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Dr. Bob is Robert Hsiung, MD,
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Posted by Lyrical13 on December 21, 2003, at 21:54:29
Anyone take Lamictal for BP2? Alone or in combo with an AD? My doc is suggesting trying Lamictal with Effexor XR b/c he suspects BP2 is my dx vs. depression and anxiety.
Any side effects? Also, any sexual side effects?
Thanks
Lyrical13
Posted by Mr. Scott on December 21, 2003, at 22:22:59
In reply to Lamictal for BPII, posted by Lyrical13 on December 21, 2003, at 21:54:29
You and me both.
I am on 50mg of Lamictal right now with no noticeable affect or effect, but I've been on it only for a week and I also am withdrawing from Lexapro which is causing moderate distress right now.
Scott
Posted by Girl1969 on December 22, 2003, at 13:41:14
In reply to Re: Lamictal for BPII » Lyrical13, posted by Mr. Scott on December 21, 2003, at 22:22:59
I have been on 300 mgs of lamictal for the past 3 weeks. I have had no sexual side effects and a definite relief of my depression. I am also on Celexa (80mgs) and Geodon (60mgs).
I haven't had any sexual side effects so far, no rash, no problems whatsoever.
I have read so many things about lamictal that lead me to believe that it's a terrific drug (if you don't get the rash).
I wish you the best of luck!
Posted by Tony P on December 22, 2003, at 15:12:03
In reply to Lamictal for BPII, posted by Lyrical13 on December 21, 2003, at 21:54:29
I am on Lamictal as a trial for BP2 or 3. Just got up to 100 mg/day 4 days ago, which sounds like the start of the effective range for most people for the depressive side of things, judging by postings here.
The couple of weeks I was on 50 mg/day, I noticed an edginess, sort of borderline anxiety plus anger. Complicated by having to go off the Serzone I had been on for a long time --- my main A/D, I've gone from 500 mg/day down to 0 over the last 3 weeks.
Today I am a mess. I called in sick to work. Mixed anxiety and depression, nausea, I couldn't get up the energy/decision making to take a shower, let alone get in to work; borderline suicidal -- which is unusual for me, I usually just retreat and isolate when my depression is severe.30 mg Valium helped a lot - or I wouldn't even be posting here! But I'm supposed to only take 10 mg a day. I have an appointment this aft. to see my MD, and I see my pdoc in about a week. I'm having trouble imagining hanging on that long feeling like this. i hope my MD will prescribe a short-term benzo, but he is very reluctant to.
Any help/experience out there?? is this part of the early side-effect profile of Lamictal, i.e. will it get better if I hang on? I am feeling desperate today - like nothing really works, even huge doses of OTC muscle relaxants, which used to at least numb me out.
Tony P
> Anyone take Lamictal for BP2? Alone or in combo with an AD? My doc is suggesting trying Lamictal with Effexor XR b/c he suspects BP2 is my dx vs. depression and anxiety.
>
> Any side effects? Also, any sexual side effects?
>
> Thanks
> Lyrical13
Posted by Lyrical13 on December 22, 2003, at 18:28:39
In reply to Re: Lamictal for BPII -- Bad Day!, posted by Tony P on December 22, 2003, at 15:12:03
Hi..
I had weird side effects coming off of Serzone when I was on it last year. I came off of 600mg over 2 weeks. The first week wasn't too bad but the 2nd week was horrible. Tues of week 2 I made it to work but wasn't there 10 min before I started sobbing uncontrollably and couldn't stop for several minutes. I managed to pull it together long enough to duck into my boss' office which was 2 doors down from mine. The minute I stepped into her office I started sobbing again. Thankfully both of my bosses have been incredibly supportive and understanding. But I cried all the way down the hall...someone had to drive me home. I was probably crying non-stop for a good hour. I ended up being off work the whole rest of the week. I was supposed to come completely off of the Serzone before starting the Effexor but when I talked to my pdoc he told me to continue the plan with decreasing the Serzone but to start the Effexor Wed night. Thursday I had the most bizarre side effects...Besides feeling incredibly zoned, so uncoordinated that I couldn't walk straight and feeling dizzy and exhausted, I felt like my skin didn't fit right on my body. I've never felt anything like that before!Good news is by the next day the side effects weren't as bad and by the next Mon I was feeling much better.
