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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by cynthia on March 2, 2000, at 11:14:00
I am currently taking 400mg Topomax and 2000mg Tegretol and 200mg Seroquel a day. I have BipolarII with rapid cycling and have been struggling with control for a while. I have experienced a very severe depression and was hospitalized and was told I could not take an anti-depressant because I am bipolar. I am also taking.175mg of synthroid due to hypothyroidism. Now I am faced with having to slowly discontinue all of my meds over the next three months and I have formulated a planthat would decrease one drug at a time by 50 mg over a three day period. I guess my question is, is it possible to be bipolar and not be on any medication? and Is it possible to get off this much medication without causing any damage. I have absolutely no choice. There are no other options at this point. Any opinions would be appreciated.
Posted by Brenda on March 2, 2000, at 11:22:47
In reply to Weaning off of bipolar meds, posted by cynthia on March 2, 2000, at 11:14:00
> I am currently taking 400mg Topomax and 2000mg Tegretol and 200mg Seroquel a day. I have BipolarII with rapid cycling and have been struggling with control for a while. I have experienced a very severe depression and was hospitalized and was told I could not take an anti-depressant because I am bipolar. I am also taking.175mg of synthroid due to hypothyroidism. Now I am faced with having to slowly discontinue all of my meds over the next three months and I have formulated a planthat would decrease one drug at a time by 50 mg over a three day period. I guess my question is, is it possible to be bipolar and not be on any medication? and Is it possible to get off this much medication without causing any damage. I have absolutely no choice. There are no other options at this point. Any opinions would be appreciated.
Is it possible that a lower dose of Topamax would help. I have found that Topamax is also used for treating depression, as well as BPII. Maybe at trial of Topamax alone.
Posted by judy on March 2, 2000, at 11:59:42
In reply to Re: Weaning off of bipolar meds, posted by Brenda on March 2, 2000, at 11:22:47
There is an excellent book entitled "Your Drug May Be Your Problem" by Peter Breggin, M.D. that should help you formulate a tapering plan. May I suggest a good psychologist to help you through this and an MD to monitor any physical symptoms of withdrawal. I got off depakote, tegretol, risperdal, wellbutrin and klonopin. I am bipolar 1, rapid cycling and despite excellent care landed up in the hospital with a manic episode. I do know someone dxed bipolar 2 who has been relatively stable for about 6 months without meds, she practices good "sleep hygeine"- recommeneded by Dr. Mondimore, takes valerian when anxious and to help sleep, and st. johns wort for depression. So I guess you would consider it a more holistic approach- she also has a sympathetic therapist. So it can be done, and I wish you the best of luck. Take care.
Posted by Chris A. on March 2, 2000, at 19:41:26
In reply to Weaning off of bipolar meds, posted by cynthia on March 2, 2000, at 11:14:00
I hope you have a good working relationship with a pDoc. Clinically our illnesses sound similar - the rapid cycling, hypothyroidism, inability to tolerate ADs, etc. I am off of mood stabilizing meds (tried them all) for the first time in five years to try a course of ECT. My doc wanted me inpatient to taper the meds quickly. The ECT may be doing the trick! I second the recommendation for Mondimore's book "Bipolar Disorder," (John Hopkin's U. Press).
Posted by cynthia on March 3, 2000, at 9:52:01
In reply to Re: Weaning off of bipolar meds, posted by Chris A. on March 2, 2000, at 19:41:26
While I am trying to wean off these drugs, where do I find the reading materials that will support me? I live in a very rural area and transportation is a problem. Is there somewhere I could call to order the books? Also, what physical symptoms might I be looking out for while doing a slow taper? I have been dropping the Seroquel by 50 mg every 3 days and have noticed that I am actually starting to dream again! I feel like I am actually sleeping now instead of just closing my eyes and then just opening thenm and its morning. Has anyone else had this experience? I have started to have a little more rapid thought processing but I am trying to manage this by journaling and with increased physical activity. I am very nervous about this whole process but I am determined. I guess I just need to hear that It can be done. Thank you so much for replying, it helps to know that there are people out there that are dealing with the same issues.-Cynthia
Posted by Janice on March 3, 2000, at 12:09:14
In reply to Re: Weaning off of bipolar meds, posted by cynthia on March 3, 2000, at 9:52:01
Hello Cynthia,
I am also a rapid cycler. Personally, I have never heard of a bipolar person doing well off their medication.
