Psycho-Babble Medication Thread 299090

Shown: posts 1 to 14 of 14. This is the beginning of the thread.

 

I Need Suggestions

Posted by Tom G on January 10, 2004, at 17:11:35

Here's my situation

I've been fighting whatever it is that I have for about seven years. I think the most accurate diagnosis that I've had from the six or more pdocs I've had is bipolar II. The diagnosis was confused for awhile with social phobia. I have hypomanic episodes with antidepressants and stress. The drugs I've been on:


-Prozac up to 80 mgs
-Serzone
-Effexor
-Paxil+Klonopin
-Wellbutrin
-Zoloft
-Xanax
-Provigil
-Celexa--- caused panic attack after 2 days
-Nardil--- tried for about 4 or 5 weeks
-Depakote--- up to 1000 mgs. for about 3 or 4 weeks
-Lithium--- at 900 mgs. it is the only drug thats has worked but only for 5 days--raised to 1200 mgs. and it caused severe agitation and discomfort
-Lamictal-- got to 400 mgs. Nothing
-Nardil 60 mgs.+Zyprexa 5 mg+Lithium 600 mg-- added Risperdal in place of Li later-- this combo caused feet to swell and had no positive results
-Zyprexa 15 mg gained weight and zoned me out
-Abilify 15 mg caused terrible akathesia and had to stop
-Flax Seed--I had an initial antidepressant response from this but different from the lithium-not as calming
-Nortriptyline 75 mg this is my most recent med--it caused a slight hypomanic reaction the first week, after that nothing positive


I really don't think I have a clear cut diagnosis. My anxiety turns into paranoia in social situations. I seem to always be tensed up. I think about death, and this seems to be worse in the evenings. I hate humans. I am always negative. I have no self confidence. I try to cause argument and controversy. I am just generally frustrated and don't like life. The lithium that worked for me had an overwhelming calming effect. So what is the best med or med combo for me? There are definately drugs that I have not tried or maybe things to retry at higher doses etc. Please, I welcome any strategies.

Thanks for reading

 

Re: I Need Suggestions

Posted by Maxime on January 10, 2004, at 17:50:06

In reply to I Need Suggestions, posted by Tom G on January 10, 2004, at 17:11:35

Hello. You sound like you are BP. Your argumentative behaviour can be mania/hypomania as well as the paranoia. I am BP1. My mania is not pleasant. I start off with extreme irritability (sometimes rage) and then I become psychotic in the form of paranoia.

Tegretol is a good mood stabiliser for the irritability. I can't take it myself because of side effects but you might want to give it a go.

You might also want to add Niacin (vitamin B3), about 300 mg a day to calm you down.

At night clonazapam will help you with anxiety.

I am also preoccupied with death. I haven't found anything to help that. I take Parnate (MAOI) as my anti-depressant.

Have you done the fish oil thing?

Did 80 mg of prozac help you at all? Before the Parnate I was on 100 mg of Prozac (after trying everything else) and it did help, but Parnate is better. I still get depressed though and suicidal so obviously it's not perfect.

That's all I can think of now.

Maxime


> Here's my situation
>
> I've been fighting whatever it is that I have for about seven years. I think the most accurate diagnosis that I've had from the six or more pdocs I've had is bipolar II. The diagnosis was confused for awhile with social phobia. I have hypomanic episodes with antidepressants and stress. The drugs I've been on:
>
>
> -Prozac up to 80 mgs
> -Serzone
> -Effexor
> -Paxil+Klonopin
> -Wellbutrin
> -Zoloft
> -Xanax
> -Provigil
> -Celexa--- caused panic attack after 2 days
> -Nardil--- tried for about 4 or 5 weeks
> -Depakote--- up to 1000 mgs. for about 3 or 4 weeks
> -Lithium--- at 900 mgs. it is the only drug thats has worked but only for 5 days--raised to 1200 mgs. and it caused severe agitation and discomfort
> -Lamictal-- got to 400 mgs. Nothing
> -Nardil 60 mgs.+Zyprexa 5 mg+Lithium 600 mg-- added Risperdal in place of Li later-- this combo caused feet to swell and had no positive results
> -Zyprexa 15 mg gained weight and zoned me out
> -Abilify 15 mg caused terrible akathesia and had to stop
> -Flax Seed--I had an initial antidepressant response from this but different from the lithium-not as calming
> -Nortriptyline 75 mg this is my most recent med--it caused a slight hypomanic reaction the first week, after that nothing positive
>
>
> I really don't think I have a clear cut diagnosis. My anxiety turns into paranoia in social situations. I seem to always be tensed up. I think about death, and this seems to be worse in the evenings. I hate humans. I am always negative. I have no self confidence. I try to cause argument and controversy. I am just generally frustrated and don't like life. The lithium that worked for me had an overwhelming calming effect. So what is the best med or med combo for me? There are definately drugs that I have not tried or maybe things to retry at higher doses etc. Please, I welcome any strategies.
>
> Thanks for reading
>

