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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Oliver71 on November 15, 2011, at 11:37:45
Hello,
Help! My name is Oliver. My psychiatric diagnosis is something like "major depression or bipolar type 2, not really sure which". I have been on and off various antidepressants & mood stabilizers for about that last 10 years (I'm 40).
Earlier this year I got off Prozac, lithium, and nortriptyline to prepare for an MAOI trial, but amazingly I found I felt better off the meds! This fall, however, a seasonal depression seemed to be returning, so I started taking Wellbutrin XL 150mg about a month ago. The past month has been terrible, a full blown major depressive episode, but with some "agitated" aspects such as seeming to need less sleep.
My psychiatrist has recommended I stop the Wellbutrin & start Depakote. Does this seem reasonable? I am skeptical but what do I know? :)
Thank you,
Oliver
Posted by billy h3ll on November 15, 2011, at 12:00:29
In reply to Should I take Depakote?, posted by Oliver71 on November 15, 2011, at 11:37:45
sounds like the prozac lithium stuff was working pretty well for you maybe go back to that before u try depakote, only problem is u gotta take it for it to work ;)
i think depakotes nice if u dont mind puttin on 20 or 30 poundsany reason not to go back to teh lithium/prozac?
Posted by Phillipa on November 15, 2011, at 12:06:06
In reply to Re: Should I take Depakote?, posted by billy h3ll on November 15, 2011, at 12:00:29
Wellbutrin can be very stimulating. Why not the prozac again? Phillipa
Posted by Oliver71 on November 15, 2011, at 12:16:52
In reply to Re: Should I take Depakote?, posted by billy h3ll on November 15, 2011, at 12:00:29
Well, actually the previous combination wasn't helping enough, which is why I'd planned to try an MAOI, but found that I felt better after stopping the prozac/lithium/nortriptylene. But "feeling better" didn't last. Thanks for the feedback on the weight gain!
In the very short term am considering just stopping the wellbutrin and taking something to help me sleep.
Posted by Oliver71 on November 15, 2011, at 12:21:24
In reply to Re: Should I take Depakote?, posted by Phillipa on November 15, 2011, at 12:06:06
Phillipa, I believe my psychiatrist now thinks I have bipolar rather than depression, and that I really need to be on a mood stabilizer rather than an antidepressant. Thanks, --Oliver
Posted by Christ_empowered on November 15, 2011, at 12:36:34
In reply to Re: Should I take Depakote?, posted by Oliver71 on November 15, 2011, at 12:21:24
maybe Lamcital? I just hate Depakote so much, so my opinion is biased. Lamcital can lift your mood a bit and can help keep future episodes of depression at bay. In my limited experience, its much easier to tolerate than depakote--no weight gain, nausea, hair loss, tremor--and its better for the low end of things. I take 200 Lamictal with 15 Abilify for a psychotic mood disorder.
Posted by creepy on November 15, 2011, at 15:53:28
In reply to Should I take Depakote?, posted by Oliver71 on November 15, 2011, at 11:37:45
depakote is good for mixed stuff, but its not all that good on depression. How much of the agitation is depression and how much is some sort of mixed brought on by wellbutrin and stopping the other meds?
Discontinuation can definitely include hypomanic symptoms followed by relapse of depression.
Personally Id rather try an AAP than depakote for this sort of thing.
Posted by Oliver71 on November 15, 2011, at 16:24:30
In reply to Re: Should I take Depakote?, posted by creepy on November 15, 2011, at 15:53:28
I believe that the wellbutrin has led to this "mixed" state.
When I went off everything back in June/July, I definitely did get a hypomanic boost for a while.
I'm not in a crisis, so I'm considering just tapering the wellbutrin and seeing what happens.
Thanks for the helpful feedback.
Oliver
Posted by jono_in_adelaide on November 15, 2011, at 18:03:49
In reply to Should I take Depakote?, posted by Oliver71 on November 15, 2011, at 11:37:45
You've only been taking half the dose of welbutrin (usual dose is 300mg/day)
Might be worth asking if you can try taking Welbutrin plus a mood stabaliser - wether Depakote is the right mood stabaliser for you I cant say
Posted by Phidippus on November 15, 2011, at 21:19:01
In reply to Should I take Depakote?, posted by Oliver71 on November 15, 2011, at 11:37:45
Depakote is preffered in the treatment of Bipolar 2 disorder, but it really bodes well for you to get a diagnosis nailed down. Otherwise you're just throwing things at a wall to see what sticks.
