![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 23 of 23. This is the beginning of the thread.
Posted by purplesky on July 28, 2006, at 20:51:41
Hey everyone, I'm new here so I'll give you a little background. I apologize now, and thank those who read this, for this will be a really long post.
I'm a 24 yr old female college student with no health insurance and minimal coverage at my student health clinic. I'm diagnosed as BPII but I somewhat question that diagnosis (I think it's closer to mood-reactive atypical depression, though the difference between the two seems to be a bit of a scholarly debate according to Pubmed). I've been psychiatrically hospitalized twice following suicide attempts. I exist in a state of varying levels of depression, which is relieved temporarily when I'm around people and good things are happening, but the depression sets back in as quickly as people leave. I'm not an extrovert or a people-person by any means--I just perk up when I have friends around.
I am currently unmedicated, and have been for several months.
My main complaints are that I am tired and unmotivated. I find both physical and mental labor exhausting. I have withdrawn from my family and friends, choosing to stay alone instead. I am sleeping 10+ hours a day, and the hours I spend awake I spend essentially staring into space and doing nothing. I don't have the drive to do things that I used to enjoy. Even going to the kitchen to make a frozen dinner seems like a daunting task. I've completely lost my libido. I am not necessarily "sad" all the time; instead I feel more empty and apathetic. My memory is spotty, and I tend to drift off when I should be paying attention. I've been a highly motivated and goal-oriented person in the past, so these symptoms are really holding me back. I've lost my spark.
I've been on the following medications and would not consider them again:
Lamictal
Zyprexa
Remeron
Effexor
Paxil
LexaproI have been on the following medications and I would not object to taking them again for whatever intended purposes:
Xanax (PRN)
SeroquelI'm not sure what approach I should take now. My psychiatrist wants me to try Prozac with Seroquel, but the WORST medication experiences I've had have been with SSRIs, and while I'm not suicidal now, I wasn't before I went on Paxil and I quickly became suicidal after starting it.
My mother had bad cardiac and diabetic reactions to tricyclics, so I'm hesitant to take them.
I have a previous bulimia diagnosis so Wellbutrin is contraindicated, though I would be willing to try the SR version if my doctor were comfortable with that. (I am not currently engaging in eating disordered behaviors, and I am at a healthy BMI.) On that same note, I cannot guarantee my treatment compliance and lack of bulimic behaviors on any drug that will cause excessive weight gain or carbohydrate cravings. I know I have a weakness there, and I'd like to avoid that trigger if possible. I'm also uncertain if I could follow strict dietary restrictions for an MAOI, as deprivation leads to bingeing.
What are my options now? Does it seem like my problem is with Norepinephrine/Dopamine and not Serotonin? Do I have to go off-label now?
The various options I've come up with are:
Wellbutrin (maybe with an anticonvulsant?)
Strattera
Emsam
Provigil
Low-dose stimulants
Mirapex/Parkinson's medications
DLPA/L-tyrosine/DMAE/ginseng/ginko/etc.Of course, these would all be paired with a mood stabilizer if appropriate.
I can't switch doctors or ask for a second opinion as I don't have any money (the student clinic is free.) I'm especially worried because I usually feel better during the summer, and if I'm already feeling low then I won't be in good shape at all by the time winter comes around. Do any of you have an idea what I should do? Have any of you experienced symptoms like this and found relief from a certain medication? Is there anything that is particularly good at decreasing sleep while increasing drive and motivation?
I really appreciate any advice, anecdotes, or encouragement you can give me. Thanks!
Posted by linkadge on July 29, 2006, at 0:55:28
In reply to Help! I'm running out of treatment options!, posted by purplesky on July 28, 2006, at 20:51:41
You might want to push for the wellbutrin. It seems like it might be a better option for your symtpoms. The SR version will reduce risks further, but you'd likely need to let your doctor know where you are at with your bulimia.
Linkadge
Posted by pseudoname on July 29, 2006, at 9:56:55
In reply to Help! I'm running out of treatment options!, posted by purplesky on July 28, 2006, at 20:51:41
Hi, purplesky, and welcome to Babble.
