![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by AzureBay on March 12, 2004, at 21:26:28
Hi All,
I'm fairly new here. It's obvious that most of you really know your stuff, so I would appreciate some of your excellent advice on my med cocktail.
MY BACKGROUND - I was initially diagnosed with ADD of the inattentive type about 5 years ago. The neurostimulants worked well. After several months I began to notice sub-layer symptoms that I believe were there all along, probably since childhood. These included depression and severe anxiety. Interestingly, the neurostims made improvements on both. But, what I'm getting at is that I essentially became more "AWARE" of them as my ADD symptoms got under control.
I was then treated with the typical gambit of AD's - tried every damn one of them, and never really got good results except with Celexa in low doses. At this point, Xanax was added into the mix, along with Atenolol for some essential tremors from the ADD med.
About a year ago I arrived at point where I felt I was getting no better. I honestly felt disabled most of the time, despite the fact that the neurostim meds allowed me more focus. It was through researching online that a light went on, and I came to the conclusion that I was likely BIPOLAR II. I fit the criteria to a tee on every test.
So, back to the pdoc I went, and he hesitantly agreed with me at first. We started trials of several drugs over the course of the next months, including Lithobid, Zyprexa, Geodon, Gabatril and several others whose names I forget at the moment. I had the best results with Zyprexa and Lithobid, but the side-effects were simply NASTY - weight gain and all that. Hell, I'll bet I gained 30 lbs just from picking up the prescription of Zyprexa lol.
This brings us to the present.
MY MED COCKTAIL NOW IS AS FOLLOWS:
Ritalin 20mg tid
Aricept 10mg
Abilify 10mg
Celexa 20mg
Atenolol 50mg
Klonopin 1mg tid/prn
and some experimentation with PicamilonNow I'll tell you what's wrong with this picture. Something is just a little bit off in this mix. My hunch is that it's the Celexa because there is an all-to-common apathy that's been going on way before I started Abilify or Klonopin. My libido is also pretty much limp, pardon the expression, and my creativity is dampened. I'm unmotivated and unproductive. I'm not really severely depressed at the moment, but I do have highs and lows. Anxiety is a definite issue.
Guys, believe me I've tried discontining them one at a time, all but the Celexa, and it's the only one constant that seems to be a likely culprit. Besides, I feel as if it interferes with the Abilify for some reason. I've also experimented with adding Lithium to this combo with very mediocre results.
So... what are you honest thoughts on this medication combo? Do any of you see any interactions that throw up a red flag? Do you believe I'm correct about the Celexa being part of the big problem or is it something else? How does the Abilify fit in with my ADD med?
I have had mild manic episodes while on the Celexa in this mix, and I tend to do outrageous things off and on, like spending too much or gambling - just stupid things that I later regret.
If I had to keep 2 drugs and toss the others they would be the Ritalin and the Klonopin. Both seem very effective. But something else in the mix is just not working right. And I don't get the bipolar problem addressed with those two meds alone, so I'm back to square one.
Have any of you with Bipolar II had good results with Abilify? Are any of you both ADD and Bipolar II?
Your thoughts and help with this are deeply appreciated.
Be well and thanks,
Azure
Posted by HappyGirl on March 13, 2004, at 1:41:40
In reply to Expert Opinions Please on My ADD/BPII Med Cocktail, posted by AzureBay on March 12, 2004, at 21:26:28
Hi:
It sounds to me like you're quite happy about 'Ritalin' and 'Ability,' but those two meds. are 'Stimulant.' Normally, if you're Bp, it's better to 'avoid' any stimulating effects because those form of med. brings up 'hypomania,' as you might already know.
Besides this, Bipolar and ADD goes hand in hand that is most of cases, but there is always exception.
Your pdoc. might NOT totally agree with your self-dx'ed Bipolar as seeing med. combo., especially 'Ritalin,' about which you have no suspiction, however. Ritalin is exclusively for ADD/ADDH, ... with some exception. Just few of Bps taking, but I just wonder how that affects their symptoms on their later days.
