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Dr. Bob is Robert Hsiung, MD,
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Posted by fluffy on January 4, 2004, at 17:58:14
In reply to What? Non-flexible talons??? Never! » fluffy, posted by katia on January 4, 2004, at 15:53:56
Hey Katia--
***Good to hear from you, too! I've been just trying to put this whole mess behind me, so I've avoided the PB boards.
Since being on Li. at 450mg the past two weeks, I have also experienced quite a bit of anxiety and panic - outbursts of irritability (I know what's new). But this was different - I felt disassociated as tho' in a dream (depersonalized?) and very anxious and scared. I think maybe the Li. activated the lamictal. I want to page my pdoc again. I wonder if I should stop the Lamictal altogether. He's the boss tho' and when it comes to something like this I'll listen. But I want to tell him my theory and let him know about my derealization thing that's been going on.
***Hmmm. Katia--I don't really know about the derealization stuff. Was it for an extended amount of time? Or was it like a panic attack? Have you ever tried any of the atypical antipsychotics? My experience wasn't great because of the stiffness side effect. But supposedly, they are great for anxiety, derealization, irritability, etc....I think I've read that you take seroquel for sleep? Just curious if you've ever done one for maintenence purposes. I'm not sure how I feel about them at this point.
My rash is the same as yesterday - not worse - not better. I gues that's a good sign? and no sores in my mouth.
>
***Well that's good. No sores is good. Again--I'm sorry about the rash. Keep an eye on it. I really don't know what psoriasis is. But whatever the case, BOTH Lithium AND Lamictal can cause rashes. And certainly together they can! Most of them are not fatal. So try not to worry too much.
>
As I said before, I think Depakote may work for you.***I have very little hope at this point. But i guess I have to raise my hopes a little when trying a new potion. I'm just afraid to hope too much in case my hopes get dashed again!
When you were on Li. you said you felt stupid? I'm wondering that about myself - but how does a stupid person know they're stupid? It just seems like reality no? How do you have such a clear grasp on what's normal for you and remember that in the midst of hazy heads? I forget and get confused and probably remain needlessly stupid for longer than I have to!
***That's quite a whopper of a question, Katia. (from a philosophical standpoint. Very existential!) For me, Lithium made me feel confused and slow. I had a hard time doing things I could normally do. Like, well, finding where I live! I also couldn't write a paragraph, I remember. I just felt trapped in a stupor. You'd know if you were having the "stupid" side effect..promise.
Thanks for your well-wishing, Katia. You take care, too. Keep in touch,
Katy
Posted by Karen_kay on January 4, 2004, at 19:59:34
In reply to Re: I got the rash - Lithium or Lamictal? » Karen_kay, posted by katia on January 4, 2004, at 1:12:27
Lithium doesn't cause the potentially fatal rash that Lamictal does. I can't remember what the particular name of the rash is called (Johnson something). How much Lithium are you taking? And when is the last time you had a blood test? Did he send you in to get your blood drawn? What other symptoms are you having now? I've just been doing a bit of reading and a rash from Lithium could also be a sign of possible Lithium toxicity. Now, you'd know if the levels of Lithium in your system were toxic... Trust me!!! When I took it I was paranoid! To the point that once, over the span of a week, I had my blood drawn every single day. And that gets expensive. But the signs are as follows:
Fine hand tremor, polyuria, and mild thirst may occur during initial therapy for the acute manic phase, and may persist throughout treatment. Transient and mild nausea and general discomfort may also appear during the first few days of lithium administration.
These side effects usually subside with continued treatment or a temporary reduction or cessation of dosage. If persistent, cessation of lithium therapy may be required.
Diarrhea, vomiting, drowsiness, muscular weakness, and lack of coordination may be early signs of lithium intoxication, and can occur at lithium levels below 2.0 mEq./l. At higher levels, ataxia, giddiness, tinnitus, blurred vision, and a large output of dilute urine may be seen. Serum lithium levels above 3.0 mEq./l may produce a complex clinical picture, involving multiple organs and organ systems. Serum lithium levels should not be permitted to exceed 2.0 mEq./l during the acute treatment phase.
