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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Maxime on June 15, 2003, at 15:44:48
Hi, I was just wondering how many people use an anti-psychotic rather a mood stabiliser for BP2. Someone posted said he used Abilify.
I have been on the following anti-psychotics and they didn't work or I had weird side effects to them:
Zyprexa
Risperidone
SeroquelThe reason I am asking is because I am now trying my second to last mood stabiliser - lamictal. If lamictal doesn't work then all I have left is Trileptal.
It would be nice to know of others who have had success with Abilify or another anti-psychotic for treatment of BP2.
FYI I am not a rapid cycler, I suffer more from mixed states.
Thanks.
Max
Posted by indivmed on June 15, 2003, at 17:58:31
In reply to Efficacy of anti psychotics for BP2, posted by Maxime on June 15, 2003, at 15:44:48
Max--I'm also BP II--I tend to rapid cycle. Have you tried combinations of mood stabilizers? Using one mood stabilizer as an adjunct to another (i.e., neurontin which might work well for mixed states) at full dose might make a difference even if alone, they did nothing. One more thing--high-dose fish oil can also help greatly--you would need to take approximately 10 g but it DEFINITELY helps. Make sure that if you do this, you get pharmaceutical grade fish-oil...what you find in health food stores is loaded with impurities and not safe at these high doses.
I took Zyprexa and Risperidone and they flattened me out to the point that I felt more depressed--I tend to have a very strong, opinionated, humorous personality and on anti-psychotics, I don't feel like myself. I stopped taking them altogether and was finally put on Depakote which seems to help with the extent to which I "deviate from base-line." I did add on Neurontin for a while but stopped taking it due to cost.
You could also try taking an AD that has little potential to kick people into hypomania, mixed states, etc. An MAOI might do the trick--they are very safe if you follow the guidelines and are EXTREMELY effective--they get a bad reputation when in actuality, they are the most effective class of AD known. An MAOI could be taken with or without the AD, depending on how extreme your mixed states are--I tend to think "mixed states" is overdiagnosed...usually it's depression and some other issue like an anxiety disorder, ADD or OCD--have you been on anything other than mood stabilizers and anti-psychotics????
Rick
Posted by Maxime on June 15, 2003, at 19:40:15
In reply to Re: Efficacy of anti psychotics for BP2, posted by indivmed on June 15, 2003, at 17:58:31
Hey Rick
I'm already on 80 mg of Parnate - it's a lifesaver.
But my mixed states are getting worse. I have tried every mood stabiliser except for the lamictal I just stated and trileptal. I am a danger to myself during these mixed states which can last a long time. 2 nights ago I cut myself severely in a rage. I'm always suicidal when I am in a mixed state. It's awful.
What would a pharmacist brand of fish be - I am not sure what you meant by that.
Thanks for your help.
Max
Posted by Maxime on June 15, 2003, at 19:44:41
In reply to Re: Efficacy of anti psychotics for BP2- rick, posted by Maxime on June 15, 2003, at 19:40:15
Oh and believe me - mixed states are VERY real.
Max
Posted by indivmed on June 15, 2003, at 22:07:27
In reply to Re: Efficacy of anti psychotics for BP2- rick, posted by Maxime on June 15, 2003, at 19:44:41
Hi Max--
I have no doubt that "mixed states" exist and that they are real...i think the symptoms are totally real and i think I have been through periods where I would be considered in a mixed state--but I think that mixed states are an overlap of two disorders--and should not be classified as a novel type of bipolar disorder. As soon as you throw a label on it, then pdocs have this subconscious list of medications that you SHOULD be on or that SHOULD work instead of really treating the symptoms. I think that gets in the way of people getting better...does that make sense?
I do know that I have had moments where I have turned to a state where I am BEYOND emotionally distraught and will start balling and freaking out to the point that I literally AM going crazy...it is the worst feeling and I can't go anywhere or be anywhere that helps...I just have to ride it out--almost like a panic attack, but a little more on the psychotic side. The last time I had one of these was in the gym...my ex had to get me out of there as quick as possible and take care of me.
I in no way would EVER say to a mentally ill patient that their experience was not real. You're talking to a guy who went into a full-blown psychosis in college where the entire universe made sense and I thought I was Jesus and had died and gone to heaven--they took me to the ER where I was given a nice big shot of Haldol--I was "not right" for an entire month. It was VERY ugly and VERY embarassing.
Anyway, pharmaceutical-grade fish oil can be bought from a few web sites (one being www.searslabs.com). I JUST lent my book concerning pharmaceutical-grade fish oil to a friend, but you should be paying approximately $40 or $50 for a month supply--anything cheaper is not very good and downright dangerous. I will try and get back to you on those websites...give me a day or two.
Have you by any chance been diagnosed as Borderline? I have heard that Clozaril has been used very successfully but MUST be administered by a pdoc that knows what they are doing (very few of those :)). It can help people that are emotionally labile to the point of self-injury. The most I know is to stay away from benzos! I hope some of that helped.
Take care,
Rick
Posted by Maxime on June 16, 2003, at 9:17:10
In reply to Re: Efficacy of anti psychotics for BP2- rick, posted by indivmed on June 15, 2003, at 22:07:27
Thanks for clarifying for me. I have never been diagnosed as borderline, and I don't fit the criteria. I am anorexic though and I know that eating disorders can go hand in hand with cutting.
I don't suffer from any anxiety or OCD either.
I am going to look into the fish oil. I do already take it but I get it from a health food store.
Thanks.
Max
This is the end of the thread.
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