![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 16 to 40 of 45. Go back in thread:
Posted by Ron Hill on October 27, 2010, at 23:17:57
In reply to Re: Ultra Rapid Cycling Stopped Using Valdoxan » Ron Hill, posted by maxime on October 23, 2010, at 23:17:15
> Sorry, I don't want to highjack the thread but ... Ron, do you find that keppra helps you and if so, how? Not many on the board take it and I was wondering how it effective it was. I also take 600 mg of trileptal.
I started taking Keppra back in 2004. At the time there were some anecdotal open studies showing the Keppra might help in the tx of rapid cycling.
At 1000 mg/day it caused depression for me, but at 500 mg/day I felt that it helped. Now that I'm taking Valdoxan, I might discontinue it. I'm inclined to keep it on-board because I only have Trileptal and Keppra as moodstabilizers (not counting Lamictal, a very weak moodstabilizer).
I send all my best to you, Maxime. You have it tough, and I care about you.
-- Ron
Posted by morgan miller on October 28, 2010, at 0:25:29
In reply to Ultra Rapid Cycling Stopped Using Valdoxan » alchemy, posted by Ron Hill on October 23, 2010, at 12:01:36
>You're bipolar II, correct?
>If so, I'm very concerned about you having an SSRI on-board.
Let's not make the same mistake psychiatrists make and put all us bipolars in a box. I'm bipolar(don't know if it's I or II, don't know if it matters, and I don't really care) and I had been on an SSRI by itself for years and did pretty damn good. I was able to escape all the possible mind numbing/cognition wrecking side effects of mood stabilizers. I was able to live a full life.
Posted by morgan miller on October 28, 2010, at 0:27:52
In reply to Re: Ultra Rapid Cycling Stopped Using Valdoxan » Ron Hill, posted by alchemy on October 23, 2010, at 13:42:26
>Wow, I wish I could afford all of those supplements.
You can afford many of them. Things like CoQ10 are expensive, but things like vitamin D3(oil based softgel is likely best absorbed) are dirt freakin cheap.
Posted by morgan miller on October 28, 2010, at 0:29:52
In reply to Re: Ultra Rapid Cycling Stopped Using Valdoxan, posted by polarbear206 on October 24, 2010, at 11:07:46
>My main problem is periods of foggyness, concentration problems, and some residual fatigue.
Some of this could be Lamictal, especially the concentration problems and the fogginess.
Posted by morgan miller on October 28, 2010, at 0:32:27
In reply to Re: ultra, ultra, and ultra rapid cycling, posted by alchemy on October 24, 2010, at 12:26:42
>My oppinion with my "waves" is that there is some correlation with epilepsy.
It was also likely exacerbated by and developed in part due to childhood neglect, stress, and trauma.
Posted by Ron Hill on October 28, 2010, at 0:34:43
In reply to Re: Ultra Rapid Cycling Stopped Using Valdoxan, posted by polarbear206 on October 24, 2010, at 11:07:46
PolarBear (I like that name!),
> Hi Ron, So glad your doing well.
Thank you.
> I've been very interested in Valdoxan and plan to trial it when it hits the market in the states.
What causes your interest in Valdoxan? What symptom(s) would you hope to treat with it?
If you think it might help you, there is no need to wait for 2+ years. You and your p-doc can legally and safely order Valdoxan off of the internet.
> I meet all of the criteria, except rejection sensitivity.
So, you have atypical depression, correct?
> Prior to Lamictal, these symptoms were worse in the winter months.
Seasonal Affective Disorder (SAD) is very common for bipolar patients with atypical depression. I am of the opinion that most bipolar patients have atypical depression.
> Still there, but not as pronounced. My main problem is periods of foggyness, concentration problems, and some residual fatigue. Motivation in the morning is a problem too at times. Currently taking effexor 300mg and Lamictal 200mg. I'm going to try and cut back on the effexor very slowly and add a low dose of Focolin. P-doc wants me to try this first vrs Provigal. Anyone have experiences with Focolin?
Have you been tested to make sure that you are bipolar? Does your p-doc believe that you are bipolar?
If so, why in the world would your p-doc add Focalin without first having a moodstabilizer (or moodstabilizers) FULLY RAMPED UP? Are you comorbid ADHD?
Is your p-doc trying to tx your foggyness, concentration problems, fatigue, and morning amotivation with Focalin?
Who was the ido*t that originally put you on the SNRI Effexor without any moodstabilizers on-board? Your current p-doc?
Polarbear, I'll hold my tongue, but boy do I disagree with the meds your p-doc has you on!!
How much of the time are you depressed and how much of the time are you hypomanic?
> Also Ron, have you ever tried to add Inositol to your mix? 12-18 gms/day from info I have gathered. Plan to trial this at some point.
I tried inositol many moons ago, but it made me depressed. But, everyone is different, so it might help you. I think you'd be better off focusing on getting some more appropriate meds on-board suitable for a bipolar.
> Depression dominated mild bipolar.-- Ron
Posted by morgan miller on October 28, 2010, at 0:39:55
In reply to Re: ultra, ultra, and ultra rapid cycling, posted by bleauberry on October 25, 2010, at 17:58:00
>Whatever is going on, it is physical, not psychiatric.
It's sad when people continue to ignore and underestimate the power of our damaged psyche to influence the development of physiological conditions and illnesses. I think saying something is physical is dangerous. If everyone believes all of our problems are physical, they will never feel the need to take the steps to better nurture themselves to health the way their parents should have. They may also never feel the need to take the steps as parents themselves to fulfill all of their children's needs in order to minimize chances of the development of disruptive psychiatric(or physical, whatever you want to call it) illnesses/conditions.
