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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Cass on February 24, 2000, at 20:09:24
Hi everyone,
The title says it all. Well, I guess it doesn't. I am still have highs and lows like crazy. My internist once prescribed Lithium to see if I would respond. I did not. I have not been diagnosed as bipolar. I'm on Celexa which I think has made some difference in my depression but not enough. My diagnosis has been borderline personality. I have social anxiety and anxiety in general. I have suicidal fantasies, but I'm not at the point of acting on it. I see my pdoc tomorrow. I've heard so many positive things about Naltrexone, I think I might suggest it. Especially since I binge drink on occasion. I feel that I have ADD. I have not been diagnosed, so I may suggest Adderall too. Just thought I'd get any feedback you all have for me.
Thanks,
Cass
Posted by Janet on February 24, 2000, at 20:36:00
In reply to Dang depressed, posted by Cass on February 24, 2000, at 20:09:24
> Hi everyone,
> The title says it all. Well, I guess it doesn't. I am still have highs and lows like crazy. My internist once prescribed Lithium to see if I would respond. I did not. I have not been diagnosed as bipolar. I'm on Celexa which I think has made some difference in my depression but not enough. My diagnosis has been borderline personality. I have social anxiety and anxiety in general. I have suicidal fantasies, but I'm not at the point of acting on it. I see my pdoc tomorrow. I've heard so many positive things about Naltrexone, I think I might suggest it. Especially since I binge drink on occasion. I feel that I have ADD. I have not been diagnosed, so I may suggest Adderall too. Just thought I'd get any feedback you all have for me.
> Thanks,
> CassDear Cass, I'm sorry that I can't help as I've had no experience of your symptons ( I'm just Low the whole time) or the medication. But I wish you all the best tomorrow with your doctor. Please tell us how you get on . Best Wishes Jan
Posted by Janice on February 24, 2000, at 20:59:49
In reply to Re: Dang depressed, posted by Janet on February 24, 2000, at 20:36:00
Hello Cass, I've had too much experience with your type of symptoms. I'm a rapid cycler bipolar and ADHD. Everything else I have is just coping mechanism for these 2 disorders (OCD, anorexia, anxiety, binge eating, drinking... blah, blah, blah).
Yes, yes yes! Look beyond anti-depressants and try medications from the other groups (stimulants, mood stabilizers, anti-psychotics)...I knew very quickly when one worked for me - and never did an AD work.
The best of luck, Janice
Posted by Chris A. on February 24, 2000, at 21:39:46
In reply to Re: Dang depressed, posted by Janice on February 24, 2000, at 20:59:49
I wouldn't give up on mood stabilizers altogether just because Lithium didn't work, (Depakote, Tegretol, Lamictal, Neurontin, Topomax, Verapamil, Klonipin, Nimotop). I don't tolerate ADs, which took years to figure out. They actually make the depression worse, if that is possible. The Merck Manual at this site talks a lot about variations of mood disorders and their friends. I pray you get some relief - and soon. I have resorted to ECT, but it isn't for everyone either.
Posted by Noa on February 24, 2000, at 22:02:34
In reply to Re: Dang depressed, posted by Chris A. on February 24, 2000, at 21:39:46
sorry you are down.
Posted by medlib on February 24, 2000, at 22:28:20
In reply to Dang depressed, posted by Cass on February 24, 2000, at 20:09:24
Cass-
Sorry I don't know your Rx history--have you tried Wellbutrin? It has been very successful for my brother who has BPD.
medlib> Hi everyone,
> The title says it all. Well, I guess it doesn't. I am still have highs and lows like crazy. My internist once prescribed Lithium to see if I would respond. I did not. I have not been diagnosed as bipolar. I'm on Celexa which I think has made some difference in my depression but not enough. My diagnosis has been borderline personality. I have social anxiety and anxiety in general. I have suicidal fantasies, but I'm not at the point of acting on it. I see my pdoc tomorrow. I've heard so many positive things about Naltrexone, I think I might suggest it. Especially since I binge drink on occasion. I feel that I have ADD. I have not been diagnosed, so I may suggest Adderall too. Just thought I'd get any feedback you all have for me.
> Thanks,
> Cass
Posted by Elizabeth on February 25, 2000, at 18:37:49
In reply to Dang depressed, posted by Cass on February 24, 2000, at 20:09:24
> Hi everyone,
> The title says it all. Well, I guess it doesn't. I am still have highs and lows like crazy. My internist once prescribed Lithium to see if I would respond. I did not. I have not been diagnosed as bipolar. I'm on Celexa which I think has made some difference in my depression but not enough. My diagnosis has been borderline personality. I have social anxiety and anxiety in general. I have suicidal fantasies, but I'm not at the point of acting on it. I see my pdoc tomorrow. I've heard so many positive things about Naltrexone, I think I might suggest it. Especially since I binge drink on occasion. I feel that I have ADD. I have not been diagnosed, so I may suggest Adderall too. Just thought I'd get any feedback you all have for me.
