Shown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by HMK on August 7, 2002, at 10:05:31
I currently take Effexor, Depakote, and Zyprexa. I'm sick to death of gaining weight but my doctor who is large himself doesn't seem to care. This new doctor says that people who are bipolar can't really do well until they are off Effexor or any type of antidepressant. Have people found this to be true?? I've been on Effexor for 3 years now at a low dose (75 mg) and am dreading going off it.
I've been on Zyprexa for a week (switched to it from Risperdal) and have missed 2 days of work when I couldn't get myself out of bed. Doc said "it is up to me to get myself out of bed and to work"- oh, really? I've never felt like this until I started the Zyprexa- I'm tired and depressed all the time and he's telling me to DISCONTINUE the antidepressant!! That makes no sense to me.
Can someone help me out? I would appreciate any insight you could offer-
Heather
Posted by sarahcat on August 7, 2002, at 15:05:14
In reply to Antidepressants (Effexor) for Bipolar II??, posted by HMK on August 7, 2002, at 10:05:31
I'm Bipolar 2, and I'm on Effexor along with Lithium, Risperdal, Lamictal, and Neurontin. I know that a lot of psychiatrists don't like to prescribe any antidepressants for people with any form of Bipolar Disorder for fear of precipitating a manic or hypomanic episode. Fortunately my doc doesn't abide by those fears. When I was in the hospital in March the psychiatrist who did my evaluation for admission said that if I were his patient he would take me off the Effexor. So I guess I'm trying to say that some, but not all, psychiatrists think the way yours does.And your reaction to Zyprexa (not being able to get out of bed) seems to be very common. I used ot be a social worker for chronically mentally ill adults, and a lot of our clients were put on Zyprexa. They ALL had similar problems as you describe, and they ALL gained at least 40 pounds on it. I'm fairly new to Psycho-Babble, so there could very well be people on the board who have had different experiences with Zyprexa. But I'm curious, why get off the Risperdal?
Sarah
Posted by inertia on August 7, 2002, at 17:41:10
In reply to Antidepressants (Effexor) for Bipolar II??, posted by HMK on August 7, 2002, at 10:05:31
Posted by cybercafe on August 7, 2002, at 23:50:38
In reply to Re: Antidepressants (Effexor) for Bipolar II??, posted by sarahcat on August 7, 2002, at 15:05:14
Why would you take an antipsychotic for Bipolar II (not psychotic)? I think you guys said you were already taking mood stabilizers.. are they not working? i know for anxiety or antidepressant effect you would only take a small dose no?
Posted by Ritch on August 8, 2002, at 1:40:41
In reply to Antidepressants (Effexor) for Bipolar II??, posted by HMK on August 7, 2002, at 10:05:31
> I currently take Effexor, Depakote, and Zyprexa. I'm sick to death of gaining weight but my doctor who is large himself doesn't seem to care. This new doctor says that people who are bipolar can't really do well until they are off Effexor or any type of antidepressant. Have people found this to be true?? I've been on Effexor for 3 years now at a low dose (75 mg) and am dreading going off it.
>
> I've been on Zyprexa for a week (switched to it from Risperdal) and have missed 2 days of work when I couldn't get myself out of bed. Doc said "it is up to me to get myself out of bed and to work"- oh, really? I've never felt like this until I started the Zyprexa- I'm tired and depressed all the time and he's telling me to DISCONTINUE the antidepressant!! That makes no sense to me.
>
> Can someone help me out? I would appreciate any insight you could offer-
> Heather
Heather,Antidepressants *are* troublesome for bipolars, but I am intensely skeptical that you can do without them with Depakote as your only antimanic agent. I haven't heard ONE bipolar person here describe taking Depakote as monotherapy for their disorder (over the "required" months and months), and feel that the depressive part of their illness has been addressed in any substantive way. Why did you get switched from Risperdal to Zyprexa (just curious)?
Mitch
Posted by HMK on August 8, 2002, at 8:05:36
In reply to Re: Antidepressants (Effexor) for Bipolar II?? » HMK, posted by Ritch on August 8, 2002, at 1:40:41
In response to your questions, my doctor just seems to think that Zyprexa is better for bipolars than Risperdal. I hate it- all it does is make me more depressed in my depressed days and manic in my manic days (I'm a rapid cycler)plus I'm am so fricking tired all the time that I've missed a lot of work.