Posted by Ron Hill on October 28, 2010, at 0:51:39
In reply to Re: ultra, ultra, and ultra rapid cycling, posted by alchemy on October 24, 2010, at 12:26:42
Alchemy,
You know that you need one or more strong moodstabilizers on-board asap, correct?
-------------------> My experiences:
> I think I have had a ultra-cycling for a long time. I don't notice a sudden change. But I do have to remind myself that when I am in a really down "episode", it won't be as bad a few days.
> When I tried Adderall (without a stabilizer), I started to go really up & down. Further ups, but further downs. It may have contributed to my hospital stay.
> For what I think is my ultra-ultra, I have gone through times where I know my morning depression will improve later during the day, but it is gradual. Then there are the times I have sudden changes - it is maybe less than a half-hour period. I am doing nothing different, and I just feel my mood just fall/switch. Why does it only go down?
> There doesn't seem to be a term for cycling within minutes or seconds. I think of mine as "waves" or intervals. I don't think they really recongnize this, but there are some experiences I found on the web. For me, this is a weird feeling, and they may be unique to just me. It only started AFTER starting dexadrine, but even Lamictal (but I'm sure it would be worse off without it.) They aren't a terrible thing, and the dexadrine is still worth it. I am just worried it will get worse. Sometimes they are subtle and barely noticable. Sometimes they are quicker or worse. For an example of one type of this for me is like saying the word "ta-da", ta(down)-da(back up)
> My oppinion with my "waves" is that there is some correlation with epilepsy. It's like I have a messed up chemical/neuron firing. There are some doctors out there that believe there is close association between epilepsy & bipolor.
> There is interesting graph of the different cycle intervals at: http://www.psycheducation.org/depression/Waves.htm
Posted by Ron Hill on October 28, 2010, at 1:10:43
In reply to Re: ultra, ultra, and ultra rapid cycling, posted by bleauberry on October 25, 2010, at 17:58:00
Hi bleauberry,
I'm interested. Will you please list the 10 or so things that I can experiment with? Thank you.
-- Ron
--------------> Well, my moods usually flip in terms of hours and minutes, not days or weeks, so what is that? Ultra ultra ultra ultra ultra?
>
> Whatever someone wants to call it, it doesn't matter. The name is simply a fancy way to say "gee, my mood doesn't stay the same very long". Big deal, thank you name, didn't help me at all. Still have no idea what is going on or what to do about. I find names fairly useless.
>
> Whatever is going on, it is physical, not psychiatric. The psychiatric part you feel is the end result of it. So it appears like all the world to be a psychiatric condition. Very deceiving.
>
> If you would like some ideas, let me know. They won't involve meds, except perhaps maybe very low dose lithium, which is actually a salt not a med. There are ideas that can truly get you feeling better.
>
> Been there done that. I can relate to your post. It would not surprise me though if you have a hard time relating to mine. But of course psych meds are the only thing we can do, right? They are the best thing we can do, right? Wrong on both counts.
>
> Food for thought. I had an entire genetic test. Very expensive. It showed all the mutations, snippets, and such in so many groups of genes, including the one you mentioned in your post. There are a few experts that are becoming well versed in knowing how to piece these clues together and choose supplements that "bridge the roadblock" where genetic flaws exist. In my case, some of them were not good for me and some were fantastic. Like meds, took some experimenting. For someone who doesn't have a genetic test, it doesn't matter. The things you would experiment with can be counted on ten fingers.
>
> > I am now to the point that I seem to have a rotation every 3-4 days; sometimes a dip or two during the day, and sometimes minutes or seconds.
> >
> > I look for page after page for any research or treatments. And this is all that I find:
> >
> > ~ It is very difficult to treat & has a poor prognosis
> > ~ Theories that antidepressants contribute
> > ~ Mostly women
> > ~ Lamictal is probably the best med to try
> > ~ mid-90's studies: Nimodipine (a dihydropyridine calcium channel blocker for high blood pressure.) probs & got no where
> > ~1998 A possible gene: Ultra-ultra rapid cycling bipolar disorder is associated with the low activity catecholamine-O-methyltransferase allele.
>
>
Posted by Ron Hill on October 28, 2010, at 2:11:32
In reply to Re: Ultra Rapid Cycling Stopped Using Valdoxan » Ron Hill, posted by morgan miller on October 28, 2010, at 0:25:29
Morgan,
I made the statement to a patient who is ultra ultra rapid cycling. Giving an antidepressant to a bipolar patient is controversial, with research on both sides of the aisle. However, giving an ultra ultra rapid cycling pt an SSRI without any anti-manic medication is like pouring fuel on the fire.
I'm very happy to hear that you are doing well.
-- Ron
----------------> >You're bipolar II, correct?
>
> >If so, I'm very concerned about you having an SSRI on-board.
>
> Let's not make the same mistake psychiatrists make and put all us bipolars in a box. I'm bipolar(don't know if it's I or II, don't know if it matters, and I don't really care) and I had been on an SSRI by itself for years and did pretty damn good. I was able to escape all the possible mind numbing/cognition wrecking side effects of mood stabilizers. I was able to live a full life.
Posted by morgan miller on October 28, 2010, at 2:32:45
In reply to Re: Ultra Rapid Cycling Stopped Using Valdoxan » morgan miller, posted by Ron Hill on October 28, 2010, at 2:11:32
> Morgan,
>
> I made the statement to a patient who is ultra ultra rapid cycling. Giving an antidepressant to a bipolar patient is controversial, with research on both sides of the aisle. However, giving an ultra ultra rapid cycling pt an SSRI without any anti-manic medication is like pouring fuel on the fire.
>
> I'm very happy to hear that you are doing well.
