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Dr. Bob is Robert Hsiung, MD,
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Posted by Ritch on December 27, 2002, at 10:02:58
In reply to Calling all bipolars! Any Of You? , posted by Mr.Scott on December 26, 2002, at 23:40:46
> Have any of you PRIMARILY DEPRESSED bipolar types be it bipolar II, cyclothymia, or those who react with bipolar symptoms only to ADs ever been able to completely give up the antidepressants and just get well on the anticonvulsants or lithium?
>
> Thanks For your Response!Hi Scott, I would have to vote NO on that one. There was a stretch of several years where I was on lithium+benzo and "managed" to stay employed, etc., but there were many weeks of depression every year that were needless IMO. This was back before all of the new meds. The only thing available were tricyclics and MAOIs (I never thought to ask for those back in 1984) and TCA's have never worked that well for me (by themselves anyhow). I hope you get some positive responses. I would be interested in their med combo for sure. ----Mitch
Posted by Tabitha on December 27, 2002, at 14:12:30
In reply to Calling all bipolars! Any Of You? , posted by Mr.Scott on December 26, 2002, at 23:40:46
Isn't that supposed to be the new thinking on bipolar treatment-- mood stabilizers only? It scares me to death. I briefly tried neurontin- only, back when people had more of a belief in it as a mood stabilizer, and the depression came back full-force. My swings are so seasonal (depressed all winter, hypo/unstable all summer), I'd like to try a seasonal regime -- ADs only in winter, mood stabilizers only in summer.
Posted by ROO on December 27, 2002, at 14:43:36
In reply to Re: Calling all bipolars! Any Of You? , posted by Tabitha on December 27, 2002, at 14:12:30
I'll have to go along with the rest of the posters
here and say that as a cyclothymic (which seems to be
basically like bp 2...a cyclical type depression, which for me, tends mostly
towards the depressed side)....I tried Lamictal only once, in hopes
that since it was supposed to have such an antidepressant effect that
maybe I could get away with it as a mood stabilizer only...it wasn't
enough to keep my depression at bay...so I then tried it with a low dose
of antidepressant....still wasn't enough....I had to take it with a standard
dose (at that time it was 20 mg's of prozac) of antidepressant in order
not to be depressed and to be stable.It seems like the mood stabilizer only thing works for the bipolars
who don't have many depressive episodes, but mostly hypomanic episodes.Although some woman at a party the other night was telling me something about
Richard Dryfus discovered something about Dilantin being some cure all for depression?
Have you heard anything about that? I know it's an anticonvulsant...
Posted by Gabbix2 on December 27, 2002, at 15:05:29
In reply to Re: Calling all bipolars! Any Of You? , posted by ROO on December 27, 2002, at 14:43:36
I haven't heard anything about dilantin regarding depression, but I do know three people who were on it for seizures, and actually they all suffered from moderate to severe depression.
I don't know if epilepsy,or the ramifications of epilepsy can cause depression, maybe thats it the commmon thread but either way the Dilantin isn't a magic bullet.
Drat, foiled again.
b.t.w. Roo
I don't like posting to you
I'm sending an 'e'
Posted by Nala on December 27, 2002, at 17:04:53
In reply to Calling all bipolars! Any Of You? , posted by Mr.Scott on December 26, 2002, at 23:40:46
Mr. Scott,
BPAD II here. I am about to find out the answer to your question in a few days when I transition from Remeron, (tapered 45mg-30-15 current followed by discharge 12/30) Klonopin 1mg daily and Eskalith CR 450mg to Klonopin 1mg and Eskalith CR 450mg bid. I will let you know, I start this combo Monday. I was diagnosed with so-called "Severe melancholic depression 8 months ago (hence Remeron) most recently diagnosed with BP II about 6 months ago.
Nala
Posted by Mr.Scott on December 27, 2002, at 17:38:18
In reply to Re: Calling all bipolars! Any Of You? , posted by Nala on December 27, 2002, at 17:04:53
> Mr. Scott,
> BPAD II here. I am about to find out the answer to your question in a few days when I transition from Remeron, (tapered 45mg-30-15 current followed by discharge 12/30) Klonopin 1mg daily and Eskalith CR 450mg to Klonopin 1mg and Eskalith CR 450mg bid. I will let you know, I start this combo Monday. I was diagnosed with so-called "Severe melancholic depression 8 months ago (hence Remeron) most recently diagnosed with BP II about 6 months ago.
