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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by linkadge on July 31, 2005, at 21:01:57
In reply to Re: Dysphoric Mania, posted by rjlockhart98 on July 30, 2005, at 23:40:38
I don't know if you can get this supplement where you are, but folic acid can prevent some of the depression from anticonvulsants. It can also aid in prozac's function.
I would add 1mg of folic acid, it's cheap, at least here in canada.
Linkadge
Posted by med_empowered on July 31, 2005, at 21:01:57
In reply to Re: A small idea, posted by linkadge on July 31, 2005, at 1:11:31
hey! I think the folic acid idea is very good...its cheap, its good for your overall health, and it might make your meds work better. Another thought: sometimes benzos (especially at upper-end doses) can cause agitation/irritability, occasionally to the point of inducing a rage reaction and/or psychosis. Xanax is the biggest offender of all the benzos in terms of causing angry, aggressive reactions; in my experience, though, higher doses of Klonopin can make me really irritable and just generally "down"--oversedated and angry. Dysphoric mania is a kind of understudied, complex concept...I had an episode when I was 17 that a shrink described as either being "dysphoric mania"...another one used the term "mixed episode," which is apparently an off-shoot of the old-school term "agitated depression". Anyway, basically I didnt sleep very much, and over the course of 2 weeks I slept progressively less and less, and became increasingly anxious to the point I wasn't leaving my room. Then, I started having hallucinations--minor auditory ones at first, but later it developed into full blown psychosis, complete with pretty well developed auditory hallucinations and delusions with a hefty dose of paranoia thrown in for good measure. It didn't stop until I finally sedated myself into a long, deep slumber...after that, I took some anxiolytics, antidepressants, and sleeping pills for a little while; the overall "calming" effect dampened the psychosis and I returned to normal w/o any lithium or neuroleptics. SO...that's apparently a pretty good example of dysphoric mania or a mixed episode (for some reason, psychosis is unusually likely to occur in mixed episodes). You might have some sort of lower-level mixed episode--maybe depression with hypomanic features and agitation--but I'm kind of inclined to think you're dealing with something that is either caused by or worsened by your med cocktail. Prozac is known for causing hypomania, anger, agitation, and anxiety; higher-dose Klonopin, on the other hand, can induce depression and the oh-so-fun "paradoxical reactions" of rage, agitation, irritability, etc. in susceptible individuals and/or when used at unusually high doses. The zyprexa...2.5mgs may help you in some respects, but the dose is a bit low to have any full-fledged mood-stabilizing or antipsychotic efficacy. Plus...you could be having some low-level neuroleptic side effects (minor sedation, sub-syndromal akathisia or neuroleptic induced dysphoria, etc.) that are exacerbating your pre-existing condition and any problems you're having with other meds. This is just a theory though. Good luck!
Posted by rjlockhart98 on July 31, 2005, at 21:01:57
In reply to Re: A small idea, posted by med_empowered on July 31, 2005, at 3:49:12
I take Vitamen B-12, niacin, B-6, and other multivitemen supplements. Here in the US. I live in Dallas, Texas.
I do agree with folic acid, but sometimes high doses are needed. I do recognize that i do have energy, but sometimes the mood will still be egdy.
Depressiogenic Clonazepam needs to go in the trash, toilet.
Diazepam is another benzo i havent taken but i have haerd numerous reports it causes depression too. Why the hell was it prescribed in the 70's and 80's for depression!
Well maybe benzo arnt for me. Antipsychotics maybe alot better..... make my brain "shut the hell up"
jk
I may start a stimulant (Dextrostat) soon, low dose 10mg. I may go back to Ativan, because that nerve crisis i went through is ending, ativan wasnt helping during that time. But now it may be fine, doesnt cause depression, i dont know.
thanks guys for posting
matt
Posted by Phillipa on July 31, 2005, at 21:01:57
In reply to Re: A small idea, posted by rjlockhart98 on July 31, 2005, at 14:46:03
Matt, I've forwarded your picture to a few others since you said you wanted to post it on Social. Let me know if this is okay. You sound soooo much better. Fondly, Phillipa
Posted by Nickengland on August 1, 2005, at 13:58:54
In reply to Re: A small idea, posted by linkadge on July 31, 2005, at 1:11:31
Hi Linkadge,
Interesting what you say about Folic acid preventing depression from anticonvulsants...
I wonder whether it would be a wise idea for someone with bipolar to take as much as 1mg of folic acid?
Folacin (folic acid) decreases the anticonvulsant action of Phenytoin (Dilantin) Also, high doses of folic acid for extended periods of time are not recommened for anyone with a medical history of convulsive disorders...seeing as people with bipolar take anticonvulsives this makes me wonder whether or not it would be wise to take as much as 1mg of folic acid to prevent depression?
I got the above information from a book i've been reading called the Vitamin Bible by Earl Mindell
Kind regards
Nick
Posted by Meri-Tuuli on August 1, 2005, at 16:54:48
In reply to Re: A small idea » linkadge, posted by Nickengland on August 1, 2005, at 13:58:54
Another good book to try is "Patrick Holford's New Optimum Nutrition Bible" by Patrick Holford. Also by him: "optimum nutrition for the mind"
They are pretty good for general health stuff, although he thinks that mental illness can be cured through adequate nutrition - nice idea in theory!
He sounds abit zany, but the books are actually pretty gounded and quite scientific. For instance, he was one of the first reseachers to discover the link between lead in petrol (car gas) and childhood er, I forget!
I'm trying to use the double quotes feature - although I might have got it wrong! Plus I don't know if these books are published in the US....