I agree with linkadge that Wellbutrin might be a really good choice to try next. It treats a broader spectrum of a person's problems (including several you mention) than those stimulating drugs typically do, and it has a better initial success rate against depression in the literature than Mirapex and ginseng/etc. A stimulant like Ritalin or Adderall might have an immediate benefit, though.
My own experience with Wellbutrin was that it didn't help my depression much, but it was a lot different from the SSRIs & NRI I'd tried. There were no bad side effects, and I *felt* better on Wellbutrin, even if I was still depressed.
I also wouldn't expect it to lead to cravings. A lot of people find it energizing and some take it for attention problems. (But I never slept better in my life than when on Wellbutrin.) Also, there's a good chance it would help with your libido. It really sounds like a good choice for you next.
I assume you mention the anticonvulsant with Wellbutrin because of its seizure publicity? I was worried about that, too. My pdoc insisted that Wellbutrin has a bad rap. I made him get his boss and ask her about it, and she agreed. Neither of them had ever had a patient or heard of any colleague's patient (except in the literature) having a seizure from Wellbutrin. The actual statistics are that unless you have a prior history of seizure or head injury, the Wellbutrin risk is identical to other drugs.
Was the Remeron a horrible experience? It was for me.
Posted by Phillipa on July 29, 2006, at 12:08:29
In reply to Wellbutrin a good option » purplesky, posted by pseudoname on July 29, 2006, at 9:56:55
Well right now I'm trying to get to a theuraputic dose of lamictal but the sores in my mouth are starting again and wellbutrin put me in the hospital as it made me appear manic to the pdoc. Good luck. Love Phillipa
Posted by pseudoname on July 29, 2006, at 12:12:58
In reply to Re: Wellbutrin a good option, posted by Phillipa on July 29, 2006, at 12:08:29
> the sores in my mouth are starting again
Sorry about that. :(
> wellbutrin put me in the hospital as it made me appear manic to the pdoc.
He thought you were manic enough to be hospitalized? If you don't mind my asking, what did he say you were doing that alarmed him so much?
Posted by purplesky on July 29, 2006, at 12:48:44
In reply to Wellbutrin a good option » purplesky, posted by pseudoname on July 29, 2006, at 9:56:55
Re: Was the Remeron a horrible experience? It was for me.
I went on a combination of Remeron and Zyprexa during my 2nd hospitalization. I suspect the psychiatrist there hated me. I was fairly underweight at the time (mostly from school and work stress and being so busy, party from being depressed, and partly from my body image issues.) I was always getting light-hearted teasing during vitals about how tiny I was and how they used a child's cuff, and they would tease me at mealtimes as to what I did and did not eat, which was really triggering to me and irresponsible of them.
I assume they were trying to get me to gain quickly without dealing with underlying issues, but I went from a moderately depressed, apathetic individual to an emotionally labile wreck with sugar cravings, and I dealt with it how I used to.
I just about cleared out the cereal pantry of the psych ward every night and purged between 15 minute checks. I hadn't purged regularly in almost a year. The staff was so incompetent, they were completely oblivious, even though I had disclosed everything on the charts. I gained a lot of weight in a very short period of time.
I'm not sure whether to blame the Remeron or the Zyprexa or myself, but I quit them as soon as I got out of the hospital at the advice of a holistic/naturalist friend of my mom's who suggested an arsenal of amino acids and vitamins, which actually worked much better than Zyprexa/Remeron did. So I guess I don't exactly have a horror story on Remeron, just a miserable story of which we're not sure the culprit!
What is your horror story of Remeron?
Posted by pseudoname on July 29, 2006, at 16:01:29
In reply to Re: Wellbutrin a good option » pseudoname, posted by purplesky on July 29, 2006, at 12:48:44
Wow, that *was* a miserable experience.
> I suspect the psychiatrist there hated me.
They really do seem to have a lot of animosity toward their patients sometimes.
> What is your horror story of Remeron?