Also, if you're dx'ed with Bipolar, the very first thing is a mood-stabilizer, such as Depakote, Lithium, Lamical and more to list. Then, for me as Bp II, it's quite confusing to analyze your med. combo. Mostly, your pdoc. might think you're still ADD with slight Bp, thus he/she still keeps you on 'Ritalin?' Because, if you're truly Bipolar II, Ritalin and Ability combo. is a way 'stimulant' not to able to sleep during the night, in my guess. Just Abilify must be enough, if you're Bp. Other med. Klonopin might alleviate your insomnia from those two med., however.
Celexa is one of SSRIs that causes sexual disfunction, I believe.
Lastly, Zyprexa and Lithium, both meds. are one of top lists in regard to the effectiveness, although Zyprexa causes weight issue among some of its takers.
Not only you but most of Bp folks take quite awhile to find a right med. combo. It's very unfortunate to have Bipolor, but you may need more time and patience along with frequent trips to your pdoc. in order to find a right med. combo. that alleviates your symptoms.
In my case, it took almost two years to find a good med. combo., but still NOT 'perfect,' about 85-90% in normalcy.
Hopefully more insightful opinion coming to your med. combo. question.
H.G.
Posted by Azurebay on March 13, 2004, at 13:04:19
In reply to Re: Expert Opinions Please on My ADD/BPII Med Cocktail, posted by HappyGirl on March 13, 2004, at 1:41:40
Thanks, happygirl for your insight. Yes, I have found that the stimulants are sometimes a bit much. The problem is that they help the ADD sooooooooooo much that it's hard to give them up. I think that's why my doc wants to keep me on them.
May I ask what works for you? I'm curious if you or anyone else has had experience with Abilify and Bipolar II. So far I really like it, but as I said my hunch is that it's the Celexa causing the problem and not the other meds.
Your response is really appreciated.
Azure
> Hi:
> It sounds to me like you're quite happy about 'Ritalin' and 'Ability,' but those two meds. are 'Stimulant.' Normally, if you're Bp, it's better to 'avoid' any stimulating effects because those form of med. brings up 'hypomania,' as you might already know.
> Besides this, Bipolar and ADD goes hand in hand that is most of cases, but there is always exception.
> Your pdoc. might NOT totally agree with your self-dx'ed Bipolar as seeing med. combo., especially 'Ritalin,' about which you have no suspiction, however. Ritalin is exclusively for ADD/ADDH, ... with some exception. Just few of Bps taking, but I just wonder how that affects their symptoms on their later days.
>
> Also, if you're dx'ed with Bipolar, the very first thing is a mood-stabilizer, such as Depakote, Lithium, Lamical and more to list. Then, for me as Bp II, it's quite confusing to analyze your med. combo. Mostly, your pdoc. might think you're still ADD with slight Bp, thus he/she still keeps you on 'Ritalin?' Because, if you're truly Bipolar II, Ritalin and Ability combo. is a way 'stimulant' not to able to sleep during the night, in my guess. Just Abilify must be enough, if you're Bp. Other med. Klonopin might alleviate your insomnia from those two med., however.
> Celexa is one of SSRIs that causes sexual disfunction, I believe.
> Lastly, Zyprexa and Lithium, both meds. are one of top lists in regard to the effectiveness, although Zyprexa causes weight issue among some of its takers.
> Not only you but most of Bp folks take quite awhile to find a right med. combo. It's very unfortunate to have Bipolor, but you may need more time and patience along with frequent trips to your pdoc. in order to find a right med. combo. that alleviates your symptoms.
> In my case, it took almost two years to find a good med. combo., but still NOT 'perfect,' about 85-90% in normalcy.
> Hopefully more insightful opinion coming to your med. combo. question.
> H.G.
Posted by HappyGirl on March 13, 2004, at 15:22:03
In reply to Re: Expert Opinions Please on My ADD/BPII Med Cocktail, posted by Azurebay on March 13, 2004, at 13:04:19
Hi:
I've been on 5 mg. Zyprexa, 900 mg. Lithium, Wellbutrin SR 300-400 mg. and occasionally using Serzone for 'good night sleep.' As I said in my previous post, this med. combo. offerring me a great deal of relief, ... but I'm still VERY cautious NOT to get into any stressful situation, such as any new environment, even new neighbor makes me stressful, not to the extent I get nervous, but more than normal reaction that non-Bipolars exhibit.In regard to Abilify, I've never been on, ... but in my knowledge from other's experience, this med. is one of newer form of anti-psycho.meds. and has some anti-depressant effect, thus some of Bipolars taking Abilify alone, a sort of 'All-in-One' med. regimen. But, ... for me, it's quite scary thing to do.
