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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by holymama on August 12, 2005, at 7:37:33
I've been in a 5/6 month depression funk, I'm bipolar and have reduced my meds to lithium and wellbutrin this summer. I wanted to get off paxil, since it wasn't helping with the depression anyway and I was guessing SSRIs were making me rapid cycle. Since getting off the paxil, I've been more stable -- stably depressed. Finally, after not being able to stand it any longer, I had a long talk with my pdoc, and the options she offered me were: depakote, topomax, or an SSRI. I'm afraid of Depakote! My nephew took it as a toddler, and gained a ton of weight on it and lost his personality. Of course, this was for severe epilepsy, so this was better than risking the seizures. Topomax I'm less scared of, but I am in Graduate school and have three kids, and need to have all of the brain power I can get, and isn't topomax also known as 'stupidmax'? I'm also worried that a mood stabilizer may take a while to touch the depression, and I start school in a few weeks. So I opted for Zoloft, which I have faith will bring me out of the depression....but in the long run it will cause me more problems -- cycling and instability. My pdoc says at the first sign of hypomania she will take me off the zoloft (and do what else, I'm not sure). In any case, as soon as this happens, I'll need to choose something else I'm sure. Does anyone have any thoughts for me?
~~Autumn~~
Posted by Nickengland on August 12, 2005, at 9:25:26
In reply to Scared of Depakote, Topomax, posted by holymama on August 12, 2005, at 7:37:33
Hello there..
I understand your fear of the "stupidmax" or 'dopamax' effect of Topamax...
I can say though that I have been on all the common mood stabilisers and have now ended up on topamax - and really the "stupid" side effects are not that bad. In fact i've had far worse from the other more well known traditional mood stabilisers with cognitive difficulties.
Its swings and roundabouts alot of the time, depakote may not have the stupidness, but at the same time you don't want to be fat. Also theres the main factor of if the medication will actually do its job and treat the illness. If it does then you can deal with the side effects when they arise...you may find (I have) that the benefits of topamax outweigh any negative side effects..
Hope that helps...
Warm regards
Nick
Ps I also find topamax helps greatly with bipolar depression - far more so than sodium valproate did when I took that. Of course thats justs me and everyone reacts differently...
Posted by med_empowered on August 12, 2005, at 14:28:30
In reply to Re: Scared of Depakote, Topomax » holymama, posted by Nickengland on August 12, 2005, at 9:25:26
hey! I understand your fear of Depakote and Topomax. Depakote made lots of my friends fat and slow, and it made me throw up so much that I couldnt even take it (maybe that was for the best?). Topomax...I've never taken it, but in people I know I've seen mixed results. Some people seem just fine, and they love the weight loss; some people seem kinda stupid and "flat". So...its a mixed-bag, I guess. I completely understand the SSRI-induced cycling..its awful, isn't it? And...I hear you on the cognitive thing. I'm in college, and I have been delayed in graduating b/c of a bad doc who had me so overmedicated I couldn't function as I needed to (hate to sound bitter but, hey, that's what happened). I'm going to talk to a doc soon about Keppra, which (supposedly) controls mood swings without causing stupidity. I also have the hardcore depression you seem to get--I came out of a period of depression with psychotic features a few months ago, and I still feel blah (but better). Have you thought about Lamictal? I dont think it'd be a great idea for monotherapy if you've had signifcant problems with mania or hypomania, but it does seem to help lots of people with bipolar disorder while depressed...sometimes its combined with a stronger "anti-manic" mood-stabilizer to (hypothetically, at least) get the best of both worlds. Usually, the combo seems to be depakote+lamictal....I'm going to ask my new doc about Keppra+lamictal...do you think that'd be something you'd be interested in, as well? Another thing that interests me is "as-needed (PRN)" use of antipsychotics, especially Zyprexa. The idea seems to be that if you feel yourself really "losing your grip," you can take an antipsychotic, chill, and then address the situation as-needed. In my experience, alot of times all that's needed to prevent severe depression or mixed-episodes (I dont get "classic" mania) is something to calm my brain down...so, it seems like a PRN prescription of zyprexa or abilify would be potentially useful (and comforting, reassuring) add-on med. Maybe your shrink would consider something like that? Anyway, good luck and please post and let us all know how you're doing.
Posted by holymama on August 12, 2005, at 15:07:13
In reply to Scared of Depakote, Topomax, posted by holymama on August 12, 2005, at 7:37:33
Thanks for the replys! THis is all helpful to me.
