![[dr. bob]](/dr-bob-sm.gif)
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 Collete on July 29, 2001, at 15:22:20
I have been on Prozac for bipolar depression ever since it came on the market. The past two years or so I have had a problem with persistant dysthymia and insomnia( well I've always had the insomnia). I finally saw a pdoc and he perscribed Depakote(250mg)in addition to the Prozac. Everything I read says it's for mania, which I never had. Does this make sense? Additionally, I take Xanax and benedryl at night to get to sleep.I am new here. Thank you, Collette
Posted by Else on July 29, 2001, at 20:37:13
In reply to Depakote for dysthymia?, posted by Collete on July 29, 2001, at 15:22:20
I don't understand how you could have been diagnosed with bipolar depression if you've never been manic. Perhaps you meant unipolar depression. If so, Depakote is sometimes used to augment the effects of an anti-depressant that is responding only partially. If in fact you do have bipolar disorder, then Depakote is indicated as well as a mood stabilizer. 250mg is a very small dose so I'm assuming your doctor has prescribed it to augment the Prozac rather than prevent mania or hypomania.
> I have been on Prozac for bipolar depression ever since it came on the market. The past two years or so I have had a problem with persistant dysthymia and insomnia( well I've always had the insomnia). I finally saw a pdoc and he perscribed Depakote(250mg)in addition to the Prozac. Everything I read says it's for mania, which I never had. Does this make sense? Additionally, I take Xanax and benedryl at night to get to sleep.I am new here. Thank you, Collette
Posted by Collete on July 30, 2001, at 9:41:38
In reply to Re: Depakote for dysthymia? » Collete, posted by Else on July 29, 2001, at 20:37:13
Thank you for your response. Actually, I never thought I was bipolar, but that is the diagnosis I was given after spending one year is a depression study at the Univ. of PA. The pdoc seemed to feel I had mood swings even though the "up" cycles were never manic. At any rate, Prozac has helped me tremendously and I have been on it for about 14 years(or as long as it's been available) but lately, I still experience what has been called dysthymia. I have many depression symptoms but can still function. I have felt that the Prozac wasn't "working" very well for me anymore, so I went to see this pdoc, who prescribed Depakote. I am starting to learn what I can online and Depakote just doesn't sound sensible to me. He says he wants to stop my swings, but I already feel so lifeless all the time.
Posted by Else on July 30, 2001, at 19:12:48
In reply to Re: Depakote for dysthymia?, posted by Collete on July 30, 2001, at 9:41:38
I'm assuming your diagnosis is Bipolar II or Cyclothymia. This means you must have been hypomanic at least at some point in your life. If your "ups" weren't manic then what were they?
It's possible your diagnosis is wrong and that Depakote is not needed. I have been given a (dubious) diagnosis of Borderline Personnality Disorder mainly due to the fact that I am both labile and impulsive. I found anticonvulsants like Depakote and Neurontin considerably reduced my impulsive , sometimes self-destructive behavior. But I do feel this relief comes along with a price tag: a sort of numbness, not as bad as what I get with SSRIs, but similar. If you are not impulsive or out of control, you may not need Depakote. Wellbutrin is a more activating type of antidepressant than Prozac and is indicated in Bipolars because it appears to be the least likely to trigger mania according to many doctors(oddly, it made me hypomanic twice, but let's assume my reaction was atypical.)You say you feel so lifeless all the time. That's pretty much how I felt the whole time I was on Zoloft. I took it for almost a year and never responded. I actually attempted suicide while I was on is (not BECAUSE of it, but IN SPITE of it). SSRIs may not be ideal for you. Consider different types of antidepressants. A lot of them are mentionned on this board but just in case you don't know, if you don't respond to Prozac, you're not likely to respond to Paxil, Zoloft, Luvox or Celexa. They all do pretty much the same thing although some people respond differently. The same goes for TCAs. The only drug I ever found really useful was Parnate (an MAOI) but I was taken off after three weeks so I don't know whether the positive effects were due to the early, amphetamine-like effects of the drug or the antidepressant effect. I am tying to get my doctor to prescribe it again and not having much luck. But this is only one example. There are plenty of choices out there. Get as much information as you can before you see your doctor.
> Thank you for your response. Actually, I never thought I was bipolar, but that is the diagnosis I was given after spending one year is a depression study at the Univ. of PA. The pdoc seemed to feel I had mood swings even though the "up" cycles were never manic. At any rate, Prozac has helped me tremendously and I have been on it for about 14 years(or as long as it's been available) but lately, I still experience what has been called dysthymia. I have many depression symptoms but can still function. I have felt that the Prozac wasn't "working" very well for me anymore, so I went to see this pdoc, who prescribed Depakote. I am starting to learn what I can online and Depakote just doesn't sound sensible to me. He says he wants to stop my swings, but I already feel so lifeless all the time.