In my guess, the reason why your pdoc. keeps you on Ritalin is because he/she believes you need this med. for your productive activities. In most of cases, those pdocs. are willing to rx some of meds., including Ritalin if his/her patients persistently asking in favour for your emotional well-being or circumstantial reason, ... in my guess. Especially, those who need a great amount of concentration, either on study or at work. Not everyone afford to sacrifice their productivity for the sake of Bipolar. This is my personal opinion based on the experience along with other Bps.'s words.Lastly, if you suspect about Celexa, then try to get the dosage down gradually to completely eliminate this med., as long as you think you can live without Celexa. Normally, for Bp II, any SSRIs could avoid as much as possible, due to the tendency of producing 'manic episodes.'
Besides this all above, you may ask your pdoc. whether your current med. combo. is truly for Bp II which you're suspecting. From there, you may get some good clue to find a med. combo. which alleviates the symptoms, both ADD and Bp.
H.G.
Posted by PsychoSage on March 13, 2004, at 16:54:34
In reply to Expert Opinions Please on My ADD/BPII Med Cocktail, posted by AzureBay on March 12, 2004, at 21:26:28
> Hi All,
>
> I'm fairly new here. It's obvious that most of you really know your stuff, so I would appreciate some of your excellent advice on my med cocktail.
>
> MY BACKGROUND - I was initially diagnosed with ADD of the inattentive type about 5 years ago. The neurostimulants worked well. After several months I began to notice sub-layer symptoms that I believe were there all along, probably since childhood. These included depression and severe anxiety. Interestingly, the neurostims made improvements on both. But, what I'm getting at is that I essentially became more "AWARE" of them as my ADD symptoms got under control.
>
> I was then treated with the typical gambit of AD's - tried every damn one of them, and never really got good results except with Celexa in low doses. At this point, Xanax was added into the mix, along with Atenolol for some essential tremors from the ADD med.
>
> About a year ago I arrived at point where I felt I was getting no better. I honestly felt disabled most of the time, despite the fact that the neurostim meds allowed me more focus. It was through researching online that a light went on, and I came to the conclusion that I was likely BIPOLAR II. I fit the criteria to a tee on every test.
>
> So, back to the pdoc I went, and he hesitantly agreed with me at first. We started trials of several drugs over the course of the next months, including Lithobid, Zyprexa, Geodon, Gabatril and several others whose names I forget at the moment. I had the best results with Zyprexa and Lithobid, but the side-effects were simply NASTY - weight gain and all that. Hell, I'll bet I gained 30 lbs just from picking up the prescription of Zyprexa lol.
>
> This brings us to the present.
>
> MY MED COCKTAIL NOW IS AS FOLLOWS:
>
> Ritalin 20mg tid
> Aricept 10mg
> Abilify 10mg
> Celexa 20mg
> Atenolol 50mg
> Klonopin 1mg tid/prn
> and some experimentation with Picamilon
>
> Now I'll tell you what's wrong with this picture. Something is just a little bit off in this mix. My hunch is that it's the Celexa because there is an all-to-common apathy that's been going on way before I started Abilify or Klonopin. My libido is also pretty much limp, pardon the expression, and my creativity is dampened. I'm unmotivated and unproductive. I'm not really severely depressed at the moment, but I do have highs and lows. Anxiety is a definite issue.
>
> Guys, believe me I've tried discontining them one at a time, all but the Celexa, and it's the only one constant that seems to be a likely culprit. Besides, I feel as if it interferes with the Abilify for some reason. I've also experimented with adding Lithium to this combo with very mediocre results.
>
> So... what are you honest thoughts on this medication combo? Do any of you see any interactions that throw up a red flag? Do you believe I'm correct about the Celexa being part of the big problem or is it something else? How does the Abilify fit in with my ADD med?