I would recommend Lamictal instead if you have more trouble with depressive symptoms. Depakote can make you feel really blah and sometimes even depressed-its great for mania but does nothing for depression.
Has the Wellbutrin been helpful in anyway? If so, keep it on if you take on the Depakote or something else. Wellbutrin is pretty popular as a treatment for bipolar depression. You're on a really low dose anyway and I don't see how you're mood would be compromised if you're bipolar.
Eric
Posted by bleauberry on November 16, 2011, at 5:09:33
In reply to Should I take Depakote?, posted by Oliver71 on November 15, 2011, at 11:37:45
I probably wouldn't mention this except for your long history of meds, and more importantly how you felt better for a little while when off meds.
Rhodiola Rosea and St Johns Wort combo. Start Rhodiola first for a couple weeks. Then add in St Johns Wort. Us the liquid tinctures for both for easy custom dosing....starting with tiny doses is a good way to get acclimated to these botanical medicines.
I've been on this combo now for several weeks and it is doing a better job than ANY of the dozens of psych meds or ECT did. Imagine that, stupid plants can do better than ECT? Better than meds? Anyway, that's just the way it is.
A few other people have noticed the special synergy between these two plants and their comments can be seen at sjwinfo.org. Either one have good reputations for depression, but the two combined is quite a bit better than either alone.
Only two tricks needed....start with small doses, and it needs some time.
In terms of meds, no I do not see any sense in Depakote. I've been on that drug and know plenty of others who have too. It's decent for antiseizures. For psychiatric usage I'm sorry but I just have not seen it very useful except maybe sometimes. For depression I have never seen it do anything special. It's not an antidepressant or a mood elevator. I guess if the goal is to stabilize mood so that bipolar swings are milder then it might be one of several options to look at, but then again I can think of several natural approaches and herbal approaches that are more dependable and reliable to get the job done in both bipolar and depression. For example, rhodiola is mood stabilizer, mood elevator, and energy booster all in one, while sjw is antidepression and anxiety. Combine them for a full spectrum approach.
Just my opinion. The subtle clues in your post tell me you are all done with meds, but I'm not a doctor so keep that in mind.
> Hello,
>
> Help! My name is Oliver. My psychiatric diagnosis is something like "major depression or bipolar type 2, not really sure which". I have been on and off various antidepressants & mood stabilizers for about that last 10 years (I'm 40).
>
> Earlier this year I got off Prozac, lithium, and nortriptyline to prepare for an MAOI trial, but amazingly I found I felt better off the meds! This fall, however, a seasonal depression seemed to be returning, so I started taking Wellbutrin XL 150mg about a month ago. The past month has been terrible, a full blown major depressive episode, but with some "agitated" aspects such as seeming to need less sleep.
>
> My psychiatrist has recommended I stop the Wellbutrin & start Depakote. Does this seem reasonable? I am skeptical but what do I know? :)
>
> Thank you,
> Oliver
>
Posted by creepy on November 17, 2011, at 9:17:21
In reply to Re: Should I take Depakote?, posted by bleauberry on November 16, 2011, at 5:09:33
I looked into rhodiola rosea also since it supposedly has some MAOI properties. The only thing that worries me is I see a lot of people talk about tolerance to its effects. Makes me wonder how similar it is to a traditional stimulant in that respect.
I would be very careful adding either of these to any SSRI. Id -guess- that if you went slowly up from a small dose you could play it safe. It should be pretty obvious when you start to get serotonin toxicity.
Posted by Oliver71 on November 17, 2011, at 11:40:01
In reply to Re: Should I take Depakote?, posted by creepy on November 17, 2011, at 9:17:21
Thanks everyone for the help. I decided not to take Depakote for now. I'm feeling much better and I'm tapering off the Wellbutrin, hoping that my sleep will improve. So far, I'm sleeping a little better.
I am planning on tracking my moods while off all meds/supplements in order to try to nail down the bipolar vs. depression diagnosis.
Also trying to do all the other good self-help stuff such as diet, exercise, therapy, etc.
This is the end of the thread.
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