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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 2 to 26 of 26. Go back in thread:
Posted by Ritch on September 30, 2002, at 22:30:28
In reply to Chloe, How are you?, posted by Denise528 on September 29, 2002, at 10:38:02
Posted by Chloe on October 1, 2002, at 21:16:49
In reply to CHLOE, How are you? (nm), posted by Ritch on September 30, 2002, at 22:30:28
Hey Denise, Ritch,
I stopped the regular ECT a week ago. My mood has slowly deteriorating into rapid cycling/mixed states. I am either really giddy, talkative and taking on too much or suicidally depressed. It is very scary. AND my face is tingly. It feels almost like my nose, lips, cheeks and maybe a bit of my scalp has gone to sleep and I have a mild headache. I think the feeling is like if (and this is an awful experience) you start to come out of the anesthesia before the ECT is over. So I wonder if I am having some kind of strange siezure activity. But I don't feel like I am have a siezure, my face just feels numb. What the heck is wrong with me? Why can't I feel well, stabile and happy unless I am having ECT 3x a week? There has to be a way for me to feel good without this invasive procedure. I asked my pdoc about going up on the 300 mgs of lithium I take a day. She said that she would rather I drop down on the doxepin (75mgs) before I go up on a med. So I will. But honestly, does anyone have any idea why I am rapid cycling??? And why my face is numb??? ECT really works. But one can't have it 3x a week forever. Thank God my insurance is covering it. I just thought it's positive effects would last longer than 5 days!!!Thanks for asking, guys. You are true friends :)
Chloe
Posted by jaby on October 1, 2002, at 21:43:53
In reply to Re: CHLOE-My face is numb..., posted by Chloe on October 1, 2002, at 21:16:49
The numb face thing is something that my sister got when she had ECT too. It was nothing serious and went away with time. I imagine you are just experiencing a momentary setback in your therapy and you'll be back to the cheery person we got an email from last in no time. Keep us aprised of your progress and take care of yourself. Best Wishes!
Posted by Chloe on October 1, 2002, at 21:51:47
In reply to Re: CHLOE-My face is numb...Chloe, posted by jaby on October 1, 2002, at 21:43:53
> The numb face thing is something that my sister got when she had ECT too. It was nothing serious and went away with time. I imagine you are just experiencing a momentary setback in your therapy and you'll be back to the cheery person we got an email from last in no time. Keep us aprised of your progress and take care of yourself. Best Wishes!
Jaby,
Oh, what a relief to know that it is nothing serious. It's a strange phenomenon to have your face feel "asleep." Thanks so much for sharing. I feel better now!
Chloe
Posted by Ritch on October 2, 2002, at 8:40:28
In reply to Re: CHLOE-My face is numb..., posted by Chloe on October 1, 2002, at 21:16:49
Chloe, I was reading some abstract a couple of days ago that discussed lithium and possible aggravation of rapid-cycling because of lithium induced *hypothyroidism*. Get your TSH and free T4 checked. You may only need a *little* thyroid hormone to balance things out. I don't think you ever gave that a try. I wonder what your pdoc(s) think about it.
Posted by jaby on October 2, 2002, at 13:25:14
In reply to Re: CHLOE-My face is numb... » jaby, posted by Chloe on October 1, 2002, at 21:51:47
I would be really, really curious to hear how long it had been between your last treatment and you 9/30 message that you wrote. Have received your latest just one day later, you sound like an entirely different person in just one day. I would question whether many of the ill effects you have been experience are actually the residual side effects of the treatments, which disappear in a day or two's time.
Posted by Dave1 on October 2, 2002, at 13:31:17
In reply to Re: CHLOE-My face is numb..., posted by Chloe on October 1, 2002, at 21:16:49
Hi Chloe,
I was wondering what meds you are taking in addition to doing the maintainance ECTs.
Dave
Posted by Chloe on October 2, 2002, at 18:26:38
In reply to Re: CHLOE-My face is numb... » Chloe, posted by Ritch on October 2, 2002, at 8:40:28
> Chloe, I was reading some abstract a couple of days ago that discussed lithium and possible aggravation of rapid-cycling because of lithium induced *hypothyroidism*. Get your TSH and free T4 checked. You may only need a *little* thyroid hormone to balance things out. I don't think you ever gave that a try. I wonder what your pdoc(s) think about it.
