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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by Marty on March 24, 2009, at 14:39:44
I'd like to talk to some people having both disorder as I think Social phobia when comorbid to Bipolar is a very hard to treat.We may have some valuable information for each others.
Thank you,
/\/\arty
Posted by Phillipa on March 24, 2009, at 16:31:41
In reply to Bipolar + Social Phobia: Who are both ?, posted by Marty on March 24, 2009, at 14:39:44
Guess Gad doesn't count? Love Phillipa
Posted by Marty on March 24, 2009, at 16:34:18
In reply to Re: Bipolar + Social Phobia: Who are both ? » Marty, posted by Phillipa on March 24, 2009, at 16:31:41
> Guess Gad doesn't count? Love Phillipa
Hi Phillipa. No indeed, it doesn't in this case.
/\/\arty
Posted by SLS on March 24, 2009, at 20:54:03
In reply to Bipolar + Social Phobia: Who are both ?, posted by Marty on March 24, 2009, at 14:39:44
> I'd like to talk to some people having both disorder as I think Social phobia when comorbid to Bipolar is a very hard to treat.
When depressed, I feel socially inhibited, anxiety, and sometimes phobic. However, these things come and go with the depression, so I would consider them symptoms of my bipolar disorder rather than a comorbid condition.
I thought you were currently in remission with agomelatine.
Did agomelatine poop-out on you?
- Scott
Posted by Marty on March 24, 2009, at 21:30:10
In reply to Re: Bipolar + Social Phobia: Who are both ? » Marty, posted by SLS on March 24, 2009, at 20:54:03
>
> I thought you were currently in remission with agomelatine.
>
> Did agomelatine poop-out on you?Hi Scott,
Yes it did at about 85%. Not sure where to go from there. I wish I would know how to bring back the Agomelatine effect since it was by far the best I had after trying 25+ meds. Don't want to go back on an SRI but I feel stuck. I'm giving myself some time to think about my options. I'm curious about Pramixemole .. and I think I should maybe give NETs another try since I only tried Valenfaxine and Wellbutrin. (The latter being one of the stimulating one I can tolerate at low dose)
Hope your doing well,
/\/\arty
Posted by Sigismund on March 24, 2009, at 23:51:15
In reply to Re: Bipolar + Social Phobia: Who are both ? » SLS, posted by Marty on March 24, 2009, at 21:30:10
>Yes it did at about 85%
Could you say a little more Marty?
I don't quite understand.
Posted by Marty on March 25, 2009, at 8:56:56
In reply to Re: Bipolar + Social Phobia: Who are both ? » Marty, posted by Sigismund on March 24, 2009, at 23:51:15
> >Yes it did at about 85%
> Could you say a little more Marty?The antidepressant effect is gone, except for a couple hours after I took the pill (Before going to sleep... so the next day when I wake up I feel bad). The anxiolytic effect is gone at about 85%, but again is strong for a couple hours after I took the pill.
I don't know what more I could tell about this. If you have specific questions, I'll answer them.
All the best,
/\/\arty
Posted by polarbear206 on March 25, 2009, at 16:46:13
In reply to Re: Bipolar + Social Phobia: Who are both ? » Sigismund, posted by Marty on March 25, 2009, at 8:56:56
> > >Yes it did at about 85%
> > Could you say a little more Marty?
>
> The antidepressant effect is gone, except for a couple hours after I took the pill (Before going to sleep... so the next day when I wake up I feel bad). The anxiolytic effect is gone at about 85%, but again is strong for a couple hours after I took the pill.
>
> I don't know what more I could tell about this. If you have specific questions, I'll answer them.
>
> All the best,
> /\/\arty
>Marty,
Were you taking anything else to augment it? Perhaps that's why you didn't get the full AD effect. If you are bipolar, you need a mood stablizer with it.
Posted by Marty on March 25, 2009, at 17:46:56
In reply to Re: Bipolar + Social Phobia: Who are both ?, posted by polarbear206 on March 25, 2009, at 16:46:13
Hi Polarbear,
> Were you taking anything else to augment it? Perhaps that's why you didn't get the full AD
>effect. If you are bipolar, you need a mood
>stablizer with it.I had a dx of Bipolar Type 2 for many years. Now they just don't know.. I was also on:
Clonazepam 0.25mg at bedtime
Lamotrigine 100mg at bedtime
Trazodone 50mg at bedtime
.. and for some time also on Wellbutrin, but I felt it was somehow antagonistic to Agomelatine in terms of effects (not in term of mechanism of action)Do you see something in that list that could be modulating badly the Agomelatine effect ? Also, are you suggesting that without proper mood stabilization it's normal I couldn't sustain the effect more than 2 months ?
