![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by AnneL on September 1, 2007, at 21:22:14
In addition to Effexor and clonazepam, my pdoc started me on Abilify 5 mg. daily, up to 15 mg. daily for symptoms of Bipolar (most likely BPII - overspending, not needing sleep, etc).
I had no problems with 10 mg. of Abilify, but when I kicked it up to 15 mg., I had a terrible bout of akasthesia (they say this is experienced as "inner restlessness" - holy moly it was MAJOR PANIC). I am an RN and had to get a replacement nurse so that I could go home. I was literally not safe to care for my patients. My thoughts were racing and I was panicky.
What are the other mood stabilizer choices that don't make people gain a lot of weight? :) AnneL
Posted by Phillipa on September 1, 2007, at 21:48:30
In reply to My Horrible Experience on Abilify, posted by AnneL on September 1, 2007, at 21:22:14
Anne I'm a nonworking nurse RN right now. What type of nursing? My thyroid created so much anxiety for me in the beginning I quit nursing. But have you been on a mood stabalizer? Lamictal, Trileptal, Tegretol, Depakote a lot more to google. Phillipa
Posted by AnneL on September 2, 2007, at 1:43:40
In reply to Re: My Horrible Experience on Abilify » AnneL, posted by Phillipa on September 1, 2007, at 21:48:30
> Anne I'm a nonworking nurse RN right now. What type of nursing? My thyroid created so much anxiety for me in the beginning I quit nursing. But have you been on a mood stabalizer? Lamictal, Trileptal, Tegretol, Depakote a lot more to google. Phillipa
Hi Phillipa,
As you know, the thyroid is a very powerful gland which is very often under treated or goes undiagnosed. I have been on levothyroxine (Synthroid) 0.15 mg. for about 20 years now. My TSH has been stable for the last 10 years (knock on wood). When my TSH got too low (hyperthyroid) I had palpitations, a racing heart, insomnia, and horrid anxiety. I hope you have a good endocrinologist to take care of your thyroid issues.I have tried Lamictal once before, but I think it made me angry - it may have been disinhibiting in concert with the clonazepam. I was horrible to be around at work! I will look up the other stabilizers. Thank you for your reply. :) AnneL
Posted by rina on September 2, 2007, at 13:46:34
In reply to Re: My Horrible Experience on Abilify » Phillipa, posted by AnneL on September 2, 2007, at 1:43:40
I'm on Topamax and I've actually lost quite a bit of weight on it. I was on Depakote with the Topamax before and still lost a lot of weight. Good Luck!
Posted by AnneL on September 2, 2007, at 17:37:20
In reply to Re: My Horrible Experience on Abilify, posted by rina on September 2, 2007, at 13:46:34
Any side effects with Topamax? I've heard it referred to as "Dopamax" because it makes some people have trouble processing their thoughts. How much are you taking?
I am thinking of trying Lamictal and/or Depakote.
:) AnneL
Posted by med_empowered on September 2, 2007, at 22:12:33
In reply to My Horrible Experience on Abilify, posted by AnneL on September 1, 2007, at 21:22:14
wow. That sucks. I've had akathisia, too--terrible, isn't it? From what I've read, Abilify is higher on the akathisia-inducing scale of the "atypicals" than, say, Seroquel, but not as bad as old-school meds. Geodon might be an option, but it has cardio side effects. Plus, any antipsychotic can give you akathisia or dysphoria, and the longer you're on it, the more risk you run of permanent (tardive) akathisia.
How much Klonopin do you take? Do you think upping the Klonopin might do the trick? Have you tried Trileptal? Its pretty much weight-neutral, I think, and there's minimal blood work involved. If antipsychotics do the trick for you, some docs have found that giving metformin with zyprexa helps prevent/minimize weight gain and other probs. Other docs use zyprexa as-needed, so maybe you could stabilize on trileptal or Keppra and take a zyprexa as-needed?Anyway...sorry about the akathisia; best of luck to you.
Posted by AnneL on September 2, 2007, at 23:16:27
In reply to Re: My Horrible Experience on Abilify, posted by med_empowered on September 2, 2007, at 22:12:33
Gosh yes, the panicky feeling of akasthesia is horrid! I think you make a very good point about a stabilizer such as Trileptal or Keppra and Zyprexa as an add-on as needed.