Hi Mitch,
It might be a good idea to get the thyroid levels checked. But I doubt I have lithium induced hypothyroidism, because I am taking the tiniest of doses. I just take 300 mgs of lithium. And frankly, I don't think that is enough. But my pdoc doesn't want to increase the dose because I have such "idiosyncratic" responses to meds. She wants to meet with me to discuss it more. But it's so hard to get to her office, because I can't drive! Some how I willl have to find a way into town, and then I can talk to her about TSH and T4...But I am a little scared to mess around with my thyroid. I'm so worried that I will get revved or hyper or even short fused. Finally with ECT I have become much more calm and patient. It's such a relief not to always be on edge and ready to snap. Can thyroid supplementation cause a person to feel revved up? What are the typical side effects? Have you ever taken thyroid meds for cycling? What is the mechanism that makes it so it decreases cycling?
Thanks,
Chloe
Posted by Chloe on October 2, 2002, at 18:48:04
In reply to Re: CHLOE-My face is numb...Chloe, posted by jaby on October 2, 2002, at 13:25:14
> I would be really, really curious to hear how long it had been between your last treatment and you 9/30 message that you wrote. Have received your latest just one day later, you sound like an entirely different person in just one day. I would question whether many of the ill effects you have been experience are actually the residual side effects of the treatments, which disappear in a day or two's time.
I am having maintenance ECT now. So my last treatment was on Wednesday 9/25. I didn't have another one until today, Wednesday, 10/2. My mood was particularly eratic over this past weekend and on Monday where I was giddy, impulsive and irresponsible. I feel much more sober now, after my treatment today.
The ECT doc said that if I am acting so manicky, that I should perhaps go back to more frequent treatments...But I don't know how long my insurance is going to cover this. It's also very expensive to take a 45 minutes cab ride to the hospital. (I can't seem to find any other way of getting into town.) And it's somewhat traumatic to go through these treatments. I always wake up with a headache and awful nausea, even though they give me meds to combat those complaints.
I think the treatments settle me down, and the farther I get from the treatment, the more irratic my mood seems to get, IMHO...
Chloe
Posted by Chloe on October 2, 2002, at 19:14:44
In reply to Re: CHLOE-My face is numb..., posted by Dave1 on October 2, 2002, at 13:31:17
> Hi Chloe,
>
> I was wondering what meds you are taking in addition to doing the maintainance ECTs.
>
> DaveHi Dave,
I am taking:
300 mgs QD lithium
1.5 mgs QD Celexa
60 mgs Doxepin HS, my pdoc just reduced that from 75 mgs due to the increase cycling
5 mgs Valium BID, 2.5 mgs prn has been very useful when I get too giddy or "high." It seems to put a lid on my behavior.Hope this helps :)
Chloe
Posted by Dave1 on October 2, 2002, at 20:51:23
In reply to Re: CHLOE-meds+ECT... » Dave1, posted by Chloe on October 2, 2002, at 19:14:44
Hi Again,
Are you still getting maintainance treatments?
Did they/are they helping? Are you still depression free as you were after the initial treatments? I was a little confused by your other messages regarding this.For your benefit, it might be too late for this, but I know in Columbia University studies, they found that the best meds after the ECTS were nortriptyline + lithium. It sounds good that you are taking the lithium with the celexa. Maybe they could add nortriptyline to your current cocktail.
Bye,
Dave
Posted by Chloe on October 2, 2002, at 21:39:37
In reply to Re: CHLOE-meds+ECT..., posted by Dave1 on October 2, 2002, at 20:51:23
> Hi Again,
> Are you still getting maintainance treatments?Yes, I am getting a treatment once a week on Wednesdays.
> Did they/are they helping?
Yes, they seem to help dramatically for the first few days after the treatment. But by the weekend, my mood seems to get erratic, i.e too high or too low...
>Are you still depression free as you were after the initial treatments? I was a little confused by your other messages regarding this.
No, I would not say depression free, since my mood is so changeable. I am sorry if I was not clear, but it's difficult to describe my disposition when it is constantly switching. I tend to feel rather "well" for a few days after the treatment. Then the giddy/impulsive + anxious/downcast rollercoaster ride starts a couple days post treatment.