My plan: switch back to Risperdal (I've been on Zyprexa for 9 days and it's been nothing but downhill)then taper off the Effexor. Next, go off the Depakote. The Depakote seems to have very little effect on me, so why take it- just to gain more weight? I want to try Risperdal as monotherapy because it is the only medication that I've seen truly amazing results with. I HATE these pills!!
I'm scared to go off Effexor because I've been on it for 3 years. Luckily I'm taking a low dose- 75 mg.- so am hoping that side effects of going off it will be minimal.
HMK
Posted by Ritch on August 8, 2002, at 9:48:10
In reply to Re: Antidepressants (Effexor) for Bipolar II?? » Ritch, posted by HMK on August 8, 2002, at 8:05:36
> In response to your questions, my doctor just seems to think that Zyprexa is better for bipolars than Risperdal. I hate it- all it does is make me more depressed in my depressed days and manic in my manic days (I'm a rapid cycler)plus I'm am so fricking tired all the time that I've missed a lot of work.
>
> My plan: switch back to Risperdal (I've been on Zyprexa for 9 days and it's been nothing but downhill)then taper off the Effexor. Next, go off the Depakote. The Depakote seems to have very little effect on me, so why take it- just to gain more weight? I want to try Risperdal as monotherapy because it is the only medication that I've seen truly amazing results with. I HATE these pills!!
>
> I'm scared to go off Effexor because I've been on it for 3 years. Luckily I'm taking a low dose- 75 mg.- so am hoping that side effects of going off it will be minimal.
> HMK
You will need to do a little arm twisting to get him to back off the Zyprexa I am afraid. He will probably relent and let you go back on the Risperdal if you really press it. If you reason it well it might do the trick. It *isn't* good to be sleeping excessively. That tends to reinforce depression-that's bad, that's all there is to it! The Effexor can be reduced gradually. It can cause a lot of sleepiness in people and aggravate cycling. I can't stand more than 12.5mg per day! You will probably have the most difficult time talking him out of taking Depakote. He might agree to a switch from Depakote to maybe lithium or Neurontin?good luck,
Mitch
Posted by crepuscular on August 8, 2002, at 11:05:59
In reply to Antidepressants (Effexor) for Bipolar II??, posted by HMK on August 7, 2002, at 10:05:31
Many, many people with bipolar disorder are doing well on low-dose atypicals. my personal experience with these mdeications is much better than the anticonvulsants which left me totally brain dead.
i think we must accept the following: symptom clusters identifiable as disease X may or may not have the same biogenesis in everybody. eg, my observed "bipolar disorder" may originate in a schizophrenia-like neural substrate and thus respond well to antipsychotics.
the brain is so complicated, and people so idiosyncratic, that we need to keep focused on whether or not, at the end of the day, you are *doing better*. i'll take personal progress over nosological guesswork any day. and so should a good doc.
my 2c.
Posted by Squiggles on August 8, 2002, at 11:55:00
In reply to Re: Antidepressants (Effexor) for Bipolar II??, posted by crepuscular on August 8, 2002, at 11:05:59
Hey,
You sound like Dr. Healy! :-)
Seriously, it sounds like superb advice;
however, it requires some experimentation
i think - so do you recommend say Effexor
over lithium or the anticonvulsants (I hate
them) for BP?Squiggles
Posted by crepuscular on August 8, 2002, at 16:28:28
In reply to Re: Antidepressants (Effexor) for Bipolar II?? » crepuscular, posted by Squiggles on August 8, 2002, at 11:55:00
effexor is a pure AD right? man, if i'm on just an antidepressant alone - look out, mania time. no way could that substitute for a mood stabilizer/atypical (in my opinion.)
Posted by sarahcat on August 8, 2002, at 17:59:28
In reply to Re: Antidepressants (Effexor) for Bipolar II??, posted by cybercafe on August 7, 2002, at 23:50:38
> Why would you take an antipsychotic for Bipolar II (not psychotic)? I think you guys said you were already taking mood stabilizers.. are they not working? i know for anxiety or antidepressant effect you would only take a small dose no?
