety and obsessive thoughts (kept picturing my 2-year-old drowning in the pool, or getting carried away by a wave in Florida. I was constantly on guard to rescue her. Very scary).
I am looking for some help and advice. I can't tolerate most meds, so it's pretty complicated. I've been trying small doses of Prozac periodically -- like 2 mg a day for a few days, then stop for a few days (Hattree, you and I discussed this at one point.) It might be helping a BIT, but not much. Even at that low of a dose I get fatigued and spacy.
I'm looking for options that won't cause much fatigue or side effects. I'm curious about Neurontin and the MAOIs. If I tried these, would I keep up with the Lamcital? I've tried most everything else, it seems -- everything but mood stabilizers (Lamictal is the only one I've tried) and MAOIs. Can't tolerate the SSRIs, stimulants, tricyclics, APs.
Thanks in advance for any help!! And I hope you are all doing well.
Cindy
Posted by Bekka H. on March 24, 2002, at 22:37:31
In reply to Re: Lamictal - bekka, hattree, emme, jane, etc. , posted by Cindylou on March 24, 2002, at 14:55:24
Hi Cindy Lou.
Thanks so much for your help. It's good to have you back. Like you, I have a really hard time with medication combinations, and I have to take very low doses or else I get sick. My doctor said I'm a "poor metabolizer" or "slow metabolizer" or something like that.
I am also interested to find out more about Neurontin. I'll try to get more info. and I'll let you know.
Bekka
Posted by Emme on March 25, 2002, at 7:58:24
In reply to Re: Lamictal - bekka, hattree, emme, jane, etc. , posted by Cindylou on March 24, 2002, at 14:55:24
Hi Cindylou,
To answer your curiousity about neurontin, I personally find it one of the easiest drugs I've tried. I seem to have no side effects except it being a bit sedating if I take a higher dose than I really need. (YMMV of course.) I have found it very easy to increase or decrease the dosage - no side effects on that count. It's anxiolytic effects are more subtle for me than a benzo. If you want an anxiolytic that won't knock you out, I'd say give neurontin a try. (Do I sound like an advertisement or what? :)
Sorry I don't have any good suggestions on the depression. Can you deal with inching the lamictal up and see if that helps? I've inched up in 5 mg/week increments - they make 5 mg tablets.
Emme> Hi fellow Lamictal takers!
> I've been on a psycho-babble holiday, but just checked back in.
>
> First, Bekka, like the others mentioned, I also experienced agitation every time I titrated up on the Lamictal (this included difficulty with sleep). For me, a small dose of Serzone helped (just 50 mg), and a very small dose of Klonapin helped me sleep -- still does when I need it. (I only take a quarter of a .25 mg tablet.) I am extremely med-senstive, so all my doses are very low. Anyway, the agitation went away for the most part once I stabilized on the Lamictal.
>
> NOW, however, my depression is back, so is anxiety and obsessive thoughts (kept picturing my 2-year-old drowning in the pool, or getting carried away by a wave in Florida. I was constantly on guard to rescue her. Very scary).
>
> I am looking for some help and advice. I can't tolerate most meds, so it's pretty complicated. I've been trying small doses of Prozac periodically -- like 2 mg a day for a few days, then stop for a few days (Hattree, you and I discussed this at one point.) It might be helping a BIT, but not much. Even at that low of a dose I get fatigued and spacy.
>
> I'm looking for options that won't cause much fatigue or side effects. I'm curious about Neurontin and the MAOIs. If I tried these, would I keep up with the Lamcital? I've tried most everything else, it seems -- everything but mood stabilizers (Lamictal is the only one I've tried) and MAOIs. Can't tolerate the SSRIs, stimulants, tricyclics, APs.
>
> Thanks in advance for any help!! And I hope you are all doing well.