> For your benefit, it might be too late for this, but I know in Columbia University studies, they found that the best meds after the ECTS were nortriptyline + lithium. It sounds good that you are taking the lithium with the celexa. Maybe they could add nortriptyline to your current cocktail.I am aware of the TCA+lithium as maintanence therapy after ECT. However, I did not know it was exclusive to nortriptyline. Doxepin is a TCA, related to imiprimine just like nortriptyline. So I believe that is why it's in my cocktail.
Hope this is more clear...I had ECT today, so my brain is a bit fuzzy, but my mood is good :)
Chloe> Bye,
> Dave
Posted by Ritch on October 2, 2002, at 21:51:27
In reply to Re: CHLOE-Thyroid... » Ritch, posted by Chloe on October 2, 2002, at 18:26:38
> > Chloe, I was reading some abstract a couple of days ago that discussed lithium and possible aggravation of rapid-cycling because of lithium induced *hypothyroidism*. Get your TSH and free T4 checked. You may only need a *little* thyroid hormone to balance things out. I don't think you ever gave that a try. I wonder what your pdoc(s) think about it.
>
> Hi Mitch,
> It might be a good idea to get the thyroid levels checked. But I doubt I have lithium induced hypothyroidism, because I am taking the tiniest of doses. I just take 300 mgs of lithium. And frankly, I don't think that is enough. But my pdoc doesn't want to increase the dose because I have such "idiosyncratic" responses to meds. She wants to meet with me to discuss it more. But it's so hard to get to her office, because I can't drive! Some how I willl have to find a way into town, and then I can talk to her about TSH and T4...But I am a little scared to mess around with my thyroid. I'm so worried that I will get revved or hyper or even short fused. Finally with ECT I have become much more calm and patient. It's such a relief not to always be on edge and ready to snap. Can thyroid supplementation cause a person to feel revved up? What are the typical side effects? Have you ever taken thyroid meds for cycling? What is the mechanism that makes it so it decreases cycling?
> Thanks,
> Chloe
Chloe, check out this abstract http://www-east.elsevier.com/bps/abstracts/26588abs.htmI would LIKE to try T4 augmentation to my meds. I have got a theory that I can try just low-dose Depakote+T4+bupropion and that would be all I need to take for BP-II/ADHD/panic. But my pdoc doesn't want the conflict with my "t"doc about bone-density issues. If you *aren't* a post-menopausal woman, then normal "replacement" thyroid hormone isn't supposed to be any problem.
Posted by Chloe on October 3, 2002, at 19:12:48
In reply to Re: CHLOE-Thyroid... » Chloe, posted by Ritch on October 2, 2002, at 21:51:27
> > > Chloe, I was reading some abstract a couple of days ago that discussed lithium and possible aggravation of rapid-cycling because of lithium induced *hypothyroidism*. Get your TSH and free T4 checked. You may only need a *little* thyroid hormone to balance things out. I don't think you ever gave that a try. I wonder what your pdoc(s) think about it.
> >
> > Hi Mitch,
> > It might be a good idea to get the thyroid levels checked. But I doubt I have lithium induced hypothyroidism, because I am taking the tiniest of doses. I just take 300 mgs of lithium. And frankly, I don't think that is enough. But my pdoc doesn't want to increase the dose because I have such "idiosyncratic" responses to meds. She wants to meet with me to discuss it more. But it's so hard to get to her office, because I can't drive! Some how I willl have to find a way into town, and then I can talk to her about TSH and T4...But I am a little scared to mess around with my thyroid. I'm so worried that I will get revved or hyper or even short fused. Finally with ECT I have become much more calm and patient. It's such a relief not to always be on edge and ready to snap. Can thyroid supplementation cause a person to feel revved up? What are the typical side effects? Have you ever taken thyroid meds for cycling? What is the mechanism that makes it so it decreases cycling?
> > Thanks,
> > Chloe
>
>
> Chloe, check out this abstract http://www-east.elsevier.com/bps/abstracts/26588abs.htm
>
> I would LIKE to try T4 augmentation to my meds. I have got a theory that I can try just low-dose Depakote+T4+bupropion and that would be all I need to take for BP-II/ADHD/panic. But my pdoc doesn't want the conflict with my "t"doc about bone-density issues. If you *aren't* a post-menopausal woman, then normal "replacement" thyroid hormone isn't supposed to be any problem.