Just the side effects. I used to read people on Babble complaining about the side effects of various meds, and I'd think, "Gosh, if I ever found an antidepressant that worked, I wouldn't care what kind of side effects it gave me." Yeah, well, then I tried Remeron.
The feelings were indescribable. Like my muscles were full of meth-addicted ants in withdrawal. Plus the hunger-like feeling. Food lost all satisfaction and pleasure for me, yet I shoved it in my mouth all day long, and still I craved more. Plus bad sleep and no concentration and worsening mood; it was like an air horn was blaring in my head all the time. Anyway, it did nothing for my depression, thank heaven; I think I would prefer to be depressed.
On "running out of treatment options"… I just wanted to urge you to continue trying. I can say that because I went through (and I sound like a repetitious old man posting this yet again) 36+ med trials, ECT, etc, before finding one that really helps.
Posted by greywolf on July 29, 2006, at 16:59:50
In reply to Remeron stories » purplesky, posted by pseudoname on July 29, 2006, at 16:01:29
I would recommend thinking about Nardil. Don't be put off by the dietary restrictions, they're not very difficult to abide by. As the ADs went, Nardil had zero side effects for me, and proved to be more effective than any SSRI.
Best of luck.
Posted by purplesky on July 29, 2006, at 17:10:10
In reply to Remeron stories » purplesky, posted by pseudoname on July 29, 2006, at 16:01:29
> > I suspect the psychiatrist there hated me.
>
> They really do seem to have a lot of animosity toward their patients sometimes.I really think she was on a power trip and went out of her way to keep the patients "in their places". Several other patients felt like that too. Luckily I have a psychiatrist now that I have a therapeutic relationship with. We're still getting frustrated though!
>
> The feelings were indescribable. Like my muscles were full of meth-addicted ants in withdrawal. Plus the hunger-like feeling. Food lost all satisfaction and pleasure for me, yet I shoved it in my mouth all day long, and still I craved more. Plus bad sleep and no concentration and worsening mood; it was like an air horn was blaring in my head all the time. Anyway, it did nothing for my depression, thank heaven; I think I would prefer to be depressed.
That's horrific! How long did you put up with that? I don't know if I would have been able to endure that side effect for very long without clawing my arms off. It's very disheartening that a lot of these medications seem to make us sicker or "crazier" when they're supposed to be making us better.
> On "running out of treatment options"… I just wanted to urge you to continue trying. I can say that because I went through (and I sound like a repetitious old man posting this yet again) 36+ med trials, ECT, etc, before finding one that really helps.I commend you on your perseverance! I know it had to have taken a lot of strength and willpower, in a time where both of those are difficult to come by, so as not to give up along the way. Out of curiosity, if you don't mind sharing, what medicinal cocktail has helped you the most?
Posted by pseudoname on July 29, 2006, at 18:16:16
In reply to Re: Remeron stories » pseudoname, posted by purplesky on July 29, 2006, at 17:10:10
I wanted to say, purplesky, that I really identified with a lot in your original post. Like not being able to, well, do *any*thing.
> That's horrific! How long did you put up with that?
On Remeron I stuck it out only 3½ weeks at the treatment dose, so 5-6 weeks altogether. I bailed. But I should add for public readership that I don't want to discourage anyone else from trying Remeron. It obviously affects people differently.
> I commend you on your perseverance!
Thanks. But I gave up lots of times, and I've gone without treatment for years at a stretch. Also without functioning, employment, friends, sunlight, etc. Treatment was just so worthless to me it wasn't worth the additional struggle. I'm now 41. (I'm also male; Babblers sometimes wonder.)
> Out of curiosity, if you don't mind sharing, what medicinal cocktail has helped you the most?
I love sharing about it. (I think I yak about it too much on Babble, LOL.) I've been taking the opioid buprenorphine (Subutex) for about 8 months. It turns on some opioid receptors and blocks others, and for this unusual combo of properties it's used to treat opioid addicts in recovery. It takes away their craving without getting them high, so I'm told. I'm not an addict, and I'm amazed my pdoc was willing to let me try this. It doesn't make me buzzed or high, it just takes away the depression. And it was effective in a few days, not 3-6 weeks. I take about 0.5 mg a day, which is 1/20 or less of what a typical recovering addict might take. I have not had to increase the dose due to tolerance, either.
