Posted by Shandra on October 29, 2003, at 22:47:04
In reply to Re: Zoloft or Wellbutrin rollercoaster ride sensation? » Shandra, posted by katia on October 29, 2003, at 20:25:25
Bipolar II is what I wound up being diagnosed with shortly after going with the second pdoc (I had seen therapists, MD's, others prior to seeing the first actual pdoc this past year - diagnosed previously w/depression, anxiety and ADD). the second pdoc knew what was wrong in the first session and confirmed his suspicions on the second visit. Remember the song Killing me softly? "He read my life out loud as if I wasn't there!" Talk about being shocked by how accurately someone could describe exactly what I was going through! Oh the euphoria to finally be understood. And then the shock of how hard it is to find the right combination of meds to help! Yikes!!!
I am hopeful that the pdocs out there are starting to become more knowledgable about bipolar disorder, particularly for women, who seem to struggle with the depression side of things more severly and have terribly underdiagnosed Bipolar Type 2 (as in my situation). Reading everything I could get my hands on has made a world of difference for me since my second pdoc gave me a definite diagnosis of Bipolar II.
After quitting my job (and subsequently losing my insurance as a result), I am now off all prescription meds (because it would cost me $500 per month out of pocket for the mood stabilizer, AD, anti-anxiety and stimulent, and I don't yet meet many of the qualifications for the drug companies' free drug programs, since I have had a decent income this year). In the last couple of months, I have been educating myself about OTC supplements and what works for me. When I got my diagnosis and started mood stabilizer, I swore I would never stop taking my prescription meds. However, since my financial situation has done a complete about-face since leaving my job, it has been interesting to change my attitude from "I'll never stop taking these meds" to "I'll never ignore my disorder just because I'm feeling better today".
The prescriptions/combination that worked for me:I was on Depakote at 750 mg per day for mood stabilization, but went off that about 6 weeks ago and now I'm losing my hair!! (Trying to see what other people had experienced with Dep. & hair loss is how I found this site.) Besides the Depakote, I was on 18mg of Concerta, a new stimulent, which I liked much better than Ritalin, if only because it is a once daily med which works for 12 hours straight, no ups and downs whatsoever, and zero side effects. If you need to be on any kind of ADD-type stimulent drug, you might ask your pdoc about it - it's new and therefore expensive w/out insurance, but I found it to be an excellent alternative to Ritalin, if only because I didn't have to remember to take it except once in the morning and also because there is no energy surge associated with it (which can sometimes throw me into a rapid-cycle depression). I was also on clonazapam .5 mg twice a day (or three times if it was a bad day) for anxiety. Add to that the Wellbutrin, and that's four different prescription meds which were pretty much working for me if I was absolutely diligent (I was about 98% compliant, which I was very proud of myself for). Unfortunately, $500 a month is pretty high, and my agitation level would rise unpredictably with the Wellbutrin, and the mood stabilizer didn't handle that agitation when it got more extreme (ie when the anger/aggitation would come on with no warning).
Another interesting side note was that I wound up feeling suicidal more often than before I went on meds, even with the mood stabilizer, which I thought was weird. Then I would have a tendency to ask myself whether this was all just a matter of adjusting to the diagnosis. However, earlier today I read a new study (article published on 9/17/03, so VERY current) showing that Depakote has a much higher risk of suicide and/or hospitalization than Lithium! As I read these new findings today, it clicked - I have actually had almost no suicidal feelings/thoughts since going off Depakote!! I am not someone who would attempt suicide (I don't fit the profile at all), but that didn't stop me FEELING like it! I have no idea how widespread this phenomenon is, but I actually thought my moods were better on that combination of meds, even though at the same time I was having an awful lot of suicidal thoughts! Weird! Whether I would attempt suicide or not, having those thoughts popping up when you're feeling crappy is just miserable in and of itself! Guess all I'm saying here is that I know my first several months after the bipolar diagnosis were very difficult in terms of sorting out 'how much of this is meds' and 'how much of this is the disorder' and 'how much of this will I settle into/figure out as I discover new coping mechanisms'... In the first several months of the diagnosis, I felt I really second-guessed absolutely everything I felt or thought. That in itself is pretty traumatic! So if you (or others reading this) find yourself feeling suicidal or thinking about death while taking Depakote, given the new study pointing to higher risk on that drug than previously known, definitely check into it further and talk to your pdoc. You can find info on the web about this new study via Google search for "Depakote suicide 9/17/2003".