 

Re: I Need Suggestions

Posted by brussell on January 10, 2004, at 17:53:02

In reply to I Need Suggestions, posted by Tom G on January 10, 2004, at 17:11:35

You've certainly covered your bases well. I have two suggestions:

Topomax--never tried it, but may work as a mood stabilizer for you.

Risperdal--I personally don't like antipsychotics, but they can be great for anxiety. This is one you didn't mention.

Parnate--This drug very likely saved my life. Besides being a MAOI, it has very little in common with Nardil. It's definitely worth a try. It did wonders for both my depression and anxiety.

Best wishes.

 

Re: I Need Suggestions

Posted by Sebastian on January 10, 2004, at 19:16:23

In reply to I Need Suggestions, posted by Tom G on January 10, 2004, at 17:11:35

Try: 7.5 mg zyprexa + 5 mg Abilify?

 

Re: I Need Suggestions

Posted by Maxime on January 10, 2004, at 19:48:51

In reply to Re: I Need Suggestions, posted by Sebastian on January 10, 2004, at 19:16:23

Oh and of course you should also be in therapy. Some cognitive behavioural therapy might help you with your preoccupation with death.

Maxime

 

Re: I Need Suggestions }} Maxime

Posted by Tom G on January 10, 2004, at 20:58:24

In reply to Re: I Need Suggestions, posted by Maxime on January 10, 2004, at 17:50:06

Thanks for the reply

The Prozac at 80 mgs did nothing but make me tired and increased anxiety. About a year and a half earlier before this I had tried Prozac 20 mgs. This was the first drug that I tried and it sent me into a three month hypomanic episode. Later trials of ssri's including Prozac did not cause hypomanic episodes, but instead increased the intensity of my symptoms.

How is the Parnate? Does it work for you? I've been thinking about giving it a try and I truly don't know if I gave Nardil long enough or had an optimum dose according to this Ace guy. Does it improve apathy and give one a more positive attitude. It seems to me that with most people it helps mainly with motivation and energy. My last doctor was hesitant to use it because of my anxiety.

I've been thinking about trying the Li again with the addition of Neurontin

Good Luck!

 

Re: I Need Suggestions--Sebastian

Posted by Tom G on January 10, 2004, at 21:01:13

In reply to Re: I Need Suggestions, posted by Sebastian on January 10, 2004, at 19:16:23

What is your experience with this combination or what do you know about it?

 

Re: I Need Suggestions }} Tom

Posted by Maxime on January 10, 2004, at 21:30:45

In reply to Re: I Need Suggestions }} Maxime, posted by Tom G on January 10, 2004, at 20:58:24

Yes, you are BP for sure if SSRIs did that to you.

The Parnate works well for me on several levels. It's the best anti-depressant I have been on. My pdoc chose Parnate over Nardil because of my apathy and because I was "slow". When my depression gets bad I become almost catatonic. So since Nardil is sedating, he didn't want me to be on it. Also, if I feel a manic/hypomanic episode coming on I can decrease the Parnate and it will stop me from going into full blown psychotic mania. I only just tried this out in the past 4 months. And if I become too depressed I can increase the Parnate for a few weeks and get myself out of it. Basically I like the fact hta I can play with the dosage and get an immediate response.

I take clonazapam for anxiety/sleep plus thorazine for sleep/mood stabilization. Plus trileptal for mood stabilisation.I'm allergic to depakote and I was always toxic on lithium no matter what dose I was on.

I think you should try the lithium again since you had a good response to it already.

