Posted by Patient on December 30, 2003, at 16:49:58
In reply to Re: Best Approach for Bipolars, posted by leopard on December 28, 2003, at 2:40:43
Hi,
I found this string of messages interesting concerning meds. for bipolar disorder, due to my own experiences and frustrations with antidepressants. I've been seeing a psychiatrist every few months since 2000. I've been on Zoloft, Celexa, Wellbutrin for a very short period, Celexa, Prozac, Celexa, Lexapro with not the best results. The first time I tried Zoloft, which was when I went to my GYN complaining of Premenstrual Syndrome symptoms, she put me on Zoloft. I started on 25mg and within 2 days I felt great. This is usually how I react to SSRI's and then after a month or two I go down hill or feel that drug-poop out is occuring.
My doctor has loosely diagnosed me with Borderline Personality Disorder, but main diagnosis is moderate depression with extreme anxiety. Last Feb. I started on Lexapro with carbamazepine (Tegretol) anticonvulsant, to see if it would help stabilise my moods, especially before that time of the month. It didn't help, and I couldn't tolerate the dose he wanted me to go up to (400mg a day). So then I was on just the Lexapro 5mg and after a while it wasn't helping-increasing the dose only gave me anxiety. I added Wellbutrin SR to it and it helped very much, but the combo. was too pricey for us-my husband and I are currently having severe money problems due to lack of income from lack of job (engineer)f--(" One of these days you're gonna have to decide between heartworm medicine for the dog, or your brain candy!". Anyway, I decided to stop taking Lexa. and Wellb. to save money-well that only brought out all my terrible self in full force, so back on it. Then I decided to stop Lexa. and go on Prozac. I already had lots of leftovers of this med. At the very first it was fine, then by the end of the second week I was doing badly (I was ready to take the family dog to the Humane Society or dump him some where). So, after 2 1/2 weeks of Prozac I switched to trazodone and only a low dose during day, higher dose at bedtime. I feel calmer, but I am still depressed as well as a bit irritable. I have recently upped the dose of traz. (trazodone does cause lightheadedness and a drugged feeling, but otherwise no complaints, and just yesterday I started taking Lexapro again-I took 5mg in morn. and 5mg at noon for 10mg is too anxiety producing for me. I feel much better than just the trazodone alone. So, now I wonder where I go from here and look forward to talking this over with my doctor next month. so I am seriously taking an overview of myself and my meds.--my doctor isn't real good at this, and I only see him every two or three months-once again, to save money. Geodon is classed as a tranquiliser, as is Abilify (sp?). I've heard of Zyprexa as well, but don't if this is a tranquiliser as well.
So, you are taking how much Effexor and how much Geodon? I've avoided Effexor because of all the bad withdrawal complaints I have read.
All this leads me to an interest in medicines for Bipolar illness. I understand that Bord.P.D.'s have some similar symptoms to B.D. and sometimes a person can have both. I don't like the idea of taking Depakote or Depakene, lithium, or Lamictal, etc.- these anticonvulsants that are the usual standby for B.D. They can have serious side effects. It sounds like Geodon has 5-HT and NE reuptake inhibition-sounds like it would work very well for depression. Thanks for your input (as well as the others) about Geodon. I will bring this drug to my doctor's attention. I'm desperate for help. I hate this rollercoaster drug ride!
This is from http://www.rxlist.com/cgi/generic2/ziprasidone_cp.htm
ziprasidone pharmacodynamics
Ziprasidone exhibited high in vitro binding affinity for
the dopamine D 2 and D 3 , the serotonin 5HT 2A , 5HT
2C , 5HT 1A , 5HT 1D , and (alpha) 1 -adrenergic
receptors (K i 's of 4.8, 7.2, 0.4, 1.3, 3.4, 2, and 10 nM,
respectively), and moderate affinity for the histamine H
1 receptor (K i =47 nM). Ziprasidone functioned as an
antagonist at the D 2 , 5HT 2A , and 5HT 1D receptors,
and as an agonist at the 5HT 1A receptor. Ziprasidone
inhibited synaptic reuptake of serotonin and
norepinephrine. No appreciable affinity was exhibited
for other receptor/binding sites tested, including the
cholinergic muscarinic receptor (IC 50 >1 µM).The mechanism of action of ziprasidone, as with other
drugs having efficacy in schizophrenia, is unknown.
However, it has been proposed that this drug's efficacy
in schizophrenia is mediated through a combination of
dopamine type 2 (D 2 ) and serotonin type 2 (5HT 2 )
antagonism. Antagonism at receptors other than
dopamine and 5HT 2 with similar receptor affinities
may explain some of the other therapeutic and side
effects of ziprasidone.Ziprasidone's antagonism of histamine H 1 receptors
may explain the somnolence observed with this drug.Ziprasidone's antagonism of (alpha) 1 -adrenergic
receptors may explain the orthostatic hypotension
observed with this drug.
poster:Patient
thread:293032
URL: http://www.dr-bob.org/babble/20031225/msgs/294787.html