Posted by BarbaraCat on August 21, 2003, at 11:34:12
In reply to Re: Paradoxicals, posted by fluffy on August 21, 2003, at 10:53:05
Hi Katy,
I was just about to fire off a post asking how you've been! The Bobbles, love it. It will become part of my psych lexicon. I'm not sure if I have found the right mix of meds, but probably better than it's ever been. If you don't count my 20 year disastrous history with mainly serotonin type drugs (Trazodone, Prozac, Paxil, primarily Zoloft, Effexor) for what was thought to be major depressive disorder, the progress went more rapidly once I dx'd myself as bipolar. Reading the posts on this board made me question the violent nature of my depressions and my cyclic bouts of overboard enthusiasms and crash and burn as more bipolar in nature.I've never been on Depakote, only Lithium, and this is what has made the most difference for me in controlling the fractured and frightening nature of my mixed states condition. Mixed states psychotic horrors are no more since lithium although I still get bad depression, but more of the typical variety, bad mood, cynical, lethargic, sludgy, everything sucks brand. So we added lamictal to control that end of it and provide some extra energy. 125mg is about the top end for me because I develop a bad itch beyond that. At 150mg I was also feeling a mg seems to be holding, but I have little faith that this will last indefinitely.
The biggest blip in this was a few months after my Mom died in December and all the unrelenting stress it caused. I went into a very bad place, which is understandable, but for me it started spinning off into panic attacks, reactivation of PTSD symptoms, no sleep, despair - a really really bad mixed state that I knew I needed extra help for. My pdoc put me on nortriptyline and within 2 weeks it worked like a charm and brought me out of it long enough to establish equilibrium again by allowing me to get an exercise regime in place. I stopped nortrip 6 weeks ago because of dry mouth and weight gain. I had a few very bad weeks not too long ago which could have been the nortrip rebound or any number of other stressors. Went from 75mg lamictal to 125mg which made a big difference.
This 600mg lithium and 125mg lamictal combo seems to be the most successful for me so far. I've also recently stopped all sleep meds because, with my fibromyalgia, I need the deep stage IV sleep which sleepers inhibit. I'm also taking thyoid meds for long-term hypothyroid condition which lithium unfortunately aggravates (the ONLY complaint I have with it).
The most important ingredient for me is getting enough and the right kind of exercise, 8 hours of sleep before 11pm, very little alcohol, and doing whatever I can possibly do to limit stress like meditate, praying, healthy breathing, hanging out with inspiring teachers and books, mainly lifestyle type things. But I cannot accomplish these healthy endeavors without the support of meds, at least not yet cause I don't know how. Everything is too hard and confusing and pointless when I'm in the grip of disordered chemistry. So, here's the breakdown:
Lithium 600mg
Lamictal 125mg
thyroid 135mcg
Natural progesterone and estrogen (you also might want to check your hormone levels at any age)
Occassional valium taken with 900mg neurontin (benzos work paradoxically without neurontin - go figure).Once I addressed the mixed states and got the lithium mix it took about 2 months to stabilize. Sometimes I go off my feed and don't know why, I'll just feel scared, anxious, hopeless, weird and wired. I'm learning to not freak out thinking it means something more than I'm just having a downturn in my biorhythms. Usually it has alot to do with worry about money and survival issues which are my stress buttons.
poster:BarbaraCat
thread:9730
URL: http://www.dr-bob.org/babble/20030818/msgs/252756.html