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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 10 to 34 of 34. Go back in thread:
Posted by cybercafe on June 6, 2003, at 1:29:56
In reply to Re: Bipolars---would you go nuts if your mood » McPac, posted by Ritch on June 6, 2003, at 1:14:58
>trouble. I would call up people I hadn't talked to for awhile and talk nonstop until they hung up on me! ;)
>what?! that's a symptom of mania? no dude... i think that's just being social <ponders recent behaviour>
Posted by dddiane on June 6, 2003, at 6:54:08
In reply to Bipolars---would you go nuts if your mood , posted by McPac on June 5, 2003, at 16:37:59
Everyone's bipolar has a different manifestation. I can say for sure if I was deprived of my mood stablizers I would be come angry, irritible, irrational, and possibly violent. If I even lower the doseage, I find myself ready to argue with anyone or anything! In general I pride myself on my long fuse - but once I was trying to cut back on my Tegretol, and I found myself screaming at a woman in a parking lot! I wanted to beat her up! Needless to say, I went back to my regular dose of Tegretol after that outburst. I didn't like to see myself turn into a "fishwife".
This has nothing to do with antidepressant use, since I can't and don't use antidepressants. They seriously wind the key in my back, if you know what I mean.
Who I am without mood stablizers, and I mean specificly AEDs, has been my motivation to stay medication compliate for years. It is just too ugly otherwise.
Also, without AEDs my thinking becomes highly disorganized. It is difficult to read, and sometimes to drive, or even understand what people are saying to me. I just remember how it was before my dx, and before medication. Sometimes my thinking was so very clear and sharp, and other times simple thinking was a challege. My mind was either moving so fast or so slow.
So my answer is yes, I would go nuts!
Diane
Posted by Ritch on June 6, 2003, at 10:27:30
In reply to Re: Bipolars---would you go nuts if your mood, posted by cybercafe on June 6, 2003, at 1:29:56
Posted by starlight on June 6, 2003, at 15:19:56
In reply to The lore of talked-off legs----- (nm) » cybercafe, posted by Ritch on June 6, 2003, at 10:27:30
I've wondered about that. I knew that going off of AD's would give you a horrible reaction, but didn't know about anti convulsants. I figured that if you were in the throws of depression or mania that it would have an effect, but even if you're stable underneath (if that's possible)?
Starlight
Posted by linkadge on June 6, 2003, at 19:51:12
In reply to Bipolars---would you go nuts if your mood , posted by McPac on June 5, 2003, at 16:37:59
What seems to be the source of your anger. If you have a simple anger stemming from a "lack of confidence" in yourself, it is likely depression.
But if your anger seems linked with an "extreme confidence". Or if you are annoyed with the world because it "doesn't understand you", or "doesn't understand just how smart you are". If you feel that you are so much higher or so far beyond the average person and you are angry that you are recognized as such, it is likely bipolar anger.
Linkadge
Posted by McPac on June 6, 2003, at 23:50:21
In reply to Re: Bipolars---would you go nuts if your mood » McPac, posted by Ritch on June 6, 2003, at 1:14:58
What happens if you back off the SSRI's?
>>>>>>>>I can't drop the ssri because I need it for ocd.....that really "ties my hands".
I've been on lithium before for years with no anti-dep. I needed something to "lift my spirits" though...the lithium alone wasn't enough to lift them enough....and my ocd was much worse w/out the srri.
Posted by McPac on June 7, 2003, at 0:23:26
In reply to Read, posted by linkadge on June 6, 2003, at 19:51:12
What seems to be the source of your anger?
>>>>>>>>>>>>>>>>Neither of the scenarios you mentioned. Rather, I'm trying to determine if it is because I'm bipolar (is it hypomanic anger) OR is it a reaction to meds? OR, possibly some of EACH---hypomanic symptoms AND a bad reaction to meds?
I KNOW for a FACT that Prozac caused TERRIBLE anger in me! The anger vanished after I stopped it (tried it twice, the exact same effect both times, TERRIBLE anger). Now, get this...when I take my lithium and Zoloft at the same time, I only get occassional anger, not too bad....but when I stopped taking the lithium and stayed on the Zoloft alone, TERRIBLE, DREADFUL anger....with the Prozac, EVEN ON lithium the anger was TERRIBLE---but, as I said, it started only when I started the Prozac and it disappeared as soon as I stopped the Prozac.....so, right now, I'm on lithium AND Zoloft...IF I stopped taking the lithium, AND STAYED on the Zoloft, I'd go NUTS! ANGER/RAGE!! How do I know? Because I already DID try that! So am I a bipolar who is having bipolar-like anger if I stop my mood stabilizer...OR, do I just have terrible reactions to some meds?