>
When I was in the hospital last summer the doctor there put me on the Risperdal to try to control my suicidal thoughts. I don't need it to stabilize any hypomania since I hardly ever have that anyway and the lithium seems to work on it. It would be great if it helped with the depression, but I haven't seen it have any such effect. It may possibly be helping my anxiety, since that isn't as bad as it has been in years past. But I've noticed that lithium has helped the anxiety too. For what it's worth, my regular psychiatrist has said that he'll probably start to decrease the Risperdal next month, provided I start doing better than I have been the past few weeks.Sarah
Posted by Mr.Scott on August 8, 2002, at 18:42:24
In reply to Antidepressants (Effexor) for Bipolar II??, posted by HMK on August 7, 2002, at 10:05:31
Sounds like you may have one those obtuse doctors who reads the latest journal articles that are secretly paid for by anticonvulsant making drug companies who want some of that fat antidepressant money we spend every year. Your doctor should work with you to find what works best for you. Looking at populations of 10,000+ may be good at the internists office and dysthymics in need of prozac, but for the majority of people on this board individual differences seem key.
I don't think the verdict is out yet on the Effexor part of your question, but if Risperdal seemed better than Zyprexa, I see no reason why he wouldn't switch you back aside from some meaningless FDA indication Risperdal will probably have in year anyways...
My shrink refuses to use Zyprexa at all BTW saying he hates it and that it causes as many problems as it's supposed to treat.
Posted by cybercafe on August 9, 2002, at 0:37:17
In reply to Re: Antidepressants (Effexor) for Bipolar II??, posted by crepuscular on August 8, 2002, at 11:05:59
> Many, many people with bipolar disorder are doing well on low-dose atypicals. my personal experience with these mdeications is much better than the anticonvulsants which left me totally brain dead.
> the brain is so complicated, and people so idiosyncratic, that we need to keep focused on whether or not, at the end of the day, you are *doing better*. i'll take personal progress over nosological guesswork any day. and so should a good doc.i totally agree with you -- however, i was wondering why, if the antipsychotic was working, a mood stabilizer needed to be added
Posted by cybercafe on August 9, 2002, at 0:43:46
In reply to AP's for Non-psychotic Bipolar » cybercafe, posted by sarahcat on August 8, 2002, at 17:59:28
> When I was in the hospital last summer the doctor there put me on the Risperdal to try to control my suicidal thoughts. I don't need it to
that's awesome that it works for you
>stabilize any hypomania since I hardly ever have that anyway and the lithium seems to work on it.
Yeah I'm type II as well and I seem to have very few hypomanias... (doc agrees) ... though that may be because i'm unemployed and have no stress!
... right now i'm just taking an MAOI ...
>It would be great if it helped with the depression, but I haven't seen it have any such effect. It may possibly be helping my anxiety,
lithium doesn't help with your depression? ... i was hoping to give it a try myself.... i suppose you can't guarantee anything will work...
... anyways... i'm actually starting to wonder these days if my mood swings might just be caused by too much bloody testosterone
Posted by sarahcat on August 9, 2002, at 15:31:09
In reply to Re: AP's for Non-psychotic Bipolar, posted by cybercafe on August 9, 2002, at 0:43:46
> >It would be great if it helped with the depression, but I haven't seen it have any such effect. It may possibly be helping my anxiety,
>
> lithium doesn't help with your depression? ... i was hoping to give it a try myself.... i suppose you can't guarantee anything will work...
>Oops... I was meaning to imply that the Risperdal has no effect on my depression, not the lithium. In my opinion the lithium has done more to help me than anything else I've ever taken. Effexor used to be a big help, but it pooped out on me and I had to take increasing doses of it to get the same effect. Now my doc won't increase it anymore. I wish he would let me increase the lithium. My blood level is in the low end of the therapeutic range, so I believe we would be safe, if not justified, in going higher, but he's worried about side effects (of which I notice none yet). As far as I'm concerned, effective drugs aren't effective if you don't give them at a high enough dose to be therapeutic for an individual person. But I guess that makes too much sense.
Sarah
Posted by cybercafe on August 10, 2002, at 7:56:26
In reply to Re: AP's for Non-psychotic Bipolar » cybercafe, posted by sarahcat on August 9, 2002, at 15:31:09
> Oops... I was meaning to imply that the Risperdal has no effect on my depression, not the lithium. In my opinion the lithium has done more to help me than anything else I've ever taken.
