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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by crazyrage on February 15, 2006, at 11:12:58
Anyone had a mixed state? Looking for anything that works.. Taking lamictal and abilify... still crazy!
Posted by fenix on February 15, 2006, at 12:18:58
In reply to Mixed state, posted by crazyrage on February 15, 2006, at 11:12:58
What is this "mixed state" that you speak of?
Posted by James K on February 15, 2006, at 14:46:40
In reply to Mixed state, posted by crazyrage on February 15, 2006, at 11:12:58
> Anyone had a mixed state? Looking for anything that works.. Taking lamictal and abilify... still crazy!
===Hello, let me be the first to welcome you to this great site (which I have nothing to do with, I just like to welcome people).
If by mixed state, you mean like being depressed, angry, irritable, agitated etc. at the same time. Like some kind of Bipolar mixed up (my knowledge of bipolar is new cause they never used to say I had it) I can relate. Lamictal sounds like the right start, maybe a clonazepam would help. I'm not the best person on meds yet because I'm living in a screwed up state myself, but more will be along with good questions and info soon.
James K
Posted by TJO on February 15, 2006, at 15:26:58
In reply to Re: Mixed state » crazyrage, posted by James K on February 15, 2006, at 14:46:40
Hi there,
I get a mixed state (I am bipolar). I get both manic symptoms and depressed symptoms at the same time. I take a "cocktail" of 4 meds -
Seroquel 800 mg (anti-psychotic)for the mania
Abilify 30 mg (anti-psychotic)for the mania
Wellbutrin 300 mg (anti-depressant)for the depression
Neurontin 1200 mg (mood stabilizer) to even out the bipolar mood swings.good luck
Tam
Posted by blueberry on February 15, 2006, at 17:40:54
In reply to Mixed state, posted by crazyrage on February 15, 2006, at 11:12:58
I had a mixed state and it was NOT fun. Very scary. What ended it in a hurry was depakote 500mg extended release. It began working the first day for me. I don't use it any more, but I do keep it onhand just in case. If you were to try it though, it has to be done carefully with lamictal because it will effectively double the lamictal blood level. You would have to cut the lamictal dose in half at the same time you start depakote.
I've been on lamictal. I've been on lithium. I've been on antipsychotics. I've been on benzos. For me, nothing compares to the rapid stoppage of a mixed state better than depakote.
Posted by crazyrage on February 15, 2006, at 17:54:28
In reply to Re: Mixed state, posted by blueberry on February 15, 2006, at 17:40:54
thanks to everyone who has answered so quickly. I took the abilify today... NOT working yet; the lamictal isn't yet at a therapeutic dose either as I am going as fast as possible (upping every 3 days) Depakote sounds like a good idea. Did the ER make you tired? Tried it before but it wasn't the ER and I was zombied! However; right now that might be better than this irritable ANGRY and confused state...
Posted by Phillipa on February 15, 2006, at 22:00:39
In reply to Re: Mixed state, posted by crazyrage on February 15, 2006, at 17:54:28
I know you're in a hurry to feel better. But if you continue to take lamictal it should be upped very slowly there is a rash that can be quite dangrous should it happen. Fondly, Phillipa
Posted by fenix on February 16, 2006, at 5:35:38
In reply to Mixed state, posted by crazyrage on February 15, 2006, at 11:12:58
I understand now, and it reminds me of a bourbon and coke. You mix them, and in mixing them a new drink is made... balanced and tastes good.
Posted by TJO on February 16, 2006, at 5:45:40
In reply to Re: Mixed state, posted by fenix on February 16, 2006, at 5:35:38
Hi,
Something else that works well (for me) to knock out a mixed state in a hurry is 3 or 4 mg of Risperdal. I go to sleep and in the a.m. am fine :-).Tammy
Posted by Sobriquet Style on February 16, 2006, at 7:21:37
In reply to Re: Mixed state, posted by fenix on February 16, 2006, at 5:35:38
>I understand now, and it reminds me of a bourbon and coke. You mix them, and in mixing them a new drink is made... balanced and tastes good.
Thats a mixed drink, and for you is balanced and tastes good.
This subject is about a mixed state associated with Bipolar Disorder.