>
> I have had mild manic episodes while on the Celexa in this mix, and I tend to do outrageous things off and on, like spending too much or gambling - just stupid things that I later regret.
>
> If I had to keep 2 drugs and toss the others they would be the Ritalin and the Klonopin. Both seem very effective. But something else in the mix is just not working right. And I don't get the bipolar problem addressed with those two meds alone, so I'm back to square one.
>
> Have any of you with Bipolar II had good results with Abilify? Are any of you both ADD and Bipolar II?
>
> Your thoughts and help with this are deeply appreciated.
>
> Be well and thanks,
>
> AzureCheck this out:
http://www.jrn.columbia.edu/studentwork/cns/2002-03-04/126.aspConsider the least number of meds as possible to be able to truly observe what is going on.
Consider dropping Klonipin if possible and finding alternative ways to deal with anxiety. Any benzo even taken before bed will affect more than GABA even after the theraputic effect wears off. This means it dulls other systems. There will be newer and more selective sleeping/anxiety aids because this is a huge and hot market.
Consider a mood stabilizer instead of the antipsychotics which can suck the life out of you. I personally am on Trileptal, and the side effect profile is excellent except you need bloodwork for sodium done. Lithium and depakote can be heavy duty as far as being sedating for some people, but I wouldn't know and I hope I never find out. Trileptal is my first mood stabilizer.
Consider wellbutrin, strattera or provigil for stimulant poop out and tolerance build-up.
Consider asking your pdoc to go as low as possible or when he gives a dosage ask him for less of the figure he gives you. Going low on serotonergic and antipsychotic drugs if using them is necessary can be a way to get benefits with the least trouble. I personally don't like them, and they are on the bottom of my list. I have been on two antipsychotics, and I am not interested unless I have some wild episode.
I seldom see anxiety as something that should be treated with benzos unless it is the predominant problem as if it were PTSD or Panic. benzos and SSRIs will just dull your anxiety, and they won't help you attack the issues anxiety are entangled with.
some mood stabilizers are also considered antianxiety agents sometimes.work things out based on your feelings and observations of your mood and symptoms instead of what they claim the drug does on paper. Drugs are just claims. Substances in the body are different things. Don't be biased by what the drug is supposed to do according to the manufacturer.
To me, antianxiety, mood stabilizers{except keppra?}, antipsychotics {except abilify?}, and SSRIs are at the end of the day not good for thinking, energy and getting things done. You have to tinker to get the benefit while leaving something human left.
Posted by PsychoSage on March 13, 2004, at 17:04:28
In reply to Re: Expert Opinions Please on My ADD/BPII Med Cocktail, posted by PsychoSage on March 13, 2004, at 16:54:34
I forgot to mention. Ask some ADD people about burn out from stimulants. Even if the peaks and valleys were not pronounced before perhaps now they are, and you did not even know. You will have to do something different with your ritalin since it may make you more dysphoric.
Stimulants can trigger mixed moods and manias as well. Even if you need them there could be a time to lay off or take a holiday and do something else in the meantime. I am not sure though, so hit up the more experienced people for their tales.
Dopamine agonists {antiparkinsonians} and strattera may be some viable options.
Posted by Azurebay on March 13, 2004, at 17:22:19
In reply to Re: Expert Opinions Please on My ADD/BPII Med Cocktail, posted by PsychoSage on March 13, 2004, at 17:04:28
> I forgot to mention. Ask some ADD people about burn out from stimulants. Even if the peaks and valleys were not pronounced before perhaps now they are, and you did not even know. You will have to do something different with your ritalin since it may make you more dysphoric.
>
> Stimulants can trigger mixed moods and manias as well. Even if you need them there could be a time to lay off or take a holiday and do something else in the meantime. I am not sure though, so hit up the more experienced people for their tales.
>
> Dopamine agonists {antiparkinsonians} and strattera may be some viable options.
Very good advice. I will look into the medications you mentioned in your other post and consider just a pure mood stabilizer vs. Abilify.The Abilify, however, seems like it's the ONE balancer that is keeping me sane. I know it works on both serotonin and dopamine pathways, so that may be why it works so well in this combo. I'm afraid without it I could have some serious problems.