> Nala
Please keep us posted on your progress! I keep hearing about the mood stabilizer only thing, but I have yet to try it... Good Luck!Scott
Posted by Mr.Scott on December 27, 2002, at 17:42:22
In reply to Re: Calling all bipolars! Any Of You? , posted by ROO on December 27, 2002, at 14:43:36
Yes actually. Many years ago Jack Dreyfuss sent his book to every psychiatrist in America regarding this. He even tried to get 3 US presidents to get the FDA to open up evaluations on it. That never happened, and it was never embraced. He sure seems passionate about it though. He has a website with tons of documentation, but the fact it isn't used widespread throws up red flags to me especially since his campaign has been ongoing for years. I forget the url for the website or else I'd post it here.
Thanks for your post,
Scott
Posted by JohnL on December 28, 2002, at 5:03:42
In reply to Calling all bipolars! Any Of You? , posted by Mr.Scott on December 26, 2002, at 23:40:46
Actually, a lot of doctors are experiencing good results with Zyprexa for primarily depressed bipolar. If Zyprexa alone won't do the trick in a week, then they add an antidepressant. But doctors around the country are turning to Zyprexa instead of anticonvulsants or lithium.
Personally, Zyprexa is the best FDA med I've ever tried for my primarily depressed bipolar. And in the last 20 years I have tried nearly all FDA psychiatric medications.
I also take Prozac. I tried to eliminate it a couple months ago. It was no problem. I did not find depression creeping back in. I found out during the process though that Prozac is actually good for my sex life. So even though I know Zyprexa is doing most of the work, I still take Prozac for other benefits. I do know though, since I tried it, that I could drop the Prozac if I wanted to and just stay on Zyprexa. Zyprexa is a great mood stabilizer and antidepressant in many cases. As with all meds, it may not work or may have opposite effects in some people. But generally, results with Zyprexa in depressed bipolar are very encouraging.
JohnL
> Have any of you PRIMARILY DEPRESSED bipolar types be it bipolar II, cyclothymia, or those who react with bipolar symptoms only to ADs ever been able to completely give up the antidepressants and just get well on the anticonvulsants or lithium?
>
> Thanks For your Response!
Posted by Nala on December 28, 2002, at 14:28:22
In reply to Re: Calling all bipolars! Any Of You? » Nala, posted by Mr.Scott on December 27, 2002, at 17:38:18
Ok, will do. I will report my status in about a week or so
Nala
Posted by cybercafe on December 28, 2002, at 18:12:13
In reply to Re: Calling all bipolars! Any Of You? , posted by JohnL on December 28, 2002, at 5:03:42
> Actually, a lot of doctors are experiencing good results with Zyprexa for primarily depressed bipolar. If Zyprexa alone won't do the trick in a week, then they add an antidepressant. But doctors around the country are turning to Zyprexa instead of anticonvulsants or lithium.
>
> Personally, Zyprexa is the best FDA med I've ever tried for my primarily depressed bipolar. And in the last 20 years I have tried nearly all FDA psychiatric medications.
>
> I also take Prozac. I tried to eliminate it a couple months ago. It was no problem. I did not find depression creeping back in. I found out during the process though that Prozac is actually good for my sex life. So even though I know Zyprexa is doing most of the work, I still take Prozac for other benefits. I do know though, since I tried it, that I could drop the Prozac if I wanted to and just stay on Zyprexa. Zyprexa is a great mood stabilizer and antidepressant in many cases. As with all meds, it may not work or may have opposite effects in some people. But generally, results with Zyprexa in depressed bipolar are very encouraging.
>i'm curious... what dose of zyprexa are you taking?
how do you manage the sedation ? i find i sleep for 10 hours, which is a lot more than i'd like
Posted by Kar on December 29, 2002, at 11:42:46
In reply to Calling all bipolars! Any Of You? , posted by Mr.Scott on December 26, 2002, at 23:40:46
Hey Mr. S...plain old BP here but only depressed/fine/depressed/fine for years. Yup, my last 2 docs always stressed that the ultimate goal (and studies have shown, blah blah blah) was to get me off ADs and onto only MS because the ADs were actually increasing cycling. Never making me manic, but increasing cycling. Was on Nardil + variations of MS- sometimes 1, sometimes 2 for years. Since about 2 years ago I've been off the Nardil and we've been trying like the dickens to find a MS combo (I was skeptical) that would do the deed. Lamictal + Top, Lamictal + Tegretol, Teg +Topamax, you get the pictcha. Lately we've been hanging on tight to the Lam + Trileptal combo but it just ain't cutting it. He insisted it would work, I insisted it wasnt't working...now we've added Prozac which i haven't been on since i was 17. I wondered why we were bothering to walk the SSRI road again but he made the point that once they drugs are a combo, it's like being on one drug that works differently than it would've on other combos. Does that make sense?