Hey that sounds great... I'd like to become normal too
Risperdal - i thought it got rid of suicidal behaviour.... does that mean it relieves depression too? i thought that meant it would do some good
>Effexor used to be a big help, but it pooped out on me and I had to take increasing doses of it to get the same effect. Now my doc won't increase it anymore. I wish he would let me increase the
yeah i think above 225 mg effexor works on norepenephrine for me... which causes cycling in bipolars (like tricyclics)
hey i wonder if it's true that cycling causes anxiety -- cause MAOIs don't cause me to cycle, and my anxiety is gone
>lithium. My blood level is in the low end of the therapeutic range, so I believe we would be safe, if not justified, in going higher, but he's worried about side effects (of which I notice none yet). As far as I'm concerned, effective drugs aren't effective if you don't give them at a high enough dose to be therapeutic for an individual person. But I guess that makes too much sense.
hmmm... who knows... maybe he had patients in the past who were doing well until he gave them side effects, then they flushed all of their pills down the toilet? i'm sure it must be difficult to be a psychiatrist (or any doc... it's so icky)
my friend comes from a doc family, and he wanted to watch a video of people dying for real ... i think docs must have some strange detachment from reality to do what they do
Posted by Squiggles on August 10, 2002, at 8:04:29
In reply to Re: AP's for Non-psychotic Bipolar, posted by cybercafe on August 10, 2002, at 7:56:26
Sometimes i have doubts about my
doctor's decisions in my treatment;
for example i imagine that the lithium
and Rivotril i am taking are really not
necessary at all, and they are just
given haphazardly - ideas like that scare me;
but i think overall it is best to follow
his advice, than go off on a personal
revolution.About careers - there are two careers that
must be the hardest in the world: medical
professional such as nurse or doctor, and
lawyer. The stress must be crazy.Squiggles
Posted by sarahcat on August 10, 2002, at 23:50:23
In reply to Re: AP's for Non-psychotic Bipolar, posted by cybercafe on August 10, 2002, at 7:56:26
>
> Risperdal - i thought it got rid of suicidal behaviour.... does that mean it relieves depression too? i thought that meant it would do some good
>The Risperdal helps me with intrusive thoughts of suicide, but it doesn't actually help my mood. And I'm not completely free of suicidal thoughts all the time. I do pretty well about 2/3 to 3/4 of the time, and the remainder of the time I spend in breakthrough depressions with suicidal preoccupation at times. Still, that's better than being depressed 100% of the time.
> yeah i think above 225 mg effexor works on norepenephrine for me... which causes cycling in bipolars (like tricyclics)
I'm up to 300mg of XR and I haven't have many, if any, hypomanic episodes on it. Now Prozac and Celexa are another story for me.
> hey i wonder if it's true that cycling causes anxiety -- cause MAOIs don't cause me to cycle, and my anxiety is gone
I've actually never been on an MAOI. From what I've read here, I may end up requesting one if I get so depressed that I need a major med change.
> i think docs must have some strange detachment from reality to do what they do
I don't know, my psychiatrist seems pretty well grounded. It's weird, I recently found out that he even likes my favorite band, and I must be at least 25ish years younger than he is. He can really relate well to me, and he can explain his med choices to me pretty well.
Sarah
Posted by cybercafe on August 11, 2002, at 4:57:22
In reply to Re: AP's for Non-psychotic Bipolar » cybercafe, posted by Squiggles on August 10, 2002, at 8:04:29
> Sometimes i have doubts about my
> doctor's decisions in my treatment;
> for example i imagine that the lithium
> and Rivotril i am taking are really not
> necessary at all, and they are just
> given haphazardly - ideas like that scare me;
> but i think overall it is best to follow
> his advice, than go off on a personal
> revolution.
ahh yes ... i think you said you were one of those people who has been stable for a long period of time... so you forget what meds do for you? ... i sincerely hope one day i can be in the same situation ...... i dunno about doctors... my doc suggests that i am being a hypochrondriac reading up on all the possible different disorders i could suffer from and worrying myself... but really i find it very comforting to diagnose myself with a disorder -- because it seems to indicate that there is a treatment (as opposed to neverending suffering)...
... i wonder how appropriate it was for my doc to put me on an AD without performing any type of blood/endocrine/hormonal test first ....