The other thing I wanted to comment on was how you're saying you don't think you can make it till your docs appt and how you feel so awful. That's how I felt in Sept. The depression started creeping in around Aug 8...(that's about when the dreams started...the past few years in Aug or Sept I start having dreams where I'm incredibly depressed and I have no idea why) Anyway, shortly after the dreams started I increased the Effexor from 75mg to 150mg/day. I saw my pdoc 8-21 and he said to stay with that dose. School started (I work at a school) the next day and I was so incredibly anxious I could hardly think straight. It took so much energy to just get through the day...I had to write every little thing down and crossing something off of my daily routine was like a major accomplishment. I couldn't deal with running any errands after work..I would just go work out and then go home (I found exercise to be VERY helpful for both depression and anxiety but especially anxiety) I was also taking 0.5 mg of Attivan about every 6 hours. (I tend to be very sensitive to medication) A couple weeks later I was still really struggling and falling apart at school and I called my doc to ask him to increase my Effexor. He said to give it another week. I was like you...a week seemed like a year and I didn't know how in the hell I was going to make it that long feeling the way I did. A week later I called him again...that's when the suicidal thoughts started kicking in...he told me to wait ANOTHER week. That's when I started looking for another pdoc. I really didn't have a good feelign about him last year but was trying to give it a chance. I was so frustrated because I never knew how soon he was going to get back to me. It could be the same day or it could be 2 days later. That's an eternity when you're feeling like that.
Anyway, when he told me to wait ANOTHER week I was actually sobbing on the phone..he said that 150mg was the dose that worked last year so it should still work. I told him that it was a differnt time of year last year and he said that shouldn't matter. But it DOES for me. My worst time for the past 13 years has been Sept-Jan. He knew that. So here I am sobbing on the phone and he's saying "just give it a little more time..OK? OK?" So patronizing!!!!! The next day I asked my friend to sit with me for moral support while I called a new doc to make an appt. (the receptionist actually said she would have to check with the new doc to see if it was OK for me to switch docs! What was she? The secret police? I'm the client here...I'm paying the doc's salary..I can choose to go to whoever I want!) Anyway, that doc couldn't get me in for another month and I knew there was NO way I'd make it that long. Then my friend said I should call my current doc back...I was really nervous but we practiced what I would say. Of course I had to leave a message on voicemail because he wasn't available. BAsically I said that I had thought about what he said about waiting and about this dose being the right dose and had consulted with my husband and a close friend who had seen how I was on this dose last year and they both said that I was not doing anywhere near what I had been. also that time of year DOES matter for me...that I was trying to be proactive in preventing further difficulty and that I shouldnt' have to have a total breakdown to get help. I said that I thought it was time for a medical intervention and that my Effexor needed to be increased. He didn't call me back for THREE DAYS!!!!!!!!!!!
What really ticks me off is that I am usually someone who is trying to take as few meds on as low dose as possible. The fact that I was begging for a med increase should have tipped him off that I was having major problems. I finally did get him to increase the Effexor but I had to show up at his office at the end of the day with my husband in tow. Even then he tried to make me go into the day treatment program in order to get the med increase. When he saw we weren't falling for that, he then offered weekly appts. (I had been having a heck of a time getting monthly appts before) I said weekly appts would be wonderful (where the hell were the weekly appts last year when I was so bad that I missed 10 days of work between Sept and Christmas?!!!!!!!) Anyway, I did the weekly appts for a few weeks until I was able to get into a new doc (different one than the one with the KGB receptionist) I actually got in to see the new counselor and the new pdoc within a few days of my first phonecall but I wanted to make sure that I felt comfortable with the new set-up before firing the old doc.
Anyway, to make a short story long.....I love my new doc and my new counselor...actually care about my input and I am very much a part of the decision-making re: my care..which is as it should be IMHO.
Sorry I got off on such a tangent there. I didn't intend to rant and rave when I started this reply. all that to say, I totally get where you are and this too shall pass. Try to hang in there even if it's only by the skin of your teeth. I found that getting 7-8 hours sleep, setting up daily or almost daily things to do with friends or my husband after work, exercising every day, avoiding caffeine and sugar and eating healthy meals and snacks helped take the edge off. I also wrote down my agenda for the day so I didn't spend so much time stewing about what to do next.
Good luck to you. Believe it or not, there IS light at the end of the tunnel.