This combo seems the best so far an my fingers and toes are crossed but who knows yet. So my long winded answer to you is that although the docs say that it's the goal to get you only on MS, for the primarily depressed I haven't heard many success stories.
I often wonder...if you've gone so many years without getting manicky b/c whatever MS you've been on has put the kibosh on it, does your brain start to react differently than if you were swinging way up then way down...
Namaste an excuse the ramble...
K
Posted by Ritch on December 29, 2002, at 16:23:00
In reply to Re: Calling all bipolars! Any Of You? , posted by Kar on December 29, 2002, at 11:42:46
> Hey Mr. S...plain old BP here but only depressed/fine/depressed/fine for years. Yup, my last 2 docs always stressed that the ultimate goal (and studies have shown, blah blah blah) was to get me off ADs and onto only MS because the ADs were actually increasing cycling. Never making me manic, but increasing cycling. Was on Nardil + variations of MS- sometimes 1, sometimes 2 for years. Since about 2 years ago I've been off the Nardil and we've been trying like the dickens to find a MS combo (I was skeptical) that would do the deed. Lamictal + Top, Lamictal + Tegretol, Teg +Topamax, you get the pictcha. Lately we've been hanging on tight to the Lam + Trileptal combo but it just ain't cutting it. He insisted it would work, I insisted it wasnt't working...now we've added Prozac which i haven't been on since i was 17. I wondered why we were bothering to walk the SSRI road again but he made the point that once they drugs are a combo, it's like being on one drug that works differently than it would've on other combos. Does that make sense?
>
> This combo seems the best so far an my fingers and toes are crossed but who knows yet. So my long winded answer to you is that although the docs say that it's the goal to get you only on MS, for the primarily depressed I haven't heard many success stories.
>
> I often wonder...if you've gone so many years without getting manicky b/c whatever MS you've been on has put the kibosh on it, does your brain start to react differently than if you were swinging way up then way down...
>
> Namaste an excuse the ramble...
> K
Hi, that's an interesting ramble. Just curious, what dosages of Lamictal/Trileptal/Prozac are you taking? I found that Prozac was definitely a different experience with lithium than it was with Depakote. I'm a rapid cycler and my cycles never have gotten less or more frequent, the peaks and troughs were just more or less intense or the depressed or hypomanic parts were of different durations depending on what meds I'm on and what time of year it is.
Posted by Kar on December 30, 2002, at 15:27:44
In reply to Re: Calling all bipolars! Any Of You? » Kar, posted by Ritch on December 29, 2002, at 16:23:00
Hey- I'm on 500 Lamictal, 1050 Trilept and alternate between 20/40 of the Prozac each day. I mean, 20 one day, 40 the next, that is...I'm a little nervous now that this is a bit too good to be true...I've had a few blips in the radar over the past few weeks but that was it...
Thanks for asking...
Posted by Ritch on December 30, 2002, at 17:36:29
In reply to Re: Calling all bipolars! Any Of You? » Ritch, posted by Kar on December 30, 2002, at 15:27:44
> Hey- I'm on 500 Lamictal, 1050 Trilept and alternate between 20/40 of the Prozac each day. I mean, 20 one day, 40 the next, that is...I'm a little nervous now that this is a bit too good to be true...I've had a few blips in the radar over the past few weeks but that was it...
> Thanks for asking...
>
>
Thanks for responding. I noticed you have 1050mg for Trileptal, did you really mean 150mg? Just wondering, they come in 150/300/600 scored tabs.thanks in advance,
Mitch
Posted by Kar on December 30, 2002, at 19:32:31
In reply to Re: Calling all bipolars! Any Of You? » Kar, posted by Ritch on December 30, 2002, at 17:36:29
Hey Mitch- nope, I meant 1050...3 and 1/2 of the 300's a day.
Take care...