The following reactions have been reported and appear to be related to serum lithium levels, including levels within the therapeutic range:
Neuromuscular/Central Nervous System: tremor, muscle hyperirritability (fasciculations, twitching, clonic movements of whole limbs), hypertonicity, ataxia, choreo-athetotic movements, hyperactive deep tendon reflex, extrapyramidal symptoms including acute dystonia, cogwheel rigidity, blackout spells, epileptiform seizures, slurred speech, dizziness, vertigo, downbeat nystagmus, incontinence of urine or feces, somnolence, psychomotor retardation, restlessness, confusion, stupor, coma, tongue movements, tics, tinnitus, hallucinations, poor memory, slowed intellectual functioning, startled response, worsening of organic brain syndromes
Cardiovascular: cardiac arrhythmia, hypotension, peripheral circulatory collapse, bradycardia, sinus node dysfunction with severe bradycardia (which may result in syncope)
Gastrointestinal: anorexia, nausea, vomiting, diarrhea, gastritis, salivary gland swelling, abdominal pain, excessive salivation, flatulence, indigestion
Genitourinary: glycosuria, decreased creatinine clearance, albuminuria, oliguria, and symptoms of nephrogenic diabetes insipidus including polyuria, thirst, and polydipsia
Dermatologic: drying and thinning of hair, alopecia, anesthesia of skin, acne, chronic folliculitis, xerosis cutis, psoriasis or its exacerbation, generalized pruritus with of without rash, cutaneous ulcers, angioedema
Autonomic: blurred vision, dry mouth, impotence/sexual dysfunction
Miscellaneous: fatigue, lethargy, transient scotomata, dehydration, weight loss, leukocytosis, headache, transient hyperglycemia, hypercalcemia, hyperparathyroidism, excessive weight gain, edematous swelling of ankles or wrists, metallic taste, dysgeusia/ taste distortion, salty taste, thirst, swollen lips, tightness in chest, swollen and/or painful joints, fever, polyarthralgia, dental caries.
I suffered from hallucinations, walking into walls, stupor, fatigue, poor coordination and upset stomach (to the point that I couldn't eat or drink). But, even when I had countell blood draws, my Lithium level wasn't high. I believe the therapuetic range is at about 1.0, but don't quote me on that. And I too suffered from derealization as well.
Don't let this freak you out! It's just stuff you have to know about and be aware of. Here's a link to the site where I found this info..
http://www.healthyplace.com/medications/lithium.htm
Take care hun. And call your Pdoc!
Karen
Posted by katia on January 5, 2004, at 15:22:18
In reply to Re: What? Non-flexible talons??? Never!, posted by fluffy on January 4, 2004, at 17:58:14
> Hey Katia--
>
> Good to hear from you, too! I've been just trying to put this whole mess behind me, so I've avoided the PB boards.**Yep. me too - nice to take a break but nice to have somewhere to run to for advice when getting rashes!
**I take Seroquel for sleep.
> >Well that's good. No sores is good. Again--I'm sorry about the rash. Keep an eye on it. I really don't know what psoriasis is. But whatever the case, BOTH Lithium AND Lamictal can cause rashes. And certainly together they can! Most of them are not fatal. So try not to worry too much.
**I didn't realize that Lithium causes rashes in people.
**You never know about Depakote! and there's always topamax.> When you were on Li. you said you felt stupid? I'm wondering that about myself - but how does a stupid person know they're stupid? It just seems like reality no? How do you have such a clear grasp on what's normal for you and remember that in the midst of hazy heads? I forget and get confused and probably remain needlessly stupid for longer than I have to!