> Cindy
Posted by Cindylou on March 25, 2002, at 14:39:57
In reply to Re: Lamictal - bekka, hattree, emme, jane, etc. » Cindylou, posted by Emme on March 25, 2002, at 7:58:24
Hi Emme,
Thanks for the information on Neurontin ... it definitely sounds worth a try.A few questions for you ... do you take Lamictal with the Neurontin? And what dose of Neurontin are you on? I think I recall you were sensitive to meds, like I am.
Thanks also for the tip on Lamictal -- I wasn't aware that they made 5 mg tablets... sounds perfect for me!
Take care, cindy
> Hi Cindylou,
>
> To answer your curiousity about neurontin, I personally find it one of the easiest drugs I've tried. I seem to have no side effects except it being a bit sedating if I take a higher dose than I really need. (YMMV of course.) I have found it very easy to increase or decrease the dosage - no side effects on that count. It's anxiolytic effects are more subtle for me than a benzo. If you want an anxiolytic that won't knock you out, I'd say give neurontin a try. (Do I sound like an advertisement or what? :)
>
> Sorry I don't have any good suggestions on the depression. Can you deal with inching the lamictal up and see if that helps? I've inched up in 5 mg/week increments - they make 5 mg tablets.
> Emme
>
> > Hi fellow Lamictal takers!
> > I've been on a psycho-babble holiday, but just checked back in.
> >
> > First, Bekka, like the others mentioned, I also experienced agitation every time I titrated up on the Lamictal (this included difficulty with sleep). For me, a small dose of Serzone helped (just 50 mg), and a very small dose of Klonapin helped me sleep -- still does when I need it. (I only take a quarter of a .25 mg tablet.) I am extremely med-senstive, so all my doses are very low. Anyway, the agitation went away for the most part once I stabilized on the Lamictal.
> >
> > NOW, however, my depression is back, so is anxiety and obsessive thoughts (kept picturing my 2-year-old drowning in the pool, or getting carried away by a wave in Florida. I was constantly on guard to rescue her. Very scary).
> >
> > I am looking for some help and advice. I can't tolerate most meds, so it's pretty complicated. I've been trying small doses of Prozac periodically -- like 2 mg a day for a few days, then stop for a few days (Hattree, you and I discussed this at one point.) It might be helping a BIT, but not much. Even at that low of a dose I get fatigued and spacy.
> >
> > I'm looking for options that won't cause much fatigue or side effects. I'm curious about Neurontin and the MAOIs. If I tried these, would I keep up with the Lamcital? I've tried most everything else, it seems -- everything but mood stabilizers (Lamictal is the only one I've tried) and MAOIs. Can't tolerate the SSRIs, stimulants, tricyclics, APs.
> >
> > Thanks in advance for any help!! And I hope you are all doing well.
> > Cindy
Posted by Cindylou on March 25, 2002, at 14:43:05
In reply to Re: Lamictal - Cindy Lou. , posted by Bekka H. on March 24, 2002, at 22:37:31
Hi Bekka,
Thanks for offering to look into the Neurontin for me! It's good to be back :-)Hope you slept okay last night ... keep me posted on how you're doing!
By the way, did you try Dexedrine yet? If so, how did you tolerate it? That's the only stimulant I haven't tried ... since we both seem to have the same "low metabolism" issue, it's good to compare notes.
Thanks again,
cindy
> Hi Cindy Lou.
>
> Thanks so much for your help. It's good to have you back. Like you, I have a really hard time with medication combinations, and I have to take very low doses or else I get sick. My doctor said I'm a "poor metabolizer" or "slow metabolizer" or something like that.
>
> I am also interested to find out more about Neurontin. I'll try to get more info. and I'll let you know.
>
> Bekka
Posted by jazzdog on March 25, 2002, at 19:04:04
In reply to Re: Lamictal - bekka, hattree, emme, jane, etc. , posted by Cindylou on March 24, 2002, at 14:55:24
Hi CindyLou -
Have you considered a higher dose of Lamictal? I know you only tolerate and need small doses, but perhaps it's worth another shot. I know that at around 125 mg or so, I experienced real relief from mild obsessive thoughts (unable to clean the sink without cleaning the whole house, that sort of thing).