>Mitch,
What is a "t" doc? Do you have bone density issues? I didn't think that was common in males...No, I am not post menopausal *yet*. So it's perhaps something I should investigate...Thanks for the link.
Be well,
Chloe
Posted by Ritch on October 3, 2002, at 22:13:03
In reply to Re: CHLOE-Thyroid... » Ritch, posted by Chloe on October 3, 2002, at 19:12:48
> > > > Chloe, I was reading some abstract a couple of days ago that discussed lithium and possible aggravation of rapid-cycling because of lithium induced *hypothyroidism*. Get your TSH and free T4 checked. You may only need a *little* thyroid hormone to balance things out. I don't think you ever gave that a try. I wonder what your pdoc(s) think about it.
> > >
> > > Hi Mitch,
> > > It might be a good idea to get the thyroid levels checked. But I doubt I have lithium induced hypothyroidism, because I am taking the tiniest of doses. I just take 300 mgs of lithium. And frankly, I don't think that is enough. But my pdoc doesn't want to increase the dose because I have such "idiosyncratic" responses to meds. She wants to meet with me to discuss it more. But it's so hard to get to her office, because I can't drive! Some how I willl have to find a way into town, and then I can talk to her about TSH and T4...But I am a little scared to mess around with my thyroid. I'm so worried that I will get revved or hyper or even short fused. Finally with ECT I have become much more calm and patient. It's such a relief not to always be on edge and ready to snap. Can thyroid supplementation cause a person to feel revved up? What are the typical side effects? Have you ever taken thyroid meds for cycling? What is the mechanism that makes it so it decreases cycling?
> > > Thanks,
> > > Chloe
> >
> >
> > Chloe, check out this abstract http://www-east.elsevier.com/bps/abstracts/26588abs.htm
> >
> > I would LIKE to try T4 augmentation to my meds. I have got a theory that I can try just low-dose Depakote+T4+bupropion and that would be all I need to take for BP-II/ADHD/panic. But my pdoc doesn't want the conflict with my "t"doc about bone-density issues. If you *aren't* a post-menopausal woman, then normal "replacement" thyroid hormone isn't supposed to be any problem.
> >
>
> Mitch,
> What is a "t" doc? Do you have bone density issues? I didn't think that was common in males...No, I am not post menopausal *yet*. So it's perhaps something I should investigate...Thanks for the link.
> Be well,
> ChloeHi Chloe, I was just using that term to indicate my endocrinologist (a "thyroid-doc"), who I see once a year for an exam and to do some blood tests. I got a thyroid tumor three years ago and half of my thyroid gland was surgically removed. My Mom had the same thing happen at the same age, but she got another tumor in what remained of her thyroid gland (about 10 years later) which was cancerous, and resulted in the remainder of her thyroid gland being removed. That is why they immediately took out half of my thyroid instead of trying to shrink the tumor. I just have a theory that my Mom (with her thyroid problems and grand mal nocturnal epilepsy), and her MOM (my grandma-who was hospitalized for psychotic mania and given ECT), are the main genetic biological links to my bipolar disorder, thyroid problems, and possible epilepsy. Whew!, anyhow I really wonder if the thyroid connection with rapid-cycling (which is the variant of BP that I have), would indicate a possible treatment with T4 as a solution to some of my troubles.
Oh, the "bone-density issues". There is a risk of reduced bone-density with *hypermetabolic* doses of T4. That is doses of thryoid hormone that result in a TSH which is "clinicaly *hyper*thyroid". My endocrinologist brought that up as a concern as a general CYA statement that let me know that he wasn't going to give his approval to that form of therapy (pdoc-wise). From what I understand, if your TSH stays *above* 0.6, then there *shouldn't be any bone-loss issues to worry about. There are supposed to be tests that can check for that periodically. I don't know what they are though.
>
>
Posted by polarbear206 on October 4, 2002, at 8:04:03
In reply to Re: CHLOE-Thyroid... » Chloe, posted by Ritch on October 3, 2002, at 22:13:03
Chloe,
I have an good web page with thyroid info. www.psycheducation.org/thyroidintroduction.htm
I would suspect the TCA is causing your mood cycling. I can'g go over 50mg of imipramine or I will cycle more. My current cocktail is; Imipramine 50mg, paxil 7.5mg, and Lamictal 100mg. For the first time in YEARS I am experiencing a steady peaceful even mood!! I have a couple questions for you. Have you even tried Lamictal? Have you tried an MAOI in combo with a mood stabilizer? Is your cycling depression dominated?