I am on clonazepam 1 mg. at bedtime. I took 3 mg. total during a 24 hour period when I had the bout of akasthesia. I was pretty much zombied out during for about 48 hours - most likely caused by the increase in clonazepam and the whole emotional experience of the first time ever in 20 years of nursing of having to leave work because I felt that I was incapable of caring for my patients - in a safe manner.
I don't think upping the clonazepam is an option as I find it very, very sedating - which is good for bedtime :) Thank you for your response and your compassion. AnneL
Posted by chiron on September 3, 2007, at 11:15:58
In reply to Re: My Horrible Experience on Abilify, posted by med_empowered on September 2, 2007, at 22:12:33
I have gotten akathesia on the antipsychotics Geodon and Seroquel. I know Seroquel is usually calming, but some bodies are weirder than others (including mine :))
I took Abilify after beginning Adderall. I don't know which screwed me up more, but I ended up in the hospital. Just my experience.
Posted by rina on September 4, 2007, at 14:40:28
In reply to Re: My Horrible Experience on Abilify » med_empowered, posted by AnneL on September 2, 2007, at 23:16:27
Anne, regarding the Topomax, I'm actually on 200mg which I take at night. Also on Lamictal 175mg at night. Havn't gone stupamax as of yet...lol They actually work wonders for me as a mood stabilizer and I've had no side effects thus far. I've been on it for about 6plus months. As far as the weight goes, I've lost about 40lbs. More than anything, the mood stabilizing and rapid cycling effects of the combination have been wonderful. Good Luck! I also take Lexapro 10mg in the morning and Adderall plus to sleep I take Trazadone.
Posted by rskontos on September 5, 2007, at 14:34:44
In reply to Re: My Horrible Experience on Abilify » med_empowered, posted by AnneL on September 2, 2007, at 23:16:27
Anne, I have been on topamax now for over three years and I am not too dumb yet. I though don't take anything else with it. I was on cymbalta with it and that was BAD. I have been up to 200 mg. that was for the seizures that re-started when I tapered off cymbalta but I lowered it down as I started losing memory. That is the biggest problem is memory loss and hair loss. Now taking zinc and omega three have helped with the hair loss at least for me, maybe not with anyone else but with me it helped. I still take topomax mainly for migraines, I was having on average 4-5 a month and I am happily having none now. I didn't know it was being used to help stablize moods. I wonder if it helping mine. I will have to thing about that. I guess not since I went into my severest depression during the time I have been on it. Anyway, my daughter has been on lamictal, depakote, currently on topamax too. Lamictal and depokote made her a zombie so if that is mood stablizing no thank you. But she was still able to do well in school so go figure. But she slept all the time too. So I think they are too sedating. But she was on a high dose for her size. Anyway, just my two cents. I find topamax for me fairly side effect free if I stay at around 100 mg. probably too low for mood stablizing but good for no headaches. RK
Posted by Ron Hill on September 10, 2007, at 7:21:18
In reply to My Horrible Experience on Abilify, posted by AnneL on September 1, 2007, at 21:22:14
Anne,
I hope you are still checking this thread. I've taken the liberty of rearranging the order of your text but, of course, I did not change any of your words.
> What are the other mood stabilizer choices that don't make people gain a lot of weight?
Have you considered Trileptal? Trileptal is my “ace-in-the-hole” to reel in any breakthrough hypomania. If I get a little hypomanic, all I have to do is increase my Trileptal dosage somewhat. I can feel my hypomania subsiding within minutes of taking the dose. For me it is a great anti-manic moodstablizer.
I’ve had no weight gain due to Trileptal. But, as listed at the close of this e-mail, I also take other meds. Nardil packs on the pounds (i.e. "The Nardil 40"), but it is a great med for atypical depression, and the weight gain can be counter-acted with intense exercise.
> In addition to Effexor and clonazepam, my pdoc started me on Abilify 5 mg. daily, up to 15 mg. daily for symptoms of Bipolar (most likely BPII - overspending, not needing sleep, etc).