Nick, I'm glad to hear that topomax can be not only tolerable but especially GOOD IN DEALING WITH BIPOLAR DEPRESSION. My pdoc did not seem to think it would be as much as depakote, but of course everyone reacts differently (don't we all know), and I'm glad to put topomax down as one worth trying.
Medempowered, I have been on Lamictal and got THE RASH. Well, a slight one, but scary enough for me not to want to try it again unless totally my last resort.
Hmmm A PRN dose of an antipsychotic is an interesting idea. I've had weird reactions in the past to a DAILY dose of antipsychotic (seroquel and also risperdal), risperdal causing me mania (straight out of a deep depression), and in both cases eventually settling down into an agitated, suicidal state. As I said though, these were daily doses, and I've often wondered about using them in different ways since I know they can be powerful for me.
Keppra is a drug I definitely know nothing about and would like to research.
Thanks again for the ideas. Oh, and I am having another good day on the zoloft. I feel like I am being reborn. :)
~Autumn~
Posted by Nickengland on August 12, 2005, at 16:45:13
In reply to Re: Scared of Depakote, Topomax, posted by holymama on August 12, 2005, at 15:07:13
Posted by kerria on August 13, 2005, at 14:17:19
In reply to Scared of Depakote, Topomax, posted by holymama on August 12, 2005, at 7:37:33
Hi Autumn,
i'm afraid of meds also and can't take a lot of things because of allergy and am sensitive to getting migraines and side effects.
Depakote is one of the few things that i have been able to take.After an OD on diazapam because of severe PTSD/DID sx and depression i was hospitalized and in the hospital they started me on depakote. i was on it for about six months. My weight stayed the same, about 105lbs the whole time and didn't notice any really bad side effects except when i went hiking. It seemed to make me have less balance on slippery mountain trails and i think zapped my strength a little also. It didn't do anything really bad but it didn't seem to do anything at all so i stopped taking it when i ran out.
No withdrawal that i noticed. i was on a low dose-i don't remember what it was.
Take care,
kerria
Posted by holymama on August 13, 2005, at 20:08:38
In reply to Re: Scared of Depakote, Topomax, posted by kerria on August 13, 2005, at 14:17:19
Thanks Kerria, again, it is good to hear that there are people who don't get the side effects of drugs that we hear about so often. THere are so many horror stories, and I bet there are just as many if not more success stories that we don't hear about because those people are not on this board complaining.
Good to note: Depakote does not always cause massive weght gain.
~~Autumn~~
Posted by fairywings on August 13, 2005, at 21:37:18
In reply to Scared of Depakote, Topomax, posted by holymama on August 12, 2005, at 7:37:33
Hi holy,
I'm on a low dose of Topamax for migraines, so far just 25 mg., and so far no problems, and if you read my post below, I think it's increased my sex drive to an uncomfortable level, I've lost a bit of weight too, but I exercise a lot. I have 4 kids, so I feel your pain as far as needing all the brain power you can muster, they suck it out of you. I don't take Depakote, so I can't comment on that.
fw
Posted by holymama on August 14, 2005, at 8:16:30
In reply to Re: Scared of Depakote, Topomax » holymama, posted by fairywings on August 13, 2005, at 21:37:18
Hi FW, INCREASED your sex drive?? Is that what you meant to write? I'll read your other post. Very interesting... ~Autumn~
Posted by fairywings on August 14, 2005, at 11:30:11
In reply to Re: Scared of Depakote, Topomax » fairywings, posted by holymama on August 14, 2005, at 8:16:30
> Hi FW, INCREASED your sex drive?? Is that what you meant to write? I'll read your other post. Very interesting... ~Autumn~
Hi Autumn,
I'm not sure if it was that or not. It started after I started on the Topamax, but it could be something else, or just a hormonal thing. I have a high sex drive anyway, but this is ridiculous. From the minute I wake up, till I fall asleep I feel like I have to have an orgasm! The only thing that eases the feeling is exercise. Some people are probably thinking, "hey, why's she complaining?" But, it's uncomfortable to feel like you need to "get off" every waking moment! I don't want to complain though because I'd rather be in this quandry than have no sex drive, which is harder to fix.