>
> That's quite a whopper of a question, Katia. (from a philosophical standpoint. Very existential!) For me, Lithium made me feel confused and slow. I had a hard time doing things I could normally do. Like, well, finding where I live! I also couldn't write a paragraph, I remember. I just felt trapped in a stupor. You'd know if you were having the "stupid" side effect..promise.**You know what? This derealization I'm talking about is a stupor. I just couldn't describe it until hearing you talk about it. I feel like anything could happen - I could say anything b/c I'm not that in control - like I"m in the back seat observing it all happening. I feel slow and my brain feels pinned down. The thing that has made it worse was the upping of the Lithium. I was a retard last night at work. And then I got really giddy/silly/giggly and then drank too much. Even during the night customers made jokes about how I was drunk when I hadn't touched a drop. I would set things down on things - judgment off - bump into things. Is this what you experienced?
SHITE! Now w/in two days I find out lam and Li. won't work for me.
Does this not go away? I can't manage like this. I'm writing my thesis!!
-Katia
Posted by katia on January 5, 2004, at 15:40:12
In reply to Re: I got the rash - Lithium or Lamictal? » katia, posted by Karen_kay on January 4, 2004, at 19:59:34
Hi Karen,
Wow! You say so much. I'm cutting and pasting what I wrote in my last post to katy re: my experience. Because I wrote it and then looked at all those symptoms and it was very similar to what i've experienced."**You know what? This derealization I'm talking about is a stupor. I just couldn't describe it until hearing you talk about it. I feel like anything could happen - I could say anything b/c I'm not that in control - like I"m in the back seat observing it all happening. I feel slow and my brain feels pinned down. The thing that has made it worse was the upping of the Lithium. I was a retard last night at work. And then I got really giddy/silly/giggly and then drank too much. Even during the night customers made jokes about how I was drunk when I hadn't touched a drop. I would set things down on things - judgment off - bump into things.""
Karen, I've never had the blood level drawn because we were going to wait until I was at 900mg for twelve days. I've only been at 9 for four days and last night I reduced it to 700mg b/c I am waking up to my stupor (thank god) - yes "trapped in a stupor" is the right way to describe it. You're in such a stupor that you can't scream for help. Give me my brain!!!! and let my be stable as well!!!!Is it too much to ask?
Oh, well. Maybe topamax....
Katia
Posted by katia on January 6, 2004, at 15:24:42
In reply to Re: What? Non-flexible talons??? Never!, posted by fluffy on January 4, 2004, at 17:58:14
Hi Katy,
I"m so glad we talked. Sometimes when I'm in a state of consciousness, it takes me a long time to wake up to it. i've definitely been experiencing the Lithium stupor. I've just reduced my mgs back to 450 but I was in a bit of a stupor then too. I don't think Li. will work for me. We're just making the rounds aren't we? Maybe I'll move onto Triletptal. I need my brain back. It's powerful stuff, Lithium. Seee? I just drifted off for a couple of minutes. Ok, where was I? Oh, yeah - sick to death of moods and medications! Do I really need meds? It's been so long with this trial and error roller roaster that I long to be medfree for awhile and try that!
What do you think?
How are you Katy?
Katia
Posted by katia on January 6, 2004, at 15:49:06
In reply to Re: What? Non-flexible talons??? Never!, posted by fluffy on January 4, 2004, at 17:58:14
p.s. Didn't you say you felt numb? I feel numb - like the surface of my skin is numb and my brain. I'll go for another few days at 450 and see what happens. Adios Lamictal - Adieau Lithium - hello craziness!
Posted by Karen_kay on January 6, 2004, at 16:13:01
In reply to Lithium stupor » fluffy, posted by katia on January 6, 2004, at 15:24:42
Katia,
Hello! I know it is very dicouraging! OK, now lets talk... I have my book in front of me...*Do you have mixed states, or more of a "pure", euphoric mania?
