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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by don'ttalktome on August 15, 2012, at 11:49:31
Hi I have been recently diagnosed with bipolar after a heartbreaking manic episode that lasted the better part of a year fueled by drugs, alcohol and prescription meds. I am now trying to battle through this deep depression sobriety guilt and loss of what I did and who I hurt during my last episode, I have started Lamictal and although it's only been a week i'm wondering if it's actually going to help my bipolar depression or eventually sent me spiralling out of control like the Effexor did? I too share the obsession to research hoping that this horrible life i'm living can be cured with silly things like fish oils or hyperglycemic diets. I'm so frustrated and exhausted and so are my family and what friends I have left. I'm so worried i'm going to lose the few loved ones that remain in my life. I guess i'm just looking for someone with experience in this disaster to lead me in the right direction. Any advice would be appreciated. Thanks
AJB
Posted by Phillipa on August 15, 2012, at 12:13:24
In reply to Advice, posted by don'ttalktome on August 15, 2012, at 11:49:31
Glad to see you posted here also. I think you will get some sound advise here. And welcome to babble. Phillipa
Posted by phidippus on August 15, 2012, at 12:44:00
In reply to Advice, posted by don'ttalktome on August 15, 2012, at 11:49:31
An acute bipolar episode can be life altering, especially one lasting as long as yours did and fueled by drugs, alcohol and pills. Your sobriety and guilt are good signs of recovery, but you must make peace with what you did and know that part of it was due to mental illness, something not entirely under your control. Lamictal should help stabilize your mood aand prevent you from becoming manic again. Effexor is an antidepressant which can trigger mania in bipolar people. Lamictal will not do that to you. If you feel you are still not under control by the Lamictal, talk to your doctor about adding an antipsychotic.
Your disease cannot be cured, but only managed by medications like Lamictal. Fish oil can help, but hyperglycemic diets are injurious. Learn about what medications can help you and which ones you need to stay away from.
Your frustration and exhaustion will pass if you work hard with your doctors on a plan of stability. Also important is staying sober and having a support structure in place.
You will not lose your loved ones as long as you keep trying to stay well. They will see your hard work.
Eric
Posted by SLS on August 15, 2012, at 15:37:56
In reply to Re: Advice » don'ttalktome, posted by phidippus on August 15, 2012, at 12:44:00
Hi Eric.
I think the consensus is that Lamictal makes a better antidepressant than it does an antimanic. For me, Lamictal 300 mg/day did not prevent the emergence of a Nardil-induced mania. To complicate matters, there have been cases where Lamictal induced a manic reaction or switch. I imagine this is a very infrequent event, though. Strangely, the NIH had recommended combining Lamictal with another mood stabilizer for treating ultra-rapid cyclers. They found that it could take several months for the treatment to "penetrate" the cycle and abolish it.
http://www.ncbi.nlm.nih.gov/pubmed/18821451
I read a case report where a combination of Seroquel and Lamictal brought about a rapid remission for an ultra-ultra rapid cycler.
http://www.ncbi.nlm.nih.gov/pubmed?term=lamotrigine%20ultra%20rapid
- Scott
Posted by linkadge on August 15, 2012, at 17:54:55
In reply to Re: Advice » phidippus, posted by SLS on August 15, 2012, at 15:37:56
I know plenty of people in whom lamictal triggered manic like reactions (usually starting with less sleep). Lamictal is a fadish new fangled drug that somehow gained approval for treating some aspect of bipolar.
Don't waste your time with it....seriously. If you a really bipolar....get on lithium and continue with some fish oil.
Linkadge
Posted by phidippus on August 15, 2012, at 22:43:14
In reply to Re: Advice, posted by linkadge on August 15, 2012, at 17:54:55
Wow. There's enough data supporting Lamictal as an effective mood stabilizer. I find it hard to dismiss.
Eric
Posted by phidippus on August 15, 2012, at 22:47:25
In reply to Re: Advice » phidippus, posted by SLS on August 15, 2012, at 15:37:56
My OCD was worsened by Lamictal. There are several case reports about Lamictal's tendency to cause or worsen OCD in patients with Bipolar 2 disorder.
Have any idea why this effect would occur?
Eric
Posted by SLS on August 16, 2012, at 7:14:40
In reply to Re: Advice » SLS, posted by phidippus on August 15, 2012, at 22:47:25
> My OCD was worsened by Lamictal. There are several case reports about Lamictal's tendency to cause or worsen OCD in patients with Bipolar 2 disorder.
>
> Have any idea why this effect would occur?
>
> Eric
I don't know enough about the neurobiology of OCD to offer an intelligent answer to your question.If DBS applied to the nucleus accumbens works to treat OCD, I could offer an explanation, especially if amphetamines or cocaine makes OCD worse. I don't know that these things occur, though.
- Scott
Posted by SLS on August 16, 2012, at 7:17:28
In reply to Re: Advice » SLS, posted by phidippus on August 15, 2012, at 22:47:25
Does Mirapex or Requip make OCD worse?
- Scott
Posted by linkadge on August 16, 2012, at 11:29:44
In reply to Re: Advice » linkadge, posted by phidippus on August 15, 2012, at 22:43:14
Enough data? Says who?