Thanks,
/\/\arty
Posted by Sigismund on March 25, 2009, at 17:56:05
In reply to Re: Bipolar + Social Phobia: Who are both ? » Sigismund, posted by Marty on March 25, 2009, at 8:56:56
So you mean that the morning after you have taken your dose, 85% of the antianxiety effect is gone?
Posted by Sigismund on March 25, 2009, at 17:59:05
In reply to Re: Bipolar + Social Phobia: Who are both ? » polarbear206, posted by Marty on March 25, 2009, at 17:46:56
I have no idea, Marty, how much clonazepam 0.25mg is.
My experience has been, I think, that Valium has become less acceptable, more disorienting and dysphoric, since being on agomelatine.
This may be of no relevance, of course.
Posted by polarbear206 on March 25, 2009, at 19:28:45
In reply to Re: Bipolar + Social Phobia: Who are both ? » polarbear206, posted by Marty on March 25, 2009, at 17:46:56
> Hi Polarbear,
>
> > Were you taking anything else to augment it? Perhaps that's why you didn't get the full AD
> >effect. If you are bipolar, you need a mood
> >stablizer with it.
>
> I had a dx of Bipolar Type 2 for many years. Now they just don't know.. I was also on:
>
> Clonazepam 0.25mg at bedtime
> Lamotrigine 100mg at bedtime
> Trazodone 50mg at bedtime
> .. and for some time also on Wellbutrin, but I felt it was somehow antagonistic to Agomelatine in terms of effects (not in term of mechanism of action)
>
> Do you see something in that list that could be modulating badly the Agomelatine effect ? Also, are you suggesting that without proper mood stabilization it's normal I couldn't sustain the effect more than 2 months ?
>
> Thanks,
> /\/\arty
>
>
Have you ever tried to push the lamcital dose higher? For most people, a therapeutic response starts at 100-200mg. I have a soft bipolar II. I take effexor and lamictal 200mg. I don't think the low dose of klonopin and trazadone are interfering with the Agomelatine. What is the reccomended dose range and how much do you take?
Posted by desolationrower on March 27, 2009, at 3:03:53
In reply to Re: Bipolar + Social Phobia: Who are both ?, posted by polarbear206 on March 25, 2009, at 19:28:45
well its possible, especially with lots of drugs to affects metabolism, that you're getting a decent dose of the traz metabolite that agonises 5ht2c. maybe try w/o the trazodone?
-d/r
Posted by Marty on March 27, 2009, at 12:38:54
In reply to Re: Bipolar + Social Phobia: Who are both ?, posted by polarbear206 on March 25, 2009, at 19:28:45
> Have you ever tried to push the lamcital dose
>higher? For most people, a therapeutic response
>starts at 100-200mg. I have a soft bipolar II. I
>take effexor and lamictal 200mg. I don't think
>the low dose of klonopin and trazadone are
>interfering with the Agomelatine. What is the
>reccomended dose range and how much do you take?Yes, I've been all up to 800 mg for a while. My Pdoc of the time was quite the cowboy. While I don't think Klonopin is interfering with Agomelatine, I think Trazodone could via it's mCPP metabolite which is a 5-HT2c agonist.
/\/\arty
Posted by Marty on March 27, 2009, at 12:48:52
In reply to Re: Bipolar + Social Phobia: Who are both ?, posted by desolationrower on March 27, 2009, at 3:03:53
> well its possible, especially with lots of drugs to affects metabolism, that you're getting a decent dose of the traz metabolite that agonises 5ht2c. maybe try w/o the trazodone?
>Before giving up on Agomelatine, I should try lowering Trazodone and see if it brings back my response. You're right about that. mCPP could indeed interfer. Now that I think about it, there would even be an anecdotal evidence for this hypothesis: Taking some Agomelatine at bed(and so with Trazodone) Vs taking some Agomelatine in the evening (to take a nap and feel MUCH better after it) doesn't feel the same ... The nice feeling I have after the nap or while I'm napping ISN'T there when I wake up in the night to go to the bathroom... interesting isn't ?
I'll try lowering my Trazodone by half tonight and see how I feel in the night and afterward.
Thanks for reminding me this mCPP story d/r
/\/\arty
Posted by Marty on March 27, 2009, at 13:15:38
In reply to Re: Bipolar + Social Phobia: Who are both ? » Marty, posted by Sigismund on March 25, 2009, at 17:59:05
> I have no idea, Marty, how much clonazepam 0.25mg is.
>
> My experience has been, I think, that Valium has become less acceptable, more disorienting and dysphoric, since being on agomelatine.
>
> This may be of no relevance, of course.Interesting. I can't think of an hypothesis for why it would be so.. but I could well be and I'll try to determine if it does the same with me (Clonazepam). Thanks
Later,
/\/\arty
This is the end of the thread.
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