-Mixed states tend to have a good response to anticonvulsants whereas euphoric manias have a good response to lithium*if you cycle with depression followed by mania, then you should respond better to an anticonvulsant then lithium
*If you have a low or no prevalence of bipolar disorder in your family then you should respond better to an AC then lithium, whereas if you have a high prevalence of BD in your family then lithium should be a better choice
*If you have rapid cycling (4+) x a year, then you *should* respond better to an AC then lithium
**co-occuring anxiety or substance abuse disorders typically respond better to AC then lithium, whereas fewer previous episodes of illness respond better to lithium
----Again, this is JUST according to a book. This isn't individualized according to the person. It is normal to have side effects when you are tirating up on a medication. Then typically go away once your body becomes adjusted to having the foreign substance there. Have you been doing research on your own and really listening to your body. You do know it best. I'm lucky in that I tolerate medications well. And I mean VERY well. And when I started having these side effects, I just KNEW something wasn't right because I had been taking Lithium for quite a while and I didn't raise my dosage. My body told me something was wrong. Do some research to find which type of drug (lithium, anticonvulsant) woudl work for your symptoms best. If you need help, ask me.... Tell ,me your symptoms and I'll give you the web pages to look at. I don't mind. I don't start classes until next week, so I have some free time on my hands and I'm all about learning everything I can about Bipolar Disorder anyway. And I have several books. I WON't Steer you wrong, I promise!! I'd say the best thing you can do at this point is find eVERYTHING you can aobut what medication would be best for you and try to stick it out. When I started topamax, I had some pretty severe side effects. I couldn't remember where I lived. But, I foujnd out that it was normal and i waited it out and now my mood is great. But, I'm NOT at all saying stick it out if it doesn't feel right!!! If your body is telling you that something is not right, then I suggest calling your doctor and getting your blood drawn. DEMAND it if you have to..... My PDOC told my boyfriedn that the best sign of my lithium level being dangerously high is that I begin acting like I'm drunk. And it disturbs me that you acted that way!! He said that if I start acting giddy adn like I'm drunk to page him and get to a hospital to get my blood draw. And there was one occassion where I took my lithium 2 times. That was scary, but still, my levels weren't too high. Give me your symptoms and I'll get to work of finding links for you.....
I understand COMPLETELY if you don't want to give me this info :) I just want to help you babe! That info I gave you should help you get started at least... And a few good pages to look are..
www.healthyplace.com
www.aboutbipolar.comGood luck hun and keep me up to date!!! If you think that lithium can hlep you, give it a shot. Maybe going up slower will make the side effects less prevalent? I'm not sure.. But, listen to your body. I'm thinking about you (it seems I'm thinking about alot of people here :) but I think that finding info about your sympoms and the meds will be a good start for you!!! A strange note, I'm actually the one who suggested topamax to my Pdoc! And I found out about it here. To think, I could still be struggling if it wasn't for Dr. Bob and this place (Thanks you Dr. Bob!!!!!)... My Pdoc still doesn't understand how Topamax works for me, but it does. I worked hard to find info and it payed of for me. It will for you too hun.... My thoughts are with you :)
Posted by katia on January 6, 2004, at 16:31:15
In reply to Re: Lithium stupor » katia, posted by Karen_kay on January 6, 2004, at 16:13:01
Hi Karen Kay,
I always feel slightly drunk/dizzy/numb/stupid on this. I just called pdoc and asked if I could reduce to 225mg rather than 450mg. I was only at 900mg for a few days. He said it takes a number of days for the li. levels to rise. I don't think I'm toxic. I've only been at 450mg. apart from three days at 900. Tonight I'm definitely only taking 225. I have to have my brain. 25pgs of my thesis is due in one week!!!!
thanks for your research. I actually was aware of those things before. The reason i was on Li was b/c I WAS on Lamictal - Li. is good at snergizing meds. I have already tried Depakote and now Lamictal. I guess I could try Trileptal or Topamax. I'm a rapid cycler/II/Mixed mainly depress-o wild woman. Apart from the time in my teens/early twenties, I don't have distinct periods of high and then low. A mixed wave more like it - the up swings being in spring and early fall and the downs being in summer and winter. Too much of anything pushes me over and being at the tip of change (spring and fall) is exciting.
Why did you stop your lithium? I forgot.
Irregardless, if Li. works for me or not - I'll want to add something to it like an AD. I don't think I'd work on something like Li. alone.
You sound in good spirits? hypomania? or just a good healthy line of mood? how was your xmas?
ta ta-
katia
Posted by Karen_kay on January 6, 2004, at 19:37:35
In reply to Re: Lithium stupor » Karen_kay, posted by katia on January 6, 2004, at 16:31:15
Hey girlie!!!