Posted by Chloe on October 4, 2002, at 18:53:56
In reply to Re: CHLOE-Thyroid... » Chloe, posted by Ritch on October 3, 2002, at 22:13:03
>
> Hi Chloe, I was just using that term to indicate my endocrinologist (a "thyroid-doc"), who I see once a year for an exam and to do some blood tests. I got a thyroid tumor three years ago and half of my thyroid gland was surgically removed. My Mom had the same thing happen at the same age, but she got another tumor in what remained of her thyroid gland (about 10 years later) which was cancerous, and resulted in the remainder of her thyroid gland being removed. That is why they immediately took out half of my thyroid instead of trying to shrink the tumor. I just have a theory that my Mom (with her thyroid problems and grand mal nocturnal epilepsy), and her MOM (my grandma-who was hospitalized for psychotic mania and given ECT), are the main genetic biological links to my bipolar disorder, thyroid problems, and possible epilepsy. Whew!, anyhow I really wonder if the thyroid connection with rapid-cycling (which is the variant of BP that I have), would indicate a possible treatment with T4 as a solution to some of my troubles.
>
> Oh, the "bone-density issues". There is a risk of reduced bone-density with *hypermetabolic* doses of T4. That is doses of thryoid hormone that result in a TSH which is "clinicaly *hyper*thyroid". My endocrinologist brought that up as a concern as a general CYA statement that let me know that he wasn't going to give his approval to that form of therapy (pdoc-wise). From what I understand, if your TSH stays *above* 0.6, then there *shouldn't be any bone-loss issues to worry about. There are supposed to be tests that can check for that periodically. I don't know what they are though.
> >
> >
>
>
Hey Mitch,
That is some family history you have, and I am sorry to hear about the surgical removal of part of your thyroid. I guess I can understand why a "t-doc" might be a little shy about messing with your T values. But you might be on to something, and supplementing it might make you feel better. Hard to know...
I have been talking to my edoc and pdoc about this "manic" type state I have been in for over 24 hours. I've tried to get premission to increase the Li, but my pdoc wants to meet with me first. But she is booked for two weeks. So the edoc suggested raising it by 150 mgs, and my pdoc just OK'ed it. I have had to take some extra valium just to step myself down a notch...I keep flexing a group of muscles then letting it go, just to find myself tensing again. I don't even realize I am doing it until I feel the muscles fatiguing, BUT I have been laughing and having alot of fun despite the moving.
So tomorrow I will go to 450 mgs, that I am supposed to take all at once. I hope that won't be too much for me. I would rather divide the dose somehow. But the doc's instructions are once/day. Whatever...
Be well
Chloe
Posted by Chloe on October 4, 2002, at 19:23:31
In reply to Re: CHLOE-Thyroid... Chloe, posted by polarbear206 on October 4, 2002, at 8:04:03
Chloe,
I have an good web page with thyroid info. www.psycheducation.org/thyroidintroduction.htm. I would suspect the TCA is causing your mood cycling. I can'g go over 50mg of imipramine or I will cycle more. My current cocktail is; Imipramine 50mg, paxil 7.5mg, and Lamictal 100mg. For the first time in YEARS I am experiencing a steady peaceful even mood!! I have a couple questions for you. Have you even tried Lamictal?>>Hi PBear, Thanks for the link...Yes, I did try lamictal 2 summers ago. I could not stand the headache/insomnia, yucky feeling it gave me. I also got an actinic (rash when I went out in the sun) rash, so I could not leave the house. I quite it after about 10 days...
Have you tried an MAOI in combo with a mood stabilizer?
>>I have never tried an MAOI. My father had a collegue die from a hypertensive crisis. So MAOI's are not real popular in our family. And I don't think I would like the diet very much. Have you ever tried them?Is your cycling depression dominated?
>>Unfortunately yes. I got caught in a nasty down before ECT. Thank God, ECT has been very effective. But lately it has bummeranged me into intense hypomania...The edoc wants to go back to more frequent ECT to combat the highs now. But what is he thinking? That we will do ECT forever? I think we need to find a med regime that will even things out as I taper off the ECT.