Posted by JohnL on July 31, 2001, at 4:43:38
In reply to Depakote for dysthymia?, posted by Collete on July 29, 2001, at 15:22:20
> I have been on Prozac for bipolar depression ever since it came on the market. The past two years or so I have had a problem with persistant dysthymia and insomnia( well I've always had the insomnia). I finally saw a pdoc and he perscribed Depakote(250mg)in addition to the Prozac. Everything I read says it's for mania, which I never had. Does this make sense? Additionally, I take Xanax and benedryl at night to get to sleep.I am new here. Thank you, Collette
Just my opinion, but I think the doc made a wrong choice. Depakote is likely to further dull your emotions, which is not exactly what you want to do for dysthymia. It's just the opposite actually.
Instead, my all time number one pick to combine with Prozac is Zyprexa. Zyprexa 5mg at dinner time will completely wipe out your insomnia, and turbocharge the Prozac at the same time. Wonderful combination. My own experience verifies this, but it is based on clinical research.
I could be wrong, and Depakote might work, but I seriously doubt it. The last thing you want to do is dull your senses, and that's what Depakote is likely to do.
John
Posted by Else on July 31, 2001, at 7:16:05
In reply to Re: Depakote for dysthymia?, posted by JohnL on July 31, 2001, at 4:43:38
Zyprexa is likely to dull senses as well.
> > I have been on Prozac for bipolar depression ever since it came on the market. The past two years or so I have had a problem with persistant dysthymia and insomnia( well I've always had the insomnia). I finally saw a pdoc and he perscribed Depakote(250mg)in addition to the Prozac. Everything I read says it's for mania, which I never had. Does this make sense? Additionally, I take Xanax and benedryl at night to get to sleep.I am new here. Thank you, Collette
>
> Just my opinion, but I think the doc made a wrong choice. Depakote is likely to further dull your emotions, which is not exactly what you want to do for dysthymia. It's just the opposite actually.
>
> Instead, my all time number one pick to combine with Prozac is Zyprexa. Zyprexa 5mg at dinner time will completely wipe out your insomnia, and turbocharge the Prozac at the same time. Wonderful combination. My own experience verifies this, but it is based on clinical research.
>
> I could be wrong, and Depakote might work, but I seriously doubt it. The last thing you want to do is dull your senses, and that's what Depakote is likely to do.
> John
Posted by Collete on July 31, 2001, at 12:31:31
In reply to Re: Depakote for dysthymia?, posted by Else on July 31, 2001, at 7:16:05
> Zyprexa is likely to dull senses as well.
>
>
>
> > > I have been on Prozac for bipolar depression ever since it came on the market. The past two years or so I have had a problem with persistant dysthymia and insomnia( well I've always had the insomnia). I finally saw a pdoc and he perscribed Depakote(250mg)in addition to the Prozac. Everything I read says it's for mania, which I never had. Does this make sense? Additionally, I take Xanax and benedryl at night to get to sleep.I am new here. Thank you, Collette
> >
> > Just my opinion, but I think the doc made a wrong choice. Depakote is likely to further dull your emotions, which is not exactly what you want to do for dysthymia. It's just the opposite actually.
> >
> > Instead, my all time number one pick to combine with Prozac is Zyprexa. Zyprexa 5mg at dinner time will completely wipe out your insomnia, and turbocharge the Prozac at the same time. Wonderful combination. My own experience verifies this, but it is based on clinical research.
> >
> > I could be wrong, and Depakote might work, but I seriously doubt it. The last thing you want to do is dull your senses, and that's what Depakote is likely to do.
> > JohnI saw my regular GP yesterday ( one who is pretty well informed about ADs) and he also felt that Depekote was worth trying. I tend to agree with both of your posts, based on what I am starting to learn online, but I may not be presenting all the facts about my symptoms and/or diagnosis correctly here( not purposly!). I intend to become more educated but I will try the Depekote,125mg tonite and if I don't have a problem, increase to the 250 the was perscribed and see what happens.
I have been on Prozac so long it is hard for me to recall my original symptoms and the dysthymia I experience is just what seems to bleed through the Prozac. Perhaps I will have to start from scratch. Thank you both for your responses.
Posted by JohnL on July 31, 2001, at 18:17:08
In reply to Re: Depakote for dysthymia?, posted by Else on July 31, 2001, at 7:16:05
> Zyprexa is likely to dull senses as well.
