Psycho-Babble Medication Thread 367348

Shown: posts 1 to 17 of 17. This is the beginning of the thread.

 

non-sedating med for BP2?

Posted by Lyrical13 on July 18, 2004, at 10:33:22

HI
I'm looking for a med that doesn't completely knock me out. I am on Depakote for BP2 and all I want to do is sleep. When I'm not sleeping I want to just lay on the couch or veg in front of the computer. I have no drive to do anything. I much preferred my manic "busy" phase. At least I got things done! I"ve already tried Seroquel... that was very sedating as well. I see my doc in a couple weeks and want to have some info about some possible meds to discuss with him. I have been on Depakote several months now, so I don't think this level of sedation is going away. I also think it is causing some depression. When I got up to 1000mg which he said would be the therapuetic dose, I was crying for no particular reason, had headache, nausea, stomach cramps, diarhhea. When I backed down to 750 all that went away but was still somewhat depressed and some stomach cramps. Now am at 500 and am just a little down and incredibly tired.

Anyone else on something that keeps you on an even keel but doesn't knock you out all day?

 

Re: non-sedating med for BP2?

Posted by Jackd on July 18, 2004, at 14:49:07

In reply to non-sedating med for BP2?, posted by Lyrical13 on July 18, 2004, at 10:33:22

Hmmmmm... that's a tough one... I've personally found depakote to work the best to really keep my moods stable, but you're right; it does make you sleepy as hell. Lamictal and Lithium are both somewhat more activating, but they might not be the right drugs alone or in combination to help as much as the depakote. I dunno, for some depakote seems to help a lot more, for others Lithium. Regardless, maybe you could try adding a mildly stimulating med like Provigil or Strattera instead of switching to something that might not work as well. Good luck!

 

Re: non-sedating med for BP2? Lyrical13

Posted by SLS on July 18, 2004, at 15:55:32

In reply to non-sedating med for BP2?, posted by Lyrical13 on July 18, 2004, at 10:33:22

How severe are your manias or hypomanias? Are they manageable? If they never prevent you from functioning, perhaps you can afford to experiment with a few different drugs. Have you spoken to your doctor about any in particular? What about depression. To what extent is that a problem? How often do you cycle between mood states without medication?

There are a whole bunch of things you can try.


- Scott

 

Re: non-sedating med for BP2?

Posted by Lyrical13 on July 19, 2004, at 16:53:24

In reply to Re: non-sedating med for BP2? Lyrical13, posted by SLS on July 18, 2004, at 15:55:32

> How severe are your manias or hypomanias? Are they manageable? If they never prevent you from functioning, perhaps you can afford to experiment with a few different drugs. Have you spoken to your doctor about any in particular? What about depression. To what extent is that a problem? How often do you cycle between mood states without medication?
>
> There are a whole bunch of things you can try.
>
>
> - Scott

My bigger problem is depression. In fact, until recently, my dx was depression with anxiety. We just recently realized that I had periods of hypomania and that really explained the problems with my checking account that periodically happened. My worst spending spree was probably $200 at a craft store (keeping in mind that bills had not been paid yet). My worst hypomania was last spring when I was on Effexor. I slept about 4 hours per night and then was on the go non-stop all day until about 11pm and would get up 2-4 hours later and do it all over again for about 4 days straight and then I'd sleep maybe 6 hours for a day or two and then back to 3-4. I had literally 15 projects going on at one time. I was somewhat irritable and very impatient with people who tried to slow me down.

My depression has been a definite pattern for the past 13 years....every fall like clock work. Like I said, the hypomania has been more subtle. Mostly sleeping less, some spending sprees and many projects. Nothing too extravagant... no real grandiosity. Just LOTS of projects, many of which never got finished. My hypomania seems to hit about March or April and last a few months. Depression is August through January. The months in between the two main cycles seem to be transition periods...in July, I'm starting to get more sluggish and a little sad at times but am mostly OK. In Feb I have more energy and feel pretty good but am still keeping normal hours and not spending a lot of money. I see my pdoc next week so I'll see what he has to say. ONe of my main complaints with him is that he still doesn't believe me that I'm sensitive to meds and often require only pediatric doses. He must think it's typical manic thinking...not wanting to take meds. But he's seen the results from a few different meds so far and the side effects and effectiveness from smaller doses. I don't know why it's so hard for him to accept my particular metabolism. Very frustrating.