The level of comfort to a mixed state, can be compared to that of Tardive Dyskinesia.
It is not balanced, and does not feel good.
~
Posted by SLS on February 16, 2006, at 7:35:25
In reply to Re: Mixed state, posted by blueberry on February 15, 2006, at 17:40:54
> I had a mixed state and it was NOT fun. Very scary. What ended it in a hurry was depakote 500mg extended release. It began working the first day for me. I don't use it any more, but I do keep it onhand just in case. If you were to try it though, it has to be done carefully with lamictal because it will effectively double the lamictal blood level. You would have to cut the lamictal dose in half at the same time you start depakote.
>
> I've been on lamictal. I've been on lithium. I've been on antipsychotics. I've been on benzos. For me, nothing compares to the rapid stoppage of a mixed state better than depakote.
Yes.I was going to suggest Depakote 1000-1500mg or Zyprexa 10-20mg to treat the mixed-state acutely. Then, one can adjust dosages downward if indicated or begin to build a prophylactic regimen around other drugs. It is possible that introducing anti-manic drugs will result in a residual depression. If the depression does not resolve within a month, I would then consider the addition of an antidepressant like Zoloft. However, one must be fairly confident that the mood stabilizers or anti-manics being used will minimize the risk of a switch into mania.
I know someone for whom an antidepressant was essential to bring about a stable remission from a mixed state. She spent nearly a year suffering from an irritable mixed-state depression with racing thoughts while her doctors struggled to avoid antidepressants. The irritability and racing thoughts resolved once she was hospitalized and an antidepressant introduced. No switch ensued as she continued to take a mood stabilizer that had previous proven itself effective enough to treat her hypomamia.
There is such a thing as depression with racing thoughts that can be confused for a mixed-state hypomania. Antidepressants are almost a necessity to treat this condition. It probably represents a bipolar-spectrum disorder.
- Scott
Posted by fenix on February 16, 2006, at 15:09:23
In reply to Re: Mixed state » fenix, posted by Sobriquet Style on February 16, 2006, at 7:21:37
> >I understand now, and it reminds me of a bourbon and coke. You mix them, and in mixing them a new drink is made... balanced and tastes good.
>
> Thats a mixed drink, and for you is balanced and tastes good.
>
> This subject is about a mixed state associated with Bipolar Disorder.
>
> The level of comfort to a mixed state, can be compared to that of Tardive Dyskinesia.
>
> It is not balanced, and does not feel good.
>
> ~Yeah I know what you mean. What I was getting at is that there are some comparisons between the two. If you add too much bourbon, then the taste is too strong, etc. So, you have to find the balance and I don't know how with that sort of thing, too many factors.
Is "mixed state" a misnomer though? How could you be both opposites at the same time. Maybe it is better to think of it as a state in which you go up and down in sucession in very small and fast increments, like a roller coaster that does the same. And you are trying to find a tranquil state between the two extremes.
Posted by James K on February 16, 2006, at 15:26:48
In reply to Re: Mixed state, posted by fenix on February 16, 2006, at 15:09:23
Since I had the book out for a different reason anyway, I looked it up in the 2003 version of the merk manual of Medical information home edition. "About one of three people with manic-depressive illnesses experiences symptoms of mania (or hypomania) and depression simultaneously. This condition is known as a mixed bipolar state."
Now, I understand the knowledge and understanding or whatever of bipolar is changing all the time, so this is an outdated description. But as I experience it, if I in fact do experience it. I can be extremely suicidal and hate life and cry. while being full of violent manic rage, and it is the most dangerous time for me, because I have the energy to carry out all the bad ideas that may have me laying in bed otherwise.
How best to medicate, I don't have a clue, because I spend much of my life like this. Benzos, alcohol, ad's, all help and contribute. The most dangerous combo I was on was welbutrin, Paxil, klonopin, with booze to sleep. I was very productive, and ready to die at any moment. Best time I ever had at work until I got fired.
James K
James K
Posted by James K on February 16, 2006, at 15:48:43
In reply to Re: Mixed state *triggerish* » fenix, posted by James K on February 16, 2006, at 15:26:48
This is the end of the thread.
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