Check GSKs own clinical trial registry.... far more failed trials than sucessful ones.
Its all marketing.Linkadge
Posted by phidippus on August 16, 2012, at 12:14:38
In reply to Re: Advice, posted by linkadge on August 16, 2012, at 11:29:44
Independent studies do not indicate marketing.
Eric
Posted by phidippus on August 16, 2012, at 12:16:10
In reply to Re: Advice » phidippus, posted by SLS on August 16, 2012, at 7:17:28
No, but there is a higher risk of compulsive behaviors with those medications.
Eric
Posted by phidippus on August 16, 2012, at 12:21:16
In reply to Re: Advice » phidippus, posted by SLS on August 16, 2012, at 7:14:40
Amphetamines do not make OCD worse. In facct dextroamphetamine has been studied as a succcesful treatment for OCD and is recommended by the APA as monotherapy if there has been no response to SSRIs and atypical antipsychotics.
I don't know about cocaine though.
Eric
Posted by brynb on August 16, 2012, at 16:12:36
In reply to Advice, posted by don'ttalktome on August 15, 2012, at 11:49:31
> Hi I have been recently diagnosed with bipolar after a heartbreaking manic episode that lasted the better part of a year fueled by drugs, alcohol and prescription meds. I am now trying to battle through this deep depression sobriety guilt and loss of what I did and who I hurt during my last episode, I have started Lamictal and although it's only been a week i'm wondering if it's actually going to help my bipolar depression or eventually sent me spiralling out of control like the Effexor did? I too share the obsession to research hoping that this horrible life i'm living can be cured with silly things like fish oils or hyperglycemic diets. I'm so frustrated and exhausted and so are my family and what friends I have left. I'm so worried i'm going to lose the few loved ones that remain in my life. I guess i'm just looking for someone with experience in this disaster to lead me in the right direction. Any advice would be appreciated. Thanks
> AJBHi AJB-
I've suffered from debilitating depression since I was a teenager (I'm 38 now), and it only got worse with age. As a result, I self-medicated w/ practically every substance (pills and illegal drugs) from the time I was 28 up until my mid 30s. It was only recently that my mood disorder was properly addressed (as opposed to the substance abuse issue--the mood disorder was wrongly treated subsequently).
I'm clean now; I basically got tired of using drugs--they stopped "working," caused way more harm/shame/guilt than I could handle, and I was able to recognize that my underlying mood disorder was the real issue and that using drugs completely threw off the balance of my fragile brain chemistry.
It's not clear whether I have Bipolar or MDD (my current pdoc has yet to say definitively), but during the past few years it's become VERY apparent that treating myself well (taking my meds as prescribed, eating well and having good sleep patterns) has made a HUGE difference. I completely understand the guilt and shame and obsession over past mistakes, as well as the pain loved ones suffered. This held me back from getting well. It was a vicious cycle. If it's any consolation, the longer you stay clean and try to stabilize things, the more people will begin to trust you again.
Be kind to yourself. Meditate. Be mindful. Try to think positively. Don't get stuck in the past. Mistakes don't define you and are actually lessons (and sometimes blessing in disguise). It does get better.
And for sure keep researching/reading about meds/alternatives/things that can be helpful. Being self-aware is a blessing and a curse, but you can use it to your advantage :).
-b
Posted by linkadge on August 17, 2012, at 6:44:06
In reply to Re: Advice » don'ttalktome, posted by brynb on August 16, 2012, at 16:12:36
I don't feel that the evidence supports the efficacy of lamotrigine in bipolar disorder.
It does not have antimanic efficacy, and the so called 'anti-depressant' effects are not consistent or reliable.
Its like mixing a benzodiazapine with strong coffee and calling it a mood stabilizer.
GSK performed dozens of studies of lamotrigine in bipolar most of which failed to show superiority over placebo or existing mood stabilizers.
Posted by SLS on August 17, 2012, at 9:25:57
In reply to Re: Advice, posted by linkadge on August 17, 2012, at 6:44:06
> I don't feel that the evidence supports the efficacy of lamotrigine in bipolar disorder.
>
> It does not have antimanic efficacy, and the so called 'anti-depressant' effects are not consistent or reliable.I have plenty of evidence that Lamictal acts uniquely as an adjunct to other drugs - including antidepressants, lithium, AED mood-stabilizers, and antipsychotics - and can play a critical role that is irreplaceable in getting people with mood disorders well. My database is me (along with a few other people). That is sufficient reason for the continued availability of this drug.
Selfish, I know.
- Scott
Posted by linkadge on August 17, 2012, at 11:22:58
In reply to Re: Advice » linkadge, posted by SLS on August 17, 2012, at 9:25:57
Good for you,
Linkadge
Posted by phidippus on August 17, 2012, at 16:20:37
In reply to Re: Advice » SLS, posted by linkadge on August 17, 2012, at 11:22:58
Oh, you're one of those people...
Eric
Posted by linkadge on August 17, 2012, at 18:01:29
In reply to Re: Advice » linkadge, posted by phidippus on August 17, 2012, at 16:20:37
Yes,
As a matter of fact, I am.
This is the end of the thread.
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