Posted by barbaracat on March 18, 2005, at 18:52:36
In reply to Re: Klono not nearly as effective as X? (Oth. Benz » barbaracat, posted by cache-monkey on March 18, 2005, at 13:43:50
Hi CM,
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> I'm actually not going for the Depakote just yet. I'll wait until my Li level gets into the therapeutic window. (Just started at 1200 mg, and crossing my fingers that this will do the trick.) Did you find that you got thirsty on higher doses, but that this subsided over time?**Yes, definitely thirstier. It increases peeing and makes the kidneys work hard. It goes away if you drink extra water and increase salt intake. But definitely NOT table salt which simply causes bloat. You need to replenish electrolytes and minerals that are from a bioavailable source and a good salt will do that.
The best salt I've come across is from a deep mine in the Himalayas and tastes wonderful. I'm totally spoiled on this lovely pink salt. I order it from www.americanbluegreen.com. The website has alot of info on the its benefits. It's expensive, however, around $30 for 2lbs, but I think of it as a necessary medicine. You can get it from other sources which might be slightly less spendy, but this stuff is da kine.
**Another side effect that happened when I increased Li was hand tremors. It was very annoying. It started to subside after 2 months but I went back down to 600mg anyway, which seems to be good enough for me, although far below my therapeutic window.
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> If and when I try the Depakote, I'm shooting for a very low dose (e.g. 500 mg/day). It sounds like you replaced Li with the Depakote. Have you ever tried it as an add-on?**No, I didn't do both although I've heard it can be a good combo. I didn't do well on Dep, made me very lethargic, hair started falling out (yes, this is a sx) and did nothing to prevent mania, like racing thoughts in a lethargic body. I was also taking Seroquel for a while with it which made the lethargy worse. I wanted to just stay in bed all day paralyzed with racing thoughts.
>>Also, does the Li alone seem to help with your mixed states?
**That's difficult to say, I don't think so entirely. However, if I don't do lithium, I'm guaranteed one. Stress is my big trigger and if I let anxiety get out of hand it will escalate into a mixed state depression. But as I recall, those were also times when for one reason or another I stopped or reduced Li. Yes, I'd say Li does prevent the bleak awful mixed-states, but I can still get seriously depressed from stress and exhaustion, but it's a different animal from mixed states frenzy. There are times when I do fine on Li alone and other times when I need an AD, which is tricky for BPs. These days I seem to be maintaining on low dose Cymbalta to handle depression and doing what I can to minimize stress - benzos, breathing, walking, keeping on top of my hormones, trying to stay in the moment.
Lamictal is a good combo with Lithium for mixed states. I personally needed Lithium with it, but for some bipolars with depression Lamictal alone is enough. It was pretty activating but I never felt like I was careening off into anything too manic. Unfortunately, it eventually pooped and raising the dose caused an allergic reaction so I can't take it. But it's a good one to keep in mind.
I probably could use to increase the Li but I'm concerned about the thyroid thing and the fact that it makes it real hard to lose weight. All of them do that, unfortunately. My body can't handle complicated metabolic burdens any more and so I'm trying to manage with a minimal number of meds at the lowest doses. It's a lesson in learning to tolerate discomfort and being OK with good enough instead of perfect. A real challenge for me. Besides, I must admit that I like to dance around the edge of hypomania. As long as I can nip the axiety and bring myself down from a hypo buzz, I can still enjoy the many benefits of being bipolar.
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> After meeting with my pdoc, we ended up settling on Xanax XR for a while. I am concerned about the dependency factor.**Try not to stress about dependency right now while you're finding the right chemical balance. I know this has been a concern of yours in the past, but I truly think that dependency is more of a problem when your biochemistry is out of whack. When you get to a point where you're stable with the right meds, working on the breathing and exercise and supporting things nutritionally, you'll probably do fine with taking the Xanax only ocasionally. Until then, you gotta do what you can to manage anxiety and trust that you'll be able to wean off when you're ready. IMHO, Xanax XR is as good as a benzo gets, so consider it a helping friend and enjoy.
>>I'm not familiar with Taurine... I suppose I'll go over to the alternative board to find out more, but if you can give me a little more information on it, I'd be much obliged.**Sure. Here's an article by Margot Kidder about amino acids in bipolar with a good explanation of L-Taurine: http://www.alternativementalhealth.com/articles/aminobipolar.htm
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> In the meantime, I'll check out the website you recommend. I do feel like a chunk of my mixed-states/anxiety comes from breathing issues. And I definitely agree that regular exercise (whether from better breathing or extra endorphins) helps quite a bit.**Ah yes, lovely endorphins. Wish there was a pill for that. Guess it's called exercise. The breathing is important. Amazing how disordered breathing contributes to all this misery. Try the 1/2 tsp baking soda thing and some extra calcium. If you have uneven shallow breathing, your blood pH is most likely skewed towards acidic - a big player in panic disorder.
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> Thanks for all the info!
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**Sure thing, it's been enjoyable! Good luck and keep me posted. - BCat
poster:barbaracat
thread:470912
URL: http://www.dr-bob.org/babble/20050317/msgs/472613.html