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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 23 of 23. This is the beginning of the thread.
Posted by Zo on July 8, 2001, at 16:44:14
thanks for any feedback,
Zo
Posted by SalArmy4me on July 8, 2001, at 22:52:54
In reply to Can Zyprexa stimulate Hypomania?, posted by Zo on July 8, 2001, at 16:44:14
From http://www.dr-bob.org/tips/split/Antidep-effects-of-antipsy.html:
Date: Tue, 14 Jan 1997 08:10:33 -0800 (PST)
From: Joseph Barrett < jbarrett@u.washington.edu >
Subject: Activating effects of olanzapineMy experience with olanzapine has been that it does cause activation and potentially hypomania in bipolar and schizoaffective patients. This often comes as a relief to patients mired in clozapine sedation, but it has possible risks of worsening cycles.
Date: Wed, 15 Jan 1997 22:09:26 -0600
From: Ereshefsky@uthscsa.edu (Larry Ereshefsky)
Subject: Activating effects of olanzapineThere are anecdotal reports (many members of the Lilly Advisory Board for Zyprexa concur) suggesting some activation of bipolar patients if mood stabilizers are not coadministered.
Posted by Zo on July 8, 2001, at 23:10:12
In reply to Re: Can Zyprexa stimulate Hypomania?, posted by SalArmy4me on July 8, 2001, at 22:52:54
Thanks, you're a wonder! I don't know how you found this, I searched through tip after tip! Thought maybe I was going bonkers because Zyprexa is supposed to *medicate* bipolar, not stimulate it!
Zo
Posted by Glenn Fagelson on July 9, 2001, at 14:17:00
In reply to Can Zyprexa stimulate Hypomania?, posted by Zo on July 8, 2001, at 16:44:14
> thanks for any feedback,
> ZoHi Zo,
2 weeks ago , My doc put me on 19 mg
of Zyprexa; I got hypomanic!! I asked
him to reduce the Zyprexa to 5 mg and
add 600mg of Neurontin. It's worked!!
Glenn
Posted by Zo on July 9, 2001, at 14:33:39
In reply to Re: Can Zyprexa stimulate Hypomania? » Zo, posted by Glenn Fagelson on July 9, 2001, at 14:17:00
Thanks, Glen.. . .My BP II is fairly subtle, hard to tease out the dx, but reading here is *so* helpful. My only flagrant hypomanic episode, bordering on mania but then I crashed, was from going off Effexor overnight, impulsively (typical BP decision!) a few years ago. .. Some controversy over whether such is diagnostic, or could happen to anybody.
Xo
Posted by MB on July 9, 2001, at 21:30:02
In reply to Re: Can Zyprexa stimulate Hypomania? » Glenn Fagelson, posted by Zo on July 9, 2001, at 14:33:39
> Thanks, Glen.. . .My BP II is fairly subtle, hard to tease out the dx, but reading here is *so* helpful. My only flagrant hypomanic episode, bordering on mania but then I crashed, was from going off Effexor overnight, impulsively (typical BP decision!) a few years ago. .. Some controversy over whether such is diagnostic, or could happen to anybody.
>
> XoHa! You sound like me!! I have a history of getting fed up with my medication an flushing the whole bottle down the toilet in a rage. I've probably done that ten times over the years. Then the drug withdrawals kick in, and I sheepishly refill my prescription...or, if it's been too soon since my last refill, I suffer the withdrawal in vehement self-loathing and indignation. I thought it was just compulsive, not bipolar. Do you think (hypo)mania on ADs is indicative of bipolar disorder or not? I've heard some say that a (hypo)manic episode is necessary off of medication to warrant the diagnosis.
Posted by Zo on July 9, 2001, at 21:37:12
In reply to Re: Can Zyprexa stimulate Hypomania? » Zo, posted by MB on July 9, 2001, at 21:30:02
> Do you think (hypo)mania on ADs is indicative of >bipolar disorder or not? I've heard some say that a >(hypo)manic episode is necessary off of medication to >warrant the diagnosis.Um, that's my question. . .Let me know if you come across any references.
