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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by rina on January 28, 2007, at 0:54:15
I was recently diagnosed with bipolar disorder. I'm a little nervous about the start of different meds for me. How is it determined what meds to start someone on when newly diagnosed? Also I suffer from chronic depression as well as ADD. Any clarity would truly help.
Rina
Posted by jed on January 31, 2007, at 2:50:58
In reply to Recently Diagnosed with Bipolar, posted by rina on January 28, 2007, at 0:54:15
Hi Rina - A good doctor will look at your combination of factors (the ADD and depression, for example, or if you're anxious or have insomnia, etc.), and prescribe the meds that seem to be the best for your situation. For bipolar disorder (which I also have), they usually start you on a "mood stabilizer" first, because sometimes the mood stabilizer helps both the mania and the depression, and then you don't need anything else. (Also, if you have bipolar disorder and take an antidepressant by itself, sometimes it will bring on mania, so they like to have a mood stabilizer on board first.) For many of us, though, they end up adding more to the mix until we get the right combo.
As for which ones they go for first, I can only report what the process was for me when I first got my diagnosis. They tried lithium first, because, since it was discovered, it was the "first line" treatment for biploar disorder. It didn't agree with me, so they moved on to the other mood stabilizers, Depakote, Tegretol, Lamictal, etc. After getting a mood stabilizer on board, I was less agitated but still horribly depressed, so I started trying antidepressants. I think that is often the order in which the process goes for people diagnosed with bipolar disorder. Your doctor would consider your ADD when deciding which medication to try for treating your depression, if need be. Always remember that everyone is different, and though you may find the right medications quickly, it might turn out that you have to try different ones to get it right.
I think it's great that you are asking questions from the very beginning. We have to educate ourselves and advocate for ourselves through this whole medication process. It is essential to have a doctor whom you trust. You should always be able to ask questions until you understand what she or he is doing.
I wish you the very best!
Posted by rina on January 31, 2007, at 11:01:22
In reply to Re: Recently Diagnosed with Bipolar, posted by jed on January 31, 2007, at 2:50:58
> Hi Rina - A good doctor will look at your combination of factors (the ADD and depression, for example, or if you're anxious or have insomnia, etc.), and prescribe the meds that seem to be the best for your situation. For bipolar disorder (which I also have), they usually start you on a "mood stabilizer" first, because sometimes the mood stabilizer helps both the mania and the depression, and then you don't need anything else. (Also, if you have bipolar disorder and take an antidepressant by itself, sometimes it will bring on mania, so they like to have a mood stabilizer on board first.) For many of us, though, they end up adding more to the mix until we get the right combo.
>
> As for which ones they go for first, I can only report what the process was for me when I first got my diagnosis. They tried lithium first, because, since it was discovered, it was the "first line" treatment for biploar disorder. It didn't agree with me, so they moved on to the other mood stabilizers, Depakote, Tegretol, Lamictal, etc. After getting a mood stabilizer on board, I was less agitated but still horribly depressed, so I started trying antidepressants. I think that is often the order in which the process goes for people diagnosed with bipolar disorder. Your doctor would consider your ADD when deciding which medication to try for treating your depression, if need be. Always remember that everyone is different, and though you may find the right medications quickly, it might turn out that you have to try different ones to get it right.
>
> I think it's great that you are asking questions from the very beginning. We have to educate ourselves and advocate for ourselves through this whole medication process. It is essential to have a doctor whom you trust. You should always be able to ask questions until you understand what she or he is doing.
>
> I wish you the very best!Thank you so much for the positive insight. This is definitely information that I intend to keep in my, so I can begin and continue to advocate my treatment. Also, my appointment yesterday went well. My doc started me on Abilify 10mg and I'm also on Lamictal 300mg. Cross my finger, hopefully this is a start, for positive things to come. Once again thanks for the information.
Posted by jed on February 1, 2007, at 4:55:09
In reply to Re: Recently Diagnosed with Bipolar, posted by rina on January 31, 2007, at 11:01:22
>> Thank you so much for the positive insight. This is definitely information that I intend to keep in my, so I can begin and continue to advocate my treatment. Also, my appointment yesterday went well. My doc started me on Abilify 10mg and I'm also on Lamictal 300mg. Cross my finger, hopefully this is a start, for positive things to come. Once again thanks for the information.