Lyrical 13
PS I also started saying a little mantra to myself off and on throughout the day. The one that helped a bit was "I've felt better before and I'll feel better again" When I'm in that dark place, it's so difficult to conceive that I'll ever feel any better so I have to remind myself that it IS possible.
Posted by Lyrical13 on December 22, 2003, at 18:33:19
In reply to Re: Lamictal for BPII -- Bad Day!, posted by Tony P on December 22, 2003, at 15:12:03
Hi again
I remembered the other thing I was going to mention when I saw your post. My pdoc said that using anti-anxiety meds with BP2 was usually not a good way to go (I'm not sure why..something about them creating more problems even if they seem to help..my big problem with them is that they have a side effect of depression... so when I'm depressed AND anxious I don't know whether to take them or not. Will it just make it worse?)Anyway, he said BP2 can look like depression with generalized anxiety and that a better course of treatment for the anxiety/agitation is an atypical antipsychotic (I'm on Seroquel)
Hope that info helps
Lyrical 13
Posted by Tony P on December 22, 2003, at 19:34:56
In reply to Re: Lamictal for BPII -and no anxiety meds, posted by Lyrical13 on December 22, 2003, at 18:33:19
Thanks so much for your response - I am feeling much better after talking to my counsellor on the phone, seeing my MD, just getting out of the apartment, and feeling that people were taking me seriously -- how do you tell your boss (even if he's also a friend) that you feel like pulling your pillows and blanket into the den and lying there in the dark because it's safe ('cause it has no windows)???
My MD, bless him, has put me on 2 mg clonazepam twice a day for the next 10 days, by which time I'll be in to see my pdoc and follow up with the MD. He also put me on the Psychiatric emergency followup program, which I'd never heard of - they will call me, and I can also call them, to see how I'm doing over Xmas.
Seroquel is one of the options I'd wondered about, but the next choice recommended both by the pdoc and my MD is Effexor. Among the 3 professionals I'm seeing (!) we're not really sure how much I'm truly bipolar 2 or 3, and how much is the combination of changes in Rx medication and the excessive self-medication I've been doing with muscle-relxants (Robaxin) to try and cope with the physical tension -- which has a backlash, of course.
And thanks for the "mantra". I've been trying to keep up that kind of selftalk, too, but it also helps to hear it from someone else!
Tony
Posted by Lyrical13 on December 23, 2003, at 9:31:07
In reply to Re: Lamictal for BPII -and no anxiety meds » Lyrical13, posted by Tony P on December 22, 2003, at 19:34:56
> Thanks so much for your response - I am feeling much better after talking to my counsellor on the phone, seeing my MD, just getting out of the apartment, and feeling that people were taking me seriously -- how do you tell your boss (even if he's also a friend) that you feel like pulling your pillows and blanket into the den and lying there in the dark because it's safe ('cause it has no windows)???
>
> My MD, bless him, has put me on 2 mg clonazepam twice a day for the next 10 days, by which time I'll be in to see my pdoc and follow up with the MD. He also put me on the Psychiatric emergency followup program, which I'd never heard of - they will call me, and I can also call them, to see how I'm doing over Xmas.
>
> Seroquel is one of the options I'd wondered about, but the next choice recommended both by the pdoc and my MD is Effexor. Among the 3 professionals I'm seeing (!) we're not really sure how much I'm truly bipolar 2 or 3, and how much is the combination of changes in Rx medication and the excessive self-medication I've been doing with muscle-relxants (Robaxin) to try and cope with the physical tension -- which has a backlash, of course.
>
> And thanks for the "mantra". I've been trying to keep up that kind of selftalk, too, but it also helps to hear it from someone else!