I would **never** recommend to anyone else that they go off meds without talking with their pdoc about their concerns etc and seeing if they can come up with a solution. However, in my own situation, I felt that I wanted to try a non-prescription route and see how it worked for me. The only problem I seem to be having right now is this very irritating hair loss, which I believe is supposed to subside within the next couple of weeks (as the Depakote completely leaves my system, 6-8 wks after stopping completely - and note, I tapered off the Depakote very slowly).
I may go back to prescription meds at some point, particularly if I start suffering more with my bipolar 2 than I am currently with my present OTC regime (I keep a very close watch on my moods now to make sure I'm always doing ok, not feeling 'too good' etc). But for the moment, with careful buying and reading everything I can get my hands on, I have found a combination of OTC supplements that seems to be giving me at least as good, and in many ways better, results than the Depakote / Wellbutrin / Concerta / Ritalin / Clonazapam combination I had worked out with my very wonderful pdoc.Currently, to manage my bipolar II disorder and its related depression, anxiety, and serious lack of energy, I am taking the following:
*** One-a-day plus iron multivitamin/mineral supp. <<one daily>>
*** St. John's Wort complex: 300mg w/vit's B1, B2, B3, B5, B6, & Ginsing (100mg) <<2 tablets daily>>
*** 5-HTP 50 mg <<two tablets, twice daily for a total of 200 mg per day>>
*** One-a-day Memory & Concentration supplement: contains Ginsing 60 mg, Choline 60 mg, B6 and B12 <<one tablet twice daily>>
*** Fish oil concentrate w/omega 3 fatty acids: 850 mg fish oil concentrate, EPA 240 mg, DHA 200 mg <<One tablet twice per day>>
*** Chewable vitamin C: 500 mg <<I chew two tablets three times per day for a total of 3000 mg per day>>If I have trouble sleeping, which I do only occasionally now, I can take one OTC Valerian Root capsule, and I am able to sleep soundly without bad dreams or grogginess (years ago I would use Melatonin to help me sleep but soon found it gave me bad dreams). When I was taking my prescription meds, I would take Clonazapam right before bed and that did just about the same for me, just maybe about 15 minutes faster.
Katia - I hope your meds & pdoc are working great for you and that this posting will fall under the "I didn't need to know all that" category. However, I know that when I was first diagnosed, I got the latest books on the subject that Barnes & Noble had to offer (ha!) and though current, they were naturally very cautious in their recommendations. These resources, as well as so much I read on the internet, did acknowledge that there is much research being done to find alternatives to prescription meds; however, they were a bit short on specifics in terms of what supplements might work well together. I also found a couple of sites that offer their proprietary supplements, but they were too short on specifics for my own comfort level, in addition to which one in particular is currently doing a trial and their trial participation rules seemed too constricting for me... I'm fairly nervous about meds, so if I was going to go out on a limb and try something on my own, at least I wanted to know exactly what I was putting into my system and what the rationale behind it was. My piecemeal approach allowed me to research, add a single supplement, monitor its effects, and make adjustments.
Perhaps these supplements that are currently working for me wouldn't work for a lot of people, but perhaps there are some folks out there who would like to know what is working for me to help with my Bipolar 2, which includes severe depression, suicidal thoughts (but not attempts), anxiety, and rapid cycling. [Incidently, PMS seems to be a non-issue; I still have my standard chocolate cravings and somewhat increased libido, and this is no different for me now than it has ever been.]
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-- My current OTC regime: What does what: (1) For my depression, which was very severe, the 'magic' combination is the 5-HTP plus St. John's Wort. I recently read a study confirming that one without the other doesn't do the trick - put them together and there are impressive results. (2) The Ginko w/vit b's gives me a milder benefit than the Concerta, but very similar in that I don't feel fuzzy-headed and I have energy for the day. (3) The omega-3 fatty acid supplement helps with anxiety and helps combat depression (didn't do much at all by itself). (4) The vitamin C helps with anxiety and generally helps me feel more balanced.
poster:Shandra
thread:90018
URL: http://www.dr-bob.org/babble/20031025/msgs/274856.html