Two times I went off lithium...once I went high, and the second time, after 5 days, the bottom fell out of my life...and I found myself impulsively reaching for pills, any pills, to try to change the way I was feeling. Fortuneately, I caught my impulse in time. I hope you have people around that can gauge your moods for you.
Okay, I'll try to be some help. Following are the practical steps I've taken to help control my rapid cycling. I have listed them in the order that I have found them to help.
1.Go to bed at the same time every night (whether you sleep or not).
2.Get up at the same time every morning (whether you have slept or not).Mania, for me, (I've heard this is common for rapid cyclers) is often brought on by too little sleep, and depression is often brought on by too much sleep.
3.Use a dawn simulator to wake up to.
4.I also use lights (either a visor or light box) sometime in the late morning or early afternoon throughout the late fall and winter. You can find the time of day that lights work best for you, but make sure the timing is consistent.From what I understand, most rapid cyclers experience a seasonal cycle too. I do!
5. Eat nutritiously and at regular times.
I also am a runner. I LOVE running, and it equals the best of any medication I've ever used. But I also have ADHD, and I tend to think my running helps the ADHD more than the bipolar.
You also may want to look into the Omega Oils - there are many posts on this in the archives.
If you are looking for books, why not go to Amazon.com. They will deliver them to your house.
I have never had any physical symptoms (except for insanity) from stopping my medications, so I am unable to help you there. Good luck Cynthia.
I am a little curious as to why you are doing this? If it can be done, come back and let us know. If you have any questions for me, please ask.
take care, Janice
Posted by cynthia on March 4, 2000, at 16:33:10
In reply to Re: Weaning off of bipolar meds, posted by Janice on March 3, 2000, at 12:09:14
janice-=i can't do it. I thought i had no choice. but I have had to swallow my pride and go back to my doc and stay on my meds. I had just gone down 600mg on the Tegretol and had started feeling cycling with a lot of irritability and some intermittent mania. I have just gotten tired of all of this and I don't want to be dependant on drugs and I don't want to be crazy. I guess I am expecting too much. My life responsibilities are way too much that I can't afford to risk the possibility of crashing. I have to do what ever I can to stabalize this episode. I have nine children, yes nine. and my oldest is diabetic.,I know that trying to get off my meds would be like him giving up of his insulin. Not a posibility. My parents offer no support that they do not "believe" in bipolar. My husband is wonderful and very supportive. I have way too many people depending on me to risk crashing.It is so hard to be dependant on this stuff, am I alone in this thinking? I was just started on Remeron 45mg yesterday. I am hoping it will help. thanks so much for your support. It helps to know that there are other poeple out there like me who are dealing with this. I am scared of the feelings of being out of control. I think reading and learning more will help. -Cynthia
Posted by Chris A. on March 4, 2000, at 17:04:08
In reply to Re: Weaning off of bipolar meds, posted by cynthia on March 4, 2000, at 16:33:10
You are a brave, wise, unselfish soul. I commend you for your decision to bite the bullet and take the meds - do whatever it takes to stabilize. I'm sure your family will appreciate it. It is a lot like diabetes - a juggling act. I find my diabetic friend seems to understand my rapid cycling bipolar more than others. Please know that you are not alone in this. The only reason I'm not taking meds right now is because of the ECT treatments. Hang in there!
Chris A.
Posted by Janice on March 4, 2000, at 22:11:12
In reply to Re: Weaning off of bipolar meds, posted by cynthia on March 4, 2000, at 16:33:10
Hi Cynthia,
Yes, it's hard to be dependent on this stuff when it doesn't work well, or the side effects are bad. That is for certain! Sorry to hear your parents don't 'believe' in bipolar - they really are lucky to have this option. As far as I can tell, it's biology. I wish you many middle moods for many years to come, Janice
Hello Chris,
I am anxious to hear how successful ECT is for you. Does it generally work well for rapid cyclers? If I never find an AD that works for me, I will keep this option open. Although I am only moderately depressed and functioning fully, I'm not having the greatest life. I am going to get this book by Dr. Mordimund. Thanks for the reference.