And yes, probably like you, I am on too much TCA for stability. I have been shaving off 10mgs at a time...I am at 60 mgs now. But still pretty revved!
Thanks again, and enjoy the peaceful, steady mood!
Chloe
Posted by Ritch on October 4, 2002, at 22:01:41
In reply to Re: CHLOE-Thyroid... » Ritch, posted by Chloe on October 4, 2002, at 18:53:56
> Hey Mitch,
> That is some family history you have, and I am sorry to hear about the surgical removal of part of your thyroid. I guess I can understand why a "t-doc" might be a little shy about messing with your T values. But you might be on to something, and supplementing it might make you feel better. Hard to know...
> I have been talking to my edoc and pdoc about this "manic" type state I have been in for over 24 hours. I've tried to get premission to increase the Li, but my pdoc wants to meet with me first. But she is booked for two weeks. So the edoc suggested raising it by 150 mgs, and my pdoc just OK'ed it. I have had to take some extra valium just to step myself down a notch...I keep flexing a group of muscles then letting it go, just to find myself tensing again. I don't even realize I am doing it until I feel the muscles fatiguing, BUT I have been laughing and having alot of fun despite the moving.
> So tomorrow I will go to 450 mgs, that I am supposed to take all at once. I hope that won't be too much for me. I would rather divide the dose somehow. But the doc's instructions are once/day. Whatever...
> Be well
> Chloe
>
Yes, there are very few "sane" people in my family! The thyroid surgery was really okeedokee. A week away from stressful work situation, nice nurses, lots of great cableTV (at the time), and Vicodan-what more could you want? ;)Right now I am testing "therapeutic doses" of Wellbutrin to see if it will work for ADHD without affecting cycling or hypomania. I am aiming for the "sameness" (anticycling) response of stimulants which I get during bipolar depression which will endure throughout my otherwise typical hypomanic periods of the year. I am trying Ritalin along with it, but if the WB works (perhaps at 300-400mg/day) and I can still sleep, the stim might not be needed.
Yeah, go for the Li increase. It seems that it covers your mild psychotic symptoms rather well from what you have said. I'd still check out that TSH stuff... it might help for the rapid cycling....
Posted by Chloe on October 5, 2002, at 9:34:02
In reply to Re: CHLOE-Thyroid... » Chloe, posted by Ritch on October 4, 2002, at 22:01:41
> > Hey Mitch,
> > That is some family history you have, and I am sorry to hear about the surgical removal of part of your thyroid. I guess I can understand why a "t-doc" might be a little shy about messing with your T values. But you might be on to something, and supplementing it might make you feel better. Hard to know...
> > I have been talking to my edoc and pdoc about this "manic" type state I have been in for over 24 hours. I've tried to get premission to increase the Li, but my pdoc wants to meet with me first. But she is booked for two weeks. So the edoc suggested raising it by 150 mgs, and my pdoc just OK'ed it. I have had to take some extra valium just to step myself down a notch...I keep flexing a group of muscles then letting it go, just to find myself tensing again. I don't even realize I am doing it until I feel the muscles fatiguing, BUT I have been laughing and having alot of fun despite the moving.
> > So tomorrow I will go to 450 mgs, that I am supposed to take all at once. I hope that won't be too much for me. I would rather divide the dose somehow. But the doc's instructions are once/day. Whatever...
> > Be well
> > Chloe
> >
>
>
> Yes, there are very few "sane" people in my family! The thyroid surgery was really okeedokee. A week away from stressful work situation, nice nurses, lots of great cableTV (at the time), and Vicodan-what more could you want? ;)Hi Mitch,
I am glad it wasn't too traumatic for you...Nurses are nice people. The ECT nurses are very kind and not judgemental in anyway. I like them very much, I just wish I didn't have to see them under these circumstances!!!> Right now I am testing "therapeutic doses" of Wellbutrin to see if it will work for ADHD without affecting cycling or hypomania. I am aiming for the "sameness" (anticycling) response of stimulants which I get during bipolar depression which will endure throughout my otherwise typical hypomanic periods of the year. I am trying Ritalin along with it, but if the WB works (perhaps at 300-400mg/day) and I can still sleep, the stim might not be needed.
