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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by aazospiro on March 18, 2004, at 19:23:55
Anyone here who COULD NOT tolerate valproate or lithium or tegretol? Would gabapentin be a good choice? And would it be prude to add a stimulant for daytime?
Are the atypical anti-psychotics effective for anxiety, since they all bind to 5-HT2a receptors, in NON_PSYCHOTIC patients? Especially if nefazodone is not a choice. COuld they be used safely with antidepressants like bupropion?
WHICH IS THE ATYPICAL ANTIPSYCHOTIC LEAST LIKELY TO CAUSE SEDATION AND WEIGHT GAIN?
Please any ideas?
Posted by PsychoSage on March 18, 2004, at 20:25:42
In reply to STIMULANTS PLUS 1 MOOD STABILIZER ANYONE??, posted by aazospiro on March 18, 2004, at 19:23:55
> Anyone here who COULD NOT tolerate valproate or lithium or tegretol? Would gabapentin be a good choice? And would it be prude to add a stimulant for daytime?
>
> Are the atypical anti-psychotics effective for anxiety, since they all bind to 5-HT2a receptors, in NON_PSYCHOTIC patients? Especially if nefazodone is not a choice. COuld they be used safely with antidepressants like bupropion?
>
> WHICH IS THE ATYPICAL ANTIPSYCHOTIC LEAST LIKELY TO CAUSE SEDATION AND WEIGHT GAIN?
>
> Please any ideas?I have only been on Trileptal as a mood stabilizer, and it is not as debilitating as the antipsychotic zyprexa. I have also done risperdal too, and that one worked well, but I did not stay on it for long because I was uninsured.
If you are not pyschotic I would avoid antipsychotics at all costs. If you want to go the nontraditional route for antianxiety then stay within the anticonvulsant/antimanic realm. Zyprexa does have antianxiety properties I am told, but it hardly did much for me in that department. It's still possible to be anxious after being turned into a zombie and adding 35 pounds in less than two months. It sedated me enoughsuch that I was sleeping 10-12 hours a day, but it made me anxious that I was being sedated in such a subtle way. I just figured at the time that if it doesn't knock you out right away, it is not disruptively sedating. Boy, was I wrong.
Do you have ADHD or treatment refractory depression? Why do you want a stim? A stim will make you edgy and possibly irritably dysphoric. It can switch you into mania too.
I was on a risperdal/wellbutrin 300 combo 3 years ago, so it is possible even though I was confused because I thought the risperdal would knock out the dopamine effects from the WB.
Seroquel can knock you out. It is notorious for sedation. I remember my second psych ward trip, and I had no experiences with neuroleptics. I never took one before, and when I saw this woman on Seroquel it freaked me out. She slurred her speech, and slept all day and night. If you don't need it, don't bother.
I have read here that only Abilify is activating. None of the rest come to mind as being nonsedating except maybe geodon, but I read it has some weird potential side effect which is really scary. I am not sure what it was, but I read it on this BIPOLAR PAGE:
http://www.mcmanweb.com/index.html
in the medication section.
you will have to check with others, but I think bupropion can be taken with any antimanic/anticonvulsant or antipsychotic. However, taken with a stim it can cause excessive CNS activation. I take WB with low dose provigil, so it does happen, but you have to be careful.
Posted by sczacovi on March 18, 2004, at 21:29:58
In reply to STIMULANTS PLUS 1 MOOD STABILIZER ANYONE??, posted by aazospiro on March 18, 2004, at 19:23:55
Could not tolerate depakote, taking lamictal for seizures and adderall and zyprexa for bipolar. We added adderall to counter-act zyprexa's weight gain problem and making my son lose his "spark". Adderall seemed to work good with zyprexa except when it was wearing off around 5:00 p.m. My son seemed to be more moody. Too much lamictal made him aggressive. Right now we are back to square one and going to switch all of his meds.
Posted by HappyGirl on March 18, 2004, at 23:59:16
In reply to STIMULANTS PLUS 1 MOOD STABILIZER ANYONE??, posted by aazospiro on March 18, 2004, at 19:23:55
Hi:
> Anyone here who COULD NOT tolerate valproate or lithium or tegretol? Would gabapentin be a good choice? And would it be prude to add a stimulant for daytime?
>--- In my knowledge, gabapentin is a sort 'add-on' to 'regular' mood-stabilizer, such as the meds. you already described, above. Those three M.S. are commonly prescribed upon newly dx'ed Bipolar.
In regard to stimulant for daytime, ... in my opnion, unless you ABSOLUTELY need this, you'd better to avoid any stimulant, because those stims. often produces 'anxiety' problems. ---
> Are the atypical anti-psychotics effective for anxiety, since they all bind to 5-HT2a receptors, in NON_PSYCHOTIC patients?--- For me as Bp II that has mostly major depression with dysphoric mania, ... NON- psychotic episodes, yes, ... one of APs, Zyprexa calms me down quite a bit, ... but then, I'm on Nefadozone/Serzone occasionally that gives me 'anti-anxiety' most of time, ... along with depressive effect. ---
Especially if nefazodone is not a choice. COuld they be used safely with antidepressants like bupropion?
>--- I've been on Wellbutrin SR and Nefadone mix for both purposes, depression and anxiety along with few OCD and works good for those areas. However, like any other AD meds., you may/can NOT expect 100%, ... about 85-90%satisfactory range. The rest is you need to know how to deal with the symptoms, for the comings and goings, like tidal wave in the ocean. In my opinion, there are NO 100%/perfect AD meds. up to date. Hopefully, it will come SOON tho'. ---
> WHICH IS THE ATYPICAL ANTIPSYCHOTIC LEAST LIKELY TO CAUSE SEDATION AND WEIGHT GAIN?--- It might be either 'Seroquel' or 'Risperdal.' The former is one of the weakest APs and the latter is one of the most potent APs and works well for psychotic and delusional features, but also might be good for other symptoms that varies from person to person, ... in my guess.)---
H.G.
This is the end of the thread.
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