Zo
Posted by MB on July 9, 2001, at 21:45:44
In reply to Re: Can Zyprexa stimulate Hypomania? » MB, posted by Zo on July 9, 2001, at 21:37:12
>
> > Do you think (hypo)mania on ADs is indicative of >bipolar disorder or not? I've heard some say that a >(hypo)manic episode is necessary off of medication to >warrant the diagnosis.
>
> Um, that's my question. . .Let me know if you come across any references.
>
> ZoWell, in the DMS-IV it says that the hypomanic episode can't be drug induced if it is to count toward the diagnosis. I don't know if that has changed or not. Have you seen this site? http://www.psycheducation.org/ A friend of mine was seen by the doctor that wrote it. He seemed to think that "doing worse" on antidepressants was indicative of bipolar two, and that the DMS-IV had criteria that was too restrictive in warranting the diagnosis. However, he specialises in bipolar disorders and admitted to my friend that he could "find bipolar disorder under a rock" if he were to look there. So, he's not the most objective. Sometimes I wonder about these diagnoses. Do individual disorders fit so neatly into these boxes? That's what I wonder.
Posted by Zo on July 10, 2001, at 1:17:11
In reply to Re: Can Zyprexa stimulate Hypomania? » Zo, posted by MB on July 9, 2001, at 21:45:44
> Sometimes I wonder about these diagnoses. Do individual disorders fit so neatly into these boxes? That's what I wonder.
I wonder too, in fact am downright skeptical. . .or a little in awe of people who have such distinct dxs. How do they *know*? I have been at this for 15 years, and the best use I can find for dx is knowing how to moderate, what to avoid. Bipolar - TLE - ADD - Creative - High IQ - CFS - abusive childhood - it's a SPECTRUM. . .or a hologram, one that depends on who's looking, and on their point of view.
Zo
Posted by MB on July 10, 2001, at 3:33:43
In reply to Re: Can Zyprexa stimulate Hypomania? » MB, posted by Zo on July 10, 2001, at 1:17:11
> > Sometimes I wonder about these diagnoses. Do individual disorders fit so neatly into these boxes? That's what I wonder.
>
> I wonder too, in fact am downright skeptical. . .or a little in awe of people who have such distinct dxs. How do they *know*? I have been at this for 15 years, and the best use I can find for dx is knowing how to moderate, what to avoid. Bipolar - TLE - ADD - Creative - High IQ - CFS - abusive childhood - it's a SPECTRUM. . .or a hologram, one that depends on who's looking, and on their point of view.
>
> Zo
Right, and where do you draw a line between "disorder" and just plain "eccentric"? I guess when it interferes with daily functioning, it becomes a disorder. I guess with "psychoses" it's more straightforward: if an individual's perception is not corroboratable via ordinary consensus, they're "crazy"...but what about personality "disorders" and neuroses? The same character trait that hinders functioning might actually be a character asset in lesser amounts (e.g. the fastidiousness of an obsessive-compulsive personality might make for a really good accountant if the aforementioned fastidiousness could be harnessed), so what's being done to the individuality of a psyche--its uniqueness--when certain traits are medicated into oblivion? Would those traits flourish in a different environment; a differnt society? Would a compulsive liar, for example, flailing in his job as a bank teller, thrive as a short story writer? In other words, am I really depressive and in need of medication, or am I just living the wrong life? That is, am I sick or just an eccentric personality for which this society has no place? To medicate or to run off into the woods to engage in some lifelong, makeshift tribal ritual, that is the question.
Posted by Mitch on July 10, 2001, at 11:24:52
In reply to Re: Can Zyprexa stimulate Hypomania?, posted by MB on July 10, 2001, at 3:33:43
> > > Sometimes I wonder about these diagnoses. Do individual disorders fit so neatly into these boxes? That's what I wonder.
> >
> > I wonder too, in fact am downright skeptical. . .or a little in awe of people who have such distinct dxs. How do they *know*? I have been at this for 15 years, and the best use I can find for dx is knowing how to moderate, what to avoid. Bipolar - TLE - ADD - Creative - High IQ - CFS - abusive childhood - it's a SPECTRUM. . .or a hologram, one that depends on who's looking, and on their point of view.