I hope the WB works for you. I tried it about 10 years ago and couldn't tolerate it. I would wake up in the night drenched with sweat. But it sounds like it might do the trick for you. I'm hoping for you...Keep up posted.
> Yeah, go for the Li increase. It seems that it covers your mild psychotic symptoms rather well from what you have said. I'd still check out that TSH stuff... it might help for the rapid cycling....Oh yeah, I forgot (I forget lots of things these days...:) how effective Li is for me for the distorted thinking stuff. That will definitely come in handy when the ECT is over and those thoughts will envitably come back.
I do have a 20 min. appointment with my extremely busy pdoc on Monday. I will ask her then for a thyroid work up. But ugh, all I need is to be stuck again with a needle. I am a pin cushion from all the places that IV's have had to be placed for the ECT treatment. I am sooo bruised...
Do you remember a while back there was some discussion about how to take Li, in one dose or a divided dose. I can't recall what the conclusion of that was. But I am supposed to take all the Li at once at night. And on the night before ECT (once a week for a month), I am supposed to not take it. Then I am instructed to take the Li immediately when I get home. Is there any benefit to taking it only once per day, not twice? Can you refresh my memory?
Thanks Mitch
Chloe
>
Posted by Ritch on October 5, 2002, at 21:40:48
In reply to Re: CHLOE-Thyroid... » Ritch, posted by Chloe on October 5, 2002, at 9:34:02
> > Yeah, go for the Li increase. It seems that it covers your mild psychotic symptoms rather well from what you have said. I'd still check out that TSH stuff... it might help for the rapid cycling....
>
> Oh yeah, I forgot (I forget lots of things these days...:) how effective Li is for me for the distorted thinking stuff. That will definitely come in handy when the ECT is over and those thoughts will envitably come back.
> I do have a 20 min. appointment with my extremely busy pdoc on Monday. I will ask her then for a thyroid work up. But ugh, all I need is to be stuck again with a needle. I am a pin cushion from all the places that IV's have had to be placed for the ECT treatment. I am sooo bruised...
> Do you remember a while back there was some discussion about how to take Li, in one dose or a divided dose. I can't recall what the conclusion of that was. But I am supposed to take all the Li at once at night. And on the night before ECT (once a week for a month), I am supposed to not take it. Then I am instructed to take the Li immediately when I get home. Is there any benefit to taking it only once per day, not twice? Can you refresh my memory?
> Thanks Mitch
> Chloe
> >
>
>Chloe, Tell her you just need a TSH and free T4 blood check. Maybe they should just send you home with a "port" implanted for the blood tests-(just kidding) :)
Oh yeah, the "all at once" versus divided dose thing. I started off with an "all at once" dosing of lithium of 900mg midday. That changed later to 600mg at bedtime and then 300mg midday. When I went to higher doses it was 900mg lithobid twice daily. Evidently, some pdocs think the all at once dosing (if it doesn't exceed 600-900mg every day)is easier on your kidneys for the long haul. Others think the enhanced stability of blood levels with multiple dosing superior. Ha!, see my memory is no better than yours.
For real though-lithium *will* depress thyroid function to some degree, and depressed thryoid function *does* tend to aggravate rapid-cycling. You *really* might be able to knock out two birds with one stone---lithium to get your thoughts organized without an AP, and a little thyroxine to flatten out your cycling. Of course, everything looks better on paper... But, there are lots of reasons to be optimistic. Take care..Mitch
Posted by Chloe on October 9, 2002, at 7:45:25
In reply to Re: CHLOE-Thyroid... » Chloe, posted by Ritch on October 5, 2002, at 21:40:48
> Chloe, Tell her you just need a TSH and free T4 blood check. Maybe they should just send you home with a "port" implanted for the blood tests-(just kidding) :)Mitch,
Boy do I ever wish I could have a "heplock" so I wouldn't need so many sticks. But fortunately at my pdoc appointment, she ordered the TSH to be done as the IV is being started at ECT this week. That is a relief. But she didn't want to rush into started another drug, like T3...She thinks I have enough going with ECT, lithium, doxepin and a few drops of Celexa. But she will at least check it, which is good.> Oh yeah, the "all at once" versus divided dose thing. I started off with an "all at once" dosing of lithium of 900mg midday. That changed later to 600mg at bedtime and then 300mg midday. When I went to higher doses it was 900mg lithobid twice daily. Evidently, some pdocs think the all at once dosing (if it doesn't exceed 600-900mg every day)is easier on your kidneys for the long haul. Others think the enhanced stability of blood levels with multiple dosing superior. Ha!, see my memory is no better than yours.