Not even. Wrongo, big time. I've never felt better in my life. And I could show countless names of regular people just like me who have had wonderful responses to the medications I talk about. In actuality, Zyprexa can dull the senses, but not likely at low doses. That's the whole trick with the APs. They act one way at low doses, and completely different at high doses. For depression related symptoms, high doses are all wrong. Just my opinion. :-)
>
>
>
> > > I have been on Prozac for bipolar depression ever since it came on the market. The past two years or so I have had a problem with persistant dysthymia and insomnia( well I've always had the insomnia). I finally saw a pdoc and he perscribed Depakote(250mg)in addition to the Prozac. Everything I read says it's for mania, which I never had. Does this make sense? Additionally, I take Xanax and benedryl at night to get to sleep.I am new here. Thank you, Collette
> >
> > Just my opinion, but I think the doc made a wrong choice. Depakote is likely to further dull your emotions, which is not exactly what you want to do for dysthymia. It's just the opposite actually.
> >
> > Instead, my all time number one pick to combine with Prozac is Zyprexa. Zyprexa 5mg at dinner time will completely wipe out your insomnia, and turbocharge the Prozac at the same time. Wonderful combination. My own experience verifies this, but it is based on clinical research.
> >
> > I could be wrong, and Depakote might work, but I seriously doubt it. The last thing you want to do is dull your senses, and that's what Depakote is likely to do.
> > John
Posted by Else on August 1, 2001, at 6:54:57
In reply to Re: Depakote for dysthymia? Else, posted by JohnL on July 31, 2001, at 18:17:08
I've been told it feels like a very strong antihistamine. That would make me think it does indeed dull the senses because even something as benign as Benadryl does. But I have not tried it and you have, so perhaps you're correct. Still I don't think it would be good for dysthymia, especially combined with Prozac and even more especially if Prozac has not worked in the past.
> > Zyprexa is likely to dull senses as well.
>
> Not even. Wrongo, big time. I've never felt better in my life. And I could show countless names of regular people just like me who have had wonderful responses to the medications I talk about. In actuality, Zyprexa can dull the senses, but not likely at low doses. That's the whole trick with the APs. They act one way at low doses, and completely different at high doses. For depression related symptoms, high doses are all wrong. Just my opinion. :-)
> >
> >
> >
> > > > I have been on Prozac for bipolar depression ever since it came on the market. The past two years or so I have had a problem with persistant dysthymia and insomnia( well I've always had the insomnia). I finally saw a pdoc and he perscribed Depakote(250mg)in addition to the Prozac. Everything I read says it's for mania, which I never had. Does this make sense? Additionally, I take Xanax and benedryl at night to get to sleep.I am new here. Thank you, Collette
> > >
> > > Just my opinion, but I think the doc made a wrong choice. Depakote is likely to further dull your emotions, which is not exactly what you want to do for dysthymia. It's just the opposite actually.
> > >
> > > Instead, my all time number one pick to combine with Prozac is Zyprexa. Zyprexa 5mg at dinner time will completely wipe out your insomnia, and turbocharge the Prozac at the same time. Wonderful combination. My own experience verifies this, but it is based on clinical research.
> > >
> > > I could be wrong, and Depakote might work, but I seriously doubt it. The last thing you want to do is dull your senses, and that's what Depakote is likely to do.
> > > John
Posted by Collete on August 1, 2001, at 8:28:41
In reply to Re: Depakote for dysthymia? Else » JohnL, posted by Else on August 1, 2001, at 6:54:57
> I've been told it feels like a very strong antihistamine. That would make me think it does indeed dull the senses because even something as benign as Benadryl does. But I have not tried it and you have, so perhaps you're correct. Still I don't think it would be good for dysthymia, especially combined with Prozac and even more especially if Prozac has not worked in the past.
Actually, the Prozac was not perscribed for dysthymia, it was for BPD. It's just that the prozac doesn't seem to be working AS WELL AS IT USED TO and so now I feel like what would be described as dysthymic. I too have periods of terrible irritablity, if not anger, and I believe that may be part of why Depakote was perscribed. If it doesn't help, I will suggest adding a small amount of Zyprexa, unless the pdoc really wants me to try a different AD. I don't mind the dull feelings as much as the fatique and lack of any motivation or ability to finish anything.
Posted by Ignatz on August 1, 2001, at 9:44:39
In reply to Re: Depakote for dysthymia? Else, posted by Collete on August 1, 2001, at 8:28:41
I've found Depakote to be a helpful addition to Effexor at times. I don't feel dysthymic on Effexor-- mostly "normal"- but every now and then I start feeling really panicky that I'm getting depressed again- and Depakote levels me right out. (It also makes me a little tired, so I don't want to stay on it forever...)
