![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 35 to 59 of 63. Go back in thread:
Posted by cycling on July 30, 2010, at 18:58:27
In reply to Re: Racing/Anxiety Thoughts, Need Opinion, posted by morgan miller on July 30, 2010, at 18:55:10
Morgan, so what was your treatment again?
Posted by morgan miller on July 30, 2010, at 19:09:41
In reply to Re: Racing/Anxiety Thoughts, Need Opinion, posted by bleauberry on July 30, 2010, at 18:51:27
> Your symptoms are pretty much a deficient serotonin thing. So I don't understand the absence of serotonin enhancement in your meds. I've had that awful racing stuff before. And it is awful. It was stopped dead in its tracks with a low dose ssri in very short time, every time. Mood stabilizers and antipsychotics were basically not very helpful and sometimes even made it worse.
>
> It's serotonin. The current meds are doing nothing for that.If this is the case, an SSRI like Prozac or Zoloft may be in order.
In the meantime, I would try to stay away from Klonopin, though there is evidence that it has some serotonergic properties, and I would look into taking a good form of Magnesium(along with calcium) and a little lithium aspartate or orotate. Both magnesium and lithium can increase serotonin levels and both are calming. I would order some lithium orotate or aspartate online and go to Vitamin Shoppe or other vitamin/healthfood store nearby and get some Magnesium Glycinat or Magnesium Taurinate.
If things are really bad and you don't have anything else right now, go ahead and take a little klonopin as needed. I would even split the pills you have and see if that is enough to give you some relief.
I don't know if I necessarily agree that this is just a serotonin issue, I'm not sure it is that simple. There are underlying components of your subconscious that are playing a role in triggering some of this. And of course you are genetically predisposed as well. Stick with therapy and exercise. You may find that intense exercise for a 20 minute period followed by a thorough meditative stretch, will give you a great amount of relief. The exercise will boost serotonin and dopamine levels and the meditative stretch with boost GABA levels.
Posted by morgan miller on July 30, 2010, at 20:29:16
In reply to Re: Racing/Anxiety Thoughts, Need Opinion » morgan miller, posted by cycling on July 30, 2010, at 18:58:27
> Morgan, so what was your treatment again?
Well it used to be that I could get away with just taking an SSRI and some fish oil and a 5 to 6 day a week intense exercise regimen, but nowadays I'm dealing with a different beast.
I was taking Symbyax(combination of Prozac and Zyprexa) for several months. I decided to split them and eventually weened myself off Zyprexa. I also added 300 mg Lithium Carbonate and continued on with the Prozac. I had taken St. John's Wort in the form of New Chapter's SC27 for 2 months along with the Prozac and Lithium, but recently decided to end that experiment. Currently I am just taking 20mg Prozac and 300mg Lithium Carbonate. I have been taking extra lithium in the form of Lithium aspartate to see if it would help, not sure if it has made much of a difference. I wish I could go back to the days of just taking Zoloft and fish oil and exercising religiously, unfortunately things have changed.
You may want to try the combination of Magnesium and Lithium orotate and aspartated and continue doing everything else you are doing and see how you feel. You probably will still need to add an SSRI to the mix. I think Zoloft is superior to Prozac, especially for long term use based on it's profile. But the doctor may be more inclined to try Prozac. Starting with Symbyax may not be a bad idea for a 6 to 8 weeks and then you could split them and ween off Zyprexa. I know there are many choices and it can seem hard to decide on what might be best. The only way to find out is to start trying something.
Posted by Hombre on July 31, 2010, at 6:16:36
In reply to Re: Racing/Anxiety Thoughts, Need Opinion » Hombre, posted by morgan miller on July 30, 2010, at 17:00:16
> Hombre do you mind sharing what medications you are currently taking?
>
> Do you think you fall somewhere under the bipolar umbrella?Morgan -
I take 30mg Remeron, 150mg Effexor, and 100mg Seroquel, all generics.
Remeron alone had a strong but short-lived effect. Adding the Effexor added a lot of energy, but sleep was still a problem. The Seroquel seems to help with sleep and any tendency toward AD-induced racing thoughts or anxiety. I've never been manic or hypomanic off meds or drugs, but sleep and anxiety became serious problems along with difficulty focusing.
