Posted by Ritch on October 6, 2004, at 23:45:30
In reply to Re: rapid cycling, posted by jdawg on October 6, 2004, at 21:34:11
> Hi,
>
> Thank you for all of your replies. I have a few comments:
>
> 1) re. Depakote -- I've tried it and did not tolerate it. It made me feel like a zomby -- sleepy and unable to concentrate.
>
> 2) I'd *love* to go off some of my meds but am afraid of getting really depressed. I weaned off Effexor at one point and only took Wellbutrin. That did not work since I got really depressed.
>
> 3) My "high" periods are getting better as I'm able to sleep more and don't feel as wound up. But depressive periods are still debilitating -- I just shut down for 2-3 days unable to function well at work or at home.
>
> For now it's not crucial to me to find out what the cause is -- it could be that I'm cycling due to my meds or because of my underlying disease. It doesn't matter which one it is (just knowing that I have a mood disorder is enough for me), I just want to be functional all or most of the time.
>
> So I'm not sure how to proceed now. Should I go up on the Lamictal dose (I'm currently on 200 mg/day)? Should I increase my anti-depressant dose (Effexor XR 150 mg/ day & Wellbutrin XL 300 mg/d)? or do something else?
>
> I'd appreciate any input you may have on this.I would first consider swapping out (or cross-tapering) the Risperdal for Lithium to get some prophylactic antipsychotic effects. I'm assuming you're taking risperidone to *prevent* psychotic features of your hypomanias/depressions, rather than treating *active* positive psychotic symptoms. While lithium is generally regarded as not very effective for rapid cycling, I have heard reports that atypical AP's like Risperdal can aggravate or fail to help cyclicity. But you might be taking the Risperdal to offset some mild psychosis-*inducing* properties of Wellbutrin and also possibly Effexor (at higher doses)-- if that is the case maybe you can just reduce both Effexor and Wellbutrin and see if you can get *off* Risperdal (forget the lithium)??
poster:Ritch
thread:399302
URL: http://www.dr-bob.org/babble/20041002/msgs/399852.html