Posted by barbaracat on July 7, 2005, at 13:33:23
In reply to Wellbutrin » barbaracat, posted by yesac on July 7, 2005, at 10:42:36
Whoa! Cymbalta, Wellbutrin and no Lithium? I shudder to think. When I first started Cymbalta it was at 30mg and even though I was taking Lithium I swear I have never been so out in orbit, hallucinating, bizarre, truly terrible. I had also just come out of the hospital from major meltdown, was taken off lithium and put on depakote briefly, all my chemistry was bonkers so I wasn't sure at the time what was doing what. The fact that I'd just started back on lithium at that time also made it unclear. So I stuck with Cymbalta but started taking 3 pellets instead of the whole 30mg capsule, titrating slowly until I am now at 10mg after 5 months.
I tell you this, first of all to emphasize the crazy making nature Cymbalta has on some of us, and secondly that I believe LIthium will change the action of ADs. Cymbalta at 10mgs is the best AD I've ever had, but I believe, only because Lithium is augmenting it and allowing appropriate neural conductivity. I cannot imagine taking something like Cym without a mood stabilizer and I can't imagine going up more than 5 pellets a week.
Too many of us take too strong a dose of neuro-chemicals and when they poop or are ineffective, we ramp up even more. The problem may have more to do with gene transcription, second messenger systems and electrical potential in the neuron that the amount of chemicals floating around in the synapses, too much of which can cause problems of excess.
I've been watcing webcasts from the UCLA school of neurochemistry. These webcasts feature luminaries in the field of bipolar research. All are good, but the one by Dr. Manji explains the beauty and magic of what lithium does for bipolars. Here's the link if you want to explore:
http://www.bipolargrandrounds.com/archived.html
An important point is that if your condition is even vaguely bipolar, there are neural events occurring that no amount of antidepressants, stimulants, benzos, will work for long. From my own research, I realize that what Lithium and to a lesser extent, Depakote, provides actually CORRECT these neural anomolies and degeneration and allow the brain to function both chemically and electrically. In effect, Li is neuroprotective and neuroregenerative, grows new neurons, heals damaged ones, and compensates for quirky genes. And it seems to have these properties only for bipolars but not ALL bipolars. Dr. Manji also said bipolar disorder is hands down the most fascinating pathology ever to come along. How one disorder can present the vast array of disparate symptoms is staggering. So strange, but so much more understandable why, if we need what Lithium provides and don't take it, we have a very difficult time indeed.
I recently tried an experiment to wean off lithium. LIke all of us, I frequently wonder if I need this sh*t, if I can do it myself. Thank God I caught myself before my brain tangled too badly, because I could feel it disintegrating. Anyhow, for those of us for whom Lithium works, we are truly lucky. Watching that webcast may help you appreciate this fact and keep enough Li onboard to help augment and stabilize other meds you might be considering.
One more thing. I'm starting a trial month of Concerta because of my own cognitive issues. My pdoc said ADD is so common with bipolar that you might as well figure you've got it and see if treatment helps. I know you've been having concerns about cog dulling. It may be possible that Lithium is not causing the dulling but uncovering, bringing to the surface a coexisting condition. And if you've cold-turkeyed on Effexor, cognitive issues would certainly be in your stars for the next few weeks. - Barbara
> > Have you ever tried Wellbutrin?
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> > WB is also indicated for ADD symptoms. As I said, it didn't work for me but I've heard it works well for many who don't otherwise benefit from the typical SSRI type AD. Plus, sexual side effects are muy bueno.
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> WB was actually the very first AD that I tried. Didn't work. Then, several years later I tried it again because the shrink I was seeing wasn't sure if I had really given it a good trial (even though I had been on it previously for about 3 months, probably at 300mgs). The second time, it still didn't work after 4 months, 400mgs.
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> So then, just last February, knowing that it is used for ADD and feeling like my ADD symptoms were extremely bothersome, I tried it yet again. I was only on it for a few days when I had a complete meltdown, worse than anything I've ever experienced. Still, I stayed on it for a couple more weeks, but continued having these bizarre meltdowns. Finally I went off it. I think that since I was also taking Cymbalta, the combo was just too much for me. The addition of WB to Cymbalta seemed to totally send me over the edge of sanity. Those few weeks were when I felt like I had truly lost my mind, more than any other time in my life.
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> So unfortunately, I don't know if I can take WB. I've still been considering it though--- I can't help but wonder if MAYBE it could work now combined with lithium and not being on Cymbalta. I used to think if something doesn't work, it doesn't work, but over the past months, I've realized (and experienced) that combinations of drugs can really work differently than the same drugs by themselves.
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poster:barbaracat
thread:509665
URL: http://www.dr-bob.org/babble/20050702/msgs/524625.html