>
> -- Ron
> ----------------
>
> > >You're bipolar II, correct?
> >
> > >If so, I'm very concerned about you having an SSRI on-board.
> >
> > Let's not make the same mistake psychiatrists make and put all us bipolars in a box. I'm bipolar(don't know if it's I or II, don't know if it matters, and I don't really care) and I had been on an SSRI by itself for years and did pretty damn good. I was able to escape all the possible mind numbing/cognition wrecking side effects of mood stabilizers. I was able to live a full life.
>
>I understand, it would be very risky and not a risk worth taking. What do you think about giving a patient an SSRI in the midst of a mixed manic episode? I took Prozac during my first mixed manic episode(I know this now, at the time I just thought I was depressed, anxious, and had major OCD) and felt great 3 weeks into it. My point is, it is possible that someone in all states of bipolar may benefit greatly from an antidepressant. I do understand, giving a patient in the midst of a bipolar state an SSRI or other antidepressant is not usually the wisest of choices.
I'm really not doing well. I WAS doing fine on Zoloft for 7 years. I quit Zoloft not knowing that I was bipolar and thinking that I did not need medication anymore. 5 months later the perfect storm of events and circumstances(including not being on Zoloft anymore) sent me into a major mixed episode. I have not quite recovered since. I'm dealing with other issues now aside from just bipolar depression and anxiety.
Posted by Ron Hill on October 28, 2010, at 2:43:57
In reply to Re: Ultra Rapid Cycling Stopped Using Valdoxan, posted by morgan miller on October 28, 2010, at 2:32:45
Morgan,
I'm very sorry to hear of your setback.
I wish you well as you work through these issues. Life can be difficult at times, huh? Find a way to be well, my friend. Find a way.
-- Ron
----------------> I'm really not doing well. I WAS doing fine on Zoloft for 7 years. I quit Zoloft not knowing that I was bipolar and thinking that I did not need medication anymore. 5 months later the perfect storm of events and circumstances(including not being on Zoloft anymore) sent me into a major mixed episode. I have not quite recovered since. I'm dealing with other issues now aside from just bipolar depression and anxiety.
Posted by alchemy on October 28, 2010, at 12:15:49
In reply to Re: ultra, ultra, and ultra rapid cycling » alchemy, posted by Ron Hill on October 28, 2010, at 0:56:29
> You know that you need one or more strong moodstabilizers on-board asap, correct?
-------------------
I'm on 400mg of Lamictal. Unfortunately, all of the other ones have made my mood much worse. I haven't tried Keppra, but I don't have much hope with that one.
DEPEKOTE - worse
TRILEPTAL - Years ago. But after a couple of weeks I was in a bad agitated mixed state. I remember an ongoing desire to slash my neck, etc.
LITHIUM: tried twice. the first time it made me worse. the 2nd time was as an augmenter to Lamictal.
TOPOMAX: not only did I have no clue what my address was when being asked for it. I wrote down "internal ranting & raving"
NEURONTIN: bad, bad. Within 2nd day.Antipsychotics - I am scared to try any more. And if they block some of the dopamine, I'm confused how they help depression...?
GEODON: Ended up doing an ECT round!
ABILIFY: 2 trials.
ZYPREXA: more agitated
SEROQUEL: restless leg stuffverapamil - even though it's been dismissed, I still wonder if it is worth trying.
Posted by alchemy on October 28, 2010, at 12:22:55
In reply to Re: Ultra Rapid Cycling Stopped Using Valdoxan, posted by morgan miller on October 28, 2010, at 0:29:52
> >My main problem is periods of foggyness, concentration problems, and some residual fatigue.
>
> Some of this could be Lamictal, especially the concentration problems and the fogginess.
---------------------------------------Interesting, I never thought of that. I did notice last time I increased my dosage it affected my "word finding", but it eventually went away.
Posted by Ron Hill on October 30, 2010, at 17:35:51
In reply to Re: ultra, ultra, and ultra rapid cycling » Ron Hill, posted by alchemy on October 28, 2010, at 12:15:49
> > You know that you need one or more strong moodstabilizers on-board asap, correct?
> -------------------
> I'm on 400mg of Lamictal. Unfortunately, all of the other ones have made my mood much worse. I haven't tried Keppra, but I don't have much hope with that one.
> DEPEKOTE - worse
> TRILEPTAL - Years ago. But after a couple of weeks I was in a bad agitated mixed state. I remember an ongoing desire to slash my neck, etc.
> LITHIUM: tried twice. the first time it made me worse. the 2nd time was as an augmenter to Lamictal.
> TOPOMAX: not only did I have no clue what my address was when being asked for it. I wrote down "internal ranting & raving"
> NEURONTIN: bad, bad. Within 2nd day.
>
> Antipsychotics - I am scared to try any more. And if they block some of the dopamine, I'm confused how they help depression...?
> GEODON: Ended up doing an ECT round!
> ABILIFY: 2 trials.
> ZYPREXA: more agitated
> SEROQUEL: restless leg stuff
>
> verapamil - even though it's been dismissed, I still wonder if it is worth trying.
-----------------------I'm sorry. I had no idea. I apologize, Alchemy.
Just a thought; I have a female friend with bipolar disorder that uses Zonegran (zonisamide) with success. The only AED that she uses is Zonegran. I have no idea if it would work for you. I tried it once, and I hated it.
http://www.eisai.com/package_inserts/zonisamide%20NDA%2020789%20Zonegran%20In-Use%20label.pdf
You might consider a trial of Valdoxan. I tried every med that I could think of to stop my ultra rapid cycling. Nothing stopped it until I added Valdoxan.