Meri-Tuuli
Posted by Nickengland on August 1, 2005, at 17:01:19
In reply to Re: A small idea, posted by Meri-Tuuli on August 1, 2005, at 16:54:48
Thanks for posting that Meri-Tuuli :-)
I always like to keep an open mind to alternative idea for treating mental illness....I'm using both prescription drugs and alternatives at the moment and having pretty good results.
Kind regards
Nick
Ps - check your siberian ginseng post lol funnily enough just before I saw this one I finnished replying to that one!
Posted by Meri-Tuuli on August 1, 2005, at 17:23:46
In reply to Re: A small idea » Meri-Tuuli, posted by Nickengland on August 1, 2005, at 17:01:19
Just checked the ginseng one (and replied), and now I read the above post! :o)
Posted by Declan on August 1, 2005, at 21:01:33
In reply to Re: A small idea » linkadge, posted by Nickengland on August 1, 2005, at 13:58:54
Hi Nick
Does it work the other way too? That phenytoin depletes folic acid? Or is it something else?
Declan
Posted by Nickengland on August 6, 2005, at 6:04:55
In reply to Phenytoin and Folic Acid, posted by Declan on August 1, 2005, at 21:01:33
Hello Declan,
I don't think it works the other way round, although I can't say i'm 100% sure and it has no mention of it in the book.
"folic acid
Folic acid has been shown to interfere with phenytoin when consumed in higher than recommended doses. Let your doctor know you are taking folic acid, and never exceed recommended doses."This is from
http://www.wholehealthmd.com/refshelf/drugs_interact/1,1748,501,00.htmlThe usual recommended dosage is usually supplied in 400 mcg i think.
In the book it says strengths of 1mg (1000mcg) are avaiable by presciption only.
Also says...."If you are taking Dilantin or take oestrogens, sulphonamides, phenobarbital, or aspirin, I suggest increasing folic acid." (doesn't say what dosage to increase, but I guess you could double a 400 supplement)
Finally, it does warn "I've found that many people taking 1 to 5mg daily, for a short period of time, have reserved serveral types of skin discolouration. If this is a problem for you, its worth checking out a nutritionally orientated doctor about the possibility"
Kind regards
Nick
Posted by linkadge on August 12, 2005, at 15:35:27
In reply to Re: A small idea » Nickengland, posted by Meri-Tuuli on August 1, 2005, at 17:23:46
I think I read somewhere that folic acid revereses the effects of anticonvulsants that act upon the sodium channels, but not other anticonvulsants. Dilantin has effects on the sodium channels.
Valproate has this but direct actions on gaba too.
Folic acid did not lessen the anti-anxiety effects of benzo's for me, but seemed to lessen depression and cognative problems.
The big thing with folic acid is that it is a strong regulator of neurogenesis. So if the drugs work by creating new connections, folic acid may greatly facilitate this effect.Linkadge
Posted by Nickengland on August 12, 2005, at 17:09:11
In reply to Re: A small idea, posted by linkadge on August 12, 2005, at 15:35:27
Hi linkadge,
Any thoughts if Folic acid would work well with Topamax?
Kind regards
Nick
Ps I saw your picture of the selection of supplements you take!....I was curious what do you take?
Posted by linkadge on August 14, 2005, at 18:11:23
In reply to Re: A small idea » linkadge, posted by Nickengland on August 12, 2005, at 17:09:11
My mainstay for alternative treatemsn is folic acid, omega 3, and some magnesium. (although, as you can see, I've tried a lot)
There are some other good sups that I will take from time to time, but not on a daily basis.
Folic acid with topomax seems ok. Topomax has an antiglutamatergic effect. Folic acid is necessary for glutamate synthesis. It may help cognative effects of the drug.
Start with maybe 400mcg and see how your mood go.
The only reason I say, is that when I was on depakote, taking the folic acid was enought to reduce depression caused by the drug.
It was recomened by the doctor who prescribed the depakote.
Linkadge
Posted by Nickengland on August 15, 2005, at 5:29:55
In reply to Re: A small idea, posted by linkadge on August 14, 2005, at 18:11:23
Hi Linkadge,
I use the omega 3 too, I must say I think the stuff has greatly improved my mood/concentration.
I think I'll try the magnesium again too. I previously baught a very cheap brand of 300mg Magnesium Oxide tablets. (really cheap quality) Needless to say I didn't really feel much from it, but i've read and heard many good things about it, so i'm going to try it again, with this time a better quality brand.
What form of magnesium do you take?...is there a difference with like, oxide compared to citrate?
Although things are not too bad in the cognitive department with me and the Topamax, there is still some parts of my day where there is some residual symtoms that i'm working on clearing up with supplements....I like what you say about the folic acid connection - I'll try 400mcg and see how it goes...thanks for the information on that :-)
Kind regards
Nick
Posted by linkadge on August 15, 2005, at 17:38:24
In reply to Re: A small idea » linkadge, posted by Nickengland on August 15, 2005, at 5:29:55
I take a Jamieson brand that is a mixture of a bunch of different forms. I don't know if Jamieson is available in the U.S.
Linkadge
Posted by Nickengland on August 16, 2005, at 12:30:29
In reply to Re: A small idea, posted by linkadge on August 15, 2005, at 17:38:24
Hi Linkadge,
I ended up buying Magnesium in its citrate form...so far so good. The effects appear to be quite calming and soothing.
I've not heard of the Jamieson brand ~ I'm the UK though (England)
Kind regards
Nick
Posted by linkadge on August 23, 2005, at 15:23:03
In reply to Re: A small idea » linkadge, posted by Nickengland on August 16, 2005, at 12:30:29
Somebody told me (don't know if its true) that you can buy epsom salts, and bath in them, and you will absorb it through your skin untill you're saturated.
Linkadge
This is the end of the thread.
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