Then again, I'm certainly willing to try just a pure mood stabilizer, so will ask the doc.
Thanks so much for your replies, both you PsychoSage and H.G.
Posted by PsychoSage on March 13, 2004, at 19:27:47
In reply to Re: Expert Opinions Please on My ADD/BPII Med Cocktail, posted by Azurebay on March 13, 2004, at 17:22:19
> > I forgot to mention. Ask some ADD people about burn out from stimulants. Even if the peaks and valleys were not pronounced before perhaps now they are, and you did not even know. You will have to do something different with your ritalin since it may make you more dysphoric.
> >
> > Stimulants can trigger mixed moods and manias as well. Even if you need them there could be a time to lay off or take a holiday and do something else in the meantime. I am not sure though, so hit up the more experienced people for their tales.
> >
> > Dopamine agonists {antiparkinsonians} and strattera may be some viable options.
>
>
> Very good advice. I will look into the medications you mentioned in your other post and consider just a pure mood stabilizer vs. Abilify.
>
> The Abilify, however, seems like it's the ONE balancer that is keeping me sane. I know it works on both serotonin and dopamine pathways, so that may be why it works so well in this combo. I'm afraid without it I could have some serious problems.
>
> Then again, I'm certainly willing to try just a pure mood stabilizer, so will ask the doc.
>
> Thanks so much for your replies, both you PsychoSage and H.G.
>I personally don't understand antipsychotics too well. i have learned about them and taken them, but I don't like their side effects. I would hate to be on them for maintenance again.
Keep your benzo unless you are a real anxious type, but if it's like a constant anxiety thing then maybe you should try something else.
I know the irritable, anxious, dysphoric BP2 energy very well, and it's confusing. I just read another post about using a benzo to prevent a psychotic mania because stress and anxiety trigger it. Now there is a great reason to use a benzo. I should keep some on my shelf now.
Posted by cybercafe on March 13, 2004, at 20:20:49
In reply to Expert Opinions Please on My ADD/BPII Med Cocktail, posted by AzureBay on March 12, 2004, at 21:26:28
i have bpII + ADD
valporate made me sleepy + tremors + didnt control moods
tried zyprexa, very good, but made me want to sit down and be lazy (plus it blocks D4 and D4 is implicated in ADD)so i went to the states and not some abilify
great drug.... was also on celexa but felt apathy and still some depression
so switched to
ritalin SR 40 mg tid
abilify 3.75 mg od
parnate 20 mg bid (may reduce to 30 mg)
clonazepam 2 mg tid
lorazepam 2 mg odand i'm pretty awake and able to concentrate.... just wish i could get rid of my acne (will probably reduce parnate to 35 or 30 mg)
Posted by kotsunega on March 13, 2004, at 22:37:34
In reply to Expert Opinions Please on My ADD/BPII Med Cocktail, posted by AzureBay on March 12, 2004, at 21:26:28
I have taken zyprexa for over 3 years now. At first, I experienced all the side effects; weight gain and etc., but I stuck with it as it did my head so much good. In time, the side effects all went away and I've had no further problems. I am Bipolar I with ADD. I take zyprexa, ritilan, and paxil. It's an agreeable mix for me. Hope you can figure out what to add/remove from your cocktail. I tried Abilify for about 6 months but found it gave me a strange kind of anxiety, so I discontinued it.
kotsunega
Posted by Azurebay on March 14, 2004, at 0:51:19
In reply to Re: Expert Opinions Please on My ADD/BPII Med Cocktail, posted by cybercafe on March 13, 2004, at 20:20:49
Thanks cybercafe (and everyone) ;)
It seems to me that I've got to stick with the basics for bipolar II and ADD. That probably means for me getting off the Celexa FIRST!
In looking back at some old journal entries I can see where it tended to make me slightly manic, and never much agreed with the overall "basic" mix of a neurostim and a benzo.
Given the profile of Abilify, I'm wondering if it's possible to decrease Celexa rather rapidly. I may try that and let you know how it goes.