-- Ron
Posted by alchemy on November 1, 2010, at 15:52:14
In reply to Re: ultra, ultra, and ultra rapid cycling » alchemy, posted by Ron Hill on October 30, 2010, at 17:35:51
> Just a thought; I have a female friend with bipolar disorder that uses Zonegran (zonisamide) with success. The only AED that she uses is Zonegran. I have no idea if it would work for you. I tried it once, and I hated it.
-------
Interesting. How did her doctor decide to try such an unusual approach? Especially for grand mal seizures. And she only has bipolar? What type of bipolar?
I did order the Valdoxan. I like how it works on circadian rhythms. That may (please, please!) help my every few days and/or during the day switches.
But I think these "waves" may be a separate issue. They are occassional, and began with Dexadrine. The benefits of dexadrine outweigh these feelings, I am just worried about the future. I think it could "possibly" be related in a round-about way to seizures. Although there is barely any similarity - just misfirings or something related to the electronic communication. They are hard to explain and they vary in intervals, but they do feel like my electrical impulses are no synchronized/screwy. I have read that post-ictal seizures can cause depression.
Or of course, the dex is causing some nuerochemical imbalance.
If you can tell me anymore about her experience on Zonisamide that would be great.
Posted by Ron Hill on November 1, 2010, at 21:39:11
In reply to Re: ultra, ultra, and ultra rapid cycling » Ron Hill, posted by alchemy on November 1, 2010, at 15:52:14
> > Just a thought; I have a female friend with bipolar disorder that uses Zonegran (zonisamide) with success. The only AED that she uses is Zonegran. I have no idea if it would work for you. I tried it once, and I hated it.
> -------
> Interesting. How did her doctor decide to try such an unusual approach? Especially for grand mal seizures. And she only has bipolar? What type of bipolar?
> I did order the Valdoxan. I like how it works on circadian rhythms. That may (please, please!) help my every few days and/or during the day switches.
> But I think these "waves" may be a separate issue. They are occassional, and began with Dexadrine. The benefits of dexadrine outweigh these feelings, I am just worried about the future. I think it could "possibly" be related in a round-about way to seizures. Although there is barely any similarity - just misfirings or something related to the electronic communication. They are hard to explain and they vary in intervals, but they do feel like my electrical impulses are no synchronized/screwy. I have read that post-ictal seizures can cause depression.
> Or of course, the dex is causing some nuerochemical imbalance.
> If you can tell me anymore about her experience on Zonisamide that would be great.
------------------------
Alchemy,I will try to answer your post in full, but first I have a few questions:
1) How much dex do you take per day?
2) Do you vary your dosage of dex from day to day depending on how you feel?
3) Do you take Dexedrine Spansule sustained-release capsules;
http://us.gsk.com/products/assets/us_dexedrine.pdf ,
or do you take non-controlled release Dexedrine tablets;
http://en.wikipedia.org/wiki/File:Dexamphetamine.jpg ?
4) Do you ever think that the 30 mg/day of Celexa might be contributing to your ultra rapid cycling? I'm not trying to say it does, I'm just asking the person who knows best; You.
5) Do you ever vary the dosage of your Celexa or any of your other meds, not including your benzodiazepine?
Alchemy, write back with your responses, and then let's talk about your most recent post.
Thanks.
-- Ron
Posted by alchemy on November 2, 2010, at 11:02:10
In reply to Re: ultra, ultra, and ultra rapid cycling » alchemy, posted by Ron Hill on November 1, 2010, at 21:39:11
I take the short acting 10mg dex.
I usually vary how much I take. But it's usually 2-3 a day (no more than 4). Sometimes I take less because I have had a hard time sleeping, or take more if I need extra motivation for the day. It doesn't help my mood, just my motivation.
So far, I don't think it has affected my previous cycling patterns, it has just induced this new occassional "wave" sensation that seems to be happening more often. I can't find any patterns or triggers.> 4) Do you ever think that the 30 mg/day of Celexa might be contributing to your ultra rapid cycling?
~ As far as the every few days cycling, I'm sure it would still be there if I didn't take it. One prob is I don't know when it started it has been so long. I didn't make the connection to ongoing independent changes until a few years ago. I have mood data that indicates this has probably been happening since 2002. It very well may have been "kindled" by SSRIs. I have been on & off of them since my teens & I am now 38.
~ As far as the switches during the day- Thankfully, they haven't been as sudden and extreme lately as I guess my body adjusts to getting off of the trial of Pristiq and back on Celexa. But I wonder why that happened? Just because it was a med change? Serotonin upset because of med change? Would it have continued to be that worse if I would have stayed on Pristiq?I take all of my meds (except for dexedrine) at consistent doses in the morning.
I hope this gives you enough info.
Thanks!
Posted by Ron Hill on November 2, 2010, at 13:23:09
In reply to Re: ultra, ultra, and ultra rapid cycling » Ron Hill, posted by alchemy on November 2, 2010, at 11:02:10
Oppps; more questions:
If I understand correctly, you self-identify your bipolar disorder as depression only, with no ups.
Do you ever become hypomanic?
Have you ever been hypomanic in the past?
I know it's difficult to put into words, but can you describe what it feels like when you are in depression?
You've already said that you experience amotivation.
Do you lose your energy?
Do you sleep less?
Do you eat less and lose weight?
Do your shoulders and legs feel heavy?
Do you have more than usual cognitive problems when you are depressed?
Do you find yourself crying easily?
Do you lose self-confidence?
Do you engage in negative self-talk?
Do you ever think about wanting to just die to stop the pain?
You said that you do not become agoraphobic, but instead you go outside to keep from going nuts, right?
Does your depression get worse in the winter; in other words, do you have Seasonal Affective Disorder?