Anne, what in the world is wrong with your pdoc??!! It is completely inappropriate to prescribe an antidepressant (Effexor) before he has you FULLY ramped up to therapeutic levels of a good moodstablizer. The risks of inducing mania is one problem, but the HUGE risk is turning you into a rapid cycler for years to come, and maybe forever!!Please, PLEASE, read what Dr Phelps (pdoc who specializes in Bipolar disorder) says about the risks:
http://www.psycheducation.org/bipolar/controversy.htm
May I give you a brief summary of what a pdoc did to me in this regard? Was that a yes? Good. Here is the summary:
1996: Working as engineer and loving life. Advancing in my career. But I started having less motivation and less "Git-er-dun" energy. Went to pdoc not knowing ANYTHING about p-disorders or p-meds. Completely clueless and venerable.
Idiot pdoc misdiagnosed me as ADHD without any testing. He gave me Ritalin, and it caused erratic moods. I told p-doc that I have to stop taking it. He says "No, no. Let's add Paxil". Very reluctantly, I go along. WORST MISTAKE OF MY LIFE -- seriously.
In short order, I go full blown manic. Idiot pdoc still doesn't get it that I'm bipolar. Long story, short; I lost my career, and I lost everything I had (except my house).
But, even worse, without a fully ramped up dosage of a good strong mood stabilizer, Paxil turned me into an ultra-rapid cycler. It’s eleven years later, and I'm still cycling once every 15 days, as I have for the past 11 years. I never rapid cycled prior to taking Paxil.
For years, I used to spend 10 days in horrendous, completely debilitating depression, and 5 days in my normal mood state (10 depression + 5 normal = 15 day cycle, then repeat, repeat … for years and years and years).
Due to spending huge amounts of time reading medical journal articles, searching the archives on PB, talking to smart people on PB, and working closely with my current p-doc, I have made great gains. My current p-doc trusts my research completely and honors my medication requests, so long as I present the research, and justification for the medication trial.
Currently, I'm still ultra rapid cycling once every 15 days, like always, but I've greatly reduced the severity and duration of my depressive episodes such that I spend three days in comparatively mild depression, and 12 days in my normal mood state. PTL, and PTL for p-meds. However, my research continues because I’m still not quite there yet.
Anne, I've rambled a bit – okay more than a bit, but the ONLY reason that I took time to post to you, is in hopes that you will look into this issue thoroughly because the potential risk is HUGE, and it is not worth taking (IMHO). Please, PLEASE; 1) read Dr Phelps lengthy web page entry on the topic by clicking on the link provided above, 2)conduct further research (ask me if you need help), 3) march into your p-doc's office, with your research in hand, and demand that he put you on a good strong moodstablizer asap.
If you are BPII, use an anti-epileptic medication (AED) such as one of those that people above have suggested. BP1 patients tend to do better on lithium. I think Trileptal would be a great choice for you as a first try. Might work well for you, might not. But remember, the business of finding the right med for each individual involves a trial-and-error procedure. But the trial-and-error procedure is not conducted willy-nilly. Instead, it is conducted based on the best research you can find on the net.
And if you need the full text version of a journal article that you cannot gain access to for free on-line, go to the local library to gain assess to it. We have a good university library in our town, but I get the vast majority of my information right off the net.
Please note that most BipolarII patients often find it beneficial to have more than one AED on board in order to achieve optimal benefit. For example, I’m currently on three AED’s and I’m considering a trial adding a fourth AED; a low dosage of Topamax.
Antipsychotics (AP's) like Abilify are absolutely NOT first-line moodstabilizers for the treatment of Bipolar hypomania, and not even for full blown mania, unless the mania becomes a crisis situation and the patient is in danger. And even then, the AP is withdrawn asap.
Please do not misunderstand me. On-going low dosage use of AP's can be of great usefulness to some bipolar patients as an add-on medication. However, all I am saying with regard to AP's is that they are NOT first-line moodstabilizers for BPII patients. AED's are first-line for BPII patients.
Here is a link to the Prescribing Information document for Trileptal:
http://www.pharma.us.novartis.com/product/pi/pdf/trileptal.pdf
Sorry for the length of this post. If I did not care, I would not spend the time to post.
I wish all the best for you, Anne!