>
You're very welcome. I'm so glad your appointment went well - it sounds like you're off to a good start.
Posted by rina on February 1, 2007, at 11:29:00
In reply to Re: Recently Diagnosed with Bipolar, posted by jed on February 1, 2007, at 4:55:09
>
> >> Thank you so much for the positive insight. This is definitely information that I intend to keep in my, so I can begin and continue to advocate my treatment. Also, my appointment yesterday went well. My doc started me on Abilify 10mg and I'm also on Lamictal 300mg. Cross my finger, hopefully this is a start, for positive things to come. Once again thanks for the information.
> >
> You're very welcome. I'm so glad your appointment went well - it sounds like you're off to a good start.
>
We'll I thought I was as well. Unfortunately, Abilify was given Tuesday with the lamictal I currently take. A nightmare indeed. I have the shakes, chills and extremely tired. I'm not sure if these symtoms are from the Abilify or the detox of Effexor a week ago. This really sucks, especially since all this is new for me and I haven't the faintest idea what to do now....
Posted by jed on February 2, 2007, at 18:25:08
In reply to Re: Recently Diagnosed with Bipolar, posted by rina on February 1, 2007, at 11:29:00
> > You're very welcome. I'm so glad your appointment went well - it sounds like you're off to a good start.
> >
>
> We'll I thought I was as well. Unfortunately, Abilify was given Tuesday with the lamictal I currently take. A nightmare indeed. I have the shakes, chills and extremely tired. I'm not sure if these symtoms are from the Abilify or the detox of Effexor a week ago. This really sucks, especially since all this is new for me and I haven't the faintest idea what to do now....
>I'm so sorry the medication is giving you trouble. Were you experiencing similar symptoms within the last week, after getting off of Effexor? Sometimes it is so hard to figure out where the side effects are coming from. Also, it can be a challenge to figure out when to "hang in there" with a medication, because sometimes the side effects go away, or at least get a lot better. Trust your body and your gut feeling. The way I see it, regarding side effects, there's a difference between your system rejecting the medication, and your system just adjusting to a medication. You have to learn for your own body.
This process can be so discouraging, when side effects are terrible or the medication doesn't work for whatever reason. Everyone is different, but for sure there are a lot of people who have to go through several (or many) medication trials to find the right combo. If the first medications prescribed don't work for you, you are not alone! If you stay on this board, you'll see people getting and giving support for this very process.
Again, I'm so sorry about the side effects you're having. How are you feeling now?
Posted by rina on February 3, 2007, at 18:47:10
In reply to Re: Recently Diagnosed with Bipolar, posted by jed on February 2, 2007, at 18:25:08
> > > You're very welcome. I'm so glad your appointment went well - it sounds like you're off to a good start.
> > >
> >
> > We'll I thought I was as well. Unfortunately, Abilify was given Tuesday with the lamictal I currently take. A nightmare indeed. I have the shakes, chills and extremely tired. I'm not sure if these symtoms are from the Abilify or the detox of Effexor a week ago. This really sucks, especially since all this is new for me and I haven't the faintest idea what to do now....
> >
>
> I'm so sorry the medication is giving you trouble. Were you experiencing similar symptoms within the last week, after getting off of Effexor? Sometimes it is so hard to figure out where the side effects are coming from. Also, it can be a challenge to figure out when to "hang in there" with a medication, because sometimes the side effects go away, or at least get a lot better. Trust your body and your gut feeling. The way I see it, regarding side effects, there's a difference between your system rejecting the medication, and your system just adjusting to a medication. You have to learn for your own body.
>
> This process can be so discouraging, when side effects are terrible or the medication doesn't work for whatever reason. Everyone is different, but for sure there are a lot of people who have to go through several (or many) medication trials to find the right combo. If the first medications prescribed don't work for you, you are not alone! If you stay on this board, you'll see people getting and giving support for this very process.