Try to put into words how it feels when Alchemy goes into depression.
As an aside, when it comes to cognitive dysfunction, 400 mg/day of Lamictal will cause a ton of word finding problems for most people. I have never heard of a bipolar patient taking that much Lamictal. Epileptic pt, yes. Bipolar pt, no.
At the risk of asking too many questions, please tell me what it feels like when you cycle out of depression.
Are you completely well after you cycle of of depression?
As best you can, describe how you feel after you cycle out of depression.
As an aside, I have a hunch that Valdoxan will stop your ultra rapid cycling. I hope so. My ultra rapid cycling stopped as soon as I started taking Valdoxan.
There are some start-up side effects that I experienced for the first 4 or 5 days. Here are the side effects that I experienced:
Insomnia and choppy sleep.
Nightmares.
Vertigo (inner ear reset) when turning in bed from my left side over to my right side.
That's it. Ironically, once the side effects are gone, Valdoxan provides EXECELLENT sleep. The excellent sleep might be part of its therapeutic action???
-- Ron
Posted by alchemy on November 5, 2010, at 17:14:01
In reply to Re: ultra, ultra, and ultra rapid cycling » alchemy, posted by Ron Hill on November 2, 2010, at 13:23:09
Thank you so much for being interested & trying to help!
> If I understand correctly, you self-identify your bipolar disorder as depression only, with no ups.
--- Pretty much. The rapid stuff. My doc's opinion is that bipolar II is the CLOSEST dx that I would identifiy with. Part of the bipolar side of things is the agitation/mixed that was fairly constant. Thank god those have really decreased
> Do you ever become hypomanic? > Have you ever been hypomanic in the past?
---- No, but I do occassionally have times were I have a bit more energy & creativity. I wouldn't call it "hypomania" though. It was usually in the evening. And then in the morning I think they were dumb ideas.
I have always had a hard time with getting restless. I am not ADD except for that one problem. If I even have to sit in a class for an hour I feel like I'm going to go crazy.
> I know it's difficult to put into words, but can you describe what it feels like when you are in depression?
---- It depends on the severity & there are different types. I have times that I feel anxious/emptiness. Sometimes I can deal w/ getting out, but if there isn't anything to do it gets worse. More often it I feel that way but I also don't want to. I may feel lonely but I don't feel like calling anyone or doing anything. I go through many times that I am crazy bored, but I have no motivation, and tv may be too annoying.
Sometimes it is just feeling "blah". Sometimes it's "pretty hellish" & my head feels miserable. Not just depession, but noticible "head depression". Often I wonder how I'm going to get through the day. Time moves too slow.
And then there are the mood changes during the day. It is a usually very physical feeling. I had my brother's family in town that helps me not notice my mood as much. But there were a few days that I was just too down & wanting to hide from the world-not good timing. And I couldn't fake it. Luckily this "dip" was only a couple of days.
> You've already said that you experience amotivation.
---- ya, that has been a big problem. That is what the dex usually helps. There are times that I can sleep after taking dex.
> Do you lose your energy?
---- I go through energy/tired cycles. I think the fatigue isn't as bad as I use to be. Often it is hormone related.
> Do you sleep less?
--- Without dex there were times that falling asleep was easier. On some nights I would eventually take ambien. I usually need the regular 8 hrs.
> Do you eat less and lose weight?
--- dex helps of course. the wellbutrin & celexa probably helped a little before that. I still eat a bunch, I have hypoglycemia, but am still thing. Around 15 years ago I had a phase of really controlling how much I ate & bulemia. I am pretty sensitive to what I eat- especially carbs.
> Do your shoulders and legs feel heavy?
---- I have never heard of that question or felt that way. Just muscle aches
> Do you have more than usual cognitive problems when you are depressed?
---- Not necessarily, I think it is more related to no motivation. When I get the "brain fatigue/burnout" I can't handle using my brain/thinking anymore. This sucks for work.
> Do you find yourself crying easily?
----- Nope, even if I feel like crying, I rarely cry. Maybe because it has been so long.
> Do you lose self-confidence?
------ Ya, mostly when my mood goes down & not the opposite. But I do get a lot of positive comments that help. And I can usually put on the fake face if I need to.
> Do you engage in negative self-talk?
------ Sure. The self-talk becomes worse in relation to my mood. My thoughts are generally being pissed off or sad about my head/body funtioning. It's not so much that I don't like myself, it's that I hate living. And of course it didn't turn out to be what I hopoed. There are moments that I can do this or that & get a better career. But then I have to remind myself that it is almost like a handicap. I have been on short-term disability twice.
> Do you ever think about wanting to just die to stop the pain?
---- I haven't had the thoughts as regularly, but I have always wanted to die. I am too scared. Give a button to have never existed and I would have no hesitation to push it. I have gone through many of phases where it is an ongoing thought. As I get older & there isn't much change, I become slightly braver.
> You said that you do not become agoraphobic, but instead you go outside to keep from going nuts, right?
--- Yip, more comments above. But of course there are times that I do not want to deal with dealing with the world/people.
> Does your depression get worse in the winter; in other words, do you have Seasonal Affective Disorder?
--- No.
> As an aside, when it comes to cognitive dysfunction, 400 mg/day of Lamictal will cause a ton of word finding problems for most people. I have never heard of a bipolar patient taking that much Lamictal. Epileptic pt, yes. Bipolar pt, no.
---- I really noticed it the last time I increased my dose. It was very frustrating. I have never heard that it is a different reaction between bipolar & epilepsy. I has faded though, but I don't know if it still has any affect. I have always had a hard time writing & the verbal stuff (better at spatial/analyitical stuff). I also become initially agitated, but that goes away. Maybe the Lamictal is helping with the agitation? I've decided I don't want to increase the Lamictal because of the cognitive effect & I doubt it will really help the depression. I just like the idea of helping more of a stabilizer w/ dexadrine.