-- Ron
Bipolar II with ultra rapid cycling (15 day cycle), and mild Obsessive Compulsive Personality Disorder (OCPD)
600 mg/day Trileptal (AED)
200 mg/day Lamictal (AED)
875 mg/day Keppra (AED)
90 mg/day Nardil (MAOI)
Posted by rina on September 11, 2007, at 13:31:44
In reply to Re: My Horrible Experience on Abilify, posted by rskontos on September 5, 2007, at 14:34:44
RK,
It's funny well not funny. Bad choice of words. Concerning Depakote,zombie-like,sedating state was exactly what I experienced the short time I was on this particular drug. I started on 250mg and didn't feel this way until I titrated to 750mg. Then it hit me hard. Depression set in and that zombie zoned out stuck looking at the wall with my pajamas on all day feeling came. My pdoc quickly took me off it and said that sometimes with people that rapid cycle such as myself with depression and bipolarl tend to stop cycling and come out of the depression but go too low instead of stabilizing. That was interesting to hear,especially since I heard about so many people doing well on this drug. Also most people gain weight on this one. I lost an enormous amount of weight. Go figure...lol
Posted by AnneL on September 12, 2007, at 13:41:40
In reply to Re: My Horrible Experience on Abilify » AnneL, posted by Ron Hill on September 10, 2007, at 7:21:18
Ron,
Thank you, Thank you for your most informative and very compassionate post.I have been on Effexor for 7 years and my current pdoc did not prescribe it for me. Perhaps this is why I have cycled in and out for all of these years. My second pdoc added on Lamictal but this caused anger. Now, I don't know if I was really angry at work at the time (could be), but I did not seem to have a working "censor" button so it was hypothesized that the lamictal and the clonipin could have created a situation where I was "disinhibited". The lamital was stopped and I went on my merry way on Effexor.
New pdoc and she listens to my symptoms of BPII and puts me on Abilfy low dose 5 mg. then 10 mg. daily and honestly I did not notice one bit of difference and continued to cycle. I had lowered my Effexor from 225 to 37.5 mg. daily and I was hitting a very depressive state and she said to up the Abilify to 15 mg. - one dose of 15 mg. and I thought I was going to end up in the ER with major, intense anxiety.
Right now, I self-medicating at Effexor 75 mg. and this seems to have killed the major depressive feelings, but I know I am just waiting to cycle again. It's not a matter of will it, but when will it.
I see my pdoc on Friday and will be discussing all the AED's with her. I am a little gun shy due to the Abilify - I could kick her in the shin for that one. Thank you again for all of your help and I will read Dr. Phelp's information.
:) AnneL
Posted by Ron Hill on September 14, 2007, at 11:18:41
In reply to Re: My Horrible Experience on Abilify » Ron Hill, posted by AnneL on September 12, 2007, at 13:41:40
Anne,
Here are several links to studies and information that you may find useful:
Studies and Documents Addressing the Issue of Antidepressant Induced Rapid Cycling in Bipolar Patients:
Anne, double click on a link, and then on the Internet Explorer menu bar, click Edit, and then Find on this Page. Enter into the search box a phrase like “rapid cycling”, or “switching”, or a similar term.
Once you find the relevant potion(s) of the document via your searches, decide if you want to give a copy of the document to your pdoc. If so, print the document and highlight the relevant section(s). When reading these documents, recall that venlafaxine is Effexor.