I imagine many rapid cyclers have problems finding ADs. Janice
Posted by Chris A. on March 5, 2000, at 1:17:56
In reply to Cynthia Chris A, posted by Janice on March 4, 2000, at 22:11:12
Janice,
The jury is still out on the ect. We are changing the electrode placement Monday. If we obtain good results I'll continue with maintenance treatments, hopefully no more than once a month. My consulting pyschopharmacologist has recommended avoiding ADs altogether as long as I have any hint of mixed or hypomanic symptoms. That includes my lightbox!
He thinks ADs will make my mood worse in the long run. The only mood stabilizers I haven't given a fair trial are the Omega Three oils. It would be nice to banish the depression without too many side effects.Chris A.
Posted by Cynthia on March 5, 2000, at 12:24:58
In reply to Cynthia Chris A, posted by Janice on March 4, 2000, at 22:11:12
Janice- Thanks so much for the encouragement- I am sure that I need to do the right thing and I am too scared right now to not be on meds. I did not like the way I felt just being down just 600mg. on the Tegretol. I really felt like I was starting to cycle and my family had really been on a roller coaster the last few weeks. It is hard enough for me but they need me to be as even as possible. Have you read anything that has been valuable in offering insights into managements of the guilt and stigmas of this beast? I cant seem to shake the "something is wrong with me" feeling right now. I think it would help a lot if I were to read and become more educated on the subject. Thanks so much for your input.-Cynthia
Posted by Janice on March 6, 2000, at 0:11:34
In reply to Janice, posted by Cynthia on March 5, 2000, at 12:24:58
Hi Cynthia,
Shaking the guilt and stigma is tough. Our illness is responsible for our moods, but we are responsible for our actions, which often happen as a result of our moods - hence the guilt and remorse.What I do to combat this is keep trying to find medications that can keep my moods healthy and on an even keel. Therapy should help with this, but it doesn't seem like it has. Of course education helps - probably the most after medication. I've read a fair amount of books by Kay Jamieson, but I find she often mistakes ADHD for manic depression. Although both disorders have racing thoughts, she never distinguishes the difference between the type and quality of racing thoughts. I find she never really distinguishes between the two disorders. She also misinterprets poetry.
Alot of people like her Cynthia, and her writing is pleasant enough. I believe she is a scientist, has manic depression and is respected in her field. Me, I'm going to try this Dr. Morimund.
Hey, if I have spelt this author's name incorrectly, let me know. Remember, you never asked for or wanted these mood swings. It sure is a hard thing to separate from yourself though!
Take care, Janice
Posted by Janice on March 6, 2000, at 9:50:33
In reply to Cynthia, posted by Janice on March 6, 2000, at 0:11:34
Thanks Janice- I will try to get as much reading material as I can. I think it will help me validate the illness. I really appreciate your remarks and I am hoping to me able to get the meds right and get on and even keel. Right now I just keep thinking there is something horribly wrong and I am certain it must be the combination of meds. I am nowhere as capable as I was even six months ago. It is imperative that I become functional. I will keep reading. Thanks again- Cynthia
Posted by Chris A on March 6, 2000, at 15:00:32
In reply to Cynthia, posted by Janice on March 6, 2000, at 0:11:34
The author is Francis Mark Mondimore, M.D. The title is "Bipolar Disorder - A guide for Patients and Families." It's published by The Johns Hopkins University Press, 1999. ISBN 0-8018-6118-7. It's a fairly comprehensive, practical guide. It would be the first reference I would recommend to someone diagnosed bipolar and their families. I have a habit of reading everything I can get my hands on. Now to get well!
I wish the same for you.Chris A.