Just a thought.
- Jane
Posted by Cindylou on March 25, 2002, at 19:26:55
In reply to Re: Lamictal - bekka, hattree, emme, jane, etc. , posted by jazzdog on March 25, 2002, at 19:04:04
Hi Jane,
I have been toying with the idea of trying to increase the Lamictal again. I did get up to 125 mg at one point, but felt really lousy -- very bloated (had to buy new pants!), tired, etc. I'm not convinced it was the Lamictal, though ... You're right, it could be worth a shot.Emme mentioned that Lamictal comes in 5 mg tablets ... that would be the best way for me to go ... increase very slowly and see where I get relief.
Thanks for the advice! By the way, are you the Jane who was pregnant while on Lamictal? If so, how are things going for you? If not, just disregard!
Cindy
> Hi CindyLou -
>
> Have you considered a higher dose of Lamictal? I know you only tolerate and need small doses, but perhaps it's worth another shot. I know that at around 125 mg or so, I experienced real relief from mild obsessive thoughts (unable to clean the sink without cleaning the whole house, that sort of thing).
>
> Just a thought.
>
> - Jane
Posted by Peter S. on March 25, 2002, at 20:35:16
In reply to Re: Lamictal problems already -- any advice?-Emme » Bekka H., posted by Emme on March 24, 2002, at 10:14:57
Just thought I'd add my experience that Mirapex (I take only .25 mg/day) has helped greatly with fatigue from Prozac- caused by dopamine depletion?
Best of luck,
Peter
Posted by Emme on March 26, 2002, at 8:41:36
In reply to Re: Lamictal /Neurontin » Emme, posted by Cindylou on March 25, 2002, at 14:39:57
Cindy,
> A few questions for you ... do you take Lamictal with the Neurontin?
Yeah, in the morning and evening, with an additional dose of Neurontin in the afternoon.
> And what dose of Neurontin are you on? I think I recall you were sensitive to meds, like I am.
I take a total of 900 mg/day right now. At calmer times I've done okay with 600 mg. Right now I'm really stressed out, so I'm considering trying to go up to 1200 mg - either that or up my klonopin dose for a while. Yeah, I'm pretty sensitive to meds. So with everything I start low and inch up.
> Thanks also for the tip on Lamictal -- I wasn't aware that they made 5 mg tablets... sounds perfect for me!Yeah, and they're orange flavored. :) Made for kids I'm sure. I had a couple of rashes the first time I tried Lamictal despite following the titration recommendations. So for the rechallenge, we got the 5 mg tablets and did a very very slow titration.
cheers,
Emme
> Take care, cindy
>
>
> > Hi Cindylou,
> >
> > To answer your curiousity about neurontin, I personally find it one of the easiest drugs I've tried. I seem to have no side effects except it being a bit sedating if I take a higher dose than I really need. (YMMV of course.) I have found it very easy to increase or decrease the dosage - no side effects on that count. It's anxiolytic effects are more subtle for me than a benzo. If you want an anxiolytic that won't knock you out, I'd say give neurontin a try. (Do I sound like an advertisement or what? :)
> >
> > Sorry I don't have any good suggestions on the depression. Can you deal with inching the lamictal up and see if that helps? I've inched up in 5 mg/week increments - they make 5 mg tablets.
> > Emme
> >
> > > Hi fellow Lamictal takers!
> > > I've been on a psycho-babble holiday, but just checked back in.
> > >
> > > First, Bekka, like the others mentioned, I also experienced agitation every time I titrated up on the Lamictal (this included difficulty with sleep). For me, a small dose of Serzone helped (just 50 mg), and a very small dose of Klonapin helped me sleep -- still does when I need it. (I only take a quarter of a .25 mg tablet.) I am extremely med-senstive, so all my doses are very low. Anyway, the agitation went away for the most part once I stabilized on the Lamictal.