It is not a total cure of all my psychological problems, and I'm working a lot in self-therapy besides, but depression is effectively gone. Buprenorphine is gradually but radically revolutionizing my life. I'm not taking any other meds.
Interestingly, some opioid binding in a certain brain region was shown to be much lower in women with bulimia than in women without eating problems. One article says "medications that affect the brain's opioid receptor system and approaches to treatment for substance abuse disorders may be helpful in treating bulimia." http://www.sciencedaily.com/releases/2005/08/050811092434.htm
I know your BMI is cool now, but that tendency (call it that?) might possibly be an indication of opioid system dysfunction. So, maybe if the other options you're considering don't turn out to be satisfactory, you might consider bupe, too, although it can be very hard to get. I put together these links about buprenorphine for depression: http://health.groups.yahoo.com/group/psycho-babble-tips/links/buprenorphine_for_de_001146748536/
Posted by bassman on July 29, 2006, at 19:30:27
In reply to Wellbutrin a good option » purplesky, posted by pseudoname on July 29, 2006, at 9:56:55
The risk of seizure for Wellbutrin at 300 mg is 0.1%; for a therapeutic level of Zoloft, it is 0.3%. For 450 mg Wellbutrin, the rate is 0.4%. Wellbutrin got a bad rap early on because does above 450 mg increases the seizure rate very quickly. I agree with you trying Wellbutrin, it might well help with the depression, probably won't cause hunger, and probably will increase libido. And shine your shoes. :>} Best of luck!
Posted by Phillipa on July 29, 2006, at 19:46:42
In reply to Wellbutrin mania » Phillipa, posted by pseudoname on July 29, 2006, at 12:12:58
I don't mind. Small town only pdoc. I was angry and bored. And got up in his office and demonstrated that all I had to do was open the blinds, eat breakfast, etc. That was enough for him to think I was manic so he decided to put in the hospital. I was there one week. Bored to tears. And the young pdoc put me into withdrawal from benzos and I had to go to a neurologist. My BP was very high. And shaking all over. He told me to find a doc who wasn't benzophobic so I did. I don't think I was manic just mad and bored. I'm always bored since I'm not working. Love Phillipa
Posted by pseudoname on July 29, 2006, at 20:26:41
In reply to Re: Wellbutrin mania » pseudoname, posted by Phillipa on July 29, 2006, at 19:46:42
What rotten luck with doctors! I'm really sorry, Phillipa, you had to go through that.
Posted by Phillipa on July 29, 2006, at 21:36:48
In reply to Re: Wellbutrin mania » Phillipa, posted by pseudoname on July 29, 2006, at 20:26:41
PN thanks for caring. It means a lot. Love Phillipa
Posted by purplesky on July 30, 2006, at 13:41:22
In reply to buprenorphine » purplesky, posted by pseudoname on July 29, 2006, at 18:16:16
Thanks for all that information. Buprenorphine seems like a miracle drug for some people! This really makes me wish that there were a fancy brain scan used in diagnosis and treatment outside of research trials. It would be much easier to solve problems if we could actually tell what was going on!
Posted by purplesky on July 30, 2006, at 13:47:16
In reply to Re: Wellbutrin a good option, posted by bassman on July 29, 2006, at 19:30:27
I agree with you trying Wellbutrin, it might well help with the depression, probably won't cause hunger, and probably will increase libido. And shine your shoes. :>} Best of luck!
_______________________Wow, Wellbutrin does everything! That's awesome. If it could just clean my house for me, I'd be set!
Posted by bassman on July 30, 2006, at 15:20:13
In reply to Re: Wellbutrin a good option » bassman, posted by purplesky on July 30, 2006, at 13:47:16
It does clean your house if you take the XL! :>} Really, though, the XL really works well and if you can get it instead of SR, I think you'd be happier with it.