>

 

Re: non-sedating med for BP2? Lyrical13

Posted by SLS on July 19, 2004, at 20:34:40

In reply to Re: non-sedating med for BP2?, posted by Lyrical13 on July 19, 2004, at 16:53:24

It doesn't sound like Depakote agrees with you. It can actually make some people feel more depressed. What alternatives have you been offered?


- Scott

 

Re: non-sedating med for BP2?

Posted by metalblade on July 20, 2004, at 2:59:46

In reply to non-sedating med for BP2?, posted by Lyrical13 on July 18, 2004, at 10:33:22

I have BP2 and SP. Effexor also makes me manic. I take lithium for my depression and it works great. Doesn't make me sleepy, has very little side effects. I can hardly tell I'm on it. It doesn't give a high feeling, it just makes me feel normal. What it won't do is help you with anxiety.

 

Re: non-sedating med for BP2?

Posted by Lyrical13 on July 20, 2004, at 7:17:50

In reply to Re: non-sedating med for BP2? Lyrical13, posted by SLS on July 19, 2004, at 20:34:40

I tried Lamictal but got a rash. Also tried Seroquel which helped at lower doses in conjunction with Effexor but at higher doses it was way too sedating. We've talked about Neurontin but haven't tried that yet. In the past I've taken Paxil for depression...sexual side effects were depressing in themselves.... Celexa worked great for a few years but eventually maxed that out and it no longer worked. Tried Serzone which worked at lower doses but at higher doses I was walking into walls and was really gorked. I'm wondering if an atypical AP with an antidepressant might work. Or maybe an AS used as a MS. I'm wondering if returning to Celexa might be a good bet since it worked so well before and it's been a couple years since I used it. It didn't seem to make me manic that I can remember. Has Geodon been used for BP? I can't remember if someone mentioned it for that or for depression.

Thanks for your help.

 

Re: non-sedating med for BP2? Lyrical13

Posted by SLS on July 20, 2004, at 8:32:13

In reply to Re: non-sedating med for BP2?, posted by Lyrical13 on July 20, 2004, at 7:17:50

I wrote a pretty long post, but it really wouldn't be well targeted without asking a few questions first.

How well has Depakote stabilized your mood in the absence of an antidepressant? How long have you been on Depakote?

Also, have you tried Wellbutrin?

What exactly are you taking right now, and how are you feeling? Does it feel like you still need an antidepressant, or do you think there is a good chance that it is the Depakote that is making you feel depressed? How would you compare the feeling of depression now to the one you experienced prior to its successful treatment with Celexa? Is it the same beast?

Is there any pattern or rapid cyclicity to your mood states? How did these patterns change once Depakote was added?


- Scott

 

Re: non-sedating med for BP2?

Posted by papeeteebooh on July 20, 2004, at 10:54:53

In reply to Re: non-sedating med for BP2? Lyrical13, posted by SLS on July 20, 2004, at 8:32:13

I have the same problem as you. I am on Depakote (was on 2000, now 1000), Zyprexa (was on 10mg, then 15 then 10 again), Prozac (40mg) and Trazadone (150mg). These meds make me increadibly tired. I started taking them in the last 3-6 months and unforunately, my pdocs is still adjusting them (I had bad liver work so he had to decrease the Depakote and up some others meds) and I wished I was on a fixed medication regiment. But tiredness is the main things. Last weeks I had to call in sick twice because I did not have enough energy to go to work.

I am a rapid cycling BPII, but depression is my dominant mood, I have periodic (shorter) phases of Hypomania.

 

Re: non-sedating med for BP2?