> > >
> > > NOW, however, my depression is back, so is anxiety and obsessive thoughts (kept picturing my 2-year-old drowning in the pool, or getting carried away by a wave in Florida. I was constantly on guard to rescue her. Very scary).
> > >
> > > I am looking for some help and advice. I can't tolerate most meds, so it's pretty complicated. I've been trying small doses of Prozac periodically -- like 2 mg a day for a few days, then stop for a few days (Hattree, you and I discussed this at one point.) It might be helping a BIT, but not much. Even at that low of a dose I get fatigued and spacy.
> > >
> > > I'm looking for options that won't cause much fatigue or side effects. I'm curious about Neurontin and the MAOIs. If I tried these, would I keep up with the Lamcital? I've tried most everything else, it seems -- everything but mood stabilizers (Lamictal is the only one I've tried) and MAOIs. Can't tolerate the SSRIs, stimulants, tricyclics, APs.
> > >
> > > Thanks in advance for any help!! And I hope you are all doing well.
> > > Cindy
Posted by Emme on March 26, 2002, at 8:45:27
In reply to Emme- Mirapex for Prozac induced fatigue, posted by Peter S. on March 25, 2002, at 20:35:16
Peter,
Thanks for the input. But I've never actually taken prozac - I think this post was headed for someone else.
cheers,
Emme> Just thought I'd add my experience that Mirapex (I take only .25 mg/day) has helped greatly with fatigue from Prozac- caused by dopamine depletion?
>
> Best of luck,
>
> Peter
Posted by Cindylou on March 26, 2002, at 10:59:32
In reply to Emme- Mirapex for Prozac induced fatigue, posted by Peter S. on March 25, 2002, at 20:35:16
Hi Peter,
I think this post was meant for me -- I have a bad time with Prozac, including fatigue, and I can barely tolerate teeny doses (like 2 mg!!)I am interested in this Mirapex ... can it help with general depression-caused fatigue, too? Or is it mainly used to help medication-induced fatigue? I would love to discuss this option with my pdoc, since I can't handle stimulants.
Any more information you could give me would be great!!
Thanks,
cindy> Just thought I'd add my experience that Mirapex (I take only .25 mg/day) has helped greatly with fatigue from Prozac- caused by dopamine depletion?
>
> Best of luck,
>
> Peter
Posted by Hattree on March 26, 2002, at 11:59:22
In reply to Re: Lamictal problems already -- any advice?, posted by Bekka H. on March 22, 2002, at 20:31:30
Still on Lamictal and Neurontin (and stimulants), still off Zo. I take one 300mg neurontin once or twice during the day, sometimes 600mg if anxious, and 600 at bedtime. You might want to get some 100mg caps to start. The first night I took 100mg and felt very relaxed and floaty. That passes, tho.
Posted by Hattree on March 26, 2002, at 12:04:05
In reply to Re: Emme- Mirapex for Prozac induced fatigue » Peter S., posted by Cindylou on March 26, 2002, at 10:59:32
I was wondering how you were doing. I think Neurontin is a great choice for the med-sensitive.
Posted by Cindylou on March 26, 2002, at 21:07:19
In reply to Re: Lamictal - bekka, hattree, emme, jane, etc. , posted by Cindylou on March 24, 2002, at 14:55:24
Hi everyone,
I've been following some of the threads about SAMe ... was wondering if any of you have tried it, or know any reason why NOT to try it (especially while on Lamictal) ... We all seem to have similarities in our med reactions, so was just curious if you've tried SAM-e, or have any information on it.It sounds very tempting from the threads I've been reading, but I have learned the hard way that
these things are often too good to be true...Thanks for your help. Hope you are all doing well!
cindy
Posted by Bekka H. on March 26, 2002, at 23:32:58
In reply to Re: bekka, hattree, emme, jane, etc. - SAMe?, posted by Cindylou on March 26, 2002, at 21:07:19
Hi Cindy,
I would have to give SAMe a fair trial. I've only tried it twice in my life, and each time was for only one day. I remember feeling kind of strange and detached the first time (I was also on 10 mg Dex), and I wasn't aware of feeling anything the second time. I'd like to try it some time when I'm not on anything else, and I'd like to try it for a few days - at least. I'm also interested in the Omega-3 Fatty Acids. I take them every day, but I don't notice any change in mood. I continue to take them because I read how healthy they are, but perhaps I should just eat more fish!
