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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Peter S. on June 10, 2002, at 13:34:34
The MD who runs this site seems really honest and on the level- some excellent information.
Posted by judy1 on June 10, 2002, at 14:03:37
In reply to Excellent Site for BP Depression!, posted by Peter S. on June 10, 2002, at 13:34:34
Posted by Ritch on June 11, 2002, at 0:45:52
In reply to Excellent Site for BP Depression!, posted by Peter S. on June 10, 2002, at 13:34:34
> The MD who runs this site seems really honest and on the level- some excellent information.
>
> http://www.psycheducation.org/
Yes, that is very excellent! After reading the part about SAD and "enforced darkness" for rapid cycling I am convinced that bipolar disorder is a neuroendocrine disorder that is highly treatable if we knew all of the pieces to the neurondocrine puzzle.Mitch
Posted by JennyJen on June 11, 2002, at 7:27:49
In reply to Re: Excellent Site for BP Depression! » Peter S., posted by Ritch on June 11, 2002, at 0:45:52
Hey There,
I have read that site numerous times ... and it is very interesting. The idea of using multiple mood stablizers and no antidepressants is logical.
I have failed multiple antidepressants except for a partial response to parnate. After reading the "PsychEducation" web site, I found I met Dr Phelp's criteria for Bipolar II. So I preceded to try lamictal, lithium and depakote. All of the above made me feel more depressed and apathetic.
So now I am faced with going back to parnate ... or going on to his advice of trying multiple mood stablizers. Will I ever get better? Will I this never ending medication trial ever end? Am I really Bipolar II? I wish I had some answers and some relief.
Sorry Everyone,
Just alittle frustratedJenny
Posted by Ritch on June 11, 2002, at 10:16:15
In reply to All mood stablizers and no antidepressants?, posted by JennyJen on June 11, 2002, at 7:27:49
> Hey There,
>
> I have read that site numerous times ... and it is very interesting. The idea of using multiple mood stablizers and no antidepressants is logical.
>
> I have failed multiple antidepressants except for a partial response to parnate. After reading the "PsychEducation" web site, I found I met Dr Phelp's criteria for Bipolar II. So I preceded to try lamictal, lithium and depakote. All of the above made me feel more depressed and apathetic.
>
> So now I am faced with going back to parnate ... or going on to his advice of trying multiple mood stablizers. Will I ever get better? Will I this never ending medication trial ever end? Am I really Bipolar II? I wish I had some answers and some relief.
>
> Sorry Everyone,
> Just alittle frustrated
>
> JennyJenny,
You didn't mention a trial of Depakote/lithium + an antidepressant such as Parnate. I have been on an antimanic+antidepressant always. I have never been on an antidepressant by itself, and I haven't had success with being just on mood stabilizers alone. Akiskal doesn't represent the consensus view among pdocs. The practice of antidepressant only therapy for folks with hypomanic symptoms is generally considered a bad idea nowadays, however. If you are depressed (despite being bipolar), it needs to be treated. In the real world it usually does get treated despite all of the scare about taking an antidepressant.
Mitch
Posted by crepuscular on June 11, 2002, at 12:03:11
In reply to Excellent Site for BP Depression!, posted by Peter S. on June 10, 2002, at 13:34:34
hi all.
i'm currently off AD's for the first time in years. basically on Seroquel monotherapy with klonopin for sleep. i'm actually doing fine, but then again, it's summer, i'm exercising a lot, and other stressors are low.
in the past, everytime i would go off an AD i would become re-depressed with a month or so. my hope is that the seroquel is really doing something corrective. my mood "ripple" has really slowed in amplitude & wavelength.
my 2c!
Posted by JonW on June 11, 2002, at 16:32:53
In reply to All mood stablizers and no antidepressants?, posted by JennyJen on June 11, 2002, at 7:27:49
Hi Jenny,
Your frustration is more than understandable, we've all been there and most of us still are :) But please, don't apologize for asking questions and trying to get better!
What is it that makes you think that you are bipolar? By Dr. Phelp's definition, it's not a question of whether you are or you aren't but *how* bipolar you are. This is logical to me, but it seems important that there's a certain undetermined distance you can go from unipolar without a bipolar diagnoses being useful and may even be detrimental in a way.
One thing that Dr. Liebowitz has said to me that may be important is that it's a lot easier to stabilize someone on Nardil using thyroid than to try to stabilize someone on an SSRI. I would presume this is also true with other MAOIs but we only talked about Nardil so I can't say for sure.
When you say Parnate gave you a partial response and you've failed multiple other ADs, how long were the trials? A get the sense that a lot of people here, bipolar folks in particular, have a history of really short drug trials. People with rapid cycling may get an initial "hypomanic" reaction and have a hard time believing that it actually takes many weeks to work and then give up on it once they cycle down. My other psydoc once told me that some bipolar patients can take ADs like candy and pop 'em like they would an advil for a depressive episode. Anyhow, I just thought I'd mention these thoughts.
I think Mitch's suggestion of an ADs + mood stabilizer is an excellent idea. If you haven't tried this before you should definitely suggest this to your psydoc. What exactly are your symptoms? What makes you think you have this or that? With a list of your symptoms, several people here may be able to point you in a helpful direction.
I've refered to this post in several of my posts and so perhaps I'm being a bit redundant but I think it speaks to what you are going through and it may give you some hope. Here's a recent post by Dr. Goldberg:
http://www.dr-bob.org/babble/20020525/msgs/108025.html
Hang in there,
Jon
Posted by JennyJen on June 11, 2002, at 22:36:52
In reply to Re: All mood stablizers and no antidepressants? » JennyJen, posted by Ritch on June 11, 2002, at 10:16:15
Hey Mitch,
Yeah, I guess I got caught in the whole "all mood stablizer, no antidepressant" idea and "antidepressant worsen disease" notion. I must have misunderstood Dr. Phelps message on his web site.
The reason I felt I might meet criteria for bipolar II was:
1. Have failed several TCAs and SSRIs and effexor
2. I might meet criteria for atypical depression (severe anxiety, leaden paralysis, response to parnate)
3. Have an uncle with bipolar IISo with the failure of standard antidepressants (on therapeutic doses for 8 weeks, confirmed by blood levels with TCAs), atypical depression and family history of bipolar disorder ... it appeared I met criteria for bipolar II according to some experts on the web.
Unforunate monotherapy with lithium, depakote and lamictal made me feel more depressed and apathetic!
Thanks for listening and for the advice!
Jenny
PS My pdoc feels many patients with bipolar require both antidepressants and mood stablizers
This is the end of the thread.
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