Posted by Ritch on April 15, 2002, at 23:37:20
In reply to Help,Li vs. Zyprexa vs Lamictal for manic symptoms, posted by JohnX2 on April 15, 2002, at 20:16:30
>
> I was wondering how lithium stacks up against Zyprexa and Lamictal for particular (hypo)manic symptoms.
>
> particularly (more mild symptoms):
>
> - psychomotor agitation
> - anxiety
> - anger
> - racing thoughts
>
> more severe symptoms (fleeting):
> - paranoia (feelings of conspiracies, etc)
> - derealization/depersonalization/detachment
> - grandiose thought patterns
> - bad insomnia
> - intense rage
> - violent mood swings
>
>
> I like to just take zyprexa with my Lamictal/Topamax/Serzone since Zyprexa fixes the lingering problems quite nicely and closes the book. But I got the TD (dystonia) in my hand (a clenching) and restless legs so I try to avoid zyprexa, despite how wonderful it is. BTW, the residual TD symptoms from prior high dose Zyprexa administration have all but disappeared.
>
> I'm in the process of getting some lab testing done in preperation for Lithium trial, so i was wondering what I may expect.
>
> One thing I think is happening is that the Topamax is the culprit in these wild manic swings, as lowering the dose has decreased the symptoms substantially. I was thinking maybe I could dump or lower topamax, raise Serzone (because either med is to treat myofacial pain and depression, and I *don't* think Serzone of the 2 makes me (hypo)manic), and possibly bump Lamictal dose up.
>
> Previously bumping Lamictal above 150 mg would make the myofacial pain worse (is Lamictal a SRI at higher doses, SRI activity this seems to correlate to my pain)? But maybe with the strong Serzone (blocks bad serotonin receptors), then I can tolerate stronger Lamital (knock out the bad cycling).
>
> I think the stronger dose of Serzone has some of the beneficial anti-serotonin 5-ht2 receptor qualities that the additive Zyprexa was giving me.
>
> As you can see I am grasping to avoid Li. I don't know why???, Maybe I just don't think I can deal with side effects. Pooped out from medicine trials. Are the LI side effects really that bad? The PDR scares the shit out of me.
>
> These bad (hypo)manic symptoms are out of line for me and I really think they are Topamax related.
>
> Sorry for the ramble.
>
> Thanks for any input.
> John
Hi there RipVanWinkle! I was fixin' to post something to you about whether you had already started the lithium-given your quietness lately. I am glad you are as sparky as ever.Lithium is good and fairly reliable for the things you listed:
> - psychomotor agitation
> - anxiety
> - anger
> - racing thoughtsYou mentioned some more serious thingies:
> more severe symptoms (fleeting):
> - paranoia (feelings of conspiracies, etc)
> - derealization/depersonalization/detachment
> - grandiose thought patterns
> - bad insomnia
> - intense rage
> - violent mood swingsI found it to be a fairly decent anti-psychotic for paranoia and fairly decent for sleep, however I think the remainder of things on the "fleeting" list respond much better to Depakote-primarily the rages and rapid mood flips. Also, derealization/depersonalization tend to be worse with GABA meds (IMO). Perhaps a *combo* of Topamax (which affects GABA) at a lower dose, combined with a low dose of lithium, AND Lamictal at your "sweet spot" of 150mg would be the trick. Forget the Zyprexa altogether.
Go for the Li trial,
what the heck.Mitch
poster:Ritch
thread:103174
URL: http://www.dr-bob.org/babble/20020408/msgs/103199.html