I can distract myself, which is good, chores, reading, writing, etc... but forget watching tv, or lying down!
fw
Posted by theo on August 15, 2005, at 23:14:24
In reply to Scared of Depakote, Topomax, posted by holymama on August 12, 2005, at 7:37:33
Topomax I'm less scared of, but I am in Graduate school and have three kids, and need to have all of the brain power I can get, and isn't topomax also known as 'stupidmax'? I'm also worried that a mood stabilizer may take a while to touch the depression, and I start school in a few weeks. So I opted for Zoloft, which I have faith will bring me out of the depression....but in the long run it will cause me more problems -- cycling and instability. My pdoc says at the first sign of hypomania she will take me off the zoloft (and do what else, I'm not sure). In any case, as soon as this happens, I'll need to choose something else I'm sure. Does anyone have any thoughts for me?
> ~~Autumn~~Topamax aka "Dopamax" gave me horrible cognitive problems, Depakote did not.
As far as SSRI's, everyone is different but if you are the least bit Bipolar, Zoloft can make you a nervous wreck. When I took Zoloft, I was sleepy but had tons of anxiety, it wasn't pleasant. Paxil was the best for me but I couldn't get over the male sexual side effects.
Posted by theo on August 15, 2005, at 23:18:55
In reply to Re: Scared of Depakote, Topomax, posted by kerria on August 13, 2005, at 14:17:19
> Depakote is one of the few things that i have been able to take.
Do you remeber if you took regular Depakote or Depakote ER? Did you take it at night?
Posted by kerria on August 16, 2005, at 3:31:51
In reply to Re: Scared of Depakote, Topomax » kerria, posted by theo on August 15, 2005, at 23:18:55
Hi-
It was almost three years ago but i'm pretty sure that it was Not immediate release- just Depakote. i took it in the morning and it was a small dose- i remember the dr saying that. i was nervous because i can't take almost anything. i've had a very bad reaction to resperdal, seroquel and any anti-psychotic or anti-depressant except prozac.i remember having a blood test for liver function before taking it. i think that that's done routinely because you can't take it if there's liver problems.
It didn't seem to effect me at all- it was like normal- it didn't feel like anything at all except for giving me mild imbalance and it felt like i had less endurance when hiking long distance.
Take care,
kerria
Posted by ed_uk on August 16, 2005, at 5:44:14
In reply to Re: Scared of Depakote, Topomax » theo, posted by kerria on August 16, 2005, at 3:31:51
Hi Kerria,
How do you react to antipsychotics?
~ed
Posted by fairywings on August 16, 2005, at 6:51:48
In reply to Re: Scared of Depakote, Topomax » holymama, posted by theo on August 15, 2005, at 23:14:24
Just shows you how different everyone is. I couldn't stand the side effects of zoloft - water retention, extreme dizzyness, wanting to eat all the time, weight gain, and then to boot it made me depressed. Also, I exercise a lot, and the sweating was really awful - beach towel type sweating - and then I'd have to drink 4 large bottles of water.
So far the Topamax hasn't been too bad autumn, maybe a word find problems here and there, but I'm on a low dose for migraines, so I don't know what it would do at a higher dose. Are all the anticonvulsants used for mood stability, like tegratol, supposed to effect cognition? I know with topamax it's drug related temporal lobe problems.
fw
Posted by kerria on August 16, 2005, at 14:24:12
In reply to Re: Scared of Depakote, Topomax » kerria, posted by ed_uk on August 16, 2005, at 5:44:14
Hi. i just came home from the pain management drs appt. Everything is an absolute nightmare.
Anti-psychotics make me physically sick. The last time i was given reperdal - in the hospital three years ago. Forty minutes after taking it i lost my vision for over an hour. i thought that i would never see again, it was so frightening.
i just laid down and the worst headache started. i asked for a dr to come because i thought i was having a stroke.Everytime i ever tried to take them i get very severe stroke-like symptoms. i tried seroquel also and it made me feel like a zombie with a headache and pins and needles all over my body.
i really wonder how anyone can endure feeling like that.
maybe i'm just different because i'm prone to migraines?kerria
Posted by ed_uk on August 16, 2005, at 15:53:09
In reply to Re: Scared of Depakote, Topomax » ed_uk, posted by kerria on August 16, 2005, at 14:24:12
Hi Kerria,
>i just came home from the pain management drs appt.
What did he say?
>Forty minutes after taking it i lost my vision for over an hour.
Did you feel dizzy? Could you see anything?
>i really wonder how anyone can endure feeling like that.
They can't. Some people respond well to antipsychotics - but not you - and not me.