You could always try topamax (which is good for rapid cycling). Since it isn't particularly useful for some people for depression phase you could add an AD like wellbutrin (did I spell that right???) which is the best for not agrivating manic phases, according to what I've read. I'm not claiming to be a doctor :) But, when I started Topamax, I was in a depressed phase for almost 2 years, with slight hypomanic phases mixed in due to AD's or lithium. Lithium caused me to become hypomanic when I first start it, strange huh??? I even called my Pdoc and asked for a prescription for a vibrator, for insurance purposes! Whew! What nerve I have! But, topamax is what is working for me...
I stopped the lithium in February of last year. I was walking home from class one say and I thought "***** it! I'm done with this, I'll wait until I see a Pdoc who knows what he is doing!" But I was on the Lamictal/ Lithium/Zyprexa/Lexapro/Klonopin combo as well and began hallucinating, walking into walls, scared to take a shower, seeing my dead father and talking to him, your basic delusions!!! I was taking 1500 Lithium and 100 Lamictal. I started on Lithium and then he added Lamictal to help with depression. When that didn't help he added lexapro. Then, he added Klononpin for anxiety. When I began hallucinating, he added Zyprexa. Then, I tried various other antipsychotics (Resperdal, Seroquel, Geodon, Abilify) Currently, I'm not hallucinating. It had to do with childhood issues, not psychosis! (take that pdoc!) Sorry, tangent!)But, why didn't the lamictal alone not work for you? where you still depressed? why not just add an AD? Is that too risky? Or up the dose?
Good luck on your thesis! I'm sending good brain waves your way~~~~~~~~~~~
I stopped my lithium because I was way overmedicated and I was switching Pdocs and I just wanted a fresh start. I had a month before I saw my new one so I didn't see the harm.I'm just feeling fine now. I hope you get to feeling better!!!
Karen :)
Posted by fluffy on January 7, 2004, at 12:34:03
In reply to Re: What? Non-flexible talons??? Never! » fluffy, posted by katia on January 5, 2004, at 15:22:18
Hi Katia (and Karen)
Ok--I know you're frustrated. And writing a thesis in the middle of drug trials is to say the least stressful. But you know as well as I do that NO drugs is almost as bad as drug trials with side effects.
Speaking for myself, I've been basically on no drugs but fish oil and Temazepam for sleep. And it has totally sucked too. I've been cycling up and down EVERY OTHER DAY! Yeah--I've become one of those ultradian people now. I guess that the Lamictal actually did something for me, but I wasn't able to see it before. I can't wait to pop those depakote pills in my mouth tonight, hoping they will stop this crazy roller coaster ride!! So a "drug vacation" for me has turned out to be a learning experience. I've learned that I NEED DRUGS!! (i didn't even ask for the vacation...I just had to let my system clear out for the depakote).
Sounds to me that you are still having a hard time accepting the diagnosis. I'm struggling with it every day. I'm still not happy about the idea of taking meds, but at this point, I'm happy that i have some to try. It's not a fun thing we've been forced to deal with. I look around at other people in the grocery store and think how lucky they are that they don't have to think about thinking. I was trying to find a block of velveeta in a depressed blur two days ago, and all I could think about was that I wanted to die. All of these other people happily picking up their daily items, and I was looking at them with such jealousy, even if it was presumptuous. Frankly--we have something that SUCKS. I know you don't want to feel ill again. I don't really have any candy coated advice for you today (because I'm having a depressed day!)
Just don't give up on the drugs. Would you ever consider an atypical anti-psychotic for maintenence??? They are really effective in a lot of people on depression and mania and mixed/dysphoric/aggressive stuff. And they can have a VERY LOW side effect profile. Unfortunately, for us there is no magic pill with no side effects. You just have to figure out which ones will not interfere too much. For me, 10 extra pounds and lots of exercise may just have to enter into my life if the depakote works for me. I'll be very thankful. I may grumble later about the weight...but what a luxury to grumble about 10 pounds instead of untraradian cycling and suicidal tendencies!