http://bjp.rcpsych.org/cgi/content/full/189/2/124
http://ajp.psychiatryonline.org/cgi/content/full/163/2/232
http://ajp.psychiatryonline.org/cgi/content/full/163/8/1337
http://apt.rcpsych.org/cgi/content/full/11/1/28
http://apt.rcpsych.org/cgi/content/full/11/1/19
http://www.jabfm.org/cgi/content/full/18/4/271#R33
Expert Consensus Guidelines™ Medication Treatment of Bipolar Disorder 2000
http://www.psychguides.com/gl-treatment_of_bp2000.html
(Rapid Cycling tx discussion starts on page 36; read all of the sections on rapid cycling)Expert Consensus Guidelines™ Treatment of
Bipolar Disorder 2004
http://www.psychguides.com/ecgs15.php
(As stated on the web page, the Main Document Costs $19.99; but the (1) Table of Contents and the (2) Patient-family guide are both free of charge. Scan through both free documents, and read the paragraph on page 5 of 8 at the top left column titled “Treatments for acute depression” in the Patient-family guide.)Substance Abuse Affects on Switch Rate
http://www.psychiatrysource.com/NewsItem/Substance-abuse-increases-antidepressantinduced-ma.aspx?l1=3PsychEducation.org
“Antidepressants That Aren't "Antidepressants"
(Written 10/2005; updated 2/2006)
http://www.psycheducation.org/depression/ADwithoutAD.htmPsychEducation.org
“Rapid Cycling and Mixed States as "Waves"
(April 2006)
http://psycheducation.org/depression/Waves.htmPsychEducation.org
“Dark Therapy”
(updated 8/2006)
http://psycheducation.org/depression/darkrx.htm
Anne, the link (above) is way cool. The graph shows that the patient (pt) slept an irregular amount on an on-going basis and he was also bipolar rapid cycling. So they put this guy in a dark room for 14 hours a night, (they reduced to 10 hours a few weeks into the trial).Almost immediately after they started tossing the guy in there every night, the data tape shows that the pt almost immediately began to sleep a consistent number of hours every night. No big news, in and of itself.
HOWEVER, as soon as the pt started sleeping a consistent number of hours per night, his rapid cycling stopped!! You’ve got to be kidding me!! Check out the graphs for yourself. Absolutely astonishing!!
Obviously, these data must be taken with a grain of salt since it was a one pt open study with no control group, etc. But still, the correlation of the graphs is so astounding that we need some high quality follow-up studies conducted.
In the meantime, we bipolar rapid cycling pts need to force ourselves to establish and maintain good sleep hygiene which includes a consistent bedtime, and getting up each morning at the same time. It’s all about keeping our circadian clock in sync with the day/night cycle of the rotating earth.
I say all this, and here I am typing this post to you in the wee hours of the night. I wanted to get this to you before your pdoc appointment on Friday.
When I am in my normal phase (which I am now), I start to get tired at about 10 pm. But at 11 pm, a switch goes off in my brain, and my energy, motivation, productivity and, clarity of thought rise to the highest levels of the day. With my current workload, I love to get as much work done as possible. You know, it’s the “strike while the iron is hot” and “Git-er-dun” line of thinking.
As I eagerly work into the wee hours, I periodically look at the clock and tell myself that I need to go to bed. And, I answer myself that, as soon as I’m done with my project, I’ll go to bed. But, I often keep working through the night. Not good.
Don’t misunderstand me, Anne. This is not hypomania. I’ve been at this game of bipolar disorder for a long time, and I know exactly what I feel like when I’m hypomanic.
I am definitely not hypomanic as I work during the wee hours. If that were the case, I’d just take an extra 300 mg of Trileptal to reel in the hypomania, and that would be the end of that.
Instead, my high productivity, energy, motivation, and enhanced clarity of thought in the wee hours are because I have my circadian clock out of whack. I get tired just shortly before the sun rises.
And, by the way, as the dawn breaks, then indeed I do begin to experience some hypomania due to sleep deprivation. But, as always, I can reel the hypomania in with some extra Trileptal.
With regard to getting my circadian clock back in sync, I have some LowBlueLight (LBL) yellow glasses, but I typically use them only during the SAD season. The LBL glasses do a good job of resetting my circadian clock when I wear them during SAD season. So, I will dig out my LBL glasses and begin the process of resetting my circadian clock.
But, shame on me! In the past, I had only skimmed over the Dark Therapy PsychEd webpage. But, I read it thoroughly tonight to decide if I should send the link to you. So, I owe you a thank you. By writing this post to you, I learned something very important.
The bottom line is that my irregular sleep pattern has my circadian clock all screwed up (and vice-versa), and this may be worsening my rapid cycling. Therefore, I need to do whatever it takes to get my clock back in sync.
When you have time, click the links that Dr Phelps has imbedded within the text and read some more information (if you want to). He is a good pdoc, but he writes poorly, and his website is chaotic, and very difficult to use. He needs to hire a good webmaster. The website contains some good information, if you can find what you are looking for. He does have a search function on the site now, and that helps.