It also seems that everyone has such different opinions of Abilify, different reactions. For me it seems to be almost like a mood stabilizer, taking the place of Lithium. And I have no side-effects, just a rather pleasant feeling of balance while on it.
I couldn't tell you if it "dulls" my creativity (which is very important to me), as I think the Celexa is likely a factor there.
And the perfect ADD/Bipolar quest continues...
Azure
> i have bpII + ADD
> valporate made me sleepy + tremors + didnt control moods
> tried zyprexa, very good, but made me want to sit down and be lazy (plus it blocks D4 and D4 is implicated in ADD)
>
> so i went to the states and not some abilify
>
> great drug.... was also on celexa but felt apathy and still some depression
>
> so switched to
> ritalin SR 40 mg tid
> abilify 3.75 mg od
> parnate 20 mg bid (may reduce to 30 mg)
> clonazepam 2 mg tid
> lorazepam 2 mg od
>
> and i'm pretty awake and able to concentrate.... just wish i could get rid of my acne (will probably reduce parnate to 35 or 30 mg)
Posted by PsychoSage on March 14, 2004, at 9:52:03
In reply to Re: Expert Opinions Please on My ADD/BPII Med Cocktail, posted by Azurebay on March 14, 2004, at 0:51:19
>
> Given the profile of Abilify, I'm wondering if it's possible to decrease Celexa rather rapidly. I may try that and let you know how it goes.
>Check this link out to see how you can tell you stopped taking it too quickly.
I woul drop down a dosage interval a week. Your doctor can help you with this. If you typically increase by 10 or whatever {i am not sure about celexa since I have not taken it since 1999} then decrease by 10 each week or two weeks even. Do this gently, so it's less perceptible and jarring to your brain and body.
Posted by PsychoSage on March 14, 2004, at 13:48:59
In reply to Re: Expert Opinions Please on My ADD/BPII Med Cocktail, posted by PsychoSage on March 14, 2004, at 9:52:03
here is an excerpt from something that reminded me of your thread:
For years, the dogma was that stimulants should be avoided for bipolar patients because they will cause mania. Although mood charting sometimes reveals that stimulants will promote cycling, they may occasionally be quite effective in bipolar depression as an adjunct to a mood stabilizer regimen. Some patients, perhaps especially those with comorbid ADD, will in fact have a mood stabilizing effect from stimulants; there are cases in the literature of acute mania responding to stimulants extremely rapidly (see. e.g., Bschor et al). More often, a bipolar II patient with prominent depression will benefit from the addition of a stimulant with diminished anergy; of course, monitoring for a destabilizing effect is necessary, and mood charting here will be useful. Careful and close follow-up of response to stimulants is clearly warranted, but they should not be absolutely shunned, either in depressed or manic phases.
http://home.comcast.net/~pmbrig/BP_pharm.html#stimulants
i found the link above at this link:
Posted by HappyGirl on March 14, 2004, at 14:47:09
In reply to Re: Expert Opinions Please on My ADD/BPII Med Cocktail, posted by Azurebay on March 14, 2004, at 0:51:19
Hi:
As you're saying, Abilify is a 'three-in-one' AP med., then yes, it has mood-stabilizer effect, along with some AD effect. For that reason, some of Bp folks are taking 'Abilify' as "mono-therapy" and quite happy about its effectiveness.
Celexa, about which you're SO concerned, ... this is one of SSRIs and normally, if you're under Bp II, it's better to avoid, although you may need other form of AD for its replacement.
In your med. history, you've been already on Ritalin therapy due to ADD for the past years, then Bp med. therapy might be different from those who has no-history in regard to psycho-med. therapy. Until Bp II dx'ed, I had NEVER experienced any psycho.-med., then when I was on Depakote at the beginning of my dx'ed with Bipolar, it worked WONDER on my symptoms that happened just within few days. However, once my system used to Depakote, the chemical of my brain asked more med. and more efficacy/potency. During five-six years, # of my med. changed from one to four, as my system used to psycho.med.
In your case, there has been already 'Ritalin' in your system before taking current med. combo., then the reaction along with the effectiveness of your med. combo. might NOT be as same reaction as first-timer psycho.-med. takers, such as my case.
