Posted by petters on November 8, 2001, at 13:17:09
In reply to Re: Refractary bipolar depression To Scott !!! » petters, posted by SLS on November 8, 2001, at 10:32:27
> > Hi Scott...
>
> Hi Petters.
>
> > I forgott mention, that I also saw an artikel from DR. I Goldberg. He paid attantion to when Lamictal not was sufficient in bipolar depression. He recommend Topomax as an add on strategi. Since I know your only mood stabilizar are Lamictal if I don´t remember wrong.
>
> You remember correctly. Topomax was the first anticonvulsant my doctor mentioned if we are to add another mood stabilizer. I guess he must have heard good things about it from his colleagues at NYU (New York University). I am excited by what you say about the Lamictal + Topomax combination. I am worried about the cognitive side effects, though (slow-thinking, memory).
>
> If you don’t mind my asking, how do you know so much about psychiatry? Your observations and suggestions are very astute and intelligent. I very, VERY much appreciate your contributions.
>
> > By the way: Have you tried Flupenthixol in low dosage.
>
> There are four “typical” neuroleptics that are candidates that I would consider. Flupenthixol is one of them. The other three are molindone, sulpiride, and amisulpride. Molindone is available in the US. Sulpiride and amisulpride are not, but I can get them from England. I currently have enough sulpiride to conduct a trial. A Dr. Levine in New York who specializes in TRD (Treatment Resistant Depression) prefers to use sulpiride. In his words, he says that amisulpride is too much of an antipsychotic.
>
> > Or do you have Etilefrinhydoklorid in U.S? It´s a med for hypotension, but in low dosage it´s benefit for some depressed person, especeliy with astenia, and anergia as I know you sometimes suffer from.
>
> I never heard of this drug. Is it a ACE inhibitor (Angiotensin Converting Enzyme inhibitor)? There is some evidence that captopril (Capoten), an ACE inhibitor, has some antidepressant properties.
>
> > Stay Well...
>
> You too.
>
>
> - ScottHi Scott...
Yes, I have been working as nurse in psychiatry for many years,mostly with affective disorders. I have also have depression since age 17.
Effortil ( Etilefrinhydroklorid) is an alfa- betareceptor activation, as I say I have seen anecdotely reports especely from astenia.
I know you wait for Memantine. I will check when we can get i here in Sweden. I would like to help you with this med, if possible. I know Germany has got it.
I think a am bipolar 2. The diagnosis of bipolar 2 is crucial, we don´t have the diagnosis in my country. What do you think about this sypmtoms...?
P.S Without any meds I have all symptoms below. And with meds with not full remission I have most consentration problem, anhedonia and emotionell numbed.Phobic anxiety, social phobia ( with ssri or Venlafaxine ok with this symptom)
Interpersonal sensitivity
OCD
Nightmare
Somatization
Guilt
Distractibility
Psychomotor reardation. ( Without serotonerg drug, high state of anxiety, and therfore restless)
Worsening in the evening ( when serve melancolic,I had tre episod) serve anxiety at morning. But nowedays worsening in the evening, and carbocrawing.
Self-pity
Mood lability, and daydreaming.
Irritability, distratrtibility, sometimes racing thoughts, this despite the presence of hypersomnia.Any thougts.....
Sincerely
Petters
poster:petters
thread:83508
URL: http://www.dr-bob.org/babble/20011104/msgs/83557.html