Posted by Mark H. on February 12, 2002, at 17:20:05
In reply to Re: Is this normal...? » Mark H. , posted by Mr. Scott on February 11, 2002, at 21:34:31
Scott,
Yes -- good memory! -- and I am solidly BP II, although my depression is atypical (I sleep all the time and eat like a hungry wolf). So I need strong stimulants to stay awake during the day (methylphenidate or dexedrine), and a beta blocker to deal with my over-production of adrenaline (my body's way of fighting the sleepiness and fogginess).
Also, mood stabilizers make my depression worse. They sometimes helped for a few days, but then pushed me lower into despair.
The clonzepam is mostly for periodic limb movement syndrome, which is polite talk for thrashing about rhythmically for several hours a night, especially when I am particularly tired.
I emphatically disagree with the standard wisdom that everyone with any form of bipolar disorder should be on mood stabilizers. While this is (perhaps) true for most type one's and typicals, it simply doesn't work for some of us with atypical, refractive BP2.
I'm going to try to paste in the list I made recently for my psychiatrist. Only you would appreciate this!
Antidepressants and adjunctive medications tried, 1993 – 2002
Prozac 8/93 Odd side effects; ineffective for depression
Zoloft 9/93 Dulling, ineffective at any dose
Paxil 2/94 Nothing
Desipramine 8/94 Much worse than nothing
Cytomel 9/94 - present Helps energy level; less sleepy
Effexor 9/94 - 10/95 Effective, but at ever-higher doses
Depakote 1/96 Ineffective
Wellbutrin 2/96 Short-term memory impaired; ineffective
Lithium 3/96 & 2/97 & 4/97 Initial improvement, then worse
Nardil 4/96 Felt worse
Serzone 7/96 Mild side effects, ineffective
Ritalin 8/96 Helps with tiredness
Asendin 8/96 Initial improvement, then worse
Xanax 10/96-99 Useful for occasional anxiety
Ambien 10/96-99 Useful for occasional insomnia
Neurontin 12/96 Less anxious, but ineffective for depression
Maprotiline 12/96 Jumbled thoughts, physical weakness
Clonidine 1/97 Helped with sleep and excess adrenaline; but
caused cold hands & irregular heartbeat.
Paxil 1/97 Add-in SSRI; felt impaired.
Nortriptyline 2/97 Got worse
Trazodone 3/97 Got worse
Ultram 3/97 Used adjunctively – helps only when already feeling somewhat better
Remeron 3/97 Agitated; irritable; nauseous
Effexor 5/97- present 75 mg/day not helping much
Pindolol 5/97-present Beta-blocker; helps w/adrenalin
Propulsid 5/97 For nausea
Ritalin 6/97- present Works effectively in combination
with Effexor, Cytomel and Pindolol.
Clonazepam 1/99 - present Helps improve rest and helps with Periodic Limb Movement Disorder.
Viagra 10/98 - present Helps with antidepressant-induced ED
Zyprexa 5/00 - present As needed to “re-set” or deal w/agitated, mixed hypomanic depression
Diazepam As needed
Provigil 7/01 – 12/01 Effective, yet couldn’t get anything done!Current regimen, 1 February 2002:
Cytomel 25 mcg/morning
Ritalin 20-30 mg/day OR
Dexidrine 10 to 15 mg/day
Pindolol 2.5 mg/morning/2.5 mg/evening
Effexor 150 mg/once a day (after breakfast)
Clonazepam .25 mg/every evening; occasionally .5 mgThe combination of Cytomel-Effexor-Ritalin-Pindolol has worked for me since June 21, 1997. I still experience my cyclic ups and downs, but they are much more manageable. I weighed 143 pounds (at 6'3") from the age of 19 until the age of 48. After 4-1/2 years on this regimen, I now weigh 175, and if I didn't have the metabolism of a hummingbird, I'd weigh 350 pounds!
When I started the *combination* there was nothing subtle about the change. It was as though a heavy, thick, black curtain lifted after four years of steadily worsening depression. Once it started working, *then* I could benefit from attending therapy again. Before that, I was completely adrift.
Hang in there!
With warm regards,
Mark H.
poster:Mark H.
thread:93801
URL: http://www.dr-bob.org/babble/20020208/msgs/93903.html