It's just a gamble--crap-shoot kind of thing. And if it were the 1960's, we'd be strapped down to a bed with a piece of wood between our teeth. My grandmother wasn't so lucky. As pissed as I get about this process, I just have to remember that I'm able to have most of my functioning.
Just don't give up. I just care about you, and I can totally relate to your frustrations. Please keep in touch with your progress, and I'll do the same. I start the depakote tonight.
What's going on with you?
Katy
Posted by katia on January 7, 2004, at 15:15:45
In reply to Re: What? Non-flexible talons??? Never!, posted by fluffy on January 7, 2004, at 12:34:03
Hi Katy, (and Hi Karen - your message is mixed in with this one!)
I'm so sorry to hear about your ultradian cycling!! I've been there and you're just along for the ride hoping to hang on to something until it stops.
It's funny how fast things change, no? Now you're trying Depakote and I'm trying Lithium and we're BOTH off of Lamictal. Will you go back on it? I had some great days when the Depakote was low (50-100) and when the Lamictal was inching up. They snerygize each other (sp?). I lost all my hypomanic days from Lam. when I got off of Depakote. I think it could work for you. I'm just too afraid of the PCOS. When I've exhausted all possibilities then I may go back. I just feel like I've been on drugs for so long now - do I really need them? REALLY?! This could be talking from a lithium induced stupor. Yes, my brain - I forgot to oil the wheels - don't know where to get the oil. I feel retarded. I can't write. I don't feel motivation or inspiration - I don't have access to me. It's awful. My writing was flowing so well pre-Li. I think I'd rather have access to angst if it means be able to access that part of me - well my creative side. It's more than just about not being able to have inspiration - I feel dangerously numb. Like I don't have good judgment - I could do anything or say anything b/c I can't feel. Like I'm eating what the hell I want w/o thinking or caring about a diet, I take a glass of wine at the end of a shift whether I crave it or not. This isn't a hopeless i don't care depression, it's just I don't have the sense to say one way or another about anything. AND TO THINK I WAS ON THE PHONE YESTERDAY WITH A REAL ESTATE MORTGAGE BROKER WANTING TO BUY A HOUSE!!! I've pulled out of that one because I'm afraid that the market will crash right when I get in (No.Cal). But something tells me ;-) that I need to wait on the buying of the house when I'm not in a lithium induced haze and trying to write a thesis.
I could say that at times, I feel a rush of giddiness/euphoria but it's not a racy kind. I'm titrating down to 225mg tonight. My pdoc wanted me to stay at 450mg 'til Friday b/c it takes 4-5 days for Li. levels to fall - but looking back over the past two weeks, I've been feeling like this for awhile. I NEED ACCESS TO MY BRAIN. I feel (sp?) dsylexic when I talk - I can't get anything out. At least my irritability/agitation has gone. Maybe that's to do with adios Lamictal. I haven't considered the antipsychotics yet. There's still Trileptal and Topamax to try if Lithium doesn't get better. (or augment to Li)
Karen, I can't believe you were at 1200mg on Lithium. Weren't you in a stupor? That's soooo funny about the vibrator. It's so funny (and scary) how our judgement gets off in hypomania! The Lamictal did work for me when augmented with the Depakote - it added a nice ZING to my life. It helped me when I was solo on it - not to fall to the bottom - but I was really irritability on it and lost temper tons - also insomnia. I wouldn't have gotten off of it had it not been for the rash. But since now I'm off of it, I am not so irritability (could be the lithium) AND wouldn't want to try it again right away if something else could work.