Now that I know what I know, I wonder if I could have addressed the sleep and anxiety with herbs, but I'm not going to rock the boat until I've had a job for a while and am comfortable facing a few potentially sleepless nights.
I should add that I exercise quite regularly, and it really helps with energy and calmness. I jog, swim, do tai chi/qi gong/kung fu and lift weights. I also do a type of meditation as part of my kung fu training - Google "zhan zhuang" for more details. It's more about developing sensitivity to seldom-used muscles and to develop relaxed, whole-body power, good for any physical activity.
I also think taking magnesium citrate at night with zinc helps me to sleep well. I try to take my meds by 9-9:30 and I'm out like a light about an hour later. I am able to wake up at around 6:30-7:00 depending on when I conked out. The nightly meds never fail to knock me out. I rarely deviate from the schedule and I always turn the lights down by 9pm or so and try to avoid too much computer-time too close to bed.
And lastly, as you know, I think the herbs have really helped to smooth out the jagged edges of the meds and to make me feel less medicated in general. I actually don't feel medicated at all, but for some constipation (addressed by the mag citrate) and some sexual SEs (addressed by the herbs).
As you can see it's a pretty comprehensive routine, but I stick to it because I've wasted too much time suffering and hating myself for not being who I thought I could be.
Posted by morgan miller on August 1, 2010, at 1:04:10
In reply to Re: Racing/Anxiety Thoughts, Need Opinion » morgan miller, posted by Hombre on July 31, 2010, at 6:16:36
I hear ya Hombre.
Hey I just started taking Schizandra today. I think I've noticed something already. I will probably start a thread about it over on the Alternative board.
Posted by morgan miller on August 1, 2010, at 1:05:45
In reply to Re: Racing/Anxiety Thoughts, Need Opinion » Hombre, posted by morgan miller on August 1, 2010, at 1:04:10
How are you doing? Have you taken any steps to start treating your symptoms?
Posted by cycling on August 1, 2010, at 2:02:53
In reply to Cycling, How are things?, posted by morgan miller on August 1, 2010, at 1:05:45
hey morgan,
well, I got a psychologist and an appointment with my pdoc on monday. I was always kind of against psychologists, for some dumb reason, but come to find out, it works! haha. I've been studying the tools to get rid of my ocd thoughts and hte bad thoughts that have been plaguing my mind. Within two days of studying, I would say I've seen a significant change in my mood, for the better. I still have anxious thoughts, so what I'm hoping is that I decrease or get rid of all the drugs that are treating me for "bipolar" which includes the lamictal, lithium, and seroquel. I want to ween off carefully off of those drugs while hopefully adding an SSRI to see how that works. I honestly feel that with the right drug to calm down my mind, and with these tools at hand, give me one month and i'll be good as new. the ocd thoughts still come, but thats because that thinking pattern has been habituated into by subconscious. The hardest part about changing your thought pattern is dissolving them from your subconscious. My psychdoc is helping me learn the tools to change my focus and dissolve the thoughts that have plagued my subconscious for a while now. the more you think a certain way, the stronger it gets. my advice to anyone suffering from anxiety or ocd, start by starting your day looking for things that you find your grateful for. consistantly do this throughout your day, and i guarantee at hte end of the day you'll feel better. make sure your focussed on this task. yes, thoughts will come through and that will always disturb your train of htought, but remain strong. that's the starting point...i'll add more as i learn.
thanks for checkin up morgan. what is your diagnosis btw? have you seen a psych doc?
Posted by morgan miller on August 1, 2010, at 10:28:01
In reply to Re: Cycling, How are things? » morgan miller, posted by cycling on August 1, 2010, at 2:02:53
I fall somewhere in the bipolar spectrum. I realize this genetic predisposition has been exacerbated by not getting what I needed in childhood. This is the reason why I do see a great therapist.
Starting a few years ago for the first time in my life, I have been seeing a psychiatrist on a regular basis. In the past I just had a psychiatrist prescribe me the medication(prozac then zoloft) and I would figure out what dose worked and just have a doctor keep prescribing the medication to me. Things are more complicated and more difficult to treat nowadays, for reasons I think I have a pretty good understanding of.