Bekka
Posted by Bekka H. on March 27, 2002, at 0:28:56
In reply to Re: - SAMe? Cindy Lou, posted by Bekka H. on March 26, 2002, at 23:32:58
P.S. By the way, my cats really like the Omega-3 Fatty Acids. Their fur is so shiny since I've been giving it to them! The vet gave me some that is formulated especially for pets.
Posted by Hattree on March 27, 2002, at 9:54:25
In reply to Re: bekka, hattree, emme, jane, etc. - SAMe?, posted by Cindylou on March 26, 2002, at 21:07:19
Sam didn't do a thing for me. Wouldn't guess it would be a problem with Lamictal, though.
Posted by Emme on March 28, 2002, at 6:58:03
In reply to Re: bekka, hattree, emme, jane, etc. - SAMe?, posted by Cindylou on March 26, 2002, at 21:07:19
Posted by Ron Hill on March 31, 2002, at 10:32:59
In reply to Re: bekka, hattree, emme, jane, etc. - SAMe?, posted by Cindylou on March 26, 2002, at 21:07:19
Cindy,
SAM-e saved my life, but your mileage may vary.
-- Ron
--------------------------------------> Hi everyone,
> I've been following some of the threads about SAMe ... was wondering if any of you have tried it, or know any reason why NOT to try it (especially while on Lamictal) ... We all seem to have similarities in our med reactions, so was just curious if you've tried SAM-e, or have any information on it.
>
> It sounds very tempting from the threads I've been reading, but I have learned the hard way that
> these things are often too good to be true...
>
> Thanks for your help. Hope you are all doing well!
> cindy
Posted by Cindylou on April 8, 2002, at 20:10:44
In reply to Re: bekka, hattree, emme, jane, etc. - SAMe? » Cindylou, posted by Ron Hill on March 31, 2002, at 10:32:59
Hi Ron,
I apologize for not getting back to you sooner (I was out of town for 10 days, at my in-laws. UGH)I appreciate your response, and I'm glad to hear SAM-e worked so well for you. I remember seeing a long thread where you discuss your success with SAM-e, but if you don't mind I'll still throw out some questions to you ...
1. what is your diagnosis?
2. are you on other meds?
3. did SAM-e have side effects for you?
4. have you tried the Omega 3 fatty acids? My pdoc just mentioned that to me as a possible option, but neither one of us have much info. on it. I remember seeing a thread about that, too -- I'll have to get busy researching those posts!I was able to post a quick question to Dr. Kramer while I as away about SAM-e, and he said he wouldn't recommend it for bipolar -- I was recently diagnosed as BPII (however, I'm a bit skeptical about that diagnosis. Depression, definitely. Anxiety, definitely. Bipolar? I don't know.)
Well, thanks again for your response!
-cindy
> Cindy,
>
> SAM-e saved my life, but your mileage may vary.
>
> -- Ron
> --------------------------------------
>
> > Hi everyone,
> > I've been following some of the threads about SAMe ... was wondering if any of you have tried it, or know any reason why NOT to try it (especially while on Lamictal) ... We all seem to have similarities in our med reactions, so was just curious if you've tried SAM-e, or have any information on it.
> >
> > It sounds very tempting from the threads I've been reading, but I have learned the hard way that
> > these things are often too good to be true...
> >
> > Thanks for your help. Hope you are all doing well!
> > cindy
Posted by Ron Hill on April 9, 2002, at 14:11:35
In reply to Re: SAMe? » Ron Hill, posted by Cindylou on April 8, 2002, at 20:10:44
>I remember seeing a long thread where you discuss your success with SAM-e, but if you don't mind I'll still throw out some questions to you ...