> Thanks,
> CassHi Cass. I agree with what has been said so far --wanted to add that I have heard naltrexone helps people who have dissociative tendencies, in case that is a problem for you.
It was found a while ago that some children with conduct disorder and adults with antisocial personality or history of conduct disorder responded to stimulants; more recently, it's been argued that there may be a connection between ADHD and BPD. It's hard to predict who will do well on stimulants, but I think it might be worth a try. An alternative is MAOIs, since they're less likely to make your anxiety worse. (That would require dropping the Celexa, though, which might not be such a hot idea since the Celexa is helping somewhat.)
Whatever you end up doing, good luck.
Posted by Renee N on February 26, 2000, at 0:13:45
In reply to Re: Dang depressed, posted by medlib on February 24, 2000, at 22:28:20
> Cass-
> Sorry I don't know your Rx history--have you tried Wellbutrin? It has been very successful for my brother who has BPD.
> medlib
>
Medlib, Wellbutrin is not usually prescribed for bipolar disorder. It can induce mania in those who are susceptable. Renee N
Posted by Brandon on February 26, 2000, at 0:40:40
In reply to Wellbutrin, posted by Renee N on February 26, 2000, at 0:13:45
> Medlib, Wellbutrin is not usually prescribed for bipolar disorder. It can induce mania in those who are susceptable. Renee N
Wellbutrin actually has a smaller chance to induce mania than the SSRI's. This is why a lot of doc's do prescribe it for BPD.
Posted by Renee N on February 26, 2000, at 1:37:09
In reply to Re: Wellbutrin, posted by Brandon on February 26, 2000, at 0:40:40
>
>
> > Medlib, Wellbutrin is not usually prescribed for bipolar disorder. It can induce mania in those who are susceptable. Renee N
>
> Wellbutrin actually has a smaller chance to induce mania than the SSRI's. This is why a lot of doc's do prescribe it for BPD.Cam W. or Dr. Bob, Please help us out here. What have you read, know, or have experience with concerning Wellbutrin and mania and Bipolar disorder?
Posted by medlib on February 26, 2000, at 3:39:52
In reply to Re: Wellbutrin +mania, posted by Renee N on February 26, 2000, at 1:37:09
> >
> >
> > > Medlib, Wellbutrin is not usually prescribed for bipolar disorder. It can induce mania in those who are susceptable. Renee N
> >
> > Wellbutrin actually has a smaller chance to induce mania than the SSRI's. This is why a lot of doc's do prescribe it for BPD.
>
> Cam W. or Dr. Bob, Please help us out here. What have you read, know, or have experience with concerning Wellbutrin and mania and Bipolar disorder?Renee and Brandon--
Thanks for the input! Renee, when I read your first post my initial reaction was, "Uhoh, that'll teach me to pop off on impulse." I wouldn't put it past my brother to have found success with something no other BPD in North America uses. He's that weird. Although never formally diagnosed as bipolar, he did take Lithium for several months before the side effects drove him off of it. (He takes 600mg./day of Wellbutrin and has had no mania, but episodic depression, for 2+ years.)
Normally, I don't make a suggestion or offer what I believe to be a fact without something to back it up; this time I had. When Brandon's post came in, I decided to do what I should have done in the first place. A quick-and-dirty Medline search turned up this citation on the first page of the results. Frances AJ et al, "The Expert Consensus Guidelines for Treating Depression in Bipolar Disorder." J Clin Psychiatry. 1998; 59 Suppl 4:73-79. From the abstract:
"Among the antidepressants, the experts prefer bupropion and selective serotonin reuptake inhibitors as first line. They also believe that bupropion is least likely among antidepressants to cause switches to mania."Of course, this is just one study. If I had the energy, I'd go search AHCPR to see if that's made it to government officialdom.
Interesting point, anyway. I'd like to hear from psych clinicians, too.
medlib
Posted by Cam W. on February 26, 2000, at 8:39:44
In reply to Re: Wellbutrin +mania, posted by medlib on February 26, 2000, at 3:39:52
Renee - I have only seen Wellbutrin used as an add-on antidepressant in bipolar disorder (eg to combat sexual dysfunction of SSRIs). The books do say there is a low propensity for manic switch with Wellbutrin, but since it can be activating and is relatively new, many doctors do not seem to use Wellbutrin as a first-line antidepressant in bipolar disorder. I haven't heard of Wellbutrin causing manic switch, but since it can happen with any antidepressant, it probably has happened with Wellbutrin. Hope this helps - Cam W.
Posted by Noa on February 27, 2000, at 10:20:50
In reply to Re: Wellbutrin +mania, posted by Cam W. on February 26, 2000, at 8:39:44
Cass, we haven't heard back from you. Please let us know how you are doing.
This is the end of the thread.
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