I currently take 20 mg Prozac(brand) and 300 mg Lithium carbonate(switching to Lithobid). I may be switching back to Zoloft soon and possibly adding a small dose of Nortriptyline-I will stay on Lithium. I also may throw a 2.5 mg dose of Zyprexa back into the mix. I really wish they made a 1 mg dose of Zyprexa for people like me that just need a little maintenance. I don't know why they don't or at least make scored 2.5 mg tablets. It's an oddly made pill, they are very hard to split up. I really don't know why all medications are not made in a scored tablet form. I know it is possible.
I didn't know you were on those three medications. Did you mention that in your original post? You should always list the medications you are taking so people here can make more informed suggestions. How much of each medication are you taking? You may to want to very slowly ween off those meds, one at a time. Then again you are young and you may be able to handle a faster weening a transition. You may want to consider continuing a low dose of lithium carbonate or just buy some lithium orotate or aspartate online to keep on hand and take regularly.
Posted by ed_uk2010 on August 1, 2010, at 11:51:11
In reply to Re: Cycling, How are things? » cycling, posted by morgan miller on August 1, 2010, at 10:28:01
>I don't know why they don't or at least make scored 2.5 mg tablets. It's an oddly made pill, they are very hard to split up. I really don't know why all medications are not made in a scored tablet form.
Also, isn't it helpful how they tell you to reduce gradually when you need to come off a med, but the tablets are neither scored nor available in low strengths?! This applies to the majority of psych meds. The common practice of using 'alternate day dosing' as an alternative to cutting tablets really isn't appropriate for the majority of psych meds due to their short duration of action. Sure, you can do it with fluoxetine (Prozac), but not with most of the others. All manufacturers produce a suitable range of tablet strengths for getting onto the med, but not for getting off it! This part doesn't seem to receive much consideration.
About cutting Zyprexa.... It's OK to cut the tablets in half provided that the other half is used within the next few days (preferably the next day). The reason for this is that olanzapine begins to oxidise once the tablet coating is damaged. It's definitely best not to cut up several tablets in advance.
Posted by cycling on August 1, 2010, at 14:01:09
In reply to Re: Cycling, How are things? » cycling, posted by morgan miller on August 1, 2010, at 10:28:01
Haha yah I've listed them twice already, but no worries, this is like the longest thread in the world.
900 mg lithium carb
200 mg lamictal (weaning off)
150 mg seroquelI like your treatment. 300 mg lithium and 20 mg prozac i think could hit the nail on the head for me. The prozac would taper the anxiety a bit. I'll mention this to my pdoc. btw I'm 23 today :)
Posted by morgan miller on August 1, 2010, at 14:07:48
In reply to Re: Cycling, How are things? » morgan miller, posted by ed_uk2010 on August 1, 2010, at 11:51:11
>All manufacturers produce a suitable range of tablet strengths for getting onto the med, but not for getting off it! This part doesn't seem to receive much consideration.
Or just tablets that are scored and easy to split or smaller doses in the case of drugs like Zyprexa for people that do well on a very low dose and want to use it for maintenance like me-VERY FRUSTRATING!
Posted by cycling on August 2, 2010, at 22:41:33
In reply to Re: Cycling, How are things?, posted by morgan miller on August 1, 2010, at 14:07:48
I've been a little busy for the past two days or so with my birthday then two doctor appointments today. Today i saw a psych doc and my pdoc. New regiment as follows:
900mg lithium carb (same)
100mg lamictal (tapering)
300mg seroquel xr
5mg lexaproDoes anyone have any thoughts with the addition of lexapro to my regiment? My pdoc insists that I fit in the bipolar spectrum because I have mania. He's going with mania as my diagnosis. There's a part of me that can't disagree with him. I start the lexapro tomorrow so we'll see how i feel. usually ADs aren't given to people with mania for its been known to increase anxiousness.
thoughts?
Posted by morgan miller on August 3, 2010, at 0:16:15
In reply to Re: Cycling, How are things? » morgan miller, posted by cycling on August 2, 2010, at 22:41:33
> I've been a little busy for the past two days or so with my birthday then two doctor appointments today. Today i saw a psych doc and my pdoc. New regiment as follows:
>
> 900mg lithium carb (same)
> 100mg lamictal (tapering)
> 300mg seroquel xr
> 5mg lexapro
>
> Does anyone have any thoughts with the addition of lexapro to my regiment? My pdoc insists that I fit in the bipolar spectrum because I have mania. He's going with mania as my diagnosis. There's a part of me that can't disagree with him. I start the lexapro tomorrow so we'll see how i feel. usually ADs aren't given to people with mania for its been known to increase anxiousness.