>
> Tony
Hey, no problem. I just discovered this site and I wish I had found it much sooner. It helps to talk to people who have "been there". I know what you mean about telling people (friends, bosses etc) about how you're feeling. It's so scary because you never know how they're going to react. Will they think you are a complete nutcase or understand and give you support? I've had both types of experiences. There are times I have shared things with people where I was glad I did and other times where I'm kicking myself and feeling very vulnerable. I used to tell NO ONE about the depression/anxiety except my husband and best friend and mom. But over the years, as the public has become more educated about it, and I become more comfortable with it, I have been sharing it more and have been fortunate to be given support and kindness most of the time. What's most frustrating is that my husband's family and people at work have been very very supportive (that's good) BUT my own family has never been very supportive. My mom is becoming more supportive...she's always acknowledged my problem and actually was the one way back when I started college to push me toward getting help, but she hasn't really understood. Our dialogue has been very difficult. It was especially frustrating because she is a nurse and has a difficult time accepting new information from me (I get the "I've been a nurse for 30 years and I know what I'm talking about" response) But we had a good talk a couple days ago and she actually listened to me and for the first time I was able to describe to her how it feels when I am in a bad place. It was quite refreshing. Maybe we are embarking on a new phase in our relationship. I hate to get my hopes up but things have been getting gradually better as I assert myself (there is still quite a bit of backlash...I changed the "dance" (if you've read any of the books..."Dance of Intimacy", "Dance of Anger" etc.) and instead of just shutting up and listening to her rant and rave I started standing up for myself. Then all of a sudden I was a "bitch" and was "being defensive") But things are getting better.Anyway, I have had bad experiences with a former job in telling people (eventually lost my job because of it..indirectly...they said it was because of all of the absences..which were a result of trouble I was having with depression/anxiety...) But the good thing is that I am now in a job where supervisors and co-workers are very supportive. I only share my history and ongoing progress (or lack thereof) with a few people but I am discovering that there are many people that I work with who are in the same boat as me. That's reassuring.
Re: Effexor..that's what I am on and I feel better than I ever have in my life (that I can remember) It's supposed to help with both depression and anxiety. It really did (and does) for me. One caution though..it has the potential to push you into a hypomanic or manic state. I just recently found out that many ADs have that potential. did not know that. For me it's hypomania...but for about 10 years I've thought (and doctors, counselors etc have too) that I had chronic major depression with generalized anxiety disorder. Just a few weeks ago as I was telling my doc about sleep difficulties, talking more than usual, feeling obnoxious, having difficulty calming down when I get angry/upset, past hx of spending sprees and taking on a zillion projects at once...he said that it sounded more like BP2. In the research I've done so far on BP2, it does sound like me. So this is a new process for me and a bit scary. I'm always afraid when I start on a new med...I have a hx of reactions to meds (not all but you never know which one it's going to be!) and am very sensitive to meds.. often need only pediatric doses. So I'm always afraid when I start a new med because I don't know what it's going to do to me.
Anyway, I'm glad I could help a little bit. In a way, I feel a little bit like an ambassador for awareness for mental health issues (I don't like the label of "mentally ill"...it just sounds so negative and "crazy") What I mean is, I am getting braver at disclosing my experiences re: depression/anxiety..though still cautious. But when I am talking to someone and I suspect that they may be going through something similar, I will share that I am on meds for anxiety/depression in the hopes that they might be comforted and realize that it's OK and others are experiencing the same types of problems.
Anyway, it sounds like you're doing a little better and I'm glad for you. Good luck and hang in there.
Lyrical 13
Posted by Tony P on December 24, 2003, at 0:57:19
In reply to Re: Lamictal for BPII -and no anxiety meds, posted by Lyrical13 on December 23, 2003, at 9:31:07
I'm feeling super, thanks for your thoughtful post. The danger is that I will swing over into hypomanic! But that's what the Lamictal is for, so I'm optimistic that I'll stay within reasonable bounds,
I sometimes think we who are mostly depressed, when we finally experience life as others do day-by-day, think (mistakenly) it is euphoria or hypomania because it is so different from our normal everyday state! I remember a friend who usd to say "This feels too good to last ...". Of course it won't, entirely, real life sets its boundaries, but the trick is to accept the good feelings while they last -- and know they will return.