Posted by Ritch on June 7, 2003, at 0:42:23
In reply to Re: The lore of talked-off legs-----, posted by starlight on June 6, 2003, at 15:19:56
> I've wondered about that. I knew that going off of AD's would give you a horrible reaction, but didn't know about anti convulsants. I figured that if you were in the throws of depression or mania that it would have an effect, but even if you're stable underneath (if that's possible)?
> StarlightStarlight--Lithium isn't an anticonvulsant. If anything it lowers the seizure threshold and makes seizures more likely. But it doesn't matter-antimanics are a day to day reality that can't go ignored or trouble will happen.
Posted by Ritch on June 7, 2003, at 0:44:43
In reply to Ritch, Re: Bipolars---would you go nuts if your , posted by McPac on June 6, 2003, at 23:50:21
> What happens if you back off the SSRI's?
>
> >>>>>>>>I can't drop the ssri because I need it for ocd.....that really "ties my hands".
> I've been on lithium before for years with no anti-dep. I needed something to "lift my spirits" though...the lithium alone wasn't enough to lift them enough....and my ocd was much worse w/out the srri.
>
>
>I hear you on that one! I need a serotonergic med to keep anxiety/panic under control. I just can't handle anywhere near the dosages most people take for those problems however. Pharm. companies need to tool up the baby pills for people like us. They might even make some money.
Posted by Squiggles on June 7, 2003, at 7:05:45
In reply to Re: The lore of talked-off legs----- » starlight, posted by Ritch on June 7, 2003, at 0:42:23
Are you sure lithium lowers the seizure
threshold -- does it mean that lithium
over the "therapeutic index" is likely
to induce seizures?Thanks
Squiggles
Posted by Ritch on June 7, 2003, at 11:00:46
In reply to Re: The lore of talked-off legs----- » Ritch, posted by Squiggles on June 7, 2003, at 7:05:45
> Are you sure lithium lowers the seizure
> threshold -- does it mean that lithium
> over the "therapeutic index" is likely
> to induce seizures?
>
> Thanks
>
> SquigglesHi, yes it lowers the seizure threshold. It doesn't do it like a lot of antidepressants can do however, from what I understand. Oh, just because your "seizure threshold" has been lowered a little isn't anything horrible really-a lot of meds can do that. I'm not absolutely sure, but it seems likely that as the serum lithium level rises the seizure threshold falls accordingly. Don't know how "linear" that relationship is, though. High serum levels are likely to make you feel crummy and give you diarrhea or something rather than cause a seizure. But the risk is there.
Posted by Squiggles on June 7, 2003, at 11:05:38
In reply to Re: The lore of talked-off legs----- » Squiggles, posted by Ritch on June 7, 2003, at 11:00:46
Thank you Ritch; i will have to
do some reading on this for my site;Whimper :-)
Squiggles
Posted by judy1 on June 7, 2003, at 11:46:05
In reply to Bipolars---would you go nuts if your mood , posted by McPac on June 5, 2003, at 16:37:59
I have posted many times how I medicate manic episodes, but otherwise I do not take any mood stabilizers. My manic episodes tend to be euphoric, however when I took SSRIs the cycling was out of control and I did experience the mixed variety (those are awful). I'm a real advocate of people suffering from bipolar disorder not to use SSRIs- I really do think they make things worse (and my pdoc agrees). best of luck in whatever you decide-judy
Posted by cybercafe on June 7, 2003, at 15:24:05
In reply to Re: Bipolars---would you go nuts if your mood » McPac, posted by judy1 on June 7, 2003, at 11:46:05
> I have posted many times how I medicate manic episodes, but otherwise I do not take any mood stabilizers. My manic episodes tend to be euphoric, however when I took SSRIs the cycling was out of control and I did experience the mixed variety (those are awful). I'm a real advocate of people suffering from bipolar disorder not to use SSRIs- I really do think they make things worse (and my pdoc agrees). best of luck in whatever you decide-judy
fair enough.... what would you recommend as an antidepressant?