H.G.
Posted by AzureBay on March 14, 2004, at 15:03:09
In reply to Re: Expert Opinions Please on My ADD/BPII Med Cocktail, posted by HappyGirl on March 14, 2004, at 14:47:09
> Hi:
> As you're saying, Abilify is a 'three-in-one' AP med., then yes, it has mood-stabilizer effect, along with some AD effect. For that reason, some of Bp folks are taking 'Abilify' as "mono-therapy" and quite happy about its effectiveness.Hi HappyGirl,
Very succinctly put. I agree that I could probably use Abilify as monotherapy for Bipolar II. And I say that based upon my experience with Lithium as well as Gabitril. Abilify works far better than Lithium in my case and seems to have AD properties.
> Celexa, about which you're SO concerned, ... this is one of SSRIs and normally, if you're under Bp II, it's better to avoid, although you may need other form of AD for its replacement.
Agreed. From everyone's input, great links, and my own person feeling about it... CELEXA IS THE PROBLEM. I think it tends to "switch" me, particularly into mild manic states where I do stupid things. It also makes me extremely unmotivated. At least by all accounts Celexa is the only med to which I can attribute these problems.
> In your med. history, you've been already on Ritalin therapy due to ADD for the past years, then Bp med. therapy might be different from those who has no-history in regard to psycho-med. therapy. Until Bp II dx'ed, I had NEVER experienced any psycho.-med., then when I was on Depakote at the beginning of my dx'ed with Bipolar, it worked WONDER on my symptoms that happened just within few days. However, once my system used to Depakote, the chemical of my brain asked more med. and more efficacy/potency. During five-six years, # of my med. changed from one to four, as my system used to psycho.med.
>
> In your case, there has been already 'Ritalin' in your system before taking current med. combo., then the reaction along with the effectiveness of your med. combo. might NOT be as same reaction as first-timer psycho.-med. takers, such as my case.
> H.G.Thanks a bunch!! Thanks to PsychoSage and everyone else too!!
Posted by AzureBay on March 14, 2004, at 23:39:16
In reply to Expert Opinions Please on My ADD/BPII Med Cocktail, posted by AzureBay on March 12, 2004, at 21:26:28
Guys,
I just realized from looking back at some old journal notes that I was on Lithium/Lithobid last August, and did remarkably well on it. Why I stopped it I don't know unless it was to try the Abilify (most likely the case).
So if my ADD is a given, and bipolar II is a high probability, and lithium works well with the neurostims... wtf am I doing messing around with all of these other meds???
I'll bet I would do just fine on Lithobid, Klonopin and small doses of Ritalin.
Any thoughts; any similar experiences? Thanks to everyone for your great advice. ;)
Azure
Posted by interject79 on March 14, 2004, at 23:46:02
In reply to Expert Opinions Please on My ADD/BPII Med Cocktail, posted by AzureBay on March 12, 2004, at 21:26:28
Quickly, Celexa might be a large part of your problem. It can be quite destabilizing for those with Bipolar Disorders (and in many cases for those without).
Abilify may be a good choice (hopefully and presumably you don't have problems with uncontrollable movement), as had Aricept (for ADD symptoms).
With your concerns Abilify+Aricept might be all that's needed. I'd seriously consider/reconsider Celexa, Ritalin, Klonopin, and Atenolol--with Celexa being 'most needs to go' and Atenolol least, though still perhaps 'to go'. However, quitting any of these will not be a walk in the park, so a very knowledgeable physician should help.
Best,
interject
Posted by AzureBay on March 14, 2004, at 23:50:11
In reply to Re: Expert Opinions Please on My ADD/BPII Med Cocktail, posted by interject79 on March 14, 2004, at 23:46:02
Thanks interject. I now concur 100% that the Celexa simply has to go first and foremost, as well as some of the other meds.
Going to see the doc this week. Your help is appreciated!