>
> thoughts?I think your pdoc made a pretty decent move here. I prefer Zoloft just because I am biased and love it's profile, but Lexapro may be best for you right now.
Actually, ADs can take someone straight out of a mixed state agitated mania(which I believe you experience a kind of). I had my first mixed state(I didn't know it at the time) when I was 22 and a pdoc gave me 20 mg of Prozac. For 3 weeks I noticed nothing a I was still suffering thinking it may never work. I was encouraged to keep taking it by my mom and I knew that these drugs could take a while to work. At almost exactly 3 weeks, I woke up, took my strange little pill, and withing the hour I felt f*ck*ng amazing. All of my anxiety, racing thoughts, obsessive thoughts, and depression were completely obliterated. It really was a magical experience that I probably will never have again. Prozac worked! I will admit though, I was on the hypomanic side for sure, especially when I drank. But, much of the time, I was pretty chill. After 9 months I decided I didn't want to be medicated and I stopped taking Prozac. I wish I had had an inkling of an idea that I was bipolar, it may have impacted the way I went about many things in my 20s and early 30s.
I think you should stay on 5mg Lexapro for at least a month before even thinking twice about raising the dose. Lexapro is VERY powerful and doctors often prescribe way too much. My friend does great on just 10 mg. I've even considered adding 2.5 mg to the mix just for sh*ts and giggles(well really for my hurting brain and mental health!). Lexapro may be extremely effective at easing your anxiety and obsessive thinking.
Maybe in a month, if you start feeling much better, you can lower your Lithium dose to 600 mg and start weaning off the seroquel. You are already getting off Lamictal, so eventually and ideally you could just be on Lexapro and lithium.
Why the Seroquel again? I'm sure your pdoc is trying to treat what he believes is a form of mania(and he may very well be right). So the Seroquel doesn't sedate you? Or does it? And you are NOT taking it for sleep, is that correct?
Posted by cycling on August 4, 2010, at 1:43:16
In reply to Re: Cycling, How are things?, posted by morgan miller on August 3, 2010, at 0:16:15
> Maybe in a month, if you start feeling much better, you can lower your Lithium dose to 600 mg and start weaning off the seroquel. You are already getting off Lamictal, so eventually and ideally you could just be on Lexapro and lithium.
What he wants to do is wean me off the Lithium and keep me on Seroquel and lexapro. But, we just found out my insurance doesn't accept seroquel and seroquel is reallll expensive. Right now he gave me about 1-2 months supply of seroquel at 300mg daily at night.
>
> Why the Seroquel again? I'm sure your pdoc is trying to treat what he believes is a form of mania(and he may very well be right). So the Seroquel doesn't sedate you? Or does it? And you are NOT taking it for sleep, is that correct?Correct. I'm given seroquel to hopefully calm down the racing thought. He believes I have mania, and honestly, I believe I have it too. Initially, my symptoms were: pressured speech, racing thoughts, irritability, impulsiveness, extreme intensity, and high confidence. I wanted to deny I had mania but after taking a step back, I think I agree with him on the diagnosis.
So the deal now is, there's no way he can provide me samples of seroquel for the next how long this is going to take, and currently my thoughts are still racing. If the Lexapro does not calm down the thoughts and I can't use seroquel (150mg hasn't helped thaat much), what do I use? What are some common treatment combinations for the long term treatment of mania?
I'm hoping I can get over this episode and not have to be on my meds for the rest of my life. I'd also like to have people's thoughts on this as well. Do people with diagnosed mania usually stay on a regiment of meds or can they move on with their merry lives and never look back?
Posted by SLS on August 4, 2010, at 3:58:30
In reply to Effective Treatments for Mania » morgan miller, posted by cycling on August 4, 2010, at 1:43:16
You might have bipolar II. Depakote (valproate) can be a very effective treatment for the manic component of this disorder. The other drug that comes to mind is Zyprexa (olanzapine).