> At the risk of asking too many questions, please tell me what it feels like when you cycle out of depression.
-- I may forget if I was even in a terrible state a few days ago. I may feel blah and can be more social, or it is not as had to be social. Hard to describe, but I don't feel like I could even feel like that the rest of my life.
> Are you completely well after you cycle of of depression?
---- Not "well", just improved.
> As an aside, I have a hunch that Valdoxan will stop your ultra rapid cycling. I hope so. My ultra rapid cycling stopped as soon as I started taking Valdoxan.
>
> There are some start-up side effects that I experienced for the first 4 or 5 days. Here are the side effects that I experienced:
>
> Insomnia and choppy sleep.
>
> Nightmares.
>
> Vertigo (inner ear reset) when turning in bed from my left side over to my right side.
>
> That's it. Ironically, once the side effects are gone, Valdoxan provides EXECELLENT sleep. The excellent sleep might be part of its therapeutic action???
Posted by Ron Hill on November 7, 2010, at 16:49:33
In reply to Re: ultra, ultra, and ultra rapid cycling » Ron Hill, posted by alchemy on November 5, 2010, at 17:14:01
Achemy,
I have not forgot you, I'm just swamped with work. I will try my best to reply to you in the next couple of days.
Sorry for the delay, but I will not forget.
-- Ron
------------------------
> Thank you so much for being interested & trying to help!
>
> > If I understand correctly, you self-identify your bipolar disorder as depression only, with no ups.
> --- Pretty much. The rapid stuff. My doc's opinion is that bipolar II is the CLOSEST dx that I would identifiy with. Part of the bipolar side of things is the agitation/mixed that was fairly constant. Thank god those have really decreased
> > Do you ever become hypomanic? > Have you ever been hypomanic in the past?
> ---- No, but I do occassionally have times were I have a bit more energy & creativity. I wouldn't call it "hypomania" though. It was usually in the evening. And then in the morning I think they were dumb ideas.
> I have always had a hard time with getting restless. I am not ADD except for that one problem. If I even have to sit in a class for an hour I feel like I'm going to go crazy.
> > I know it's difficult to put into words, but can you describe what it feels like when you are in depression?
> ---- It depends on the severity & there are different types. I have times that I feel anxious/emptiness. Sometimes I can deal w/ getting out, but if there isn't anything to do it gets worse. More often it I feel that way but I also don't want to. I may feel lonely but I don't feel like calling anyone or doing anything. I go through many times that I am crazy bored, but I have no motivation, and tv may be too annoying.
> Sometimes it is just feeling "blah". Sometimes it's "pretty hellish" & my head feels miserable. Not just depession, but noticible "head depression". Often I wonder how I'm going to get through the day. Time moves too slow.
> And then there are the mood changes during the day. It is a usually very physical feeling. I had my brother's family in town that helps me not notice my mood as much. But there were a few days that I was just too down & wanting to hide from the world-not good timing. And I couldn't fake it. Luckily this "dip" was only a couple of days.
> > You've already said that you experience amotivation.
> ---- ya, that has been a big problem. That is what the dex usually helps. There are times that I can sleep after taking dex.
> > Do you lose your energy?
> ---- I go through energy/tired cycles. I think the fatigue isn't as bad as I use to be. Often it is hormone related.
> > Do you sleep less?
> --- Without dex there were times that falling asleep was easier. On some nights I would eventually take ambien. I usually need the regular 8 hrs.
> > Do you eat less and lose weight?
> --- dex helps of course. the wellbutrin & celexa probably helped a little before that. I still eat a bunch, I have hypoglycemia, but am still thing. Around 15 years ago I had a phase of really controlling how much I ate & bulemia. I am pretty sensitive to what I eat- especially carbs.
> > Do your shoulders and legs feel heavy?
> ---- I have never heard of that question or felt that way. Just muscle aches
> > Do you have more than usual cognitive problems when you are depressed?
> ---- Not necessarily, I think it is more related to no motivation. When I get the "brain fatigue/burnout" I can't handle using my brain/thinking anymore. This sucks for work.
> > Do you find yourself crying easily?
> ----- Nope, even if I feel like crying, I rarely cry. Maybe because it has been so long.
> > Do you lose self-confidence?
> ------ Ya, mostly when my mood goes down & not the opposite. But I do get a lot of positive comments that help. And I can usually put on the fake face if I need to.
> > Do you engage in negative self-talk?
> ------ Sure. The self-talk becomes worse in relation to my mood. My thoughts are generally being pissed off or sad about my head/body funtioning. It's not so much that I don't like myself, it's that I hate living. And of course it didn't turn out to be what I hopoed. There are moments that I can do this or that & get a better career. But then I have to remind myself that it is almost like a handicap. I have been on short-term disability twice.
> > Do you ever think about wanting to just die to stop the pain?
> ---- I haven't had the thoughts as regularly, but I have always wanted to die. I am too scared. Give a button to have never existed and I would have no hesitation to push it. I have gone through many of phases where it is an ongoing thought. As I get older & there isn't much change, I become slightly braver.
> > You said that you do not become agoraphobic, but instead you go outside to keep from going nuts, right?
> --- Yip, more comments above. But of course there are times that I do not want to deal with dealing with the world/people.
> > Does your depression get worse in the winter; in other words, do you have Seasonal Affective Disorder?
> --- No.
