Posted by Ron Hill on December 9, 2003, at 13:55:27
In reply to Re: The Joys of Being Bipolar » Ron Hill, posted by SLS on December 9, 2003, at 9:15:24
Hey Scott,
> My doctor wants me to try Aricept (donepezil) next.
Aricept is used in the treatment of Alzheimer’s, no?
> I have a somewhat radical idea that involves the pulsing of TCA on top of MAOI, allowing for an exaggerated TCA-discontinuation rebound improvement. I wish I didn't have to go to such lengths, though.
What does your pdoc think of your idea? Could it cause serotonin syndrome?
> What was your reaction to Lamictal?
Yeah I hear ya. The problem is that I developed a severe rash on Lamictal when I tried it years ago (Depakote also causes rash problems for me). However, there is a small caveat regarding my prior Lamictal trial.
Back in 1996 I was having trouble focusing on my work so I made an appointment with a pdoc. I knew virtually nothing about mental disorders and even less about p-meds. Looking back now I suspect that my distractibility at work was caused by a combination of hypoglycemia and mild BP II hypomania.
My original pdoc initially diagnosed me as ADHD and gave me Ritalin which was absolutely incredible (almost euphoric) until it started making me VERY moody after a couple months. So I went back to the pdoc and told him that although I loved the initial focusing effect that I experienced with Ritalin, I needed to take myself off of it due to the moodiness. In response to my concerns, he convinced me to continue the Ritalin and add Paxil. Big mistake!! The Paxil/Ritalin combo pushed me into a full blown drug induced mania which began to screw up every segment of my life. But, the mania caused me to think that life was great.
This mania went on for several months and then I started rapid cycling. At that point my pdoc changed my dx to ADHD with comorbid BP II and he added Lamictal to the Ritalin and Paxil. He started me out at 200 mg/day and he increased it to 300 mg/day a week later. I liked how Lamictal felt in my brain but I developed severe rashes over a large portion of my body. Not SJS but a bad rash none-the-less.
I bring all this up only to say that there is a possibility that the Lamictal rash might have been avoided if the pdoc had implemented a start low and go slow approach in the dosing. Therefore, I sometimes toy with the idea of trying Lamictal as an add-on to my Lithobid starting at about 5 mg/day and slowly titrating up trying to avoid the rash. However, my current pdoc (a good one) is of the opinion that Lamictal will cause a rash even if I go low and slow. But, I’m sure he would let me try it if I asked him to do so.
> No more TMG?
TMG is in the “small pocket-full of vitamins and minerals”. I don’t take it everyday, however.
> Where can I find more information on L-theonine? I'd love to try it.Here you go: http://www.dr-bob.org/babble/alter/20031104/msgs/281539.html
> Lamictal is not a good anti manic agent per se, but is supposed to help stabilize rapid cyclicity. Lithium is a good antimanic agent, but is not usually of any value to prevent or mitigate depressive episodes, despite its occasional us as an augmentor of antidepressants. A combination of the two (Lamictal + lithium) has been shown to increase the time before relapse of both manic and depressive phases of bipolar disorder. Maybe I can dig up some of the material I came across that describes this observation.
Yeah I hear ya, Scott. As I indicated above, I periodically toy with the idea of a trial of a Lamictal add-on to my Lithobid.
> > Currently, I take 300 mg/day of Lithobid (under normal circumstances).
> I might end up trying that myself. Do you find that 300mg flattens your affect or leaves you more passive and apathetic? Higher dosages of lithium leave me feeling worse.The flattening effect is why I reduced my dosage from 600 mg/day to 300 mg/day (except on those days when I need more to reel-in some hypomania). The flattening is greatly reduced at the lower dosage, but the very fact that lithium curbs hypomania might cause some patients to feel that it has some amount of flattening at any dosage. I like Lithobid. I’ve been on it for over four years.
> I found that Depakote or Zyprexa did a good job of curbing the few manic-dysphoric reactions I have experienced. Zyprexa is interesting. It seems that it possesses mood-stabilization properties in addition to its acute anti-manic effects.For me, Depakote caused weight gain, hair loss, rash, and it seemed to make my depression worse. I’ve considered Zyprexa from time to time, but all AP’s scare me (e.g.; TD, etc).
> What is the Zone diet?"The Omega Rx Zone: The Miracle of the New High-Dose Fish Oil"
> > I’ve not been posting lately because I’m tied up with projects on my desk and projects around the house.> This is a good thing.
Yes indeed! I’m thankful.
> * What is the meaning of life?For me, the purpose of life is to love the Lord our God with all my heart and all my soul and to love my neighbor as myself.
-- Ron
poster:Ron Hill
thread:287370
URL: http://www.dr-bob.org/babble/20031208/msgs/288042.html