Posted by barbaracat on August 5, 2005, at 12:30:10
In reply to Re: What to try next for stubborn Biplar?, posted by holymama on August 5, 2005, at 11:40:26
A TCA is a tricyclic antidepressant. The older ones before SSRIs came out. They work better for some people but have more side effects. The side effects tend to diminish with time but Ms. Princess and the Pea (me) has a hard time with things like that.
Some ADs are notoriously hard to get off. Paxil and Effexor are among the hardest. Even though it's miserable and drawn-out, always taper off slowly. I don't doubt you had to be hospitalized going cold turkey. Some people get a small tapering down amount of Prozac during this period. It has a long half life and can smooth the ride while getting off the others which have a very short half-life and this causes many of the withdrawal problems.
If you were on ADs when you were not on lithium it's also no wonder you had a hard time. I didn't know I was bipolar, resisted the diagnosis actually, and SSRIs kept pooping out and causing awful reactions. When they pooped the dose would go higher and I ended up in the hospital.
Lithium has made all the difference in my life. It actually augments the effect of ADs so you generally don't need as much and the dose stays more stable. Microdosing is not something that you'll easily find references to on the internet, but a few of us bipolars on this board have discovered that it works for us.
For whatever reason, our chemistry and genetics seem to make it difficult to clear certain meds out of our system and they end up circulating longer and building up causing the various serotonin syndromes and noradreline anxieties from too high concentrations. Micro dosing takes care of this since lithium and the bipolar chemistry seems to potentiate the meds.
I can now get by with about 1/4 or less than the typical dose of SSRIs that would be prescribed for unipolar depression. More than that wigs me out badly. This doesn't extend to benzos unfortunately. I need to keep my anxiety levels very cool and calm and so I take the standard dose of ativan and ambien for sleep. Although ANY med changes character and has an effect at a very small dose. I can take a sliver of a benzo and feel it definitely affect me with a different feel. All so interesting.
I really urge you to look into your hormone profile, thyroid especially. If they are out of whack you'll have all the symptoms of a serious mood disorder that no psych meds can help with.
> thanks everyone, there is a ton of stuff out there. After spending two years rapid cycling on AD/mood stabilizer combos, I was so darn happy to get off the Paxil, (and before that, lexapro), that I was suspicious of causing the cycling. I had to finally go off paxil cold turkey to do it. I have a hard time getting off the ADs; once I start one, even a small tapering makes me violently depressed. I decided to go cold turkey and go into the hospital instead. So I'm cautious about what I add to my little cocktail, you see.
> What Barbara said about Bipolars being really sensitive to ADs and needing to microdose is an idea that is new to me. It's something to keep in mind.
> What is a TCA???
>
poster:barbaracat
thread:537167
URL: http://www.dr-bob.org/babble/20050803/msgs/537849.html