Posted by desolationrower on November 22, 2008, at 18:36:09
In reply to Re: Treatement resistant bipolar depression..., posted by bleauberry on November 22, 2008, at 17:39:43
> I am extremely sorry you are feeling so bad. Believe me though, we are all either there in the same place or have and may be again. While friends or family might not be able to relate, we can.
>
> A few comments I hope might be helpful.
>
> You may or may not be bipolar, and it doesn't matter anyway. What ends up helping you feel better has nothing to do with the manmade term used to describe a certain cluster of symptoms. Bipolar is just a broad term that includes all kinds of physical and mental illnesses. I've known a few people who were called bipolar when in fact it was silver fillings in their teeth causing chronic longterm mercury intoxication. That is just one of many possible examples.
>
> In any case, as your instincts tell you, there is something definitely wrong in the nervous system. What exactly, who knows. When the correct bridge is found that bypasses whatever the problem is, you'll feel a lot better.
>
> For med suggestions, here are some. With your doctor's help, eliminate the lamictal. It isn't helping in any way, as you said. Lower the lithium to a maintenance antidepressant augmentation dose of 300mg-600mg. Like lamictal though, if it isn't providing any benefit, you kind of have to re-assess whether it is worth taking at all.
>
> For a mood stabilizer to replace the ones that haven't worked, consider a switch to zyprexa 5mg-10mg. There is a med FDA approved for bipolar depression, and it is also pretty good for treatment resistant depression. That is, the combination of Prozac+Zyprexa. I am surprised this combo is not more popular than it is. It served me well for almost a decade when pretty much everything else was not helping much. Another combo in that same vein is Lexapro+Risperdal or Lexapro+Zyprexa.
>
> In any case, Lexapro in metastudies was shown to be superior to all other SSRIs by a small margin. It might be worth having that on your side. Personal opinion, but I think Prozac is one of the best SSRIs. Whatever, Zoloft aint cutting it. Just because one ssri doesn't work does not mean another won't work brilliantly.
>
> Lifestyle...as mentioned, heavy exercise a few times per week or daily. Purified water and lots of it. Heavy on proteins and raw or slightly cooked veggies, cut way back on sugars and caffeine. Cod liver oil or fish oil, and borage oil daily. Of the vitamins, I would start with Vitamin D3 in a dose of 400iu-1000iu per day. As for any other vitamins, do them one at a time individually to see what helps or what harms. Big mistake to just start popping B complex pills or taking a handful of vitamins by pure guess. You won't know what is doing what and can shock an already traumatized system. On the alternative board check out Lao's posts on his creative artistic way of discovering which vitamins help him.
>
> ECT is a lot of hype. I know it was mentioned favorably by another poster, but honestly, that kind of experience is rare. ECT has a high percentage of relapse even when it does work. Some people escape the memory loss/brain trauma effects from it, but not many, and the risks of permanent memory loss and congitive dulling are very real. I and others can attest to that from personal experience. Someone else may recommend ECT, but I am strongly against it. It ruined my life more than the depression did, not to mention it cost $20,000 for 12 shocks.
>
> Prozac+zyprexa, or some antipsychotic with Lexapro, would be my first choices for you. Get off the stuff that aint working.
>
>The dose of lamotragine he's on isn't very high, he should increase it to 200 at least because that could get a response; especially since it takes a while to titrate lamotrigine, you shouldn't waste the time already spent if you are close to a dose that would cause a response.
I don't think b vitamins are nearly so powerful; getting the necessary amount is only necessary because few people eat the 15 servings of vegetables you'd need otherwise.
And ECT is quite effective; if you have insurance that covers it its something to think about. And of course some people need maintenance treatment. And current ect technique doesn't cause as much memory problem as it used to. So if you do go for ECT, just make sure to look into what kind they will be giving you.
-d/r
poster:desolationrower
thread:864627
URL: http://www.dr-bob.org/babble/20081114/msgs/864741.html