Posted by Mitch on May 31, 2001, at 2:13:16
In reply to Re: Tired of chronic BP II misery Mitch, posted by loosmrbls on May 30, 2001, at 10:35:29
LM,
I also have had very intense hostility (and hypomanic) responses to *tiny* doses of Effexor, but NO hypomania and less grouchiness with Wellbutrin. I had NO HYPOMANIA and even *less* grouchiness with LOW-dose Adderall (with an obvious anti-cycling effect).
One AD that happened also to help attention and did't get me hypomanic or irritable was nortriptyline (Pamelor)-low-dose, 10-25mg/day. It helped me focus A LOT BETTER at work without making me uptight or bitchy. Just an FYI.Have you ever tried any Neurontin? I find that (thus far) it is the only anti-convulsant med that seems to help my ADHD (at reasonable lower doses). I know that many pdocs are using it for that.
The "dopamine thing" is really odd. It is true that if I took a higher dose of Adderall-that there were times that I got a high autonomic response to a temper situation (challenge).
The "anti-cycling" thing about the Adderall was this: It created a relatively acceptable SAMENESS. I FELT much the same EVERY DAY/ALL DAY, got up at the SAME TIME every day, went to sleep at the SAME TIME everyday-NO SLEEP DISTURBANCES WHILE I WAS ASLEEP. I just woke up rapidly from being asleep, had the same FEELING (which wasn't very remarkable) most of the day, and then went to sleep quickly and slept (7-8hrs consistently), and repeated that pattern-very consistently.
When I am cycling (3-week cycles) all of that GOES TO HELL-sleeping a lot, sleeping a little, grouchy for a few days, depressed intensely for a few days, laughing and acting foolish for a few days, etc. That all came to a halt with the Adderall. (That is my *good* two-cents worth about it).
I also have two seasonal major depressive episodes and I was taking the Adderall during one of them and had NO depressive symptoms. The trouble is that I had discontinued an SSRI+benzo just a few weeks before I started the Adderall and I got real edgy/panicky at times from the stim. I wonder if that was mainly a withdrawal from them that I was experiencing.
I think you are going to do ok. When the Depakote starts really kicking in you are prob. going to settle down a lot, and they will prob. decrease the dosage a little at a time to get to a min. level that keeps you stable.
As far as ECT is concerned-I am completely unafraid of it. I am seriously considering it for my S.A.D. episodes (twice a year-just about the time they start).
You are going to do OK,
Mitch> Mitch, as I mentioned in an earlier post your course and response to drugs seems very similar to mine.
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> Two psychiatrists have told me I probably have ADHD, but I had horrible irritability to both Wellbutrin and high-dose Effexor XR -- both increase dopamine. So they both were very reluctant to start any ADD meds.
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> Right now, they think this is agitation/irritability related to the depression, now that the vegetation is starting to lift. They are giving me PRN Klonopin (.25mg every six hours as needed). It seems to help.
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> I have thought about ritalin/dexedrine, and may try it when not on AD's if things continue to decline.
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> Right now I am on Depakote 1500mg/day, Remeron 30mg/day (5-6 days, irritability was almost immediate), and now the Klonopin as needed every six hours.
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> My plan is to give the Remeron a fair shot (four weeks at least) with the Klonopin as-needed. If I am still irritable or depressed, I will ask for ECT. If they flat-out refuse, then I will refuse any medical therapies that do not include a mood stabilizer and an ADD med.
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> I feel better today. Guess the Klonopin is working on the agitation.
poster:Mitch
thread:64595
URL: http://www.dr-bob.org/babble/20010530/msgs/64837.html