Posted by cynthia on March 7, 2000, at 9:19:58
In reply to Re: Author's name, posted by Chris A on March 6, 2000, at 15:00:32
Chris-thanks so much for the info on the book I will buy it as soon as I can get to a book store!I too am one to read as much as I can and for some reason have been remiss in the area of bipolar. I have been reading the book by Danielle Steel. I think it is a fast read and very strong on the point of how serious bipolar is. Thanks again for your input. Here's wishing us strength!-Cynthia
Posted by Janice on March 7, 2000, at 12:08:54
In reply to Re: Author's name, posted by cynthia on March 7, 2000, at 9:19:58
Hi Cynthia, From what I've heard (you probably already know this) most rapid cyclers also have seasonal affective disorder, and this could be contributing to how you're feeling right now.
thanks Chris for the gentleman's name.
Do either of you (or any other rapid cyclers out there) have ADD also?
Do you find that you are not only emotionally sensitive, but physically sensitive? (I may be getting confused with my ADD here, but do you have allergies, get sick easily, have highly developed smell or taste buds?)
thanks, Janice
Posted by Chris A. on March 7, 2000, at 14:26:40
In reply to Cynthia, Chris and other rapid cyclers..., posted by Janice on March 7, 2000, at 12:08:54
>
> Do either of you (or any other rapid cyclers out there) have ADD also?No, I don't have ADD but have a son with it. It's very quiet here with him being thousands of miles away.
>
> Do you find that you are not only emotionally sensitive, but physically sensitive?I am quite sensitive to medication side effects and am also treatment resistant - figure that one out!
Perhaps I should quit trying to figure it all out. It would be nice if we'd just all get well.
Blessings,
Chris A.
Posted by judy on March 7, 2000, at 18:31:56
In reply to Re: Cynthia, Janice and other rapid cyclers..., posted by Chris A. on March 7, 2000, at 14:26:40
> I am quite sensitive to medication side effects and am also treatment resistant - figure that one out!
>
> Perhaps I should quit trying to figure it all out. It would be nice if we'd just all get well.
>
> Blessings,
>
> Chris A.Amen. Some specialists say there is a subset of bipolar that meds only work for a particular episode- I guess like trying to put the fire out instead of preventing it. I know that's how my disorder is, I guess I've just learned how to live with it. Take care.
Posted by cynthia on March 8, 2000, at 15:00:32
In reply to Re: Chris A, posted by judy on March 7, 2000, at 18:31:56
Chris and Judy and all- I am at a loss I have been
having a hard time with not just throwing up my hands and saying forget it to all of this! I have not been overly ill that I have noticed but very hard to medicate. I have had very odd reactions to the psych meds. I was started on Wellbutrin and within a few days had severe hives on my hands and feet- I am still peeling from that episode. Then I was tried on Celexa for 24 hours and experienced double/rolling vision and couldn't even get out of bed for two days. I am now on Remeron and It has been 6 days and I am holding my breath. I am just hard to medicate. I am getting increasingly angry and I am not sure if I am just normally(whatever that is) tired of this or if this is part of my deppresive state fluctuating. I am feeling too much of the responsibilities on me and I feel like "OK now enough time to get it together!" Sorry for the "novel" I am just trying to make sense of this. Thanks for listening-Cynthia
Posted by judy on March 10, 2000, at 13:14:59
In reply to Re: Chris A, posted by cynthia on March 8, 2000, at 15:00:32
I truly feel for you- I have been through so many medications and combos, I can no longer remember them all. Many times I have felt like I've had enough and gone off meds. One time I tried to taper off under the care of a psychologist and MD- no psychiatrist would help me- and I got manic. But I did start feeling better physically without all those side effects, so I've gotten a lot more forceful with my pdoc about what meds I'll accept now. I am considered treatment resistant and the only thing left is ECT, which I refuse. So the only lessons I've learned are anti-depressants worsen my cycling no matter what mood stabilizer I'm on, my depressions are time limited and I tend to step up therapy to deal with that, and when manic (not hypomanic) I use benzos or neuroleptics if really bad to stay out of the hospital. This isn't a perfect solution by any means, it's just what I have to do. If it's any consolation, I don't know your age but I had a 3 year bout of rapid cycling in my early 20's, then was relatively stable for about 10 years (except for 1 or 2 episodes a year) until now. My hope is that this too will pass, and I wish the same for you. Take care.
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