Az
Posted by cybercafe on March 18, 2004, at 17:46:02
In reply to Re: Expert Opinions Please on My ADD/BPII Med Cocktail, posted by HappyGirl on March 14, 2004, at 14:47:09
> Hi:
> As you're saying, Abilify is a 'three-in-one' AP med., then yes, it has mood-stabilizer effect, along with some AD effect. For that reason, some of Bp folks are taking 'Abilify' as "mono-therapy" and quite happy about its effectiveness.
> Celexa, about which you're SO concerned, ... this is one of SSRIs and normally, if you're under Bp II, it's better to avoid, although you may need other form of AD for its replacement.
> In your med. history, you've been already on Ritalin therapy due to ADD for the past years, then Bp med. therapy might be different from those who has no-history in regard to psycho-med. therapy. Until Bp II dx'ed, I had NEVER experienced any psycho.-med., then when I was on Depakote at the beginning of my dx'ed with Bipolar, it worked WONDER on my symptoms that happened just within few days. However, once my system used to Depakote, the chemical of my brain asked more med. and more efficacy/potency. During five-six years, # of my med. changed from one to four, as my system used to psycho.med.
>
> In your case, there has been already 'Ritalin' in your system before taking current med. combo., then the reaction along with the effectiveness of your med. combo. might NOT be as same reaction as first-timer psycho.-med. takers, such as my case.
> H.G.i was taking 2.5 mg zyprexa, lorazepam and ritalin.... and depressed.... when i added celexa, i noticed it made me a little psychotic (so i increased zyprexa to 5 mg)
so there is definately some synergy going on there
Posted by cybercafe on March 18, 2004, at 17:48:29
In reply to Abilify, Celexa and My ADD/BPII Med Cocktail » HappyGirl, posted by AzureBay on March 14, 2004, at 15:03:09
> > As you're saying, Abilify is a 'three-in-one' AP med., then yes, it has mood-stabilizer effect, along with some AD effect. For that reason, some of Bp folks are taking 'Abilify' as "mono-therapy" and quite happy about its effectiveness.
>
> Hi HappyGirl,
>
> Very succinctly put. I agree that I could probably use Abilify as monotherapy for Bipolar II. And I say that based upon my experience with Lithium as well as Gabitril. Abilify works far better than Lithium in my case and seems to have AD properties.Wow how much are you guys taking? i definately still need some antidepressant while taking abilify, of course i'm only taking a quarter of a pill 3.75 mg (actually right now i'm trying an eighth of a pill) ....
Posted by cybercafe on March 18, 2004, at 17:52:34
In reply to Re: Expert Opinions Please on My ADD/BPII Med Cocktail, posted by interject79 on March 14, 2004, at 23:46:02
> Quickly, Celexa might be a large part of your problem. It can be quite destabilizing for those with Bipolar Disorders (and in many cases for those without).
really? paxil and effexor were okay for me but celexa made me feel too stable.... like blunt emotions etc .. no highs no lows... also didnt totally make me euthymic .... so i switched back to parnate
btw i think i get tremors from low dose abilify... but they may also be from having taken zyprexa? i don't know... but they disappear when i take my first clonazepam dose, so it doesn't bother me
>
> Abilify may be a good choice (hopefully and presumably you don't have problems with uncontrollable movement), as had Aricept (for ADD symptoms).
>
> With your concerns Abilify+Aricept might be all that's needed. I'd seriously consider/reconsider Celexa, Ritalin, Klonopin, and Atenolol--with Celexa being 'most needs to go' and Atenolol least, though still perhaps 'to go'. However, quitting any of these will not be a walk in the park, so a very knowledgeable physician should help.
>
> Best,
> interject
Posted by AzureBay on March 18, 2004, at 19:53:44
In reply to Re: Abilify, Celexa and My ADD/BPII Med Cocktail, posted by cybercafe on March 18, 2004, at 17:48:29
Hey cybercafe,
I am or was taking between 10 and 15 mg, experimenting with dosages. Now that I think about it I would probably be wise to take a lower dose like you. It's a good drug, BUT it tends to zone me just a little bit, ya know? Especially at that high of a dose.
Food for thought... thank you!!
Azure
>> Wow how much are you guys taking? i definately still need some antidepressant while taking abilify, of course i'm only taking a quarter of a pill 3.75 mg (actually right now i'm trying an eighth of a pill) ....
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