- Scott
Posted by cycling on August 4, 2010, at 4:05:01
In reply to Re: Effective Treatments for Mania » cycling, posted by SLS on August 4, 2010, at 3:58:30
what makes you think I have bp2 over bp1? and what is the difference? bear in mind i don't have swings
Posted by SLS on August 4, 2010, at 4:30:28
In reply to Re: Effective Treatments for Mania » SLS, posted by cycling on August 4, 2010, at 4:05:01
> what makes you think I have bp2 over bp1? and what is the difference? bear in mind i don't have swings
There are some people who experience chronic hypomania. The difference between the manic episodes of bipolar I and bipolar II are largely a matter of degree of severity. Bipolar II is characterized by the less severe hypomania. I may have assumed too much about the severity of your mania. You don't seem to be delusional or psychotic, and you function well enough to have insight into your illness. I might be wrong, of course.
http://www.fortunecity.com/campus/psychology/781/dsm.htm
- Scott
Posted by cycling on August 4, 2010, at 4:40:39
In reply to Re: Effective Treatments for Mania » cycling, posted by SLS on August 4, 2010, at 4:30:28
i must admit, it is very interesting you bring up bp2 though. if you do some searches on here, there's a thread about overlapping symptoms between adhd and bp2. growing up we (my family) knew i was hyperactive, but i never really had problems in class for my GPA was always near the 4.0 range. It makes me think whether my hyperness was adhd (which we all thought it was) or underlying mania. I don't believe I suffer from psychosis which would kick me out of the bp2 range correct? I am aware of whats going on in my head, and I'm coherent enough to understand this is all one big pain in the *ss. I don't think someone with psychosis could analyze this situation in such a manner. I'm just hoping one day soon I get these meds right. I understand its a process, but damn do I want to get on with my life and live the life that I want underneath this mess. so would you reccommend a mood stabalizer in my case over an antipsychotic like seroquel or abilify?
Posted by SLS on August 4, 2010, at 5:16:48
In reply to Re: Effective Treatments for Mania » SLS, posted by cycling on August 4, 2010, at 4:40:39
> i must admit, it is very interesting you bring up bp2 though. if you do some searches on here, there's a thread about overlapping symptoms between adhd and bp2.
Bipolar disorder often occurs comorbidly with ADD/ADHD.
> growing up we (my family) knew i was hyperactive, but i never really had problems in class for my GPA was always near the 4.0 range.
I don't know how to interpret this.
Depakote or antipsychotic? 10 years ago, I would have easily chosen Depakote first. However, I now feel that most atypical antipsychotics are generally safe. I guess Risperdal would be the exception when used at dosages above 3mg. If you do decide upon trying Depakote, it is advisable to test for liver enzymes during the first 6 months. I think Depakote has become an overlooked drug.
- Scott
Posted by morgan miller on August 4, 2010, at 10:22:39
In reply to Re: Effective Treatments for Mania » SLS, posted by cycling on August 4, 2010, at 4:40:39
> i must admit, it is very interesting you bring up bp2 though. if you do some searches on here, there's a thread about overlapping symptoms between adhd and bp2. growing up we (my family) knew i was hyperactive, but i never really had problems in class for my GPA was always near the 4.0 range. It makes me think whether my hyperness was adhd (which we all thought it was) or underlying mania. I don't believe I suffer from psychosis which would kick me out of the bp2 range correct? I am aware of whats going on in my head, and I'm coherent enough to understand this is all one big pain in the *ss. I don't think someone with psychosis could analyze this situation in such a manner. I'm just hoping one day soon I get these meds right. I understand its a process, but damn do I want to get on with my life and live the life that I want underneath this mess. so would you reccommend a mood stabalizer in my case over an antipsychotic like seroquel or abilify?
I bet your symptoms of ADHD were your genetic predisposition to bipolar manifesting.
If your going to take an atypical antipsychotic, I think you should be taking Zyprexa(at night) instead of Seroquel(overprescribed drug that sucks donkey dong IMHO).
So wait, did I read this right(sheesh my short term memory is bad right now-this is one thing that could happen to you if you don't take all precautions to prevent bipolar from developing into something much worse than what it is now), your doc wants to take you off lithium? I would at least stay on a low dose, maybe 300 mg. I am finding that 300 mg of extended release lithium carbonate has been working well for me lately.