Posted by Collete on August 1, 2001, at 10:49:55
In reply to Re: Depakote for dysthymia? Else, posted by Ignatz on August 1, 2001, at 9:44:39
> I've found Depakote to be a helpful addition to Effexor at times. I don't feel dysthymic on Effexor-- mostly "normal"- but every now and then I start feeling really panicky that I'm getting depressed again- and Depakote levels me right out. (It also makes me a little tired, so I don't want to stay on it forever...)
Do you take the Depakote daily or as needed and how much? I am glad to hear that it helps you.
Posted by Else on August 1, 2001, at 18:56:22
In reply to Re: Depakote for dysthymia? Else, posted by Collete on August 1, 2001, at 8:28:41
If you think Zyprexa will help, it's up to you. My only advice is, look it up in the PDR before. Me and JohnL strongly disagree on this as you may have noticed. I guess you can see for yourself. I personnally would never try it but if you respond as well as he does (which is unlikely since he also takes a stimulant along with the Prozac and Zyprexa, whereas you don't), good for you.
> > I've been told it feels like a very strong antihistamine. That would make me think it does indeed dull the senses because even something as benign as Benadryl does. But I have not tried it and you have, so perhaps you're correct. Still I don't think it would be good for dysthymia, especially combined with Prozac and even more especially if Prozac has not worked in the past.
>
> Actually, the Prozac was not perscribed for dysthymia, it was for BPD. It's just that the prozac doesn't seem to be working AS WELL AS IT USED TO and so now I feel like what would be described as dysthymic. I too have periods of terrible irritablity, if not anger, and I believe that may be part of why Depakote was perscribed. If it doesn't help, I will suggest adding a small amount of Zyprexa, unless the pdoc really wants me to try a different AD. I don't mind the dull feelings as much as the fatique and lack of any motivation or ability to finish anything.
Posted by Else on August 1, 2001, at 18:59:45
In reply to Re: Depakote for dysthymia? Else, posted by Ignatz on August 1, 2001, at 9:44:39
I was on both Effexor and Depakote this winter and felt really awful the whole time. I never slept and the Depakote made me swell like a baloon. This really did not work for me at all. Actually I wish I could handle Effexor because a lot of people seem to improve a lot on it but the nervous tension just never went away and I had to stop taking it.
> I've found Depakote to be a helpful addition to Effexor at times. I don't feel dysthymic on Effexor-- mostly "normal"- but every now and then I start feeling really panicky that I'm getting depressed again- and Depakote levels me right out. (It also makes me a little tired, so I don't want to stay on it forever...)
Posted by DaveW on August 1, 2001, at 23:44:10
In reply to Re: Depakote for dysthymia? Else » Ignatz, posted by Else on August 1, 2001, at 18:59:45
Working in a mental health clinic I've noticed a large upswing in Depakote prescriptions as well as the diagnosis of bipolar disorder. I think there is often a rush to try new drugs for mental health problems, and it's understandable given the desperation people (including myself) feel who suffer from depression/bipolar/etc. I have thought about Depakote also for myself but I have heard mixed reviews--in general from the people I've talked to it works better for bipolar than unipolar. I've seen people with bonafide mania improve on it, but people who lack the mania (which again I think is being overdiagnosed) haven't seen much improvement. Again, based only on a few observations. In the meantime, I am also finding Prozac after 5 years not as effective, with more fatigue, so I am considering adding a stimulant but I tried Ritalin and it created too much anxiety so I am searching for something else. I had hoped Reboxetine (Edronax, Vestra) would be a possibility but from the posts I don't see too many people having much luck with it and I see where the FDA has delayed again approving it (By the way, if anyone knows why the FDA did not approve, I'd be interested to know). Great website and forum and it's helped me to feel less "alone" and "unique" with my own symptoms. Thanks for the input.
Posted by Collete on August 2, 2001, at 9:34:09
In reply to Re: Depakote for dysthymia? Else, posted by DaveW on August 1, 2001, at 23:44:10
Dave in an odd way, it is reassuring to hear someone else share my problem. Even though I never suffered what I felt were manic symptoms, I think my new pdoc is taking my mood swings and periods on tremendous unfocused anger into consideration. The more I read, I can see why he is trying Depekote for me. Because I have a house ful of company coming for a week (what could be worse?) I am going to put off the Depakote for several days. I recently doubled my Prozac ot 40mg and have noticed my usual bizarre dreams to be even more horrible. Also, I am eating a lot more junk food with no control(in the house for my guests). I don't know if this is from the increased Prozac, but I decided to drop back to 20 mg since I didn't see much improvement anyway. I am glad to hear from you,
Collette
Posted by MB on August 2, 2001, at 17:42:35
In reply to Re: Depakote for dysthymia? Else » JohnL, posted by Else on August 1, 2001, at 6:54:57
> I've been told it feels like a very strong antihistamine. That would make me think it does indeed dull the senses because even something as benign as Benadryl does. But I have not tried it and you have, so perhaps you're correct. Still I don't think it would be good for dysthymia, especially combined with Prozac and even more especially if Prozac has not worked in the past.
