Psycho-Babble Medication Thread 583598

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whats the best treatment for rapid cycle bipolar?

Posted by arina on November 30, 2005, at 1:07:06

yeah,what is the best treatment in all of your wise opinions for (my partners) rapid cycling bipolar? Any advice really appreciated.Lithium?

 

Re: whats the best treatment for rapid cycle bipol

Posted by med_empowered on November 30, 2005, at 1:32:39

In reply to whats the best treatment for rapid cycle bipolar?, posted by arina on November 30, 2005, at 1:07:06

hey! A lot of rapid-cyclers don't respond well to lithium...lithium really seems best for "classic" bipolar I (euphoric mania, severe depression, good recovery between episodes). Rapid cycling is a little trickier. Depakote helps some, as does Tegretol (Trileptal, which is alot like Tegretol, could be a good option). Some docs swear by antipsychotics (the new ones..seroquel, abilify, geodon, zyprexa, etc.). Id avoid antidepressants...you might also want to avoid Lamictal, since it can push people into (hypo)mania. Keppra, a very new anticonvulsant, might be a good option..it mixes well with other drugs and doesn't mess up thinking like other drugs do. The downsides are expense, lack of data, and it occasionally pushes people into depression.

From my experience, I'd try to start with Trileptal (no blood work needed, minimal start up side effects). If possible, try adding a benzo--Klonopin might be good. That helps with anxiety and mood-stabilization. Trileptal doses vary wildly, but for Bipolar you're probably looking at 600-2400mgs..personally, 900 was good for me without causing "flatness." Taking care of anxiety and sleep issues can also help, too...it helps you keep "an even keel," so you'll probably see fewer major episodes. Good luck!

 

Re: whats the best treatment for rapid cycle bipol

Posted by arina on November 30, 2005, at 3:25:02

In reply to Re: whats the best treatment for rapid cycle bipol, posted by med_empowered on November 30, 2005, at 1:32:39

hey med_empowered,thanks for that.Iv just realized theres a sight called psychobabble newbies.Im allways too far ahead of myself its typical.Haha,well i got so much out of this site thanks and Im going to go to the newbies site and start how I should have.Great being here and thanks,I am strengthened.You all seem to offer each other so much,I will go back to where I should have started!!!!!!!!kindly,luv Arina

 

Re: whats the best treatment for rapid cycle bipol

Posted by Squiggles on November 30, 2005, at 7:29:02

In reply to whats the best treatment for rapid cycle bipolar?, posted by arina on November 30, 2005, at 1:07:06

> yeah,what is the best treatment in all of your wise opinions for (my partners) rapid cycling bipolar? Any advice really appreciated.Lithium?

I am not sure what other's experience has been;
I have read on the net (perhaps from the Cochrane
research group?] that drugs other than lithium
are good for rapid cycling. And by rapid cycling
I take it you mean that the mood can swing within
days or weeks.

In my case, I was literally saved from
suicidal depression and manic motor agitation
by increasing my lithium dose (WITHIN 24 hrs.).
I was impressed and scared that it wouldn't
work :-).

Squiggles

 

Re: whats the best treatment for rapid cycle bipol

Posted by MoparFan91 on November 30, 2005, at 13:02:47

In reply to Re: whats the best treatment for rapid cycle bipol, posted by Squiggles on November 30, 2005, at 7:29:02

Depakote has always been the first line choice for rapid cycling and mixed states.
Lamictal is now one of the best meds for rapid cycling.

However, if you cycle every few hours and stuff, Topamax is the best one out there for that type of rapid cycling, also referred to as ultra-rapid or ultradian cycling.

SSRI's are good as add-ons as well. At higher doses, they seem to have a more stabilizing effect as they indirectly lower glutamate levels and reduce obsessive ruminations that aggravate mood cycling.

Stay away from anti-psychotics. They're crap.
I took them, and they worsened my cycling.
Zyprexa caused severe mixed state symptoms (ultra agitation/hostile feelings) few hours after each dose.
Geodon made me berserk and manic and also at times worsened the mixed state.
Seroquel, when I took it for sleep, made me jazzed up and wired the next day.
Abilify caused dysphoric manic symptoms, xtreme anxiety, paranoia, and distorted thinking.
Risperdal, at least in my grandmother (also bipolar cycling), made her more on the manic side.

I have Bipolar-NOS ultra-rapid/ultradian cycling, social phobia, ocd.

 

Re: whats the best treatment for rapid cycle bipol

Posted by Squiggles on November 30, 2005, at 13:17:42

In reply to Re: whats the best treatment for rapid cycle bipol, posted by MoparFan91 on November 30, 2005, at 13:02:47

Thanks. I hope beepers on the board
can benefit from your advice. I have
been taking lithium for 25-27 years (approx.).
I'm not getting off it.

I have learned to manage some of the side
effects btw, e.g. diarrhea with Metamucil,
and the Synthroid has probably made me more
normal than the normal population.

You probably know that changing meds is
a tricky thing to do, and in a climate
of overworked doctors and multifarious
psychotropics coming out every year --
it's quite a bonanza.

Another good thing about attaining
a successful treatment (on a chronic
basis) is that you can predict what
is going to happen from experience.

Squiggles

 

Re: whats the best treatment for rapid cycle bipol » Squiggles

Posted by Phillipa on November 30, 2005, at 20:43:03

In reply to Re: whats the best treatment for rapid cycle bipol, posted by Squiggles on November 30, 2005, at 13:17:42

Squiggles how true! Fondly, Phillipa

 

Re: whats the best treatment for rapid cycle bipolar?

Posted by blueberry on December 1, 2005, at 5:03:23

In reply to whats the best treatment for rapid cycle bipolar?, posted by arina on November 30, 2005, at 1:07:06

We're all different, but for me it was 500mg depakote extended release. It works fast, like in one to two days, usually within six days. Other ultra fast options are antipsychotics, though they don't really stop the cycling like depakote or lithium do, but they instead just block it so you can't feel it going on. Lamictal can work good, but is very slow due to slow dose titration to avoid the rash. Different people have different preferences over lithium, depakote, lamictal, and the others. Sometimes just a benzo like klonopin works fast and fine.

I personally found lithium aggravated my condition, making me very hyper, uneasy, restless, anxious, and had lots of side effects. Depakote, for me, has minimal side effects and keeps me stable. Benzos definitely stopped the dysphoric manic side for me, but at the same time worsened the depressive side. Years ago I took lamictal and it worked just fine with hardly any side effects.

 

Re: whats the best treatment for rapid cycle bipolar?

Posted by arina on December 1, 2005, at 6:06:46

In reply to Re: whats the best treatment for rapid cycle bipolar?, posted by blueberry on December 1, 2005, at 5:03:23

Oh thanks guys, confusing theres so many drugs.I want to help him get it right this time,he deserves a break for once in his life.Poor soul.Will look into all those drugs you all mentioned,goodnight.

 

Re: whats the best treatment for rapid cycle bipol

Posted by Squiggles on December 1, 2005, at 6:26:10

In reply to Re: whats the best treatment for rapid cycle bipolar?, posted by blueberry on December 1, 2005, at 5:03:23

Thanks for the info. on the options
Blueberry. It's comforting to know
that there are options for bipolar
disorder, just in case one drug really
disagrees with you.

Squiggles

 

Re: whats the best treatment for rapid cycle bipol

Posted by arina on December 2, 2005, at 4:53:27

In reply to Re: whats the best treatment for rapid cycle bipol, posted by Squiggles on December 1, 2005, at 6:26:10

THANKS:-)


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