> About careers - there are two careers that
> must be the hardest in the world: medical
> professional such as nurse or doctor, and
> lawyer. The stress must be crazy.... lawyer doesn't sound too bad.... work 3 hours a day, have someone come into your office and ask you how to fill out a form, and then charge them $200 .... i am seriously considering becoming a lawyer myself, but who knows what my personality will be like if/when i become sane
Posted by cybercafe on August 11, 2002, at 5:00:54
In reply to Re: AP's for Non-psychotic Bipolar » cybercafe, posted by sarahcat on August 10, 2002, at 23:50:23
> The Risperdal helps me with intrusive thoughts of suicide, but it doesn't actually help my mood. And I'm not completely free of suicidal thoughts all the time. I do pretty well about
... not perfect... but sounds pretty good to me :)
... did your doc suggest upping the dose to work 100% of the time? ...
> I'm up to 300mg of XR and I haven't have many, if any, hypomanic episodes on it. Now Prozac and Celexa are another story for me.
... that's good stuff... what is your doc's plan to make you 100% happy?
> I've actually never been on an MAOI. From what I've read here, I may end up requesting one if I get so depressed that I need a major med change.
i am tired of being even somewhat depressed.... i want to be happy damn it :) ...
.. i wonder how i'd respond to thyroid hormone ...>he even likes my favorite band, and I must be at least 25ish years younger than he is. He can really relate well to me, and he can explain his
i'm glad you've found a cool doc... :)
what is your favourite band?
Posted by Squiggles on August 11, 2002, at 8:52:46
In reply to Re: AP's for Non-psychotic Bipolar, posted by cybercafe on August 11, 2002, at 4:57:22
Hmmm.... took the words right out of my mouth.
Squiggles
Posted by nikioct73 on August 11, 2002, at 11:17:44
In reply to Re: Antidepressants (Effexor) for Bipolar II??, posted by sarahcat on August 7, 2002, at 15:05:14
I was wondering if anyone could tell me the average time of "withdrawl s/sx from Effexor xl?...I had been on the med for about six months..(second time around this one)..when I had switched off before I had no symtoms most likely because i was placed on celexa and being another SSRI this somehow did not make me so friggin' ill..I was N/V/D for three days and now just am experiancing the "shocks" with any activity and sometimes just with eye movement..not horrible but very unpleasent to say the least..I am BP2 and am giving up on AD med's mainly SSRI because of the side effects ie weight gain contact wear intolerance and so goes the lisit on and on..I am hoping to try Topamax and or Lamictal...I have a family memebr who was on Topamax for a while to combat a tumour induced Migrane complex (for which every med know to man has been tried without consistant relief..) and she had very bad cognitive side effect..bad..she was a fruit loop and then some..but anyways I hope someone has some advice..did I say good advice?..well one can always hope..:)
Niki..
Posted by cybercafe on August 11, 2002, at 11:21:18
In reply to Re: Antidepressants (Effexor) for Bipolar II??, posted by nikioct73 on August 11, 2002, at 11:17:44
> I was wondering if anyone could tell me the average time of "withdrawl s/sx from Effexor xl?...I had been on the med for about six months..
doc gave me klonopin
Posted by sarahcat on August 11, 2002, at 20:29:38
In reply to Re: AP's for Non-psychotic Bipolar, posted by cybercafe on August 11, 2002, at 5:00:54
> > The Risperdal helps me with intrusive thoughts of suicide, but it doesn't actually help my mood. And I'm not completely free of suicidal thoughts all the time.
>
> ... not perfect... but sounds pretty good to me :)
>
> ... did your doc suggest upping the dose to work 100% of the time? ...My doc is actually suggesting that I decrease the Risperdal in the near future. I don't know... I guess he wants to have me on as few meds as possible, and he seems pretty high on Lamictal, which we have been increasing over the past few months. I think his ultimate plan is to get me off Risperdal and Neurontin but to keep me on Effexor, Lithium, and Lamictal. I'll be sad to see the Neurontin go as well, becuase it has done wonders for my anxiety.
> ... that's good stuff... what is your doc's plan to make you 100% happy?Having me stay in therapy, which he and my therapist believe will help me get closer to 100% happiness.
> i am tired of being even somewhat depressed.... i want to be happy damn it :) ...
> .. i wonder how i'd respond to thyroid hormone ...I was on Cytomel once (sorry, I can't remember if it's T3 or T4) back when I was on Zoloft. Funny thing... neither one did a darn thing for me.
> what is your favourite band?
>Wilco.
Sarah
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