Posted by starlight on July 20, 2004, at 11:41:10

In reply to Re: non-sedating med for BP2?, posted by papeeteebooh on July 20, 2004, at 10:54:53

Trileptal, tegretol - excellent med choices. Tegretol and actually help with weight loss. Did your doc titrate up really slowly on the lamictal? Where was the rash and what did it look like? I got a rash after being on it for about a year, but it was heat rash. Got another rash after working in the backyard, and discovered that I'm highly allergic to bamboo. Could it be that you were exposed to an allergen?
starlight

 

Re: non-sedating med for BP2?

Posted by Lyrical13 on July 20, 2004, at 18:25:28

In reply to Re: non-sedating med for BP2? Lyrical13, posted by SLS on July 20, 2004, at 8:32:13

I've been on Depakote since about April. This definitely feels like my usual beginning depressed state. I am only on Depakote 500 mg at this point. I tried WEllbutrin several years ago, mainly to help counteract the side effects of Paxil. But it is a possibility. I'm sure it is the Depakote that is causing the depression because the higher the dose I take, the worse the depression gets. since I started backing down the dose, it has started abating some.

It definitely helped stabilize the hypomania. I was spending, not sleeping much (4-6 hrs per night) and was incredibly irritable (just ask my husband....)

The only time I really rapid cycled was when I was coming off the Lamictal. I was back and forth between 10 different moods in teh course of an hour. It was scary.

Thanks for your continued interest in my plight. What experience do you have with BP2? Patient, doctor, or both?

 

Re: non-sedating med for BP2? starlight

Posted by Lyrical13 on July 20, 2004, at 18:31:15

In reply to Re: non-sedating med for BP2?, posted by starlight on July 20, 2004, at 11:41:10

I always titrate up incredibly slowly becaues I am so sensitive to meds and never know what they will do to me. I had a rash on my face that appeared exactly 5 days after I started taking the med. It was several dots that looked like bug bites under my eye. After a couple more days, the same rash appeared on the left side of my face. It faded when I d/c'ed the med. The same thing happened when I got above a certain level on the Seroquel. I don't remember the exact dose now, but it was 5 days after I had raised the dose. The nurse at work, who has a lot of experience with psych meds, took a look at the rash and said it matched the description in the PDR.

My sister was on Trileptal for a while. She's gone off all meds at this point (not a good idea but she's young and apparently hasn't suffered enough yet) I'm thinking that might be a good one to try. The Tegretal sounds enticing, esp the weight loss part since I've gained 10 pounds on Depakote so far.

Thanks
Lyrical

 

Re: non-sedating med for BP2? Lyrical13

Posted by SLS on July 20, 2004, at 23:03:05

In reply to Re: non-sedating med for BP2?, posted by Lyrical13 on July 20, 2004, at 18:25:28

Hi.

> What experience do you have with BP2? Patient, doctor, or both?

I have a strange kind of bipolar disorder where there is chronic depression with medication-induced manias. Like a great many people here, I'm just a regular Joe who needed to learn something about mental illness because my doctors weren't able to fix me so easily.

> It definitely helped stabilize the hypomania. I was spending, not sleeping much (4-6 hrs per night) and was incredibly irritable (just ask my husband....)

I agree with Starlight. I think Trileptal is worth considering, especially when mania and impulse control are issues. It is a sister drug to Tegretol, but doesn't carry with it the same risk of producing agranulocytosis, a negative reaction that affects the production of white blood cells.

Neurontin is a drug that some doctors have faith in and others don't. After looking at Neurontin for a few years, the NIMH feels that it is of limited value as a mood stabilizer when used alone, but can be useful when combined with Lamictal. It definitely possesses anxiolytic properties and seems to help with anxiety disorders. Perhaps your doctor has had positive outcomes when using Neurontin in cases such as yours. I guess you need to decide how much confidence you have in his expertise to trust his judgment.

> Has Geodon been used for BP?