> >
> > Zo
>
>
> Right, and where do you draw a line between "disorder" and just plain "eccentric"? I guess when it interferes with daily functioning, it becomes a disorder. I guess with "psychoses" it's more straightforward: if an individual's perception is not corroboratable via ordinary consensus, they're "crazy"...but what about personality "disorders" and neuroses? The same character trait that hinders functioning might actually be a character asset in lesser amounts (e.g. the fastidiousness of an obsessive-compulsive personality might make for a really good accountant if the aforementioned fastidiousness could be harnessed), so what's being done to the individuality of a psyche--its uniqueness--when certain traits are medicated into oblivion? Would those traits flourish in a different environment; a differnt society? Would a compulsive liar, for example, flailing in his job as a bank teller, thrive as a short story writer? In other words, am I really depressive and in need of medication, or am I just living the wrong life? That is, am I sick or just an eccentric personality for which this society has no place? To medicate or to run off into the woods to engage in some lifelong, makeshift tribal ritual, that is the question.Wow, this is a fascinating discussion. We have learned that our experiences "re-wire" our brain. Well what if the type of society that we live in now has re-wired our brains and made half of us ill that wouldn't have been ill otherwise?? I am thinking in the context of the "Third Wave" of technology (the information age). So now we have to use medications to correct the imbalances brought on by an "ill" environment. Sounds a lot like Soma in Huxley's 1984.....
Posted by Mitch on July 10, 2001, at 11:35:14
In reply to Re: Can Zyprexa stimulate Hypomania?, posted by MB on July 10, 2001, at 3:33:43
Zo/MB:
Whoops!
I guess George Orwell wrote 1984...but there was something in my brain that was thinking Aldous Huxley. I guess I just have a haywire personality disorder. Alright, where did I put that Zoloft bottle? :-)
Posted by Zo on July 10, 2001, at 14:37:12
In reply to Re: Can Zyprexa stimulate Hypomania? » MB, posted by Mitch on July 10, 2001, at 11:24:52
Funny you should mention the environment: a great portion of my illness is as a result of pesticide exposures, piled on top of a genetric vulnerability - I do believe my entire family suffers from that glitch on the dopamine receptor site - part of which vulnerability, it is theorized, stems from high intelligence and the resultant overabundance of receptor sites. . .!
I suppose what we're talking about is whethere your dx/eccentricity gets in the way of what you want to do in life. Or, whether you feel like hell or not. I simply don't stay on any med that makes me feel zoned out - that's no answer.
But I've no doubt those of us born after WWII (starting with me, as oldest!) are affected by a whole new plasticized, sprayed, fumigated environment. . .and that we ARE the canaries, keeling over left and right. The human brain wasn't meant to tolerate all this s**t.
Zo
Posted by Mitch on July 11, 2001, at 1:24:45
In reply to Re: Can Zyprexa stimulate Hypomania?, posted by Zo on July 10, 2001, at 14:37:12
> Funny you should mention the environment: a great portion of my illness is as a result of pesticide exposures, piled on top of a genetric vulnerability - I do believe my entire family suffers from that glitch on the dopamine receptor site - part of which vulnerability, it is theorized, stems from high intelligence and the resultant overabundance of receptor sites. . .!
>
> I suppose what we're talking about is whethere your dx/eccentricity gets in the way of what you want to do in life. Or, whether you feel like hell or not. I simply don't stay on any med that makes me feel zoned out - that's no answer.
>
> But I've no doubt those of us born after WWII (starting with me, as oldest!) are affected by a whole new plasticized, sprayed, fumigated environment. . .and that we ARE the canaries, keeling over left and right. The human brain wasn't meant to tolerate all this s**t.