Tony
Posted by Lyrical13 on December 24, 2003, at 8:24:26
In reply to Re: Lamictal for BPII -and no anxiety meds, posted by Tony P on December 24, 2003, at 0:57:19
> I sometimes think we who are mostly depressed, when we finally experience life as others do day-by-day, think (mistakenly) it is euphoria or hypomania because it is so different from our normal everyday state!I know what you mean. Last spring when I was feeling so wonderful I didn't know if what I was feeling was "normal" or manic. It had been so long since I felt good that I had no barometer. I remember saying to my husband "I forgot what happy felt like". I think that's part of the reason it has taken so long to figure out this BP2 thing. BP has been in the back of my mind for several years, but I didn't even know BP2 existed until a month ago. I kept thinking that I couldn't be BP because I didn't go into a full blown mania. And my old doc actually reinforced that belief....when I brought up my concerns last spring, he said it sounded like I was hypomanic but he basically blew it off. He said if we medicated everyone who was hypomanic that we'd be medicating half of America. So I thought I was OK...no big deal. Now that my new pdoc is telling me about BP2 on the one hand, I'm pissed at the old pdoc because I could have been getting help for this sooner. Not to mention the fact that NO ONE has really explained depression to me until this new doc. He was amazed that no one had explained about the recommended treatment for chronic major depression (meds and counseling...which basically I had been getting, but when I felt good, we d/c'd tx for a while until I had trouble again. He said I should be in counseling all the time...just when I felt good it wouldn't be as frequent) Then he explained about my type of depression needing more than one med to do the trick. He gave me all the information on the various ways to augment the AD (which admittedly was info overload at the time) and then said "What do you want to do?" I had been given choices before... but I was only told a couple different meds and a very brief Q&A about side effects, benefits, etc.
The other thing I'm feeling about the BP2 thing is relief. I don't really want to be BP...it sounds more "crazy" doesn't it? So many people are on meds for anxiety and/or depression that it's starting to be accepted. But BP is still murky territory. There isn't as much of an awareness about what it really is. I read an article online about the new thinking re: mood disorders...that it's more of a spectrum disorder. That makes sense to me. At one end of the spectrum you have major depression. At the other end you have full blown mania. The various other dx'es are in between with the BPs somewhere near middle. For me, I'm more towards the depressed end with just a tidbit of mania which translates into hypomania.
Well, I thought this was going to be a short post this time, but I guess not! I'm glad to hear that you are feeling better. The stress of the holidas doesn't help but I'm holding my own. I feel better than I've felt in a long time at this time of the year. I'm a little miffed at my stepmom but that's nothing new (they get a real Christmas tree even though they know that I am deathly allergic to the thing. That's nothing new. But she actually sounded surprised that we're not coming over on Christmas Eve. I haven't gone over there for Christmas Eve in years because of the damn tree. I decided it wasn't worth it. I get sinus infections, bronchitis, you name it from being around it. Why should I have to be sick for 2 weeks? So I don't go over there now and I invite them to my place after Christmas. She actually sounded pissed when I asked when she wanted to do our gift exchange. She's the one that continues to choose to get the real tree. If I had a relative that was this allergic to trees, I would buy a fake one. In fact, my husband's family, after we had only been dating a year, went out and bought a fake tree. They love the cutting down the tree and the smell of it, etc etc just as much as my step-mom but it's more important to them that I am able to be there and enjoy myself. Hello! It really says something when virtual strangers are kinder to you than your own family. In fact, not only do they get a real tree every year, this started when I was still living at my dad's house. I've been allergic to Christmas trees since 6th grade (I'm now 34). They used to have a fake tree. Then one year she brought in an 8 foot pine. I said, "What are you trying to do? Kill me?" She actually said that she thought since the cedar chips in the guinea pig cage didn't bother me that the tree wouldnt' be a big deal. Everyone knows that it's more than a case of the sniffles for me. ONe year she had a sinus infection and was complaining about how miserable she felt for 2 weeks. I said that was how I felt after being around a Christmas tree....
I'm already all plugged up and having sinus headaches because I was over at their house for a total of about a 1/2 hour on Thursday when I went to pick up my little sister. And there's not much I can take. I can't take any decongestants because they all have pseudophedrine in them and that hypes me up. I take guafenisin to thin out the "goop" and drink lots of water. But even that is a problem because I'm already dried out from the other handful of meds I'm taking.
Anyway, sorry to get off on a rant about that. But thanks for listening! (not that you had a choice :) Well, I guess you could have just stopped reading....
Have a good holiday
take care
Lyrical13
Posted by brussell on December 24, 2003, at 13:19:06
In reply to Re: Lamictal for BPII -and no anxiety meds, posted by Lyrical13 on December 24, 2003, at 8:24:26
Happy Holidays!
Posted by Lyrical13 on December 24, 2003, at 23:41:11
In reply to BP2 and the Christmas Tree of Doom!, posted by brussell on December 24, 2003, at 13:19:06
> Happy Holidays!
Thanks! Aren't families wonderful?
Hey, I think this is a world record for shortest post I've made since I started posting to this site! Miracles DO happen!
Happy holidays everyone!
Lyrical13
This is the end of the thread.
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