Posted by Mr.Scott on December 30, 2002, at 22:10:35
In reply to Re: Calling all bipolars! Any Of You? » Ritch, posted by Kar on December 30, 2002, at 15:27:44
I wonder why this no AD philosophy for BP II is being so readily propagated by some theorists and practitioners when few of us can attest to it's efficacy? Just thinking out loud...
Posted by Ritch on December 31, 2002, at 9:07:20
In reply to Re: Calling all bipolars! Any Of You?, posted by Mr.Scott on December 30, 2002, at 22:10:35
> I wonder why this no AD philosophy for BP II is being so readily propagated by some theorists and practitioners when few of us can attest to it's efficacy? Just thinking out loud...
Hi Scott, if I take *standard* doses of AD's I do get hypomanic and worsen. However, if I don't take any I might not have a job for very long. If I take "plenty" of mood stabilizer, so I approach a "standard" dose of antidepressant, then I can't function either (cognitively). So, I take just a little AD and it works fairly well. Finding methods to divide things that small is a real hassle however.
Posted by Nala on December 31, 2002, at 14:18:29
In reply to Re: Calling all bipolars! Any Of You? » Mr.Scott, posted by Ritch on December 31, 2002, at 9:07:20
> > I wonder why this no AD philosophy for BP II is being so readily propagated by some theorists and practitioners when few of us can attest to it's efficacy? Just thinking out loud...
I agree< I don't think this proposed "Lithium unitherapy" will work. However, I'm trying it. one day down and ok.
>
> Hi Scott, if I take *standard* doses of AD's I do get hypomanic and worsen. However, if I don't take any I might not have a job for very long. If I take "plenty" of mood stabilizer, so I approach a "standard" dose of antidepressant, then I can't function either (cognitively). So, I take just a little AD and it works fairly well. Finding methods to divide things that small is a real hassle however.
Posted by doggrrl on January 2, 2003, at 19:09:01
In reply to Calling all bipolars! Any Of You? , posted by Mr.Scott on December 26, 2002, at 23:40:46
I am bipolar I and was able to give up all of the ADs and other meds and just use lithium and Topomax for several years until I intentionally decreased my Li level to a .6 for a number of reasons. The Li/Topomax was a great combination for me. Depression tends to be the most salient and enduring characteristic of my disorder. Now, I am back on ADs because I am experimenting with a lower LI level.
Posted by The Kenosha Kid on January 3, 2003, at 5:41:09
In reply to Calling all bipolars! Any Of You? , posted by Mr.Scott on December 26, 2002, at 23:40:46
I haven't used an AD since I was diagnosed with BP2 9 years ago. For the first two years I was on Lithium alone. The depression was bad at times, but I was never even _tempted_ to try an AD. If the risk of it inducing a manic episode is even one-in-a-trillion it's too high. But that's just me - some people are more leary of depression than mania. Go figure.
For the last seven years I've been on Depakote (1500mgs and higher) and Clonazapam (1-3 mg). My depression now is rare, mild, and fleeting.
I've been offered Ad's by several Pdocs over the years, but I won't go near them because of a phobic-like concern of avoiding mania at all costs. As ghastly as depression can be, at least it doesn't transform one into a raving, public jack@ss.
Posted by Tabitha on January 4, 2003, at 3:34:37
In reply to Re: Calling all bipolars! Any Of You? » Mr.Scott, posted by Ritch on December 31, 2002, at 9:07:20
>
> Hi Scott, if I take *standard* doses of AD's I do get hypomanic and worsen. However, if I don't take any I might not have a job for very long. If I take "plenty" of mood stabilizer, so I approach a "standard" dose of antidepressant, then I can't function either (cognitively). So, I take just a little AD and it works fairly well. Finding methods to divide things that small is a real hassle however.Interesting. I've come to the same place. I can't get anywhere near a normal dose of mood stabiliser due to dizziness, stomach pain, and hypersomnia (with all that going on I barely notice the cognitive problems). Yet a normal does of AD makes me agitated and hypo. Right now I'm using a half-dose of celexa and a pinch of neurontin for sleep. I still get hypo in the summer, and was thinking I'd have to do another mood stabiliser trial. Perhaps I'll just chop the celexa into quarters instead.
My pdoc doesn't really accept this approach-- he keeps wanting to add more mood stabilisers on top of what I'm taking.
