Posted by barbaracat on December 12, 2004, at 20:03:46
In reply to Thank You! Thank You! » barbaracat, posted by smith562 on December 12, 2004, at 17:28:40
Have you tried Lamictal? It's worked for alot of folks. I got the rash, but it wasn't directly related to lamictal. But it is activating and if you're prone to panic may not be the best way to go. I know how terrible panic is. I can take just about anything, but not panic. My panic used to be a cyclical thing, hang around for awhile and then leave for no reason. I eventually realized that it was part of the bipolar mixed states syndrome. Bleak depression fueled by agitated mania = panic. It would cause anyone to feel panicked, no? So, the recipe is always treat the bipolar first and then you can start experimenting with different ADs with less risk of panic and destabilization.
I personally think you're not on enough lithium, especially since it truly sounds like you're dealing with at least some form of BP (how many is it up to now? 500?). Until you get that stabilized you're shooting blanks as far as any other meds being effective for long.
You know, there are so many metabolic and chemical dysfunctions coming to light with tests to ferret them out. Sometimes all the mood meds in the world aren't going to address an underlying metabolic disorder. It could be hormonal (have you had your thyroid checked lately?) it could be a pyrrole disorder, so many things. A few on this board have gone to the Pfeiffer Institute to get massive and expensive testing and some found out interesting information and felt it worthwhile. Ed O'Flaherty on this board is an MD in Ireland and has a website that discusses some of these metabolic markers. He and others on this metabolic track feel that bipolar may be a pyrrole disorder - an inability to metabolize B6 and other important neurotransmitter precursors. Might be interesting to talk with him on this board and go to his site.. Here's a recent post with at least his name
http://www.dr-bob.org/babble/alter/20041123/msgs/427813.htmlI've been helped alot once I got some major hormonal imbalances dealt with, but of course, not 100%. All I ask at this point is to be kept well enough to be able to exercise because without that I get really wiggy. Unfortunately, most pdocs stop at the head and managed care doesn't do a good job with the rest of the body. I see a naturopath and a functional medicine MD. Might be worth looking into other body parts if you continue to get no relief from mood meds.
> My situation is strange ... Father is BPII and Mother is Major Depression with Panic. I am a hybrid .... started to get panic age 25, then major depression 26 then typical ad poop out with imipramine and other ads.
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> I have tried the "Dr Phelp's" approach 3 years ago .... try lithium solo (still with panic and depression), then lamictal (still with panic and depression), then depakote (250 sent me into a stupor).
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> So I guess I am Bipolar III (I think hypomania with nardil) with panic disorder. My problem is mood stablizers do nothing for the depression and SSRIs flat me out and TCAs/Wellbutrin increase my panic.
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> Damned if I mood stablize, damned if I antidepress! Any thoughs .....
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> Smith
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> PS I have always enjoyed reading your posts ... I feel like my mood disorder is very similar to "Ritch" and yourself (I feel as I get older, more of the bp will emerge ... now age 32)
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> > The question of are the blahs related to the meds or depression is a good one. It could be a little of both, but it sounds like you have an anxiety component and vegetative listless depression is definitely not typical with agitated depression (if that's what your's typically is).
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> > I was on Zoloft for many years and it worked off and on pretty well. But it did cause alot of flattening of mood which at first was great because I was pinging like a live wire with anxiety, but then it got to be very boring. I couldn't cry appropriately or feel much of anything. I sat through an aunt's funeral trying to feel something but mainly feeling bored. The Klonopin is of course adding to your malaise but I'd guess it's the Zoloft.
> >
> > Are you BP-II? In which case 100mg Zoloft or any SSRI could be problematic. For me, finally admitting I was BP and adding Lithium was like a blessed relief and everything worked better - not perfect though because I still get depressed and anxious, just not the awful mixed states kind.
> >
> > After trying alot of things, I've found a pharmaceutical brand of St. John's Wort to be the best preventative for depression. It's put out by HBC Protocols and is the best I've found in quality and price. My husband has benefitted greatly from it as well and he didn't even realize he was chronically dysthymic until he started feeling better.
> >
> > But if you're in a skid or in a definite depression, then SJW will not be enough. Christmas is a very hard time for me since I lost my Mom 2 years ago this month. I was feeling the signs of anxiety, weeping, fatigue, sleeplessness, despair that is much different than appropriate mourning. I started taking 100mg Wellbutrin along with SJW, lithium and occasionally neurontin and ativan. I think it's helping - I notice a definite improvement. No flattening of mood, anxiety or sexual side effects. But I have to watch for signs of hypomania which WB is rumored to cause. On the other hand, I've been reading research papers on how WB has proven to be a very successful AD for bipolars.
> >
> > So, if you were me, I'd experiment with less zoloft and more lithium. Whatever you can do to reduce the zoloft and Klonopin will help the blahs, and lithium is an antianxiety and AD in its own right. It seems around 900mg is the upper limit of what I can tolerate of lithium, but that's just me. More than that and I get tremors and cognitive problems.
> >
> > As for the Klonopin, you have to reduce that very slowly, if that's what you want to do, as I'm sure you and your pdoc are aware. Gabapentin, or Neurontin is good for the transition period. I like it also for general anxiety relief, as long as I keep the dose low and don't take it on a regular basis, it's much better than a benzo. Good luck and happy holidays.
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> > > I seem to need a small dose of lithium to make my ads work (450 mgs). I was on nardil 60 alone ... but I think it made me hypomanic. Now I am on zoloft 100 and lithium 450 and klonopin 1 ... but I feel apathy. My mood is calmer and less anxious, but flat and unmotivated. Have you had this problem? ... is it the meds or the depression?
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> > > Thank You,
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> > > Smith
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> > >
> > > > I think you'll find that with lithium, whatever you take will work better and you'll need less. It seems to be a potentiator. Lithium also has a neurogenesis and protective effect in that it actually grows dendrites in the brain. Non-bipolar longevity buffs take low doses of it for this advantage. I feel very fortunate that I can tolerate it because I feel it's doing good for me beyond the miracle it's done for my mood disorder.
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poster:barbaracat
thread:425540
URL: http://www.dr-bob.org/babble/20041211/msgs/428543.html