>
> ZoZo,
I was bringing up the "environment" not as chemicals that we can't perceive affecting us in an invisible anonymous toxic sense. I was talking about our *culture* and how technology affects OUR THOUGHTS AND BELIEFS ABOUT OURSELVESS AND OTHERS. These experiences ALTER our brain connections. And if the individuals we interact with (as well as ourselves) have been fundamentally changed by medications (for good or ill), then that is also SHAPING our brain connections.
Mitch
Posted by MB on July 11, 2001, at 1:51:29
In reply to Re: Can Zyprexa stimulate Hypomania? » MB, posted by Mitch on July 10, 2001, at 11:24:52
> > > > Sometimes I wonder about these diagnoses. Do individual disorders fit so neatly into these boxes? That's what I wonder.
> > >
> > > I wonder too, in fact am downright skeptical. . .or a little in awe of people who have such distinct dxs. How do they *know*? I have been at this for 15 years, and the best use I can find for dx is knowing how to moderate, what to avoid. Bipolar - TLE - ADD - Creative - High IQ - CFS - abusive childhood - it's a SPECTRUM. . .or a hologram, one that depends on who's looking, and on their point of view.
> > >
> > > Zo
> >
> >
> > Right, and where do you draw a line between "disorder" and just plain "eccentric"? I guess when it interferes with daily functioning, it becomes a disorder. I guess with "psychoses" it's more straightforward: if an individual's perception is not corroboratable via ordinary consensus, they're "crazy"...but what about personality "disorders" and neuroses? The same character trait that hinders functioning might actually be a character asset in lesser amounts (e.g. the fastidiousness of an obsessive-compulsive personality might make for a really good accountant if the aforementioned fastidiousness could be harnessed), so what's being done to the individuality of a psyche--its uniqueness--when certain traits are medicated into oblivion? Would those traits flourish in a different environment; a differnt society? Would a compulsive liar, for example, flailing in his job as a bank teller, thrive as a short story writer? In other words, am I really depressive and in need of medication, or am I just living the wrong life? That is, am I sick or just an eccentric personality for which this society has no place? To medicate or to run off into the woods to engage in some lifelong, makeshift tribal ritual, that is the question.
>
> Wow, this is a fascinating discussion. We have learned that our experiences "re-wire" our brain. Well what if the type of society that we live in now has re-wired our brains and made half of us ill that wouldn't have been ill otherwise?? I am thinking in the context of the "Third Wave" of technology (the information age). So now we have to use medications to correct the imbalances brought on by an "ill" environment. Sounds a lot like Soma in Huxley's 1984.....Yeah, or vodka in Soviet Russia. Sometimes I really do think that I wouldn't need medication if I could run off half naked with some tribe somewhere in the Amazon. A lot of my depression comes from the fact that I fail to see this society as capable of offering *anything* meaningful or worthwhile. Then I stop and wonder if that thought isn't indicative of a *greater* need for medication!! LOL!
Posted by MB on July 11, 2001, at 1:54:34
In reply to Re: Can Zyprexa stimulate Hypomania? » MB, posted by Mitch on July 10, 2001, at 11:35:14
> Zo/MB:
>
> Whoops!
>
> I guess George Orwell wrote 1984...but there was something in my brain that was thinking Aldous Huxley. I guess I just have a haywire personality disorder. Alright, where did I put that Zoloft bottle? :-)Aldus Huxley wrote Brave New World, and there was a drug used in that book, I think, by the government to keep the discontent people subdued. Aldus Huxley was quite the LSD tripper, you know.
Posted by Zo on July 13, 2001, at 1:41:16
In reply to Can Zyprexa stimulate Hypomania?, posted by Zo on July 8, 2001, at 16:44:14
Well. What I learned today: that my pdoc has considered me Bipolar II for a long time. . .we just kind of got distracted what with my TLE being revealed this year, and with some RL issues.
But he also says the high I got from Zyprexa was almost surely NOT hypomania, because mania of any degree is marked first and foremost by a reduction in sleep.
His first line of treatment for me, at this point, is - you may have read about this discovery - an omega-3 supplement called OmegaBrite, avail. only from their website, omegabrite.com. For omega-3 to work on bipolar, there must be a 2 to 1 ratio of EPA to DHA - apparently hard to find.