PsychEducation – The Blog
“Yellow lenses at night for sleep: Not Such a Strange Idea”
http://www.psycheducation.com/2006/08/yellow-lenses-at-night-for-sleep-not.htmlWelcome to lowbluelights.com
“Products for a Healthier Life” (check out the way cool glasses)
https://www.lowbluelights.com/index.asp“Sleep” (click ALL links on this page, and read them all)
https://www.lowbluelights.com/sleep.asp“SAD” (click ALL links on this page)
https://www.lowbluelights.com/sad.asp
Anne, I have more that I can send you, but this is plenty for now.Just ask if you need something.
If it is okay with you, I need to follow this post up with another post because I need to ask you some questions about your bipolar symptoms.
Be well.
-- Ron
Bipolar II with ultra rapid cycling (15 day cycle), and mild Obsessive Compulsive Personality Disorder (OCPD)
600 mg/day Trileptal
200 mg/day Lamictal
875 mg/day Keppra
90 mg/day Nardil
----------
> Ron,
> Thank you, Thank you for your most informative and very compassionate post.
>
> I have been on Effexor for 7 years and my current pdoc did not prescribe it for me. Perhaps this is why I have cycled in and out for all of these years. My second pdoc added on Lamictal but this caused anger. Now, I don't know if I was really angry at work at the time (could be), but I did not seem to have a working "censor" button so it was hypothesized that the lamictal and the clonipin could have created a situation where I was "disinhibited". The lamital was stopped and I went on my merry way on Effexor.
>
> New pdoc and she listens to my symptoms of BPII and puts me on Abilfy low dose 5 mg. then 10 mg. daily and honestly I did not notice one bit of difference and continued to cycle. I had lowered my Effexor from 225 to 37.5 mg. daily and I was hitting a very depressive state and she said to up the Abilify to 15 mg. - one dose of 15 mg. and I thought I was going to end up in the ER with major, intense anxiety.
>
> Right now, I self-medicating at Effexor 75 mg. and this seems to have killed the major depressive feelings, but I know I am just waiting to cycle again. It's not a matter of will it, but when will it.
>
> I see my pdoc on Friday and will be discussing all the AED's with her. I am a little gun shy due to the Abilify - I could kick her in the shin for that one. Thank you again for all of your help and I will read Dr. Phelp's information.
> :) AnneL
Posted by Cloudydaze on September 14, 2007, at 23:07:10
In reply to Re: My Horrible Experience on Abilify » rskontos, posted by rina on September 11, 2007, at 13:31:44
Thats strange, because Lamictal caused me nervous-twitchy (even slightly OCD type) symptoms. My doc confirmed that it put me into a manic state.
But he gave me Abilify to calm me down and level me out...
I hadn't slept the last 2 weeks on Lamictal, but last night I took my first dose of Abilify, and I SLEPT. It's wonderful.
I feel calmer already.
Isn't is weird how medications affect people differently?
Posted by Phillipa on September 15, 2007, at 20:00:42
In reply to Re: My Horrible Experience on Abilify, posted by Cloudydaze on September 14, 2007, at 23:07:10
I know was given only low dose trileptal l50mg to help with depression. No side effects at all. Phillipa now I understand this is extremely low dose.
Posted by AnneL on September 16, 2007, at 22:56:01
In reply to Re: My Horrible Experience on Abilify » AnneL, posted by Ron Hill on September 14, 2007, at 11:18:41
Hi Ron,
Anne here. I remember you. I have been on this site since 2000. You have given me a lot of homework!I'll babblemail you. :) AnneL
Posted by Ron Hill on September 17, 2007, at 22:13:27
In reply to Re: My Horrible Experience on Abilify » Ron Hill, posted by AnneL on September 16, 2007, at 22:56:01
Anne,
You stated that you do not know for sure if are bipolar. In that case, the first thing we have to do is determine your dx. Enclosed are two diagnostic tests for bipolar disorder. Read what I’ve wrote before opening Test #2.
Test # 1: http://i.cmpnet.com/CME/pt/PDF/MDQ_Quest.pdf
Print the test and take it. When you finish, let me know and I will send you the scoring sheet. We have to reply to each other as quickly as we can, if we are going to have you ready for your pdoc appointment on 9/27/07. So check this thread as often as you can, and I will do the same.