Posted by Ritch on January 4, 2003, at 9:47:53
In reply to Re: Calling all bipolars! Any Of You?, posted by Tabitha on January 4, 2003, at 3:34:37
> >
> > Hi Scott, if I take *standard* doses of AD's I do get hypomanic and worsen. However, if I don't take any I might not have a job for very long. If I take "plenty" of mood stabilizer, so I approach a "standard" dose of antidepressant, then I can't function either (cognitively). So, I take just a little AD and it works fairly well. Finding methods to divide things that small is a real hassle however.
>
> Interesting. I've come to the same place. I can't get anywhere near a normal dose of mood stabiliser due to dizziness, stomach pain, and hypersomnia (with all that going on I barely notice the cognitive problems). Yet a normal does of AD makes me agitated and hypo. Right now I'm using a half-dose of celexa and a pinch of neurontin for sleep. I still get hypo in the summer, and was thinking I'd have to do another mood stabiliser trial. Perhaps I'll just chop the celexa into quarters instead.
>
> My pdoc doesn't really accept this approach-- he keeps wanting to add more mood stabilisers on top of what I'm taking.
>
Hi, there was an excellent post here that had a link to an article written by a psychiatrist who was questioning the use of the term "mood-stabilizer" and preferred to use "antimanic" instead. I agreed with most of his argument. I will try to find it (maybe whoever posted it will dig it back up). I realize that *ideally* avoiding antidepressants would be preferable, but what if you have comorbidities (other than depression/dysthymia) which respond well to their use? Wouldn't it be a lot easier to just take LESS of something (an AD, i.e.) than heap on more "mood stabilizers" that may or may not work well or cause other problems (psychosis, depression, depersonalization, cognitive dysfunction, ...)...
Posted by MARKED on January 17, 2004, at 12:52:39
In reply to Re: Calling all bipolars! Any Of You? » Tabitha, posted by Ritch on January 4, 2003, at 9:47:53
Can someone inform me if you can safely use Moclobemide with Trileptal ??
Thanks...
Posted by Mr. Scott on January 18, 2004, at 10:39:44
In reply to Re: Calling all bipolars! Moclobemide Trileptal, posted by MARKED on January 17, 2004, at 12:52:39
Great Posting Here! I somehow stopped getting notifications on this thread a while back and thought it ended.
Essentially it seems that MOST bipolars here are finding the same situation as I am. Proper treatment is not set in stone, it's often comorbid with other stuff, and it's often a crapshoot towards success. I finally dispelled the idea that Lithium and Depakote can and will work for everyone if they "simply take there pills."
Sometimes I forget I have bipolar disorder. I'll think I only have depression or maybe an anxiety disorder, or ADHD. Then I get hypomanic or I feel just fine, or experience unacceptable side effects. I guess I have all of these things and they alternate beyond my control and my experience in the end isn't much different from the rest of the gang here. Sometimes I worry it is and my doctor is an idiot, but I guess treating this stuff is highly complex.
I would like to get onto a more stable regimen of meds and not have to jump in every few days with psychiatric bandaids consisting of MS's, AD's, benzos all the time.
Thanks for sharing,
Scott
Posted by fluffy on January 18, 2004, at 15:41:05
In reply to Re: Calling all bipolars!, posted by Mr. Scott on January 18, 2004, at 10:39:44
Oh goody! This is a good thread. I was just thinking that i'd like to have a slice of all the BP peep's thoughts!
I've never been able to stop cycling since my diagnosis one year ago. Mainly, I've been depressed and/or irritable. Only been on various combos of MS's (mainly Lamictal) with the exception of one week on Wellbutrin, in which I had audible hallucinations!! EEEKKK!
Currently, I'm on 250mg Depakote ER, and 25mg of Lamictal. I've tried Lamictal *only*, Lamictal+Trileptal (worked great, but I had sodium loss, which is dangerous), Zyprexa 2.5mg (stiff hands, ankle swelling). I broke out in a rash after discontinuing Trileptal, so my doc wants to trash Lamictal altogether.
I feel very flat, irritable, dysthymic on Depakote.
I'm tempted to try again with the AD add on with Depakote, but my pdoc will probably not agree. Have any of you tried Depakote+Lamictal? Have any of you tried atypical AP's (besides Zyprexa) for depression? I've heard that Risperdal has an AD effect on some. WHAT TO DO?? I've been depressed/rapid cycling for 5 months now--trying to hold on to friendships and career. I don't want to be flat, stiff, or psychotic--I'm at my wit's end with this crap-shoot med trial stuff.
Sorry for the lack of clarity and length of this rant.
Bipolars, UNITE!
Katy
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