Posted by McPac on June 7, 2003, at 16:27:52
In reply to Re: Bipolars---would you go nuts if your mood » McPac, posted by judy1 on June 7, 2003, at 11:46:05
Hi Judy,
" I'm a real advocate of people suffering from bipolar disorder not to use SSRIs">>>>>>>>>>>> I really have no choice....I need to take an ssri for my ocd (there really is VERY little else to choose from for severe ocd). Thanks
Posted by Ritch on June 7, 2003, at 17:07:37
In reply to judy,Re: Bipolars---would you go nuts if your mood, posted by McPac on June 7, 2003, at 16:27:52
> Hi Judy,
>
>
> " I'm a real advocate of people suffering from bipolar disorder not to use SSRIs"
>
> >>>>>>>>>>>> I really have no choice....I need to take an ssri for my ocd (there really is VERY little else to choose from for severe ocd). Thanks
I'm in a similar boat. I have to take a little bit of Effexor to keep my comorbid panic disorder under control. It only takes a tiny pinch, but I have to take it. I've been off them and after about two months or so it starts getting worse and more clonazepam just makes me depressed (to keep a lid on the panic). The other serotonergics did make me very goofy acting though, especially Celexa and Luvox for some reason. They would cause the worst hyena-like laughing spells I've ever experienced. :)
Posted by judy1 on June 7, 2003, at 19:09:22
In reply to Re: Bipolars---would you go nuts if your mood, posted by cybercafe on June 7, 2003, at 15:24:05
Hi-
I mainly use psychotherapy for depression- if it's really bad, opiates work well for me (again only medicating the episode).
take care, judy
Posted by judy1 on June 7, 2003, at 19:11:23
In reply to judy,Re: Bipolars---would you go nuts if your mood, posted by McPac on June 7, 2003, at 16:27:52
I don't have OCD, so I understand your need for an SSRI. has therapy helped your symptoms at all? take care, judy
Posted by judy1 on June 7, 2003, at 19:16:23
In reply to Re: judy,Re: Bipolars---would you go nuts if your mood » McPac, posted by Ritch on June 7, 2003, at 17:07:37
Ritch,
I also have panic disorder and while I understand klonopin can be depressing, xanax has proven to work better for me and have somewhat of an AD effect. have you tried that instead? do you also have what my pdoc calls the 'manic-panic' syndrome?
take care, judy
Posted by judy1 on June 7, 2003, at 19:24:02
In reply to Re: Bipolars---would you go nuts if your mood » McPac, posted by Ritch on June 6, 2003, at 1:14:58
do you have bipolar 1 or 2 disorder? I have bp1 and manic episodes are much more prevalent than depressive for me, although I also am pretty seasonal- May is a very happy month for me:-)- judy
Posted by McPac on June 7, 2003, at 23:26:38
In reply to Read, posted by linkadge on June 6, 2003, at 19:51:12
The anger is a med side effect, the ssri's in particular cause that problem for many; many bipolars can't take ssri's for that reason. It's not typical, everyday anger that stems from getting mad at someone or something, it's drug-induced. I have a website article that talks about the subject (ssri-induced anger) in great depth, if anybody would like to read it. Ron was talking about the phenomenon earlier.
Posted by McPac on June 7, 2003, at 23:44:25
In reply to Re: judy,Re: Bipolars---would you go nuts if your mood » McPac, posted by Ritch on June 7, 2003, at 17:07:37
"The other serotonergics did make me very goofy acting though, especially Celexa and Luvox for some reason. They would cause the worst hyena-like laughing spells I've ever experienced".
>>>>>>> Yep, ssri's can induce anger as well as those laughing spells. If I can keep the ssri dose low enough (but still effective) I don't get either anger or laughing induced spells. Found a great website that talks about the ssri-induced anger; didn't realize that so many folks, even many on this board, have gotten that effect from meds, particularly the ssri's.
Posted by Ritch on June 8, 2003, at 10:29:39
In reply to Re: judy,Re: Bipolars---would you go nuts if your mood » Ritch, posted by judy1 on June 7, 2003, at 19:16:23
> Ritch,
> I also have panic disorder and while I understand klonopin can be depressing, xanax has proven to work better for me and have somewhat of an AD effect. have you tried that instead? do you also have what my pdoc calls the 'manic-panic' syndrome?