>
> Again, I'm so sorry about the side effects you're having. How are you feeling now?Jed, thanks so much for the insight concerning the med process. I'm feeling awful with all words capitalized. It feels worse than when I was detoxing from MSContin. This is crazy!!
Posted by jed on February 4, 2007, at 23:37:18
In reply to Re: Recently Diagnosed with Bipolar, posted by rina on February 3, 2007, at 18:47:10
>
> Jed, thanks so much for the insight concerning the med process. I'm feeling awful with all words capitalized. It feels worse than when I was detoxing from MSContin. This is crazy!!
>Wow. I'm so sorry it's so bad. I have a really hard time with meds and I know what you're talking about.... Only you know whether or not to stick with a med, but it does sound like this is over the top. I want to encourage you to hang in there with the process (whether or not you stay with this med) - it isn't always this bad. You know, you might find that you need to start with smaller doses. I'm super medication-sensitive and take only a fraction of what most doctors prescribe. Sometimes I have to start out with miniscule doses. Fortunately, I finally found a doctor who totally gets it and understands that a therapeutic dose, for me, is often unexpectedly low. It is, of course, important to take enough of the medication for it to work well, but this varies for each individual. I say all this to encourage you to listen to your body and work with it. You may have a high tolerance and none of this may apply to you, but I want to mention it, just in case!
Hang in there, Rina. Please let us know how you are, when you can.
Posted by rina on February 4, 2007, at 23:53:49
In reply to Re: Recently Diagnosed with Bipolar » rina, posted by jed on February 4, 2007, at 23:37:18
> >
> > Jed, thanks so much for the insight concerning the med process. I'm feeling awful with all words capitalized. It feels worse than when I was detoxing from MSContin. This is crazy!!
> >
>
> Wow. I'm so sorry it's so bad. I have a really hard time with meds and I know what you're talking about.... Only you know whether or not to stick with a med, but it does sound like this is over the top. I want to encourage you to hang in there with the process (whether or not you stay with this med) - it isn't always this bad. You know, you might find that you need to start with smaller doses. I'm super medication-sensitive and take only a fraction of what most doctors prescribe. Sometimes I have to start out with miniscule doses. Fortunately, I finally found a doctor who totally gets it and understands that a therapeutic dose, for me, is often unexpectedly low. It is, of course, important to take enough of the medication for it to work well, but this varies for each individual. I say all this to encourage you to listen to your body and work with it. You may have a high tolerance and none of this may apply to you, but I want to mention it, just in case!
>
> Hang in there, Rina. Please let us know how you are, when you can.Thank you so much for the kind words and yes, I have a high tolerance for meds. I don't know many people that can take 60mg of Ritalin and take a nap...lol
Posted by jed on February 6, 2007, at 3:11:38
In reply to Re: Recently Diagnosed with Bipolar, posted by rina on February 4, 2007, at 23:53:49
>
> Thank you so much for the kind words and yes, I have a high tolerance for meds. I don't know many people that can take 60mg of Ritalin and take a nap...lol
>I have to laugh, that IS a high tolerance! So, looks like hyper-sensitivity to medications won't be an issue for you... I hope you find the right combo soon. --jed
Posted by rina on February 6, 2007, at 15:31:17
In reply to Re: Recently Diagnosed with Bipolar, posted by jed on February 6, 2007, at 3:11:38
> >
> > Thank you so much for the kind words and yes, I have a high tolerance for meds. I don't know many people that can take 60mg of Ritalin and take a nap...lol
> >
>
> I have to laugh, that IS a high tolerance! So, looks like hyper-sensitivity to medications won't be an issue for you... I hope you find the right combo soon. --jed
>Jed, I hope so too, especially since I have BipolarII and get this, I haven't a clue what that is. My pdoc never thought to tell me,just medicated me.
>
Posted by jed on February 8, 2007, at 1:30:50
In reply to Re: Recently Diagnosed with Bipolar, posted by rina on February 6, 2007, at 15:31:17
There is some great information in past threads on this board that you might find helpful. I just did a search on "bipolar II" and got a lot of good stuff. Maybe you've done that, but I just thought I'd mention it...
I hope you're feeling better.
This is the end of the thread.
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