Kind regards
~Ed
Posted by kerria on August 16, 2005, at 23:40:27
In reply to Re: Scared of Depakote, Topomax » kerria, posted by ed_uk on August 16, 2005, at 15:53:09
Hi Ed,
Resperdal made my vision so disorganized that i thought i was having a stroke. It started on one side and spread over to where i couldn't see anything but a bunch of distorted lines and shapes of things around me. It lasted for over an hour and then a bad headache started that lasted all night.
Yes- i think i was dizzy with it but was too sick to sit or stand up anyways. Seroquel made me dizzy also.The pain management dr today was so negative- i should have had someone with me because he never would talk to me as he did if someone else was there.
he stated again that he wasn't going to treat me and complained that he hadn't received the faxes of my gyn visits that i called last week to be faxed. i called each of the gyn offices from his office today and asked them to 'please fax now because i was at my drs office" and waited until they did. The receptionist brought the papers back to the pain dr- now he can't accuse me of that anymore.Earlier when i was in the treatment room he verbally abused me accusing me of lying about seeing the drs. When he said he wasn't going to treat me because i didn't have a dx, i was crying so hard- i told him i couldn't live in the pain and i did everything i could to get a dx. i told him how horrible the nerve block was without the sedation that he agreed to beforehand and he still defended himself. He also minimized the numbness in my right leg saying, "At least you can walk on it- the muscles are ok."
i was a mess there- i could hardly breathe because i was so upset.
It's so wrong for him to abandon me like this- without a referral that can take up my pain control. I''m so afraid now- with only two weeks medicine.i can't handle the terrible emotional distress of worrying if i will be in severe pain again in two weeks. He told my psychiatrist that he was going to not treat me and would wean me off opioids.
i can't get off now because i'm in too much pain.No one will stand up for me. What am i going to do?
i cried in T's office and hardly remember anything else. T said he was sorry. Parts feel like nothing matters- if we can't find anyone to help pain we can't live like this. It's over. i'm so afraid of what's going to happen to me. tears.
Posted by ed_uk on August 17, 2005, at 10:28:55
In reply to Re: Scared of Depakote, Topomax » ed_uk, posted by kerria on August 16, 2005, at 23:40:27
Dear K,
((((K))))
>i should have had someone with me because he never would talk to me as he did if someone else was there.
Could you bring a friend for support?
>i can't get off now because i'm in too much pain.
Will your pdoc continue prescribing the morphine?
Ed x
Posted by kerria on August 17, 2005, at 12:28:40
In reply to Re: Scared of Depakote, Topomax » kerria, posted by ed_uk on August 17, 2005, at 10:28:55
Hi.
Yes- i'll have to bring someone with me next time.
it was such a bad idea to go alone.He grugdingly precribed only for two weeks- the kadian doesn't work as well-Today i couldn't get my pain under control in time to leave for work:( It's also twice the price as a month of oxycontin.
i can't get generic because i found that it works even worse. finally after five hours the horrible burning pain feels better.i can't live like this:(
He said after prescribing two weeks meds "We'll see in two weeks." There were threats tohroughout the visit of "i can't treat you without a dx" , etc.
i had the results form the gyn drs given to him yesterday that were faxed as i waited to make sure he received them but i don't think it will make a difference. He plans to wean me off- my psychDr said in a message on phone.
i don't know what to do because i can't manage already.It's so hard to start going to a new dr now after i tried all the different meds and elival, neurontin, other meds failed to help. i'm so afraid they will make me start all over again and i physically can't. pschyoloogically can't either- so hurt by this dr threatening to abandon me everytime i see him.
i hate everything about this- the pain, the way that dr is treating me, the way i'm so afraid, the way i have to depend upon him, the way he;s abusing his power to hurt me, the way i act when i was there. It's so complicated- i feel sorry for myself and angry with myself at the same time. i know i need pain meds legitimately but feel so guilty at the same time. i hate to miss work. It's really hard to have separate parts - so much internal conflict. my parts take the negative side against me.
It's the worse confusing mess- just want it to be over. i wish somone else can find help for me because i'm not able now.k
Posted by ed_uk on August 17, 2005, at 14:16:39
In reply to Re: Scared of Depakote, Topomax » ed_uk, posted by kerria on August 17, 2005, at 12:28:40
Hi K,
>Kadian
>It's also twice the price as a month of oxycontin.If possible, could you get a prescription for a less expensive brand of morphine? There are lots of different brands.
>i wish somone else can find help for me because i'm not able now.
Do you have a friend or family member who can be your advocate?
Ed
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