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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by holymama on August 23, 2005, at 16:26:46
I've just started on my fifth pdoc in 2 years. After my third firing me in June, I tried a fourth at a bipolar clinic in Boston, and she was SCARY. Suggested I start Lithium when I am already on it, suggested Paxil when I just got off it, forgetful and spacy and never checked my chart. I was NOT feeling comfortable about trusting her with my mental stability and LIFE. I've been questioning the whole psychiatric profession and wondering if I will ever find a doctor who is smart and caring -- someone I can trust.
Well, I had a 1 1/2 hour visit with a new doctor, and I want everyone to know that good doctors DO exist! She was smart, concerned (wants me to check in with her in a week), and had tons of ideas for me (my third pdoc said 'this is as stable as you're going to get', and admitted she was stumped by me.). She also had answers to questions I have had about why I have reacted to certain drugs in certain ways. Noone else has been able to answer those questions. She also right away let me know that she has observed how important it is to get bipolar patients off antidepressants -- for most they cause cycling and more instability. THat is something I have thought for the past two years, and I have had no doctor really agree with me or try hard to get me off of them. Yay! So far so good, and I am so relieved, I feel like I should throw a party. :)
Posted by tecknohed on August 23, 2005, at 20:22:55
In reply to Finally! A good pdoc!!, posted by holymama on August 23, 2005, at 16:26:46
Good for you! I'm happy for ya! (and I mean that).
It took me best part of 6 years to find a doctor who 'knows his stuff' as well as being (somewhat) caring. Mind you, he's still 'WAY' over-conventional. (:
Posted by Phillipa on August 23, 2005, at 20:28:15
In reply to Re: Finally! A good pdoc!!, posted by tecknohed on August 23, 2005, at 20:22:55
Well once I did have a good pdoc. He also did psychtherapy. He even had me to a point that I didn't need meds really! But I moved to VA and since then none have been the same. Fondly, Phillipa
Posted by Ilene on August 23, 2005, at 20:53:42
In reply to Finally! A good pdoc!!, posted by holymama on August 23, 2005, at 16:26:46
Congratulations! All the work of finding a new pdoc paid off. I'm glad to hear that it *can* happen. I have a new one who seems pretty conservative. :-(
I.
Posted by fires on August 23, 2005, at 22:18:53
In reply to Finally! A good pdoc!!, posted by holymama on August 23, 2005, at 16:26:46
>>She also right away let me know that she has observed how important it is to get bipolar patients off antidepressants -- for most they cause cycling and more instability.<<
I've been dxed with BP NOS (probably BP II) and I wouldn't give up my Wellbutrin unless they pried it from my cold blue hands. ;) My pdoc and the "big" pdoc I recently consulted haven't even mentioned stopping Wellbutrin. I don't have real proof that it is working, though, because I didn't begin taking it when I wasn't severely depressed.
I could become severely depressed at any time. (unless the Wellbutrin is working).
One question:What happens if a BP becomes depressed while only taking only a mood stabilizer?
Posted by holymama on August 24, 2005, at 7:32:25
In reply to Re: Finally! A good pdoc!! » holymama, posted by fires on August 23, 2005, at 22:18:53
Dear Fires,
Yes, that is the question. I know that some, maybe a lot of Bipolar people can take an antidepressant with a mood stabilizer. You must be one of them. For me, wellbutrin seems to have no effect on my depression, while SSRIs cause me to rapid cycle -- initially I feel great, but within weeks I get depressed again, and so on.My new pdoc said that she wants to take me off the wellbutrin (even though it seems not to make me cycle, it could be the'gasoline on the fire' -- just a little extra that might set off cycling. THen I assume she'll want me off the zoloft I just started.
She said (shwich I already knew) that there aren't any bipolar meds for depression. Not good ones anyway. She said she thought the best way to treat a bipolar is to have them on 2 mood stabilizers -- preferably Lithium and Depakote, which are the two top stabilizing meds, with the rest of the mood stabilizers far behind in their stabilizing abilities.
I'm already on Lithium, and I've alwaays been afraid of Dapakote, but hell, I guess I'm ready to try if it will keep away the depressions.
~~Autumn
Posted by holymama on August 24, 2005, at 7:34:31
In reply to Re: Finally! A good pdoc!! » holymama, posted by Ilene on August 23, 2005, at 20:53:42
Thanks for the congrats everyone,
I wish you all the same.
I'm glad I kept trying to find one even though it was a lot of effort and more money initially. I think it's going to be worth it. :)
Posted by fires on August 26, 2005, at 19:06:51
In reply to Re: Finally! A good pdoc!!, posted by holymama on August 24, 2005, at 7:32:25
> Dear Fires,
> Yes, that is the question. I know that some, maybe a lot of Bipolar people can take an antidepressant with a mood stabilizer. You must be one of them.I'd rather have the hypomania I experienced (no elation, just hyper talkative and hyperpsychomotor)than depression.
>
> She said (shwich I already knew) that there aren't any bipolar meds for depression. Not good ones anyway. She said she thought the best way to treat a bipolar is to have them on 2 mood stabilizers <<No one has even begun to consider 2 mood stabilizers in my case. Many years ago I was on lithium alone for depression, and all I got was shaky handwriting.
I think our experiences are very different, and require different treatments. BTW, unless it is a last chance type of "thing", I will never take an SSRI again. They are like poison to me. I would try a SNRI again, even if it might trigger hypomania.
Posted by holymama on August 26, 2005, at 19:23:15
In reply to Re: Finally! A good pdoc!! » holymama, posted by fires on August 26, 2005, at 19:06:51
Fires,
But if a medication triggers hypomania in you, does it then later cycle into depression, I mean, does it start you cycling?
I agree that I would love to be triggered into hypomania rather than have the depression (my depressions are long and dangerous)...but in the end, the few weeks of feeling good turn into a vicious cycle of depression, hypomania, depression, hypomania...no stability.
I agree completely though, that no two people are alike in how they are 'bipolar'. This is just how it is for me.
~~Autumn~~
Posted by fires on August 26, 2005, at 20:01:24
In reply to Re: Finally! A good pdoc!! » fires, posted by holymama on August 26, 2005, at 19:23:15
> Fires,
>
> But if a medication triggers hypomania in you, does it then later cycle into depression, I mean, does it start you cycling?
>
> I agree that I would love to be triggered into hypomania rather than have the depression (my depressions are long and dangerous)...but in the end, the few weeks of feeling good turn into a vicious cycle of depression, hypomania, depression, hypomania...no stability.
>
> I agree completely though, that no two people are alike in how they are 'bipolar'. This is just how it is for me.
>
> ~~Autumn~~
I had absolutely no history of BP, until Effexor triggered some hypomania after I improved from Major Dep. about 18 months ago.When I've been hypomanic, I've also had residual dep., so it's very hard to speak about cycling.
I have had some rapid cycling -- hypomanic right out of bed, then little to no hypomania for the rest of the day -- only to have it return the next morning.
I should add that I have other conditions which may be complicating the picture: Fibromyalgia (relatively mild) and Periodic Limb Movements during Sleep (PLMS or PLMD). I take low dose Mirapex for the PLMS at bedtime. Can't say whether or not it's helping much.
As you can tell, BP is all relatively new to me, and I don't fit the "normal" BP profile -- and I've yet to read about anyone experiencing what I'm experiencing.
I'm just hoping that Wellbutrin and Lamictal will help me out (a lot).
Thanks
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