For anyone interested, the dosing is:
4caps 2x daily for the first week
5 caps " " for the second
6 caps " " for the third.Benefit normally appears between weeks 2 and 3; the efffective dose range is btwn 2.5 and 6 grams of *EPA* daily.
I'll be starting as soon as it arrives. He says about 6 out of 10 of his patients get good effect from this; the others feel nothing. And the neat thing is, no downside!
Thanks for all the great feedback!
Zo
Posted by Cecilia on July 13, 2001, at 2:51:21
In reply to Re: Zo's pdoc answers the question, posted by Zo on July 13, 2001, at 1:41:16
> Well. What I learned today: that my pdoc has considered me Bipolar II for a long time. . .we just kind of got distracted what with my TLE being revealed this year, and with some RL issues.
>
> But he also says the high I got from Zyprexa was almost surely NOT hypomania, because mania of any degree is marked first and foremost by a reduction in sleep.
>
> His first line of treatment for me, at this point, is - you may have read about this discovery - an omega-3 supplement called OmegaBrite, avail. only from their website, omegabrite.com. For omega-3 to work on bipolar, there must be a 2 to 1 ratio of EPA to DHA - apparently hard to find.
>
> For anyone interested, the dosing is:
> 4caps 2x daily for the first week
> 5 caps " " for the second
> 6 caps " " for the third.
>
> Benefit normally appears between weeks 2 and 3; the efffective dose range is btwn 2.5 and 6 grams of *EPA* daily.
>
> I'll be starting as soon as it arrives. He says about 6 out of 10 of his patients get good effect from this; the others feel nothing. And the neat thing is, no downside!
>
> Thanks for all the great feedback!
> ZoRE: Fish oil capsules; there was definitely a downside for me: I gave them up after 2 days (one capsule a day) because of the horrible tasting fishy reflux-YUCK!
Posted by Mitch on July 13, 2001, at 13:08:59
In reply to Re: Zo's pdoc answers the question, posted by Zo on July 13, 2001, at 1:41:16
Hi, Zo,
Well, welcome to the BPII crowd! The reduced sleep test is the best one for hypomania. The atypical AP's have good antidepressant effects. I have tried Risperdal and Seroquel. The risperdal gave me dystonias though-had to stop it. The Seroquel would knock me out at nite real good-but ONE thing I ntoiced that was really neat-when it WORE OFF about 12-16 hrs. later-just before I would go to bed (and take my tiny bedtime dose for sleep) I had the most incredible ability to FOCUS and pay attention to things-it was really wonderful. There is some sort of anti-ADHD effect it has-can't put my finger on it.
Oh, the fish oil stuff-yep I tried it and I have got GERD and it was pretty nasty-BUT I have heard somewhere you can get some specially coated tabs or something that doesn't give you that.
Mitch
> Well. What I learned today: that my pdoc has considered me Bipolar II for a long time. . .we just kind of got distracted what with my TLE being revealed this year, and with some RL issues.
>
> But he also says the high I got from Zyprexa was almost surely NOT hypomania, because mania of any degree is marked first and foremost by a reduction in sleep.
>
> His first line of treatment for me, at this point, is - you may have read about this discovery - an omega-3 supplement called OmegaBrite, avail. only from their website, omegabrite.com. For omega-3 to work on bipolar, there must be a 2 to 1 ratio of EPA to DHA - apparently hard to find.
>
> For anyone interested, the dosing is:
> 4caps 2x daily for the first week
> 5 caps " " for the second
> 6 caps " " for the third.
>
> Benefit normally appears between weeks 2 and 3; the efffective dose range is btwn 2.5 and 6 grams of *EPA* daily.
>
> I'll be starting as soon as it arrives. He says about 6 out of 10 of his patients get good effect from this; the others feel nothing. And the neat thing is, no downside!
>
> Thanks for all the great feedback!