Test #2: http://i.cmpnet.com/CME/pt/PDF/HAMD_Quest.pdf
The second test is designed to be given orally to the pt by the pdoc. Therefore, the test form has the score key printed in a blue box on the second page of the test immediately following question 17.Print this test, and try hard not to look at the score key. Stay honest – no cheating, Anne girl. : ) Fill out the first page, and when you turn to the second page, cover up the blue box with you hand while you finish the test.
Better yet, do not look at the two page test form. Have a friend ask you the questions and record your answers on the form. Let me know asap and I will send you the full score sheet that goes with the test.
Okay, let me ask you some questions. As I understand it, you were rx’ed the Effexor script by a GP and until very recently you have been seeing the GP and staying on the Effexor for the past 7 years. But now you are going to a pdoc and in you first meeting the pdoc rx’ed you a script of low dosage Abilify as a moodstabilizer to go with your Effexor. Tell me anything that is wrong with what I just stated.
Have you ever taken any p-meds other than Effexor and a few days of Abilify?
What caused you to go to the GP seven years ago? Depression? Did the GP diagnose (dx) your condition?
Has any doctor dx’ed you as bipolar (BP)? If so, was the dx BP 1 or BP 2?
Has any doctor dx’ed you as having any type of disorder?
Is there any history of mental illness (either dx’ed or not dx’ed) in your extended family?
How are you doing with your homework assignment? Remember Anne, just scan the research documents, and use the search features. When the document is in Internet Explorer (your normal Windows browser), then search my clicking on the Edit button on the menu bar, and then select Find on this PAGE. If the document is a pdf file then click on the picture of binoculars. Enter key words, like “rapid cycling”, “mania”, “switching”, etc. Remember, our purpose for the research documents are to show to your pdoc in order to convince him that monothearpy with Effexor is absolutely inappropriate and that Effexor has turned you into a rapid cycler.
I threw in the LowBlueLight links only as an FYI. If it turns out that you are BP, then working the midnight shift is one of the worst things a BP pt can do. It gets your circadian clock all messed up. The LowBlueLight glasses are a great help to reset your circadian clock.
But, let get your dx figured out right now.
Do you have health insurance?
What prompted you to go to a pdoc after seven years of going to a GP?
Is your pdoc male or female?
Is your pdoc open to hearing and trying your ideas regarding what meds you want to try?
What kind of vibs do you get from your pdoc?
Why did you select this pdoc?
Okay, enough for tonight. Remember, let’s do quick turnarounds so we can make our deadline. Very short answers are all I need.
-- Ron
Bipolar II with ultra rapid cycling (15 day cycle), and mild Obsessive Compulsive Personality Disorder (OCPD)
600 mg/day Trileptal
200 mg/day Lamictal
875 mg/day Keppra
90 mg/day Nardil
Posted by Ron Hill on September 18, 2007, at 1:32:31
In reply to My Horrible Experience on Abilify, posted by AnneL on September 1, 2007, at 21:22:14
Anne,
I asked you some questions in my previous post that you have already answered earlier in this thread. I'm very sorry, Anne.
This darn 200 mg/day of Lamictal that I take absolutely kills my memory.
So, I reread your posts in this thread to refresh my memory. Please make life easy for yourself, and when you get to one of my questions in my earlier post that you already answered, just say: See earlier post.
I am sorry Anne. I will not let it happen again.
I already have a vision for what I will recommend to you regarding AED medications. But, IMO our biggest challenges that we face are: 1) getting you off of Effexor and yet treating your depression, and 2) stopping your rapid cycling.
-- Ron
Posted by curiousfish on September 23, 2007, at 15:52:05
In reply to Re: My Horrible Experience on Abilify, posted by Cloudydaze on September 14, 2007, at 23:07:10
Posted by curiousfish on September 23, 2007, at 15:54:25
In reply to My Horrible Experience on Abilify, posted by AnneL on September 1, 2007, at 21:22:14
im in my last semester of nursing school.. im so scared that i wont be able to keep jobs. it is really hard to hide emotional breaks in nursing!
i think ive actually had unneeded weight loss on geodon.
This is the end of the thread.
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