Honestly, I believe it is very possible you will not have to stay on an antipsychotic or a mood stabilizer like depakote. If lexapro ends up helping you a ton, you may be able to get away with just taking it along with a low dose of lithium. I did just fine for years on SSRIs alone, free of any crappy side effects that atypicals and mood stabilizers(which were originally developed to treat epilepsy), and I think I have a version of bipolar I. I admit that I did take fish oil and I had to exercise vigorously 5 to 6 days a week. I also needed to moderate alcohol intake(which I did NOT do much of the time. I took breaks but would always return to partying and social binge drinking out of boredom and having some underlying psychological issues-the reason why I emphasize therapy). I also think I may have benefited from a little lithium back in those days of SSRI monotherapy.
Your pdoc is way too high on seroquel like many others are. I really think you should drop the seroquel and add a low dose(maybe 2.5 to 5 mg) of zyprexa. Then wait and see if Lexapro works any magic. If and when it does, maybe you can wean off Zyprexa and just stay on just Lexapro and Lithium. You may even want to just stay on a low dose of Seroquel, and if you start feeling much better on Lexapro, wean off Seroquel and see how you feel on just Lexapro and Lithium. It's possible Lexapro monotherapy along with fish oil, exercise, therapy, and maybe a few other supplements, may be enough to keep you stable and feeling good for a long time.
I'm not sure if you should even be thinking about being medication free right now. I believe, in your case, it is possible at some point down the road. I know of some people that are bipolar and have succeeded at getting off all medications. A
few of them were taking low doses of lithium orotate or lithium aspartate, though, which may be a good idea for you if you ever do successfully get off pharmaceuticals. I also know that some of these people figured out that certain vitamins and minerals and other supplements helped manage things. Things like exercise and meditation may also be necessary to achieve medication free success.Morgan
Posted by morgan miller on August 4, 2010, at 10:35:05
In reply to Re: Effective Treatments for Mania » cycling, posted by SLS on August 4, 2010, at 5:16:48
> > i must admit, it is very interesting you bring up bp2 though. if you do some searches on here, there's a thread about overlapping symptoms between adhd and bp2.
>
> Bipolar disorder often occurs comorbidly with ADD/ADHD.
>
> > growing up we (my family) knew i was hyperactive, but i never really had problems in class for my GPA was always near the 4.0 range.
>
> I don't know how to interpret this.
>
> Depakote or antipsychotic? 10 years ago, I would have easily chosen Depakote first. However, I now feel that most atypical antipsychotics are generally safe. I guess Risperdal would be the exception when used at dosages above 3mg. If you do decide upon trying Depakote, it is advisable to test for liver enzymes during the first 6 months. I think Depakote has become an overlooked drug.
>
>
> - ScottI agree with Scott that Depakote may help. You may only need as little as 500 mg. Do NOT buy into this b*llsh*t idea that you NEED to have Depakote blood levels at the therapeutic threshold in order for it to be a successful treatment. This is also the case with Lithium. I do think it is necessary to reach therapeutic blood serum levels when treating more sever acute mania, but for someone like you, sub clinically therapeutic levels may be enough to be effective.
I would actually try Depakote first, drop the Seroquel, and avoid Zyprexa(for now).It is possible that you may need to go higher on Depakote and reach the therapeutic serum level range in order for it to really work for you. If you try Depakote, just make sure you tell your doctor you want to try to take the lowest most effective dose possible, even if your blood levels are sub clinically therapeutic.
One cool thing about Depakote is that it promotes the production of progenitor stem cells-it's always nice to see the brighter sides of some of these meds that can sometimes get a bad name for causing side effects(another reason to try to stay on a lower dose since side effects can be dose dependent) like weight gain.
Morgan
Posted by bleauberry on August 4, 2010, at 16:09:32
In reply to Re: Effective Treatments for Mania, posted by morgan miller on August 4, 2010, at 10:22:39
I know this is weird to those who look at psychiatry through defined parameters, as if they were any, but for shutting down racing thoughts and/or mania the fastest things I have ever encountered were:
Serotonin boosting...ultra low doses of zoloft, lexapro, or cymbalta. Take a normal dose and expect symptoms to be worse. It only takes a smidgen of extra serotonin to calm things way down, too much will destabilize things. We're talkling 1mg lex, 6mg zoloft, 1mg cymbalta.
Antimicrobial herbs....antibiotic, antifungal, antiparasite, whatever....I believe a great deal of psychiatric sufferers have one of these problems involved. Perhaps not as a causative factor, but as an opportunistic factor. All I know is, any of the above have brought me from intense racing/mania to calm within 24 hours, and I'm not alone in that experience.
