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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by markwell on November 18, 2011, at 15:02:52
I'm really having a difficult time. I feel drugged and like I'm losing my mind. I'm currently taking 600mgs of tegretol and 2000mgs of nac. I don't feel like its the nac as I've felt like this most of my journey on tegretol, about 8 months now. Don't know what to do. The problem is the limited number of mood stabilizers. Any suggestions? I'm bp1
Mark
Posted by Christ_empowered on November 18, 2011, at 16:05:42
In reply to i feel like i'm losing my mind, posted by markwell on November 18, 2011, at 15:02:52
Trileptal (which is like Tegretol, but doesn't require labs) didn't do a whole lot for me either, except make me stupid. Abilify works better, especially with Lamictal. Then again, I have psychotic Bipolar I, so you may not need or want an atypical.
Lamictal, Depakote, Lithium, maybe calcium channel blockers. Your options really are limited man. Are you more manic or depressed? What symptom(s) do you want gone?
Good luck!
Posted by markwell on November 18, 2011, at 16:55:51
In reply to Re: i feel like i'm losing my mind, posted by Christ_empowered on November 18, 2011, at 16:05:42
Definately more depression than mania. I have a constant anxiety where I'm rubbing the back of my teeth with my tongue and curling my toes unbelievable anxiety. I wanted the pdoc to lower the tegretol but he thinks the problem is my unresolved depression. I had a problem with a very high dose of geodon that gave me td so my dr is reluctant to use an AP. I am trying the nac because I've tried all the antidepressants. Nac takes at least 8 weeks for a response and I don't think it's robust.
Mark
Posted by Phillipa on November 18, 2011, at 17:55:28
In reply to Re: i feel like i'm losing my mind, posted by markwell on November 18, 2011, at 16:55:51
I know I always bring up benzos but would on the them help with the anxiety since you can't take the ap's. Also NAC isn't that a supplement used for cognitive function? Phillipa
Posted by markwell on November 18, 2011, at 18:10:51
In reply to Re: i feel like i'm losing my mind » markwell, posted by Phillipa on November 18, 2011, at 17:55:28
I tried benzos and they made me depressed. My pdoc says nac is shown to relieve bipolar depression. Its been about 3 weeks and I see no benefit.
Mark
Posted by emmanuel98 on November 18, 2011, at 19:12:18
In reply to Re: i feel like i'm losing my mind » Phillipa, posted by markwell on November 18, 2011, at 18:10:51
What is nac?
Posted by Phidippus on November 18, 2011, at 20:25:11
In reply to Re: i feel like i'm losing my mind, posted by markwell on November 18, 2011, at 16:55:51
More depression than mania? Your choices are clear cut: Lithium or Lamictal. Both are very good for depression. There's some evidence that Trileptal boosts seratonin. Then there's Zonegran, which seems to work well for bipolar depression.
Eric
Posted by Phillipa on November 18, 2011, at 21:02:10
In reply to Re: i feel like i'm losing my mind » markwell, posted by Phidippus on November 18, 2011, at 20:25:11
Trileptal boosts serotonin? Is this why it's used to augment an SSRI? Phillipa
Posted by Phidippus on November 19, 2011, at 1:08:44
In reply to Re: i feel like i'm losing my mind » Phidippus, posted by Phillipa on November 18, 2011, at 21:02:10
It can augment an SSRI, yes.
Eric
Posted by markwell on November 20, 2011, at 6:58:51
In reply to Re: i feel like i'm losing my mind » Phillipa, posted by Phidippus on November 19, 2011, at 1:08:44
What I mean by I'm losing my mind, I am anxious with continual racing thoughts going through my mind. Really irrational thinking. I wake up two or three in the morning with extreme anxiety and racing thoughts. I'm not hearing voices but I feel psychotic. Maybe its extreme anxiety? I think a Benzo would be helpful but they make me extremely depressed. Any suggestions? I'm working but that's very difficult.
Mark
Posted by Christ_empowered on November 20, 2011, at 11:08:18
In reply to Re: i feel like i'm losing my mind, posted by markwell on November 20, 2011, at 6:58:51
I get that you're depressed, but do you think you could drop the cymbalta? My shrink won't even let me have the more sedating antidepressants b/c they might drive me mad.
Posted by Phillipa on November 20, 2011, at 19:42:16
In reply to Re: i feel like i'm losing my mind, posted by Christ_empowered on November 20, 2011, at 11:08:18
I don't feel cymbalta was sedating for me. I took 60mg for three months had forgotten first month was 30mg. I went to the gym lifted weights, walked 5 miles on the beach daily, rode bike about 20miles a day flat land there so not tiring. I found good for pain. Phillipa
Posted by Christ_empowered on November 21, 2011, at 7:35:02
In reply to Re: i feel like i'm losing my mind » Christ_empowered, posted by Phillipa on November 20, 2011, at 19:42:16
cymbalata sucked for me and now I can't even take something that's more tranquilizing, like celexa, because my shrink is concerned about making the psychosis worse.
I'm glad cymbalta worked for you. Why don't you take it anymore?
Posted by Phillipa on November 21, 2011, at 18:49:56
In reply to Re: i feel like i'm losing my mind, posted by Christ_empowered on November 21, 2011, at 7:35:02
CE good question. Went off it first time as found babble and seemed it was a med that didnt work and new at the time. Second time was here and here it cause horrible anxiety as didn't trust the new pdoc at all. Phillipa
Posted by Raisinb on November 21, 2011, at 21:34:23
In reply to Re: i feel like i'm losing my mind, posted by markwell on November 20, 2011, at 6:58:51
My bet is that one of those two meds, probably not the tegretol, is causing what you are experiencing. Did somebody say you are also on cymbalta? If so that could definitely be it. Your pdoc probably knows what he is talking about, but if it were me I would consider discontinuing the nac.
Posted by bleauberry on November 23, 2011, at 15:04:01
In reply to i feel like i'm losing my mind, posted by markwell on November 18, 2011, at 15:02:52
Well, you know it's either the nac or the tegretol. It could be the one you most suspect or the one you least suspect.
NAC at that dose is going to stir up a lot of fat stored stuff, if there is any, such as lead and mercury. But it doesn't do the complete job of safely escorting it out the body, so it results in re-poisoning. This is more common with people who have/had amalgam fillings, but we may have accumulated more toxins than we can handle along the way because some peoples' detox genes are not up to par. And if that were the case, no mystery the psychiatric symptoms, and no mystery bizarre stuff happening on nac. I'm just thinking out loud.
NAC is involved in so many complex reactions we don't have a clue as to but maybe a smidgen of all the stuff it actually does. How do we know that it isn't somehow creating a friendly and encouraging environment for adrenalin? And the resulting anxiety? Again, not sayin anything really, just thinking out loud.
Tegretol and all the psych meds for that matter, well, these things work in complex ways we only partially understand....and even what we do understand is not good enough knowledge to use it as prediction of whether it will work on a particular symptom most of the time with most people. Whatever bizarre stuff happens that we didn't expect, well, it all happened in the clinical trials too. Ya know,the 1% and the 5% crowd. "But I though that only happened to other people". Anyway, what could tegretol be doing to cause your problems? I have no clue. Maybe it's not causing any. It's either the nac or the tegretol though.
I'm not sure what I would do in your shoes other than immediate plans to begin lowering doses one at a time to test.
Posted by markwell on November 23, 2011, at 21:35:54
In reply to Re: i feel like i'm losing my mind, posted by bleauberry on November 23, 2011, at 15:04:01
Thanks blueberry, great post. I'm getting my tegretol levels checked in hopes of lowering the tegretol and I'm meeting with him next week.
Mark
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