> take care, judy>do you have bipolar 1 or 2 disorder? I have bp1 and manic episodes are much more prevalent than depressive for me, although I also am pretty seasonal- May is a very happy month for me:-)- judy
Hi Judy, yes manic-panic syndrome, that's it! Yes, it is BP-II with recurrent seasonal major atypical depressions. Rapid cycling (every 20 days). April, May, and October are my *high* months for sure. Last month I got pretty wired up, that's dying off real fast now. I was very amazed yesterday at how "quiet" my head was, practically zero anxiety. No depression... yet. I'm one of those DME types at two different levels (at the 20 day level, and at the seasonal level). After a high, I don't crash, I level out for quite awhile and then plummet suddenly. Xanax, I was given that a long time ago when I flew for the first time. It worked remarkably well for a few hours (situational things). It just has too short a half-life. I think Ativan has about 12 hr. half-life, and is more liver friendly than clonazepam and a little more AD effect to boot. All I know is, if I go up to 1.0mg of K. for more than a day or two it will make me more depressed. thanks for responding!
Posted by judy1 on June 8, 2003, at 13:08:27
In reply to Re: judy,Re: Bipolars---would you go nuts if your mood » judy1, posted by Ritch on June 8, 2003, at 10:29:39
I don't know if it's out yet, but there is supposed to be an extended release form of xanax. (since you had mentioned it worked well for you briefly). But if ativan is your benzo of choice, I'm glad it works well. wow, 20 day cycling, that must be awful. I read somewhere that BP2 is a lot harder to treat then BP1, more depressions, mixed episodes, etc. As nuts as I have gotten, I guess I should be greatful I have the 1 form. take care, judy
p.s.- my pdoc said in his experience that manic/panic is closely related to epilepsy- have you been tested for that?
Posted by Ritch on June 8, 2003, at 16:06:49
In reply to xanax » Ritch, posted by judy1 on June 8, 2003, at 13:08:27
> I don't know if it's out yet, but there is supposed to be an extended release form of xanax. (since you had mentioned it worked well for you briefly). But if ativan is your benzo of choice, I'm glad it works well. wow, 20 day cycling, that must be awful. I read somewhere that BP2 is a lot harder to treat then BP1, more depressions, mixed episodes, etc. As nuts as I have gotten, I guess I should be greatful I have the 1 form. take care, judy
> p.s.- my pdoc said in his experience that manic/panic is closely related to epilepsy- have you been tested for that?Oh, I'm not taking Ativan right now (taking clonazepam .5mg hs). I tried Ativan when I was flying (back in the 80's) when I was given Xanax and Ativan samples, and I noticed it wasn't as depressing as Valium or clonazepam. Valium is VERY depressing for me. I just wonder if I switched to Ativan (from clon) if my sleep would be better, have just as good antipanic effect, and be less depressogenic (lots to ask for!).
Twenty day cycling- It isn't really that awful, but I can track it very easily. I'm pretty high for a couple of days, and feel like crap for a couple of days, the remaining days are mixtures of euthymia, sleep disruption, tiredness/inattentiveness, grouchiness, you name it. Just a mild chronic smorgasbord which goes through the same "colors" in pretty much the same sequence, which gets a little tweaky on the high side a couple of months a year, and turns into moderate major depression for two months twice a year or thereabouts year after year after year..
The Epilepsy thing.. Well, my Mom used to have nocturnal tonic-clonic seizures for about ten or fifteen years or so. They put her on a max dose of Dilantin and they finally went away. She used to get auras during the day before she had the seizures the night before. I've had symptoms of partials, but the neuro I saw didn't catch it on the standard EEG, evoked potentials stuff,etc.. He was wanting a 24-hr ambulatory sleep-deprived EEG, but my lousy insurance was paying diddly and I thought he was trying to milk me for tests that I didn't really need. I wished I would have followed through now. SOMETHING happens to disrupt my sleep (I snore some, but not a lot), and I have these awakenings at 4 and 5am and I am not the least bit tired-and my thoughts are churning about some dumb problem I have been working on in the last several days, and I can't get back to sleep. Then I am tired and completely wiped out mentally ALL DAY the next day. OK, this is a weird thing. We tried adding 500mg/day of Keppra to my Depakote, and my sleep got MUCH better, and my thinking got MUCH clearer, BUT, the stuff starting making me more and more depressed and anxious AND listless. I don't mind taking AED's, I just don't want to take stuff that is going to make me real depressed or make my mind total mush.
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