Posted by purplesky on July 30, 2006, at 15:21:25
In reply to Re: Remeron stories, posted by greywolf on July 29, 2006, at 16:59:50
> I would recommend thinking about Nardil. Don't be put off by the dietary restrictions, they're not very difficult to abide by. As the ADs went, Nardil had zero side effects for me, and proved to be more effective than any SSRI.
>
> Best of luck.I don't know a lot about MAOIs. Did Nardil help your energy levels, or was it sedating? How long did it take to see a therapeutic effect?
Posted by greywolf on July 30, 2006, at 16:47:18
In reply to Re: Remeron stories » greywolf, posted by purplesky on July 30, 2006, at 15:21:25
> > I would recommend thinking about Nardil. Don't be put off by the dietary restrictions, they're not very difficult to abide by. As the ADs went, Nardil had zero side effects for me, and proved to be more effective than any SSRI.
> >
> > Best of luck.
>
> I don't know a lot about MAOIs. Did Nardil help your energy levels, or was it sedating? How long did it take to see a therapeutic effect?
I didn't experience even the least bit of sedation with Nardil. And sedation is one of my primary problems with ADs, so that was a real relief. I experienced a therapeutic benefit after about 3 weeks, and it continued for quite some time thereafter. I cannot recall how long, though I was on it for over a year.However, Nardil is not a first-line treatment for severe bipolar. If you have BP dominated by depressive phase it may help, but my understanding from conversations with my doc and therapist is that a mood stabilizer is necessary to effect any positive long-term change in the BO. Nardil alone (or any other AD alone) won't cut it.
I am like you in that I've been through the pharmaceutical mill. As I have explained in past posts, during the past decade I've been on almost every AD you can name-- every SSRI and most of the SNRIs, NDRIs, trycyclics, MAOIs, a couple mood stabilizers. It got to the point where I was told the only recourse was ECT--which ain't gonna happen.
I gave up for awhile, but decided that the right thing to do for myself, my family, and my friends, is to keep working at it. So, I found a new psychiatrist, and a therapist who is well known for her work in OCD--and what a difference from the prior therapists I had who did not specialize in that illness!
Right now, I'm on Lamictal at a low dose until mid-August, when it will be ramped up. I've previously been on lithium and Depakote. I had some bad times with the lithium, but have really experienced no side effects from either the Depakote SR at 1500mg/day or the Lamictal. I'm off the Depakote because it wasn't doing enough for the depressive phase, and once I'm slotted in at the right level of Lamictal, they'll add in an AD before complementing the regimen with OCD medications.
I keep hoping and praying things will work out because the hills are getting harder to climb.
Posted by Tomatheus on July 31, 2006, at 0:01:33
In reply to Help! I'm running out of treatment options!, posted by purplesky on July 28, 2006, at 20:51:41
Purplesky,
Thanks for your post. See below for my responses. Please let me know if you have any questions or if you need me to clarify anything that I've written.
Tomatheus
> I'm a 24 yr old female college student with no health insurance and minimal coverage at my student health clinic. I'm diagnosed as BPII but I somewhat question that diagnosis (I think it's closer to mood-reactive atypical depression, though the difference between the two seems to be a bit of a scholarly debate according to Pubmed). I've been psychiatrically hospitalized twice following suicide attempts. I exist in a state of varying levels of depression, which is relieved temporarily when I'm around people and good things are happening, but the depression sets back in as quickly as people leave. I'm not an extrovert or a people-person by any means--I just perk up when I have friends around.
It definitely sounds like your psychiatric illness can be at least partially characterized by the presence of a reactive mood. What you just wrote describes "mood reactivity" -- a symptom that is necessary for one to be diagnosed with atypical depression -- to a tee.
In addition to having a reactive mood, a patient must report having experienced at least two of the following symptoms to receive a diagnosis of atypical depression: oversleeping, overeating, interpersonal rejection sensitivity, and a "leaden paralysis" feeling. Based on what you've written here (not just in the previous paragraph, but in your post as a whole), it sounds like the diagnosis of atypical depression would probably fit you.