> Zo
Posted by Zo on July 13, 2001, at 16:39:50
In reply to Re: Zo's pdoc answers the question » Zo, posted by Mitch on July 13, 2001, at 13:08:59
Thanks, Mitch. I'm excited about trying the fish oil, will stock up on pickled ginger. . .that should help! Wish the flaxseed Omega-3 had the right ratio.
If it doesn't work, will give Lamictal another shot and build up VERY slowly as Cece suggested. Risperidol was another major bomb out. First time I tried Lamictal, didn't have Neurontin on board.
We're gonna get you on Dex or Adderall yet! Couldn't live with the lack of focus, without them. Focus is all, and pushing up the hypomania a little to get it is risky business, for me. Altho you would think the stimulants would stimulate mania, quite the opposite is true.
So there's the "Kindling" spectrum, all in one head, mine: Bipolar, TLE, Migraine and ADD. It's almost like one illness.
I don't know much about feeling really good that's not tweaking up a bit of hypomania. . .we shall see. Have a dreadful feeling *nothing's* as "good" as that!
Zo
Posted by Mitch on July 13, 2001, at 23:19:53
In reply to Re: Zo's pdoc answers the question » Mitch, posted by Zo on July 13, 2001, at 16:39:50
Zo, there IS something I have found for the ADHD that doesn't cause anxiety... I tried it last year during a seasonal depressive episode and it helped. Now, I am on it again for the same time of year. Nortripytline-just 10mg midday. It has REALLY helped the ADHD, AND I haven't gotten hypo on it like Desipramine did me. This is the end of the 3rd week on the very lowdose NT and I can hear words in songs again and can listen to people-like on Addrall-but without the edginess! It definitely is the NE that is helping. I don't notice any aggravated cycling on it either and I am also taking a smidge (12.5mg) of Zoloft with it. This is a new interesting combo: Zoloft+Nortripytline , Neurontin+Klonopin. I can attribute the *lack* of depression and attentional improvement for sure to the NT. Been sleeping a fairly decent 8 hours or so.
Mitch
> Thanks, Mitch. I'm excited about trying the fish oil, will stock up on pickled ginger. . .that should help! Wish the flaxseed Omega-3 had the right ratio.
>
> If it doesn't work, will give Lamictal another shot and build up VERY slowly as Cece suggested. Risperidol was another major bomb out. First time I tried Lamictal, didn't have Neurontin on board.
>
> We're gonna get you on Dex or Adderall yet! Couldn't live with the lack of focus, without them. Focus is all, and pushing up the hypomania a little to get it is risky business, for me. Altho you would think the stimulants would stimulate mania, quite the opposite is true.
>
> So there's the "Kindling" spectrum, all in one head, mine: Bipolar, TLE, Migraine and ADD. It's almost like one illness.
>
> I don't know much about feeling really good that's not tweaking up a bit of hypomania. . .we shall see. Have a dreadful feeling *nothing's* as "good" as that!
>
> Zo
Posted by Zo on July 14, 2001, at 0:16:31
In reply to Re: Zo's pdoc answers the question » Zo, posted by Mitch on July 13, 2001, at 23:19:53
Thanks for the suggestion. . .But I may have PTTD (post-traumatic tricyclic disorder). . .and don't get anxiety on Dex. But I'll keep it in mind, how very cool for you!
Zo
Posted by zidd on September 24, 2002, at 22:20:44
In reply to Re: Can Zyprexa stimulate Hypomania? » MB, posted by Mitch on July 10, 2001, at 11:24:52
I like the post about skepticism from ZO. I've often wandered if medication becomes a substitute for individuallity. It seems today that social development is like a codependency. Should we find a way to utilize our uniqueness? I know many strange people, even borderlines who are brilliant. I think it is okay not to worry too much about this though. These people like Lincoln, or hemingway with mood disorders or bipolar?? (who really knows) managed to make themeselves known. Your imagination will always remain wherever or whatever happens? And isn't It irony that these friends of our's who have something in the way ultimately inspire others to look at themeselves and wander if they personally are capable of more. This is more of phillosophy probally, but you can think about the context if you have some disorder. Zidd
This is the end of the thread.
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