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Re: Medication experiences for hypomania/bi-polar II » cybercafe

Posted by Ritch on September 14, 2002, at 10:13:30

In reply to Re: Medication experiences for hypomania/bi-polar II, posted by cybercafe on September 14, 2002, at 1:30:37

> > Cyber, is this aripiprazole the "goldilocks" antipsychotic? Just wondering. I know what you
>
> Yeah.. I still don't know how safe it is to take a drug as soon as it hits the market -- would want to know more about past med catastrophies, and how to avoid them :)


Uh, same here. AP's don't suit me well, my bipolar is mild-moderate and I've never gotten completely manic. However, with the right dose of certain AD's I could probably bring that about, but don't even want to go there...

>
> >mean about feeling "warm and fuzzy" and NOT having a direct circuit to a bunch of loud, intrusive, thought loops. Gabapentin does seem
>
> have you found anything that works for slowing down thoughts but not depressing you?
> i don't know if i should be taking a mood stabilizer for a mixed state, or an anxiolytic for anxiety/OCD!

That's a tough one. The strategy that has worked the best for me is to take a low-dose of whatever works for hypomania, and take an even *lower* dose of AD, etc. to prevent drug-induced hypomania/racing thoughts. That's my biggest trouble-a *need* for a serotonergic AD, but keeping that delicate balance between the AD and the antimanic agent.

>
> but then the GABA agents ... tiagabine/gabitril, vigabatrin/sabril, work on anxiety and mixed states ??? how many times do these have to be taken a day?

Gabitril usually needs to be taken twice daily-I have heard of people taking it only at bedtime and finding it helpful. My current pdoc says that Gabitril dosage for anxiety runs from 2mg-8mg/day (a single 2mg tab to 4mg BID). I never tried keeping it low-I was being encouraged by a neurologist to jack it way up. Got to 24mg/day and was so zonked I couldn't function, so it was given up cold turkey. Well.. there was certainly no hypomania, but I couldn't think either. It did have a mood elevating effect at lower doses. Never tried vigabatrin. I might consider at some point Gabitril 2-4mg bedtime only (as an add-on to Depakote), or 15mg Topamax bedtime only (also as an addon to Depakote).

>
> >to convert the *icky energy* in a mixed state and make it a bubbly positive type of energy. I just can't stand needing to take something three, four, five times a day... If you don't mind that sort of thing Depakote+gabapentin works pretty good.
>
> what other option have you come across?
>
> does lamictal do anything to calm you ?
>


Never tried Lamictal. I get skin reactions from various meds, and I don't entertain the idea of a rash from that one. I've heard that Depakote+low-dose Lamictal is pretty effective though. IF you can stand the nausea from Trileptal, I found that one had a distinct antidepressant effect, with increased libido and enhanced attentiveness, but I was always fixin' to hurl!

Mitch


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URL: http://www.dr-bob.org/babble/20020914/msgs/119834.html