Posted by SLS on August 7, 2004, at 14:37:02
In reply to Re: Meds or not?, posted by capricorn on August 7, 2004, at 13:32:52
Hi Capricorn.
> Years back i was prone to depression on one hand feeling useless/guilty,thoughts slowed/ no energy etc and on the other hand 'I'm so much better/miles ahead of everyone else/ silly and impulsive/excitable just coming out and saying things cos i felt like it, but over time it's developed more into combo of depression,irritability,anxiety/nervous anticipation,feeling useless,feeling guilty,feeling of being wound up inside/like a tightened coil about to spring lose,difficulty switching thoughts off ie difficulty switching mind off/mind busy but a lot of it much ado about nothing,also bouts of impatience and authoritarian 'Do what i say/listen to what i tell you' and over reacting to things' getting wound up because i think i am being ignored,also find it difficult to handle criticism or prerceived critiicism ie getting emotionally churned up inside about it and over reacting/lashing out verbally.
Your description pretty much sounds like a textbook case of bipolar II with a dysphoric hypomania or mixed-state. It would probably be a good idea to establish a consistent treatment with mood stabilizers. Depakote is usually the one most often chosen for these cases. There are a few newer ones to experiment with, though. (Lamictal, Neurontin, Topamax, Zonegran, Keppra)http://www.mentalhealth.com/dis1/p21-md05.html
Do you think you would be more compliant with taking Lamictal as a mood stabilizer? In most cases, it is a very clean drug. It usually doesn't produce sedation or impair thinking. The major issue with Lamictal is that it must be started at a very low dosage and increased gradually. This is done in order to prevent a reaction that can develop as a rash. Lamictal offers antidepressant properties with very little risk of inducing mania. It is also thought to be helpful in cases of rapid cyclicity. However, it is not usually effective to treat severe mania. Perhaps Lamictal alone would be sufficient for you. It's a trial and error process, of course.
I don't know if Abilify (an antipsychotic) is as effective at handling mania as Zyprexa, but you might find it cleaner and less sedating. I would look at Abilify before Geodon, though, as I believe Geodon is more apt to produce a manic reaction.
I guess my recommendation for you is to come to a reasonably firm conclusion about the identity of your illness and commit to finding an optimized treatment regime for it. I'll be interested to know what you decide.
Good luck.
- Scott
poster:SLS
thread:374989
URL: http://www.dr-bob.org/babble/20040805/msgs/375094.html