Psycho-Babble Medication Thread 277

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effexor and mania

Posted by gail on August 9, 1998, at 9:32:17

i can't seem to tolerate the mood stabalizers...or should i say don't want the side effects. effexor helps but i am worried about being pushed into a manic episode. has anyone out there used effexor alone with bi-polar? what are the risks? and if i do have a major manic episode will i crash into dispair, no relief from the effexor?

 

Re: effexor and mania

Posted by Toby on August 13, 1998, at 15:54:21

In reply to effexor and mania, posted by gail on August 9, 1998, at 9:32:17

Here's a list of medications used for mood stabilization in bipolar disorder: Lithium, Depakote, Tegretol (carbamazepine), Neurontin (gabapentin), Klonopin, Clonidine, Verapamil and other calcium channel blockers (blood pressure medications), Lamictal (lamotrigine), Topamax (topiramate) and Zyprexa (olanzepine).
I have seen each and every one of these work "miracles" on medication-resistant patients as well as medication-intolerant patients. As usual, some patients cannot tolerate some of the above, so you have to keep looking. And sometimes, it is worthwhile to try one that you have tried in the past because sometimes a miracle occurs and what you couldn't tolerate 3 years ago, your body suddenly embraces.
Verapamil is hot in California and is used quite a lot there with good results. Topamax is fairly new for use in bipolar patients, but what I'm hearing is phenomenal -- patients losing all the weight that Lithium put on them, total control of symptoms without side effects. Let's take that with a grain of salt, but it's worth a look because it is totally different from some of the other mood stabilizers/anticonvulsants. Zyprexa is an antipsychotic but it has been getting a reputation as an excellent mood stabilizer, especially for irritable manics and you don't have to be hearing voices for it to work.
One final option for treatment of mania is electroconvulsive therapy. The Scientologists malign it terribly, but there are people alive and well today because it worked when no medication or other therapy would. It is safe (the biggest risk is from the anesthesia, not the ECT), it isn't painful like it was in the 1940's (no strapping patients down and shocking them when they're awake -- you are now comfortably put to sleep with anesthesia and your body is relaxed so your muscles don't get sore), and the dreaded memory losses are limited to the hour or so before and after the actual ECT -- the horror stories of complete amnesia are just not true (I know somebody will write in about their Aunt Millie, but I think something else is probably going on with Aunt Millie). ECT is exquisitely effective for mania, even more so than for depression, and you don't have to tolerate ongoing medication side effects. If it was me or my beloved child, I would want ECT, not medications, but that's just me.
Talk to your doctor.

 

Re: effexor and mania

Posted by Deirdre on February 8, 1999, at 22:33:40

In reply to Re: effexor and mania, posted by Toby on August 13, 1998, at 15:54:21

> On the subject of Effexor and mania, I have some personal experience. Granted, My bipolar disorder is heavily on the depressive side, but I find that when in withdrawl from Effexor, I am very susceptible to manic episodes, including the hyperactivity, impulsiveness, and general inappropriateness that that entails. Effexor has worked quite well in controlling my depression for over two years, but I would warn anyone who is considering this drug that its side effects are severe and physical as well as mental. While withdrawing (even with a very slow reduction in dosage)I have experienced involuntary shaking, dizziness, and a strange sensation of a millisecond lag between a movement and my mental perception of that movement - what I can only describe as internalized trails. Not pleasant. So, its a trade-off. All one can hope for while withdrawing from Effexor is patience and a sympathetic psychiatrist. Good luck.

 

Re: effexor and mania

Posted by shelley on February 11, 1999, at 19:26:43

In reply to Re: effexor and mania, posted by Deirdre on February 8, 1999, at 22:33:40

involuntary shaking, dizziness, and a strange sensation of a
millisecond lag between a movement and my mental perception of that movement -
what I can only describe as internalized trails

I had these effects the entire time I took Effexor, whether withdrawing or not, about 6 months....I thought I was going insane. My doc said this situation is not possible. I don't take Effexor anymore, neither do I shake or any of the other "manic"-like things you described. I'm glad I am not the only one. Shelley

 

visual trails

Posted by Dr. Bob on February 12, 1999, at 23:30:22

In reply to Re: effexor and mania, posted by Deirdre on February 8, 1999, at 22:33:40

> > While withdrawing (even with a very slow reduction in dosage)I have experienced ... a strange sensation of a millisecond lag between a movement and my mental perception of that movement - what I can only describe as internalized trails. Not pleasant.

You might be interested in the discussion at:

http://www.dr-bob.org/tips/split/Medication-visual-trails.html

Bob


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