> My main complaints are that I am tired and unmotivated. I find both physical and mental labor exhausting. I have withdrawn from my family and friends, choosing to stay alone instead. I am sleeping 10+ hours a day, and the hours I spend awake I spend essentially staring into space and doing nothing. I don't have the drive to do things that I used to enjoy. Even going to the kitchen to make a frozen dinner seems like a daunting task. I've completely lost my libido. I am not necessarily "sad" all the time; instead I feel more empty and apathetic. My memory is spotty, and I tend to drift off when I should be paying attention. I've been a highly motivated and goal-oriented person in the past, so these symptoms are really holding me back. I've lost my spark.Your symptomatic profile actually sounds very similar to mine in a lot of ways. Before I started taking psychiatric medications, I too had very little energy and basically felt dead inside. And the sleep was probably the worst part, as I averaged 10-12 hours a night (or day, as the case sometimes was) and always felt completely unrefreshed after waking up in the morning (or in the afternoon, in some cases). Sometimes, if I was able manage to keep myself awake for longer than 16-20 hours, this extended wakefulness actually gave me a slight antidepresant effect. In college, I wrote almost all of my papers late at night because I lacked the energy and focus to write anything of significant length during the day. I would also say that once my depressive symptoms set in fully, I did't typically feel "sad," but I found that I could no longer enjoy activities that I had always enjoyed to some extent in the past.
Like you, I'm also not taking any medications at the moment. I feel almost the same as I did before I started taking medications, but I feel more anxious than I used to and sometimes experience panic attacks -- something that never happened before I started taking lithium. I was originally diagnosed with dysthymia and then rediagnosed with bipolar disorder after cycling between mild hypomania and severe depression when I was taking 60 mg/day of Paxil. I took Zyprexa for a short while but discontinued it after realizing that it did nothing but make me feel like a complete zombie. Wellbutrin monotherapy helped my depression to a very small extent, and helped slightly more when I combined it with lithium. But as I've described in other recent posts here, I stopped taking the Wellbutrin after more than a year on the Wellbutrin-lithium combo and slowly but surely began experiencing symptoms of panic disorder -- symptoms that have partially, but not completely, subsided.
In my case, being diagnosed with bipolar disorder resulted in me being prescribed medications that did nothing but make my condition worse. The only medication that I would say that I ever fully responded to was Nardil, an MAOI. But even with Nardil, I had to take the Australian version and prepare it in a special way to get a consistent antidepressant response with minimal side effects. And once I started receiving shipments of the Australian Nardil without any silica gel inside of the bottles, my antidepressant response faded, and new side effects emerged.
As I mentioned, you seem to meet the criteria for the diagnosis of atypical depression. In studies that were done before the SSRIs were introduced to the market, the MAOIs Nardil and Parnate were consistently shown to be superior to the tricyclics in the treatment of atypical depression. Unfortunately, the formulations of both of these medications have been changed in recent years, and hundreds of Nardil users have reported that the new formulation is noticeably less effective and less tolerable than the old formulation. Additionally, most doctors are at least hesitant to prescribe Nardil and Parnate because of the dietary restrictions.
More recently, EMSAM has demonstrated some efficacy in patients suffering from treatment-resistant depression, and it has been shown to be less likely to trigger a hypertensive crisis than the older MAOIs. Patients taking the 9mg/24hr and 12mg/24hr patches are advised to avoid tyramine-containing foods, but there is some indication that the warnings may be overly restrictive.
I obviously can't say for sure whether or not you will respond to any given medication, but considering that your symptoms seem to be consistent with the diagnosis of atypical depression, I think that you should consider taking an MAOI -- if not now, at some point in the future. EMSAM would probably be a good first choice for you (as far as MAOIs go) because 1) it's less likely to interact with tyramine-containing foods than the older MAOIs, and 2) your doctor would probably be more willing to prescribe EMSAM than either Nardil or Parnate.