Maxime


> Thanks for the reply
>
> The Prozac at 80 mgs did nothing but make me tired and increased anxiety. About a year and a half earlier before this I had tried Prozac 20 mgs. This was the first drug that I tried and it sent me into a three month hypomanic episode. Later trials of ssri's including Prozac did not cause hypomanic episodes, but instead increased the intensity of my symptoms.
>
> How is the Parnate? Does it work for you? I've been thinking about giving it a try and I truly don't know if I gave Nardil long enough or had an optimum dose according to this Ace guy. Does it improve apathy and give one a more positive attitude. It seems to me that with most people it helps mainly with motivation and energy. My last doctor was hesitant to use it because of my anxiety.
>
> I've been thinking about trying the Li again with the addition of Neurontin
>
> Good Luck!

 

Re: I Need Suggestions--Sebastian » Tom G

Posted by Sebastian on January 11, 2004, at 10:04:52

In reply to Re: I Need Suggestions--Sebastian, posted by Tom G on January 10, 2004, at 21:01:13

You get the effects of both. some things cancel like tiredness, you will have energy. Found it to be socialy inhibiting. Good anti-depressant effect. Small amount of social anxiety, which may be good?

 

Re: I Need Suggestions

Posted by gardenergirl on January 11, 2004, at 10:50:39

In reply to Re: I Need Suggestions, posted by Sebastian on January 10, 2004, at 19:16:23

I am on 45 mg Nardil for atypical depression. Like Maxime, I would get almost paralyzed at my worst. I just couldn't get out of bed, wouldn't go to work or school. I do have a component of anxiety to my depression that was fairly hidden. The Nardil made me feel MUCH more confident almost immediately. Once I realized I was feeling more confident, I realized I must have been quite anxious before without knowing it. So I wonder why the doc was hesitant about Nardil and anxiety.

 

Re: I Need Suggestions

Posted by crazychickuk on January 11, 2004, at 14:58:53

In reply to Re: I Need Suggestions, posted by gardenergirl on January 11, 2004, at 10:50:39

Wow tom you sound so much like me.. i am currently on 30remeron not helping my down days though :( my rages are coming on more now, i am scared... still waiting to see someone :( what shall I ask for?

 

Re: I Need Suggestions--crazyukchick

Posted by Tom G on January 11, 2004, at 20:39:40

In reply to Re: I Need Suggestions, posted by crazychickuk on January 11, 2004, at 14:58:53

Hi crazy

What have you tried so far?

I would suggest lithium to anyone who hasn't tried it

 

Re: I Need Suggestions--crazyukchick

Posted by Keith Talent on January 11, 2004, at 22:57:53

In reply to Re: I Need Suggestions--crazyukchick, posted by Tom G on January 11, 2004, at 20:39:40

I was diagnosed with Bipolar II Disorder, but after a few years, I think it's too soft a phenomenon to be meaningful. I've found it's more useful to conceive of my problem as Major Depressive Disorder. Hell, I hardly ever was high, and even then it was all too fleeting!

Five days on lithium at 1200 mg a day is not an adequate trial. More like six months at 1.0 mEq/L. In PubMed there are a couple of studies from the seventies and early eighties that found that dextroamphetamine produced some improvement acutely in manic episodes. There's a lot that we don't know! Interestingly, tranylcypromine (Parnate) is structurally similar to the amphetamines and has a short-term stimulating effect separate to its long-term antidepressant effect.

I would go on tranylcypromine. People have posted here that they've needed up to 160 mg a day, so don't accept failure at 60. If you still aren't happy with the hypomanic/manic control, go on lithium for six months. Then if it disagreed with you, divalproex, then oxcarbazepine, then lamotrigine.

 

Re: I Need Suggestions--crazyukchick

Posted by crazychickuk on January 12, 2004, at 2:34:03

In reply to Re: I Need Suggestions--crazyukchick, posted by Keith Talent on January 11, 2004, at 22:57:53

wow all these strange names... i can get manic say up to a few hrs every few days where i am so manic i think i been spiked with extasy or something and i get paranoid etc etc... to the point where i cant calm down.. then sometimes i am so low i feel suicidal, and panicky, and depressed and god you name it!! SO does lithium make you feel down or high ?
cheers


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