> > As an aside, when it comes to cognitive dysfunction, 400 mg/day of Lamictal will cause a ton of word finding problems for most people. I have never heard of a bipolar patient taking that much Lamictal. Epileptic pt, yes. Bipolar pt, no.
> ---- I really noticed it the last time I increased my dose. It was very frustrating. I have never heard that it is a different reaction between bipolar & epilepsy. I has faded though, but I don't know if it still has any affect. I have always had a hard time writing & the verbal stuff (better at spatial/analyitical stuff). I also become initially agitated, but that goes away. Maybe the Lamictal is helping with the agitation? I've decided I don't want to increase the Lamictal because of the cognitive effect & I doubt it will really help the depression. I just like the idea of helping more of a stabilizer w/ dexadrine.
> > At the risk of asking too many questions, please tell me what it feels like when you cycle out of depression.
> -- I may forget if I was even in a terrible state a few days ago. I may feel blah and can be more social, or it is not as had to be social. Hard to describe, but I don't feel like I could even feel like that the rest of my life.
> > Are you completely well after you cycle of of depression?
> ---- Not "well", just improved.
>
> > As an aside, I have a hunch that Valdoxan will stop your ultra rapid cycling. I hope so. My ultra rapid cycling stopped as soon as I started taking Valdoxan.
> >
> > There are some start-up side effects that I experienced for the first 4 or 5 days. Here are the side effects that I experienced:
> >
> > Insomnia and choppy sleep.
> >
> > Nightmares.
> >
> > Vertigo (inner ear reset) when turning in bed from my left side over to my right side.
> >
> > That's it. Ironically, once the side effects are gone, Valdoxan provides EXECELLENT sleep. The excellent sleep might be part of its therapeutic action???
>
>
>
Posted by Ron Hill on April 27, 2012, at 4:24:44
In reply to Re: ultra, ultra, and ultra rapid cycling » Ron Hill, posted by alchemy on November 5, 2010, at 17:14:01
alchemy
I dropped the ball and left you hanging about 18 months ago. I am sorry.
What meds are you currently taking? Have you tried Valdoxan? If yes, is it helping you?
How are you doing mental health wise?
-- Ron
--------------------------------> Thank you so much for being interested & trying to help!
>
> > If I understand correctly, you self-identify your bipolar disorder as depression only, with no ups.
> --- Pretty much. The rapid stuff. My doc's opinion is that bipolar II is the CLOSEST dx that I would identifiy with. Part of the bipolar side of things is the agitation/mixed that was fairly constant. Thank god those have really decreased
> > Do you ever become hypomanic? > Have you ever been hypomanic in the past?
> ---- No, but I do occassionally have times were I have a bit more energy & creativity. I wouldn't call it "hypomania" though. It was usually in the evening. And then in the morning I think they were dumb ideas.
> I have always had a hard time with getting restless. I am not ADD except for that one problem. If I even have to sit in a class for an hour I feel like I'm going to go crazy.
> > I know it's difficult to put into words, but can you describe what it feels like when you are in depression?
> ---- It depends on the severity & there are different types. I have times that I feel anxious/emptiness. Sometimes I can deal w/ getting out, but if there isn't anything to do it gets worse. More often it I feel that way but I also don't want to. I may feel lonely but I don't feel like calling anyone or doing anything. I go through many times that I am crazy bored, but I have no motivation, and tv may be too annoying.
> Sometimes it is just feeling "blah". Sometimes it's "pretty hellish" & my head feels miserable. Not just depession, but noticible "head depression". Often I wonder how I'm going to get through the day. Time moves too slow.
> And then there are the mood changes during the day. It is a usually very physical feeling. I had my brother's family in town that helps me not notice my mood as much. But there were a few days that I was just too down & wanting to hide from the world-not good timing. And I couldn't fake it. Luckily this "dip" was only a couple of days.
> > You've already said that you experience amotivation.
> ---- ya, that has been a big problem. That is what the dex usually helps. There are times that I can sleep after taking dex.
> > Do you lose your energy?
> ---- I go through energy/tired cycles. I think the fatigue isn't as bad as I use to be. Often it is hormone related.
> > Do you sleep less?
> --- Without dex there were times that falling asleep was easier. On some nights I would eventually take ambien. I usually need the regular 8 hrs.
> > Do you eat less and lose weight?
> --- dex helps of course. the wellbutrin & celexa probably helped a little before that. I still eat a bunch, I have hypoglycemia, but am still thing. Around 15 years ago I had a phase of really controlling how much I ate & bulemia. I am pretty sensitive to what I eat- especially carbs.
> > Do your shoulders and legs feel heavy?
> ---- I have never heard of that question or felt that way. Just muscle aches
> > Do you have more than usual cognitive problems when you are depressed?
> ---- Not necessarily, I think it is more related to no motivation. When I get the "brain fatigue/burnout" I can't handle using my brain/thinking anymore. This sucks for work.
> > Do you find yourself crying easily?
> ----- Nope, even if I feel like crying, I rarely cry. Maybe because it has been so long.
> > Do you lose self-confidence?
> ------ Ya, mostly when my mood goes down & not the opposite. But I do get a lot of positive comments that help. And I can usually put on the fake face if I need to.
> > Do you engage in negative self-talk?
> ------ Sure. The self-talk becomes worse in relation to my mood. My thoughts are generally being pissed off or sad about my head/body funtioning. It's not so much that I don't like myself, it's that I hate living. And of course it didn't turn out to be what I hopoed. There are moments that I can do this or that & get a better career. But then I have to remind myself that it is almost like a handicap. I have been on short-term disability twice.
> > Do you ever think about wanting to just die to stop the pain?
> ---- I haven't had the thoughts as regularly, but I have always wanted to die. I am too scared. Give a button to have never existed and I would have no hesitation to push it. I have gone through many of phases where it is an ongoing thought. As I get older & there isn't much change, I become slightly braver.