Yes, but it has been known to trigger mania. I haven't seen too many success stories with Geodon. All of the atypical neuroleptics have demonstrated antidepressant properties. However, not all of them are of equal value in treating acute mania. Abilify is the first AP I would choose for an antidepressant effect where severe manias are not an issue. It is a clean drug, although it can produce some anxiety and insomnia during the first 2-3 weeks.

What's the deal with Effexor? Did it continue to work despite your problems with Seroquel? Seroquel is kind of funny. It can be less sedating at higher dosages than it is at lower dosages. I know someone who gleans an excellent antidepressant and antimanic (psychotic) effect with Seroquel only once she reaches 700mg. She couldn't stay awake at dosages below 400mg.

You really do have quite a few options. I guess it depends on how you feel about moving in the direction of using APs and how much time you are willing to invest in trying MS emphasized treatments. I don't think I would head in the direction of going back to Celexa, though.

What does your doctor have to say about your reaction to Lamictal?


- Scott

 

Re: non-sedating med for BP2?

Posted by Lyrical13 on July 21, 2004, at 7:06:09

In reply to Re: non-sedating med for BP2? Lyrical13, posted by SLS on July 20, 2004, at 23:03:05

My doc didn't want to take any chance with the Lamictal rash because of the possibility of Steven Johnson's syndrome. The rash I got looked just like the SJ rash and it got worse the longer I was on the med.

I'll definitely talk to my doc about Trileptal. It sounds like a good bet. The problem with Effexor is that it made me really manic. After being on it in combo with Seroquel the mania-inducing properties seemed to be even worse. And I got SO incredibly irritable. Abilify sounds like it might be a good option to try too.

For me, Seroquel got more and more sedating. I almost fell down my stairs when going to the bathrooom in the middle of hte night. I was literally holding onto the walls to keep from falling down while walking. And there were a lot of neurological side effects...short term memory, word finding problems etc. And at the higher dose I started gettting a rash. Where Seroquel worked beautifully for me was at about 50 mg to augment the Effexor when I was severely depressed. It turned the depression around quickly.

Thanks again for your thoughts.

 

Re: non-sedating med for BP2?

Posted by cybercafe on July 22, 2004, at 1:08:19

In reply to Re: non-sedating med for BP2?, posted by Lyrical13 on July 21, 2004, at 7:06:09

> My doc didn't want to take any chance with the Lamictal rash because of the possibility of Steven Johnson's syndrome. The rash I got looked just like the SJ rash and it got worse the longer I was on the med.
>
> I'll definitely talk to my doc about Trileptal. It sounds like a good bet. The problem with Effexor is that it made me really manic. After being on it in combo with Seroquel the mania-inducing properties seemed to be even worse. And I got SO incredibly irritable. Abilify sounds like it might be a good option to try too.
>
> For me, Seroquel got more and more sedating. I almost fell down my stairs when going to the bathrooom in the middle of hte night. I was literally holding onto the walls to keep from falling down while walking. And there were a lot of neurological side effects...short term memory, word finding problems etc. And at the higher dose I started gettting a rash. Where Seroquel worked beautifully for me was at about 50 mg to augment the Effexor when I was severely depressed. It turned the depression around quickly.
>
> Thanks again for your thoughts.

abilify is the best mood stabilizer i have ever taken... YMMV
i am down to 1/8th of a 15 mg pill and have been on this dose for quite a while (months?) ...

 

Re: non-sedating med for BP2? cybercafe

Posted by SLS on July 22, 2004, at 8:41:34

In reply to Re: non-sedating med for BP2?, posted by cybercafe on July 22, 2004, at 1:08:19

Hi.

> abilify is the best mood stabilizer i have ever taken... YMMV

Do you feel that Abilify has anti-manic properties or stabilizes rapid-cycling patterns?


- Scott

 

Re: non-sedating med for BP2?

Posted by Lyrical13 on July 22, 2004, at 17:34:30

In reply to Re: non-sedating med for BP2?, posted by cybercafe on July 22, 2004, at 1:08:19

I'll bet it's a trick to cut that pill into 1/8s. I have a tricky enough time doing 1/4s!


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