Thanks for the info. I am taking Eskilith CR (450mgs) all at bedtime. I think it's too much for my gut...But pdoc thinks it's best too take the 450 at once. So I hope over time I will get used to it. My stools are a little looser, but not bad. I think lithobid is a bit more palitable, but it only comes in 300 mgs...and I need a little more, but 600 mgs is too much...
> For real though-lithium *will* depress thyroid function to some degree, and depressed thryoid function *does* tend to aggravate rapid-cycling. You *really* might be able to knock out two birds with one stone---lithium to get your thoughts organized without an AP, and a little thyroxine to flatten out your cycling. Of course, everything looks better on paper... But, there are lots of reasons to be optimistic. Take care..Mitch
Thanks for your help...and optimism! I will be curious about the results. However, my values do tend to *always* be in the normal range. Hope you are doing ok :)
Chloe
>
>
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Posted by Ritch on October 9, 2002, at 9:47:20
In reply to Re: CHLOE-Thyroid... » Ritch, posted by Chloe on October 9, 2002, at 7:45:25
> Thanks for your help...and optimism! I will be curious about the results. However, my values do tend to *always* be in the normal range. Hope you are doing ok :)
> Chloe
> >
> >
> >
> >
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>You're welcome! I am doing better with the wellbutrin/ritalin experiment. I can't believe I can tolerate these doses, however. I can't tolerate SSRI doses, THAT's what we are finding out. I take just a pinch of Effexor now, but with 150mg of Wellbutrin SR in the morning. Then early afternoon I take 20mg of Ritalin-LA just before I go to work. I was afraid it would make me too panicky at work, but it isn't. I calmly sat in a large meeting yesterday and listened to *everybody*! Didn't interrupt anybody, and didn't speak unless I had a pertinent point to make. I take 250mg of Depakote at night with .5mg of Klonopin. I sleep OK, but I have to double the Depakote to 500mg or add 100-200mg of Neurontin to get to sleep. It is the Wellbutrin's active metabolites lengthy half-lives(30hrs or so for one of them). I had trouble with this before. I know it isn't the Ritalin because it is designed for 8-12hrs or so, and I feel a lot less focused by the time I get off work. I can sleep OK if I double the Depakote to 500mg, but I don't want any weight gain.... Maybe the WB/Ritalin will keep it away? Anyhow, you are definitely sounding fantastic! That is REAL nice that your "e"doc and pdocs are cooperating together. Let us know what your TSH comes out to be Ok? Have you noticed the rapid-cycling beginning to setttle down? Take care---Mitch
Posted by agnes on November 2, 2002, at 15:31:45
In reply to Re: CHLOE-My face is numb..., posted by Chloe on October 1, 2002, at 21:16:49
Hi,
I'm curious as to whether the facial numbness (and paralysis?) is continuing. I have had periodic numbness, paralysis, and prickling for 4 years. Not sure if it is related to the medications I've been given for depression (including lagactil).
My guess is that my face freezes up when I pass through flickering light - sun shining through trees for example.
Regards,
Agnes
Posted by Chloe on November 2, 2002, at 17:59:56
In reply to Re: CHLOE-My face is numb..., posted by agnes on November 2, 2002, at 15:31:45
> Hi,
>
> I'm curious as to whether the facial numbness (and paralysis?) is continuing. I have had periodic numbness, paralysis, and prickling for 4 years. Not sure if it is related to the medications I've been given for depression (including lagactil).
>
> My guess is that my face freezes up when I pass through flickering light - sun shining through trees for example.
>
> Regards,
>
> AgnesHi Agnes,
My face is no longer numb. It lasted about a week or so. My edoc said it was from the mask they put on your face during the ECT treatment. When you are asleep, your breathing is assisted with a bag valve mask. I think they may have put the seal too tight, causing some numbness and tingling around my face and nose.
I am sorry to hear you have had numbness for so long. I hope you get some relief soon.
Chloe
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