> > You said that you do not become agoraphobic, but instead you go outside to keep from going nuts, right?
> --- Yip, more comments above. But of course there are times that I do not want to deal with dealing with the world/people.
> > Does your depression get worse in the winter; in other words, do you have Seasonal Affective Disorder?
> --- No.
> > As an aside, when it comes to cognitive dysfunction, 400 mg/day of Lamictal will cause a ton of word finding problems for most people. I have never heard of a bipolar patient taking that much Lamictal. Epileptic pt, yes. Bipolar pt, no.
> ---- I really noticed it the last time I increased my dose. It was very frustrating. I have never heard that it is a different reaction between bipolar & epilepsy. I has faded though, but I don't know if it still has any affect. I have always had a hard time writing & the verbal stuff (better at spatial/analyitical stuff). I also become initially agitated, but that goes away. Maybe the Lamictal is helping with the agitation? I've decided I don't want to increase the Lamictal because of the cognitive effect & I doubt it will really help the depression. I just like the idea of helping more of a stabilizer w/ dexadrine.
> > At the risk of asking too many questions, please tell me what it feels like when you cycle out of depression.
> -- I may forget if I was even in a terrible state a few days ago. I may feel blah and can be more social, or it is not as had to be social. Hard to describe, but I don't feel like I could even feel like that the rest of my life.
> > Are you completely well after you cycle of of depression?
> ---- Not "well", just improved.
>
> > As an aside, I have a hunch that Valdoxan will stop your ultra rapid cycling. I hope so. My ultra rapid cycling stopped as soon as I started taking Valdoxan.
> >
> > There are some start-up side effects that I experienced for the first 4 or 5 days. Here are the side effects that I experienced:
> >
> > Insomnia and choppy sleep.
> >
> > Nightmares.
> >
> > Vertigo (inner ear reset) when turning in bed from my left side over to my right side.
> >
> > That's it. Ironically, once the side effects are gone, Valdoxan provides EXECELLENT sleep. The excellent sleep might be part of its therapeutic action???
>
>
>
Posted by bissie66 on April 21, 2014, at 21:51:21
In reply to Re: ultra, ultra, and ultra rapid cycling » alchemy, posted by Ron Hill on November 1, 2010, at 21:39:11
I have been having ultra ultra ultra cycling. one minute i'm so happy and next minute (i can feel change coming) i'm in tears and angry, then back to happy. i take risperal for depression and bc im bipolar in addition to mood stabilizers. i'm wondering if i should split does of risperal - half in afternoon - bc that's when the rapid cycling starts. this didn't start until i started risperal but i don't want to stop it bc it helps SO MUCH with depression and energy level (unless i'm rapid cycling!)
Posted by alchemy on April 21, 2014, at 22:20:46
In reply to Re: ultra, ultra, and ultra rapid cycling, posted by bissie66 on April 21, 2014, at 21:51:21
> I have been having ultra ultra ultra cycling. one minute i'm so happy and next minute (i can feel change coming) i'm in tears and angry, then back to happy. i take risperal for depression and bc im bipolar in addition to mood stabilizers. i'm wondering if i should split does of risperal - half in afternoon - bc that's when the rapid cycling starts. this didn't start until i started risperal but i don't want to stop it bc it helps SO MUCH with depression and energy level (unless i'm rapid cycling!)
I hate it when something helps one problem but creates another! But it's great that you found something that helps that much. How long have you been on it? I'm not sure if it's long acting, but if it isn't, I would try to see if breaking it up helps.
That's so weird when something that is suppose to help stabilize does the opposite.
What else are you on? (if anything)
Posted by Bissie66 on April 22, 2014, at 9:54:27
In reply to Re: ultra, ultra, and ultra rapid cycling, posted by alchemy on April 21, 2014, at 22:20:46
Yes, it is wicked the way psychopharmacology is so difficult to be specific, you know? I read somewhere Risperdal's fairly short acting so today I'm gonna try splitting dose. If that doesn't work I'll call psychiatrist for suggestions. Maybe cut back dose, maybe increase lithium or lamictal or reduce Wellbutrin. These are the meds i take:
Wellbutrin XR450 mg morning
Risperdal1 mg morning (will try split dose today)
Lithium300 mgnight
Lamictal200 mgnight
Synthroid125 mcgmorning(for hypothyroid/Hashimoto's)
Cytomel5 mcg morning (for hypothyroid/Hashimoto's)
Klonopin1 mg night for sleep
Valium10 mg thru dayas needed (up to 4 per day) for anxiety/agitation (don't usually take that much)
Or Ativan2 tabs thru day - experimenting with it bc other benzos can make me feel depressed - but no difference
Omega 32126 mg1063 mg morning, 1063 at night
N Acetyl-Cysteine2000 mg1000 morning, 1000 night
Folic acid800 mgmorning> > I have been having ultra ultra ultra cycling. one minute i'm so happy and next minute (i can feel change coming) i'm in tears and angry, then back to happy. i take risperal for depression and bc im bipolar in addition to mood stabilizers. i'm wondering if i should split does of risperal - half in afternoon - bc that's when the rapid cycling starts. this didn't start until i started risperal but i don't want to stop it bc it helps SO MUCH with depression and energy level (unless i'm rapid cycling!)
>
> I hate it when something helps one problem but creates another! But it's great that you found something that helps that much. How long have you been on it? I'm not sure if it's long acting, but if it isn't, I would try to see if breaking it up helps.
> That's so weird when something that is suppose to help stabilize does the opposite.
> What else are you on? (if anything)
>
>
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.