I thought Zyprexa felt like a really strong antihistamine. 2.5mg knocked me right out (it was a danger to drive home...I was not even warned to take it at night). I took another dose the next day despite how bad it made me feel. The third day, I took no more, but I was paralyzed with fatigue for about three days after that...just couldn't function whatsoever.
I have to admit, I am *very* sensitive to antihistamines. I couldn't keep my eyes open on Zyrtec, and 7.5mg Remeron left me feeling comatose for 48 hours.
to tell you the truth, I can't tell the difference between antipsychotics, tricyclics and plain old antihistamines...they all feel the same...I pass out for 24-48 hrs, then suffer fatigued insomnia: all I can do is lie there, but I can no longer sleep...just lie there immobilized. If i stay on them for more than a few days, I get relly bad restless legs...it feels like someone has injected itching powder deep into the muscles, and it's excrutiatingly itchy and uncomfortable not to wiggle, kick and writhe.
Posted by Else on August 2, 2001, at 21:08:49
In reply to Re: Depakote for dysthymia? Else » Else, posted by MB on August 2, 2001, at 17:42:35
That's pretty much how I feel on Dramamine, Benadryl, Phenergan and worst of all, Desyrel. I have never tried anti-psychotics but somehow they don't sound too tempting.
> > I've been told it feels like a very strong antihistamine. That would make me think it does indeed dull the senses because even something as benign as Benadryl does. But I have not tried it and you have, so perhaps you're correct. Still I don't think it would be good for dysthymia, especially combined with Prozac and even more especially if Prozac has not worked in the past.
>
> I thought Zyprexa felt like a really strong antihistamine. 2.5mg knocked me right out (it was a danger to drive home...I was not even warned to take it at night). I took another dose the next day despite how bad it made me feel. The third day, I took no more, but I was paralyzed with fatigue for about three days after that...just couldn't function whatsoever.
>
> I have to admit, I am *very* sensitive to antihistamines. I couldn't keep my eyes open on Zyrtec, and 7.5mg Remeron left me feeling comatose for 48 hours.
>
> to tell you the truth, I can't tell the difference between antipsychotics, tricyclics and plain old antihistamines...they all feel the same...I pass out for 24-48 hrs, then suffer fatigued insomnia: all I can do is lie there, but I can no longer sleep...just lie there immobilized. If i stay on them for more than a few days, I get relly bad restless legs...it feels like someone has injected itching powder deep into the muscles, and it's excrutiatingly itchy and uncomfortable not to wiggle, kick and writhe.
Posted by super on August 3, 2001, at 15:32:43
In reply to Re: Depakote for dysthymia? Else » Else, posted by MB on August 2, 2001, at 17:42:35
my gosh, that sounds awful!!!
> > I've been told it feels like a very strong antihistamine. That would make me think it does indeed dull the senses because even something as benign as Benadryl does. But I have not tried it and you have, so perhaps you're correct. Still I don't think it would be good for dysthymia, especially combined with Prozac and even more especially if Prozac has not worked in the past.
>
> I thought Zyprexa felt like a really strong antihistamine. 2.5mg knocked me right out (it was a danger to drive home...I was not even warned to take it at night). I took another dose the next day despite how bad it made me feel. The third day, I took no more, but I was paralyzed with fatigue for about three days after that...just couldn't function whatsoever.
>
> I have to admit, I am *very* sensitive to antihistamines. I couldn't keep my eyes open on Zyrtec, and 7.5mg Remeron left me feeling comatose for 48 hours.
>
> to tell you the truth, I can't tell the difference between antipsychotics, tricyclics and plain old antihistamines...they all feel the same...I pass out for 24-48 hrs, then suffer fatigued insomnia: all I can do is lie there, but I can no longer sleep...just lie there immobilized. If i stay on them for more than a few days, I get relly bad restless legs...it feels like someone has injected itching powder deep into the muscles, and it's excrutiatingly itchy and uncomfortable not to wiggle, kick and writhe.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.