> 1. what is your diagnosis?
Hi Cindylou. My dx is BP II.
> 2. are you on other meds?
600 mg/day Lithobid and 200 mg/day SAM-e.
> 3. did SAM-e have side effects for you?
Slight nausea at times.
> 4. have you tried the Omega 3 fatty acids? My pdoc just mentioned that to me as a possible option, but neither one of us have much info. on it. I remember seeing a thread about that, too -- I'll have to get busy researching those posts!
I take salmon oil capsules and flax seed oil capsules and I try to eat a diet high in omega-3 Poly Unsaturated Fatty Acids (PUFA's). For me, omega-3 PUFA supplementation provides a slightly beneficial mood stabilizing effect, but nothing profound. By contrast, I take 500 mg/day of phosphatidylserine (PS) complex (containing 100 mg of PS) and the mood stabilizing effect of PS is, for me, much more profound than that of omega-3 PUFA's. Unfortunately, PS is expensive (about one dollar per 500 mg capsule).
As an aside, I am convinced that phospholipids play a central role in cell membrane plasticity and, as a result, contribute to improved mental health. IMHO, SAM-e's beneficial effects are partially attributable to SAM-e acting as a methyl donor in the synthesis of phospholipids. While, I believe that the primary reason for the effectiveness of SAM-e is that it serves as a methyl donor in the synthesis of neurotransmitters, I think that the phospholipids aspect is important as well. Click the link below if you care to read an article related to this topic.
http://www.immunesupport.com/news/SAMe2txt.htm
> I was able to post a quick question to Dr. Kramer while I as away about SAM-e, and he said he wouldn't recommend it for bipolar -- I was recently diagnosed as BPII (however, I'm a bit skeptical about that diagnosis. Depression, definitely. Anxiety, definitely. Bipolar? I don't know.)
I have been following your posts for about the last month or so and, therefore, I am familiar with what you wrote to Dr. K and his response. I wanted to respond to his post to you, but I decided that Dr. K was already too busy and that he did not need another input from me. I disagree with Dr. K's post to you in so much as I believe SAM-e is safe for bipolars PROVIDED the patient is taking an adequate dose of a mood stabilizer and is under the care of a good pdoc.
As I've read your posts over the past month, I have always thought that you would be a good candidate for a SAM-e trial. However, as I see in a thread below, you are discontinuing your mood stabilizer (Lamictial) during pregnancy. If in fact you are bipolar, then I would not recommend that you take SAM-e without a mood stabilizer (MS) fully in place because it may induce mania (or hypomania). At the same time, feeding a BP patient an AD (a TCA in your case) without a MS in place can also induce mania (or hypomania). Is the pdoc that gave you the BP dx the same pdoc prescribing the TCA in the absence of a MS? If so, I'd have real concerns regarding the pdoc.
If I were you, the first thing I would do is find out if the BP II dx is accurate. See another pdoc and get a second opinion. Also, as a screening tool, you might take the following online diagnostic test. It cost ten bucks, but I think it is worth the small fee. If you can, have your husband (or a very close friend) sit next to you while you take the test to provide an objective opinion of your answers.
http://www.mentalhealth.com/fr71.html
-- Ron
Posted by Cindylou on April 9, 2002, at 21:04:21
In reply to Re: SAM-e and BP II » Cindylou, posted by Ron Hill on April 9, 2002, at 14:11:35
Hi Ron,
Thanks again for your helpfulness. I am interested in taking that online screening, but was a bit confused when I checked out the link. I couldn't find the actual screening test. Do I need to pay the $10 first, in order to "subscribe" to their services, and then I'll have access to the test?As far as my pdoc prescribing the tricyclic -- she is also the one who believes that I am bipolar II. We were both in a quandry over what to do ... since no mood stabilizer that we know of is safe during pregnancy.