I personally do not like going straight to mood stabilizers or antipsychotics when mania/racing thoughts are the symptoms. Save them for later after simpler things have been tried. The simpler things can not only work real good and fast, but can give clues to help decide the next course of action if any. For example I mentioned serotonin and antimicrobials, but if someone goes straight to a potent drug without at least trying some magnesium first, that seems hasty and unjustified IMO.
Posted by cycling on August 4, 2010, at 21:13:29
In reply to Re: Effective Treatments for Mania, posted by bleauberry on August 4, 2010, at 16:09:32
> I know this is weird to those who look at psychiatry through defined parameters, as if they were any, but for shutting down racing thoughts and/or mania the fastest things I have ever encountered were:
>
> Serotonin boosting...ultra low doses of zoloft, lexapro, or cymbalta. Take a normal dose and expect symptoms to be worse. It only takes a smidgen of extra serotonin to calm things way down, too much will destabilize things. We're talkling 1mg lex, 6mg zoloft, 1mg cymbalta.
>
> Antimicrobial herbs....antibiotic, antifungal, antiparasite, whatever....I believe a great deal of psychiatric sufferers have one of these problems involved. Perhaps not as a causative factor, but as an opportunistic factor. All I know is, any of the above have brought me from intense racing/mania to calm within 24 hours, and I'm not alone in that experience.
>
> I personally do not like going straight to mood stabilizers or antipsychotics when mania/racing thoughts are the symptoms. Save them for later after simpler things have been tried. The simpler things can not only work real good and fast, but can give clues to help decide the next course of action if any. For example I mentioned serotonin and antimicrobials, but if someone goes straight to a potent drug without at least trying some magnesium first, that seems hasty and unjustified IMO.Can anyone back this up? No offense bleau, but those are bold statements and I would like to see if anyone had a similar experience. I appreciate the the other side's point of view, its good to take into account.
From the looks of the posts, I think it can be agreed that Depakote would be a good choice of treatment for my symptoms. Is depakote taken with lithium? Can depakote be taken with loses of ssri's? Is that a common treatment?
cycling
Posted by morgan miller on August 4, 2010, at 23:45:59
In reply to Re: Effective Treatments for Mania » bleauberry, posted by cycling on August 4, 2010, at 21:13:29
BB may be on to something. I think you may have felt better and had more success if you had originally tried an SSRI like Lexapro to begin with. Like I said before, I had a ton of success with SSRI monotherapy in the past and I am pretty sure I have some version of Bipolar I.
Doctors are just following protocol and are a little overly cautious in my opinion.
I think you should give Lexapro a good 6 weeks, see how you feel, and if you feel much better and your thought process has greatly improved, see what Lexapro monotherapy does for you. I still think staying on a low dose(no more than 600 mg) is a good idea.
If you do take Depakote, it is perfectly fine to combine it with Lithium. There is some recent evidence that the two may work very well together.
I still say wean off Seroquel, wean off Lamictal, stay on a low dose of Lithium, and give Lexapro a good 4 to 6 weeks before you know if it is going to give you any relief.
In the meantime, you may want to look into the supplements I suggested earlier.
Also, you may want to find another more open minded pdoc. I don't like any pdoc who is quick to prescribe Seroquel and want to stick with it, upping the dose. I just think there are better options and a really good pdoc would know this.
Posted by cycling on August 5, 2010, at 0:10:17
In reply to Re: Effective Treatments for Mania, posted by morgan miller on August 4, 2010, at 23:45:59
After this veryyy long thread (sry about that) I think we've got somewhere. Lithium and an SSRI. I haven't felt any better since being on seroquel, so I think you guys are right. The only drug that I've been prescribed so far that I felt a difference with was the Lithium...it decreased my intensity significantly. My insurance doesn't cover Lexapro but it seems like many are having improvement with Luvox. Next time I'm going to mention Luvox to my doc and by that time i'll be off lamictal and hopefully he'll be open minded enough to try the SSRI route. He's always been hesitant about the SSRI route because he thought it'd increase hte mania, but the racing thoughts may very well be ocd-derived, which I think it is. In the meantime, I'll keep up the exercise 5-6 days/week, keep on taking my omega-3's epa 2.5grams/day, and get some good magnesium while I'm at it. And Morgan, thanks a lot. I do have one question, how many of your friends know about your meds?
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