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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by frozen on October 27, 2001, at 17:32:20
Hi, im new here, my names is Luca and im looking for some advices, as im facing the most 'ugly' part of my bipolar 2 disease.My mental functioning is very dulled and i feel even more depressed because of that.
Im currently taking 225 mgs of Effexor and 300 of lithium.I've never had 'manic phases', only aggressivity and depression, disphoria.
I was thinking about moclobemide to be a substitute to Effexor, moreover i read somewhere that it may boost one's mental energy.Do you have any infos about that?
Are Maois prescribed even to bipolars?Thank you
Luca from Italy
Posted by JahL on October 27, 2001, at 17:56:32
In reply to Cognitive depression, posted by frozen on October 27, 2001, at 17:32:20
> Hi, im new here, my names is Luca and im looking for some advices, as im facing the most 'ugly' part of my bipolar 2 disease.My mental functioning is very dulled. I've never had 'manic phases', only aggressivity and depression, disphoria.
Hi. I have the same kind of Bipolar II (hostile etc) & I find the cognitive dulling very frustrating. The only thing to help thus far, after 40+ medications, is Lamictal. It's no cure but it does help a fair bit. I've heard similar reports from others. It also seems to insulate me from factors that usually make my cognitive function worse; lack of sleep, pot etc.
> I was thinking about moclobemide ...
> Are Maois prescribed even to bipolars?I was given Parnate, Nardil & Moclobemide before I was diagnosed BPII. The first two worsened my depression whilst Moclobemide was like taking a placebo. However there wasn't a mood-stabilizer present at that time...
BTW, Lithium has a reputation for actually *causing* cognitive dulling. Indeed, for me, Lithium & Effexor were the worst offenders out of the lot in terms of cognitive dysfunction (though Nortriptylene gets an honourable mention...).
Good luck,
J.
Posted by frozen on October 27, 2001, at 18:52:37
In reply to Re: Cognitive depression » frozen, posted by JahL on October 27, 2001, at 17:56:32
Thanks JahL,so it may actually because of the lithium and efexor.Im trying to boost my brain functions taking some smart drugs (piracetam and b vit.complex, Dmae)but i dont think they halp much since the positive effects are counterbalanced by the real medications.
I said its for me the most humiliating phase of my disease because when b4 i had many interests and a head full of ideas, now i can barely concentrate on daily things and my thought flow is considerably 'less powerful' than b4.-
Parnate is said having a weak amphetamine - like effect, is it that it may improve my situation?
I also read in a post that the stimulants used tor ADD/AHDD like pemoline and d-amph.actually 'calm' the subject instead of excite him/her, maybe because of a deficit of neurotrans.?Could these medications be used in my case?thx,
Luca
Posted by JahL on October 27, 2001, at 20:42:57
In reply to Re: Cognitive depression » JahL, posted by frozen on October 27, 2001, at 18:52:37
> Thanks JahL,so it may actually because of the lithium and efexor.
The cognitive dulling is of course a symptom of BPII itself. It might just be that Lithium especially isn't helping things. Of course it varies from person to person. Many swear by (& at) Effexor for example.
>Im trying to boost my brain functions taking some smart drugs (piracetam and b vit.complex, Dmae)
Though moderate vitamin intake is never a bad thing I doubt piracetam & the like will help significantly. For me at least, my mind only 'clears' when all my symptoms [of Bipolar II] resolve (a very rare occurence).
>but i dont think they halp much since the positive effects are counterbalanced by the real medications.
More likely they're just not doing too much. Expensive too, I would imagine.
> I said its for me the most humiliating phase of my disease because when b4 i had many interests and a head full of ideas, now i can barely concentrate on daily things and my thought flow is considerably 'less powerful' than b4.-
Believe me, I can relate.
> Parnate is said having a weak amphetamine - like effect, is it that it may improve my situation?
> I also read in a post that the stimulants used tor ADD/AHDD like pemoline and d-amph.actually 'calm' the subject instead of excite him/her, maybe because of a deficit of neurotrans.?Could these medications be used in my case?I'm pretty new to Bipolar having only recently been diagnosed. Add the fact that I can't think straight and I don't really feel qualified to comment. They're certainly not first-line agents for BPII but I guess this board stands testimony to the fact that the most unlikely of medications can work.
I tried stimulants; trials are pretty quick & painless and the abuse-potential is most likely overplayed. I guess it can't hurt to try but it probably makes more sense to treat the BPII itself rather than individual symptoms. Unfortunately this is easier said than done going by what I've read.
J.
PS Your English ain't bad for a guy from Italy who can't think straight :-)
(who'd you support?)
