Posted by finelinebob on January 27, 2006, at 0:51:50
In reply to New here and desperately looking for advice..., posted by fiftylager on January 25, 2006, at 22:13:48
Please folks, this is is fiftylager's thread, let's not hijack it thru our own sensitivities.
fifty -- there's an emerging diagnosis some call bipolar III or bipolar spectrum disorder. Spectrum being the key term. My own situation is hard to pidgeonhole with any one diagnosis -- like just about everybody. But BSD is often used for people who move between depression and anxiety, not mania. Poor response to SSRIs (like celexa). Laundry list of other things that can make it sound like everyone is BSD. But there are things about your experiences that sound familiar, so I had to chime in ... particularly since I just started seeing a wonderful new pdoc today who is just incredibly knowledgeable about the physiology of all this stuff.
The most important thing to remember is that YMMV -- your mileage may vary.
Another indicator for BSD is positive response to tricyclic antidepressants (TCAs). I tanked on SSRIs, but have been very stable on nortriptyline (a TCA) for about 7-8 years now. Given my anxiety, tho, my new pdoc almost considered switching me to effexor. He said that effexor could have a similar effect on managing mood while being even more effective with my anxiety. So maybe trying the effexor wouldn't be such a bad thing to consider.
A couple of people have mentioned klonopin as well. Klonopin's a benzo, and benzo's have a reputation for being addictive. I had been on klonopin on a daily basis for 5 years or so. Got off meds for a while -- no cravings, no withdrawal. Got with a different pdoc and he wouldn't start me back up on it, even tho it had been the most effect med I'd taken for managing my anxiety (to that point). Back with my new pdoc, he said that rep is rubbish for klonopin, that it's a safe drug wrt addictiveness. I'm glad to be back on it.
I'd hate to say any more given the YMMV rule. What it does come down to is having a doc that knows psych meds, and a general practitioner is not going to have the time nor the highly specialized knowledge to really know psych meds well. Even if yo only wind up consulting with a psychiatrist once every 3 months after a few initial visits, the knowledge a pdoc can bring to your treatment can be worth more than a dozen gp's can bring.
Be well,
bob
poster:finelinebob
thread:602856
URL: http://www.dr-bob.org/babble/20060122/msgs/603309.html