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Re: Need some medication support

Posted by linkadge on July 25, 2007, at 11:46:08

In reply to Re: Need some medication support » linkadge, posted by Just A Lurker on July 25, 2007, at 10:07:59


>I was on Lexapro, and was tapered off. I also >used Trazodone and Doxepin for sleep at various >points; neither was terrific, though I think the >Trazodone worked better. I've heard of problems >taking ADs if you are bipolar; is this not a >problem if you are taking a mood stabilizer?

Generally yes. Mood stabilizers can reduce the propensity of an antidepressant to cause destabilization. Remeron is probably less likely to cause destabilization than other AD's. Usually if the dose is kept low there aren't too many problems.

>I'd like to reduce the Klonopin just because >benzos can be addictive and they tend to stop >working anyway.

Yeah. It can sometimes cause depression. The addictiveness and loss off effectiveness of benzo's with time varies from person to person.

>I have some but haven't tried them yet. My new >pdoc's theory is that (at least with the >Adderall) it made my manic symptoms worse, >notably the negative ones.

This is always a possability. Provigil is an alertness promoting agent, not necessarily an attention promoting agent. If you can't concentrate for lack of alertness (ie from other meds or daytime fatique) it may help, but true ADHD is not really a lack of alertness.

You could always try another stimulant. Sometimes they don't mix well with anticonvulsants. Somtimes certain stimulants can acually improve stability in certain bipolars.

A high quality omega-3 product is always a good idea as there is evidence of efficacy in both bipolar and ADHD.

>He also suspects that I may not really have ADD >per se, but it could just be a mask for bipolar.

This is a possability too. It can go the other way around, ie bipolar symptoms can really be a result of severe ADHD. There is also high comorbidity between the two illnesses. Both illnesses seem to show deficits in prefrontal cortex activity.

>This pdoc is highly recommended (by some other >doctors who are, frankly, tops in the area), but >I'm frustrated that nobody knows what I have, >how I feel, and how to fix it.

It sucks. I am in kind of a grey area too. I personally didn't find lamotrigine to be of any use. It does't really have the same track record of other mood stabilizers.

Have you tried say lithium + omega-3 + low dose methlyphenidate?

Linkadge



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URL: http://www.dr-bob.org/babble/20070719/msgs/771878.html