Posted by frozen on October 27, 2001, at 20:52:13
In reply to Re: Cognitive depression » frozen, posted by JahL on October 27, 2001, at 20:42:57
Your English ain't bad for a guy from Italy who can't think straight :-)
>was it a compliment?Well thanks, i study languages at university , thats why my english isnt too bad, but ok,'not thinking straight' means be drugged or mad??
Im mentally sane apart from depression, and the drugs i take actually flatten my mind instead of dumbing it down..:)Luca
Posted by JahL on October 27, 2001, at 21:23:56
In reply to Re: Cognitive depression » JahL, posted by frozen on October 27, 2001, at 20:52:13
> > Your English ain't bad for a guy from Italy who can't think straight :-)
>
> was it a compliment?Yes.
>Well thanks, i study languages at university , thats why my english isnt too bad, but ok.
That would explain it. I had to drop out of university twice (never to return) because of inability to concentrate etc.
>'not thinking straight' means be drugged or mad??
Most likely drugged or insane people have trouble 'thinking straight' (& I should know re: the former %^} ), but I just meant 'having difficulty thinking/concentrating', or 'cognitive dysfunction' if you like. "Brain-fog".
> Im mentally sane apart from depression, and the drugs i take actually flatten my mind instead of dumbing it down..:)
Fortunately my current drug combination is pretty kind to my brain though Lamictal and Klonopin might impair my memory a little at higher doses. Like yourself, my meds tends to 'flatten' things. Ho hum etc...
J.
Posted by Cindylou on November 2, 2001, at 20:06:11
In reply to Re: Cognitive depression » frozen, posted by JahL on October 27, 2001, at 17:56:32
Hi Jahl,
Did you titrate slowly on the Lamictal? IF so, at what dose did you notice relief from your depression? I just started on 50 mg (was on 25 for 2 weeks) and I am still tired and irritable. I don't know if it's the Lamictal making me feel this way or just my regular depression since I'm not on a high enough dose of Lamictal yet.Thanks for your help (and by the way, you don't seem to be "dulled" at all my the meds! Your posts read very clearly.)
cindy
> . The only thing to help thus far, after 40+ medications, is Lamictal. It's no cure but it does help a fair bit. I've heard similar reports from others. It also seems to insulate me from factors that usually make my cognitive function worse; lack of sleep, pot etc.
Posted by Cindylou on November 2, 2001, at 20:08:12
In reply to Cognitive depression, posted by frozen on October 27, 2001, at 17:32:20
Hi and welcome!
My pdoc just told me that MAOIs (like Moclobemide) are not usually recommended for people with bipolar. I just found out I have bipolar as well -- like you, I don't have mania, just anxiety and agitation.I am trying out Lamictal right now. So far, not much help, but I'm still working my way up.
good luck!
cindy
> I was thinking about moclobemide to be a substitute to Effexor, moreover i read somewhere that it may boost one's mental energy.Do you have any infos about that?
> Are Maois prescribed even to bipolars?
>
> Thank you
>
> Luca from Italy
Posted by JahL on November 3, 2001, at 19:35:50
In reply to Re: Cognitive depression » JahL, posted by Cindylou on November 2, 2001, at 20:06:11
> Hi Jahl,
> Did you titrate slowly on the Lamictal?Yeah. I was effectively self-medicating (tut, tut) at the time so I was especially careful. Started at 12.5mg & increased by this amount every week to ten days.
>IF so, at what dose did you notice relief from your depression?
At 25mg, but only when I added Klonopin. My thoughts become v. muddled when I stop the Klonopin tho' I wonder if there's some benzo rebound depression type-thing confusing the picture. Anyway, the remission was fairly decent (say, 30%) but this has faded over the weeks to a steady 10/15% (& yeah, I can measure it that accurately!). I'm now on 400mg tho' I can't say it feels any different to being on 200mg.
>I just started on 50 mg (was on 25 for 2 weeks) and I am still tired and irritable.
Lamictal is generally thought to be quite activating so I don't know about the tiredness but the irritability (& agitation?) strikes a chord.
>I don't know if it's the Lamictal making me feel this way or just my regular depression since I'm not on a high enough dose of Lamictal yet.
That's the problem with Lamictal. It takes ages to reach a therapeutic dose; generally thought to be (I think) around 150-200mg for depression. I'd give it time.
> ...and by the way, you don't seem to be "dulled" at all my the meds! Your posts read very clearly.
Ta. You're making me blush. It's not the meds that 'dull' me; I have BPII psychomotor retardation+DP to thank for that. Truth be told, if it wasn't for the Lamictal I doubt I'd be up to posting here. Still have trouble reading a newspaper tho'...
Best,
J.
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