Finally, remember that even though I've given you some suggestions that you'll hopefully find helpful, I am not qualified to diagnose you. It does sound like you would qualify for the diagnosis of atypical depression, but that doesn't necessarily negate the possibility that you might also have bipolar II disorder and need a mood stabilizer. Another thing that I should add is this: even though you may not agree with everything that your doctor tells you, please try to be "civil" in your discussions with him, but don't let that hold you back from courteously expressing any concerns that you might have.
> I'm not sure what approach I should take now. My psychiatrist wants me to try Prozac with Seroquel, but the WORST medication experiences I've had have been with SSRIs, and while I'm not suicidal now, I wasn't before I went on Paxil and I quickly became suicidal after starting it.This just doesn't seem right. It seems to me that your odds of responding to Prozac (with or without Seroquel) would probably be rather low, given the fact that you did not respond favorably to Paxil, Effexor, or Lexapro. The time definitely seems right to move on to a different class of medications. But then again, I'm just another patient, so my opinion probably won't matter much to your doctor. If nothing else, I would be sure to communicate your concerns about potentially becoming suicidal on another SSRI to him as clearly as possible. I know that doing this is easier said than done and won't guarantee that your doctor will prescribe something other than the Prozac/Seroquel combo that he suggested, but it's the best that you can do at this point.
Posted by xrayartist on August 4, 2006, at 0:11:09
In reply to Help! I'm running out of treatment options!, posted by purplesky on July 28, 2006, at 20:51:41
Your symptoms are very similar to mine. Things seem to work well with other people around but, with the normal environment, I sleep or space out. I thought I was doing very well with Wellbutrin until I went 3 months without more than 3 1/2 hours sleep. I got alot done with my photos (creative activity) and little else. My wife made me go to my health care provider. Her diagnosis was Bipolar Type 2. She got me a referral to a Psychiatrist and a prescription for lithium.
The Psychiatrist said I was Type 1 and put me on a higher dose of Lithium and Lamictal.
I am also a type 2 diabetic. Since the increase in Lithium I have gained 15 pounds. I also want carbohydrate laden food like there won't be any tomorrow.
Wellbutrin is very good for Depression but probably not for Bipolar.
I miss my Wellbutrin (especially for intimate relations.)
I also am sad that when I was feeling (apparently) good, that it was causing distress in my family. I feel like for the last few years I have caused enough pain.
Posted by purplesky on August 4, 2006, at 1:03:46
In reply to Help! I'm running out of treatment options!, posted by purplesky on July 28, 2006, at 20:51:41
Well, I went to the psychiatrist today. She wants to wait for Wellbutrin as a last resort, so she increased the Prozac and decreased the Seroquel.
I was so tired in her office, then I started feeling queasy and felt like I was slurring my words. Sure enough, I had just enough time to tell her I was going to be sick, she handed me the trash can, and I spewed.
My guess is that I was dehydrated from all the heat and my hatred of plain water, skipped breakfast, and took medication on an empty stomach. She sent me next door to primary care and my pulse was 110 and bp was 90/60 so I'm guessing I was pretty dehydrated. I drank a Powerade and ate some peanut butter crackers and felt a lot better.
So...it looks like I'm on Prozac for a while.
Posted by leoleo33 on August 4, 2006, at 12:27:44
In reply to Re: Help! I'm running out of treatment options! » purplesky, posted by Tomatheus on July 31, 2006, at 0:01:33
Oh My God, i could not have said it better for myself. Exactly like I am, and Nardil was only med to truly work for me but can't take now.
> My main complaints are that I am tired and unmotivated. I find both physical and mental labor exhausting. I have withdrawn from my family and friends, choosing to stay alone instead. I am sleeping 10+ hours a day, and the hours I spend awake I spend essentially staring into space and doing nothing. I don't have the drive to do things that I used to enjoy. Even going to the kitchen to make a frozen dinner seems like a daunting task. I've completely lost my libido. I am not necessarily "sad" all the time; instead I feel more empty and apathetic. My memory is spotty, and I tend to drift off when I should be paying attention. I've been a highly motivated and goal-oriented person in the past, so these symptoms are really holding me back. I've lost my spark.
This is the end of the thread.
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