Posted by Ritch on May 29, 2003, at 23:39:59
In reply to Re:Q for Mitch » Ritch, posted by Chloe on May 29, 2003, at 19:51:46
>
> > Chloe, it seems that you have gotten a bunch of important insight about your cycling from all of your recent ECT experience. For me it is just like a tribal seasonal songdance of sorts. That makes it predictable-which is helpful-but it makes you feel fatalistic about things and sometimes I discount good news too much. That's weird about your meds-lithium+doxepin+diazepam were the first three meds in different classes that I had been on simultaneously-but that was in the early '80's! Depression-wise the lithium worked better than Depakote, but it was a little mean on my thyroid and I only have 1/3 of a thyroid left. I've been quite wirey (predictably) the last few weeks and my pdoc wanted to add some lithium (but I can't handle it very well). We tried some Zonegran and it made me very irritable with insomnia (yuck), and then tried Keppra and that just made me listless and increased my anxiety/depression (slept better though). I haven't tried Lamictal yet.. I'm thinking about bringing it up in a very formal way at my next appt. though. I think if I follow the titration guidelines (despite being on Depakote), that I will be OK. But before I do that I want to add just a *tiny* bit of Buspar (2.5-5.0mg/day) to my current meds of
> > Depakote 250mg
> > Klonopin .5-.75mg
> > Effexor approx. 4-6mg
> > Fishoil 1-2G EPA
> > I got a very good antianxiety response to Buspar previously-I'm just med sensitive and it made me dysphoric at higher doses (but it causes dysphoria in practically anybody in overdose). Thyroid stuff.... I would like to try that at some point because.... stimulants have been so successful in the past, and I think that adding something that could reduce the cycling and reduce depression/anergia would be a good route to follow.=====take care===Mitch
>
> Hey Mitch,
> Can you give me refresher on Zonegran and Keppra? I don't recall their class or what they are used for.
> And why the resurgence of Lamictal? There seems to be alot of people wanting to try it. What is your reason, if you don't mind me asking? Is Depakote not working so well? Too bad about the lithium, and your thyroid. I am sorry you lost some of your thyroid. I am glad what you have is working!
> I am very happy with lithium as a mood stabilizer. It seems to agree with me. I just wish it helped with the cycling. Nothing touches that. And frankly I am so tired of putting my body through med trials. Way too hard on my little body. So this is it until I can find a better AP for prn use, or I get someone to take my thyroid issues...
> Thanks
> Chloe
>
>Zonegran and Keppra.... Well, they are the newest anticonvulsants that have been approved (for epilepsy). Of course, pdocs are trying them off-label for bipolar in some of their patients. I have heard little that is positive. I definitely got very irritable on the Zonegran-no doubt. Keppra was very tolerable (physically), and I noticed decreased pain, better sleep, less GI disturbance (which I definitely liked!), but it seemed to slowly make me more and more depressed. That's the trouble with many AED's-they can aggravate or cause psychosis and depression. However, Lamictal (another AED), has a track record for helping bipolar depression specifically. Folks with epilepsy like it because they feel more "normal" or "like themselves" (fewer behavioural side effects). Lamictal is in Phase III trials for an FDA indication for bipolar depression. IOW, it's got the empirical science going for it, it is just the potential rash issues that freak people out (including me). It seems like Lamictal by itself may not be a very good antimanic and probably does little for psychotic symptoms (like lithium can). So it often combined with lithium or Depakote. I am interested in Lamictal as a possible means of getting through my bipolar depressions without needing AD's or not needing to increase the dose of the AD I currently take for anxiety(Effexor) to the point where it aggravates cycling. You might look into Abilify. It has some troubles with insomnia, akathisia, and some irritability in some-so I don't know how it would set with you. The nice thing is that it seems to have little dystonia-and I think that is one thing you have a lot of trouble with AP's---Mitch
poster:Ritch
thread:99976
URL: http://www.dr-bob.org/babble/20030525/msgs/230125.html