Posted by Ron Hill on July 3, 2010, at 5:21:39
In reply to Oxcarbazepine (Trileptal) + MAOIs (sort of urgent), posted by tom2228 on June 21, 2010, at 19:46:31
> So here's the story, I've got ADHD, social anxiety, and some sort of bipolar, I suspect cyclothymia. I started cycling some time in childhood but I can't pinpoint when.. I'm 18 now and the cycling has gotten more and more rapid .. from months to weeks and days at one point. Heavy weed smoking and all the antidepressants and stimulants (I've been on 18 meds and many more combos) have probably contributed to this, though it could be the natural progression of the disorder too.
-------------------Tom, I do not know you, so I run the risk of coming off as a know-it-all jacka*s. It is currently in the middle of the night, so forgive me for being blunt.
You are Bipolar II. And, your p-docs have induced your rapid cycling by giving you antidepressants and pstims without a full complement of moodstablizers fully ramped up first.
The same thing happened to me, 14 years ago. I was misdiagnosed as ADHD and given Ritalin and SSRI's. The two worst things that can be done to a Bipolar patient is to give the patient a pstim and/or an SSRI without moodstabilizers on board FIRST.
As a result, I go through one complete cycle every 15 days consisting of six days of debilitating depression, and nine days of normal mood. My 15-day ultra rapid cycle repeats over, and over, and over, without end. My depressive episodes used to be a lot worse in severity and duration. The treatment of bipolar ultra rapid cycling is VERY difficult.
Even with moodstabilizers, a bipolar patient should not be given an SSRI, and maybe not a pstim. Over time, the pstim will more than likely destabilize the Bipolar II patient's mood. In the end, the pstim often causes irritability.
Tom, if it is okay with you, I want to follow up and give you some free screening tests tomorrow or in the next few days. Also, I will try with all my heart to convince you to pay about $80 to take a very in depth test.
> OXC has a short half-life and "wears off" within a couple hours, the active metabolite is what allows for the usual twice-daily dosing.
Not true, Tom. The half life of the parent is 2 hours, but the half life of the pharmacologically active 10-monohydroxy metabolite is nine hours. See the Pharmacokinetics section on page 2.
http://www.pharma.us.novartis.com/product/pi/pdf/trileptal.pdf
-- Ron
dx: Bipolar II with ultra rapid cycling, and mild OCPD
600 mg/day Trileptal
200 mg/day Lamictal
500 mg/day Keppra
90 mg/day Nardil3.75 mg/day Deplin (taken with 2500 mcg/day of sublingual methyl B-12, and 12.5mg/day of sublingual P-5-P)
35 ml of Calsons Bottled Fish Oil
100 mg/day phosphatidylserene
Centrum Chewable Multi-vitamins; Only 100% of all the usual vitamins
2000 IU Vitamin E
850 mg/day of Mg 212% of RDA (as 5 grams of Mg Malate).
Dark therapy via LowBlueLight glasses (When I remember)
Whats next to add:25 mg/day agomelatine (if my p-doc wakes up and smells the roses due to my submitted research) {Valdoxan}
300 mg/day of lithum carbonate
CoQ10
NAC, + 8 to 10 glasses of water, + Acetyl-L-Carnitine, + Alpha-Lipoic Acid, + Vitamin C
GTF Chromium
Cromium Picolinate
Cinnamon
poster:Ron Hill
thread:951790
URL: http://www.dr-bob.org/babble/20100628/msgs/953085.html