Since depression is my predominant issue, she thought the nortriptyline would be worth a try -- and she did mention the Omega 3 fatty acids being a possiblity for stabilizing moods (although she didn't know much about it -- said I would need to take 5 grams, but that's about it.)
I wonder if SAM-e and Omega 3 could work together without a med? I'm not sure if SAM-e is safe during pregnancy, though.
I will probably be moving to Pennsylvania in the next month or two, so I am in the market for a new pdoc -- I am looking forward to another opinion; a fresh set of eyes.
I am planning to start a thread about psychiatrists vs. psychopharmacologists ... is one better than the other?
Thanks again, Ron. You've been a great help!
cindy
> >I remember seeing a long thread where you discuss your success with SAM-e, but if you don't mind I'll still throw out some questions to you ...
>
> > 1. what is your diagnosis?
>
> Hi Cindylou. My dx is BP II.
>
> > 2. are you on other meds?
>
> 600 mg/day Lithobid and 200 mg/day SAM-e.
>
> > 3. did SAM-e have side effects for you?
>
> Slight nausea at times.
>
> > 4. have you tried the Omega 3 fatty acids? My pdoc just mentioned that to me as a possible option, but neither one of us have much info. on it. I remember seeing a thread about that, too -- I'll have to get busy researching those posts!
>
> I take salmon oil capsules and flax seed oil capsules and I try to eat a diet high in omega-3 Poly Unsaturated Fatty Acids (PUFA's). For me, omega-3 PUFA supplementation provides a slightly beneficial mood stabilizing effect, but nothing profound. By contrast, I take 500 mg/day of phosphatidylserine (PS) complex (containing 100 mg of PS) and the mood stabilizing effect of PS is, for me, much more profound than that of omega-3 PUFA's. Unfortunately, PS is expensive (about one dollar per 500 mg capsule).
>
> As an aside, I am convinced that phospholipids play a central role in cell membrane plasticity and, as a result, contribute to improved mental health. IMHO, SAM-e's beneficial effects are partially attributable to SAM-e acting as a methyl donor in the synthesis of phospholipids. While, I believe that the primary reason for the effectiveness of SAM-e is that it serves as a methyl donor in the synthesis of neurotransmitters, I think that the phospholipids aspect is important as well. Click the link below if you care to read an article related to this topic.
>
> http://www.immunesupport.com/news/SAMe2txt.htm
>
> > I was able to post a quick question to Dr. Kramer while I as away about SAM-e, and he said he wouldn't recommend it for bipolar -- I was recently diagnosed as BPII (however, I'm a bit skeptical about that diagnosis. Depression, definitely. Anxiety, definitely. Bipolar? I don't know.)
>
> I have been following your posts for about the last month or so and, therefore, I am familiar with what you wrote to Dr. K and his response. I wanted to respond to his post to you, but I decided that Dr. K was already too busy and that he did not need another input from me. I disagree with Dr. K's post to you in so much as I believe SAM-e is safe for bipolars PROVIDED the patient is taking an adequate dose of a mood stabilizer and is under the care of a good pdoc.
>
> As I've read your posts over the past month, I have always thought that you would be a good candidate for a SAM-e trial. However, as I see in a thread below, you are discontinuing your mood stabilizer (Lamictial) during pregnancy. If in fact you are bipolar, then I would not recommend that you take SAM-e without a mood stabilizer (MS) fully in place because it may induce mania (or hypomania). At the same time, feeding a BP patient an AD (a TCA in your case) without a MS in place can also induce mania (or hypomania). Is the pdoc that gave you the BP dx the same pdoc prescribing the TCA in the absence of a MS? If so, I'd have real concerns regarding the pdoc.
>
> If I were you, the first thing I would do is find out if the BP II dx is accurate. See another pdoc and get a second opinion. Also, as a screening tool, you might take the following online diagnostic test. It cost ten bucks, but I think it is worth the small fee. If you can, have your husband (or a very close friend) sit next to you while you take the test to provide an objective opinion of your answers.
>
> http://www.mentalhealth.com/fr71.html
>
> -- Ron
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.