Katy, let me know how the Depakote works for you -Keep in touch sweetie!Katy and Karen! Thanks for your posts and words of reassurance and humor and sharing!
take good care,
Katia
Posted by katia on January 8, 2004, at 1:36:27
In reply to Re: What? Non-flexible talons??? Never!, posted by fluffy on January 7, 2004, at 12:34:03
Hi Katy,
I was just looking over some old posts of ours - when we were all posting tons a day. I was looking for your old posts on Lithium. and it really sounds like your experience is very similar to mine (on Li.). apart from the teeth clenching... I can't believe all that was four months ago in Sept! amazing how time flies. But from everything you talked about and thought about, Depakote was definitely your next move. I have a feeling it'll work for you. I'm wondering what my next move will be. I reduced my dose down to only 225mg tonight! It takes four-five days for it to level at the new dosage. So we'll see if I can tolerate even at that level. It all feels rather silly. I'm not on anything else except for fish oil and some seroquel for sleep. Ugggg....maybe on to Trileptal....or topamax.....
Please keep in touch miss katy! Hope it works for you.
Katia
Posted by fluffy on January 8, 2004, at 10:42:59
In reply to Re: What? Non-flexible talons??? Never!, posted by katia on January 7, 2004, at 15:15:45
Hi Katia--
Sorry about your Li troubles. It can be wonderful for some people...not for others. Actually, 1200mg is a pretty routine dose. Some people just don't have as much of a side effect problem with it. Unfortunately, the "stupid" side effect doesn't fade over time. Only with a slightly lower dose.
Have you decided to chuck the Li all together instead of just lowering the dose? You could try a lower dose as your doctor is suggesting, rather than going solo. When do you see your doctor next?
And i think it's wise to not make any, um, HUGE decisions (like buying a house) at this time in your life. Maybe give it another year or so when you are more stable, and your thesis is done, etc. One thing at a time. (what are you studying? I forget.)
Actually, Topomax is a bit further down on the decision tree than the atypical AP's for maintenence of BP. I know that Karen has had a good experience with it. But many people on this board have complained about it's even worse cognitive side effects. Probably not the drug you want to reach for next, if you want to avoid the brain-fog and get through thesis time. I don't know personally--just that according to statistics, a large number of people feel like they have deja-vu all of the time, and get very forgetful and confused for the first couple of months. (It hits the temporal lobe pretty hard). But like for Karen, it can be a wonderful drug for some. It's just a little further off down the tree, clinically speaking. Trileptal and Tegretol are next, I suppose, if you are indeed throwing the Li out the window and going the anticonvulsant route. What is your doctor suggesting?
I don't know what the solution is for you. But I also wish you luck in this shitty conquest.
Yeah--I was going to try depakote after the trileptal fiasco, but decided in favor of zyprexa. My doctor was doing the "shell game" thing with me... I think he really likes zyprexa, so we decided, what the heck--let's give it a spin. You just never really know what's going to hit the right buttons. He even says that it's just a crap-shoot (there are indicators of what may work for some people, but in general, it's hard to tell what will happen side effect wise).
I started my depakote at 250mg last night. I feel pretty drugged this morning. Ughh. I know it will fade, though. Not sure what my titration schedule is. My doctor is going low and slow. I'm still taking 25mg of Lamictal. If the rash shows again, then it goes bye bye.
Good luck,
Lots of hugs,
Katy
Posted by katia on January 8, 2004, at 15:39:50
In reply to Re: What? Non-flexible talons??? Never!, posted by fluffy on January 8, 2004, at 10:42:59
Hi Katy,
It's so good to hear from you again! I too think about you and Barb a lot. I wonder where she is? Even though it's good to take a break, I missed you guys.
I cannot get through this brain fog. I was trying to write yesterday. uh what a joke. Instead of flowing beautifully like it does, it's like i was coughing up chunks of words to eventually form a sentence and then I'd have to look at it again and again and then forget what I was doing. Wowie! lithium is by far the strongest beast I've yet to ingest. Two days after I went to 900mg, I got the rash and had to stop lam. I think that the two (as Barb's post much earlier stated when you were going on Li) Lam and Li act well together, but w/o Lam. the brain fog set in pretty hard. I decreased my dose to 225mg last night. We'll wait and see in five days if my fog lifts. It's definitely quelled my agitation/irritability. But I've lost too much in the process - i don't feel. On my mood chart, all I can document is meds and sleep hours. I haven't a clue what to put for mood. I guess I'm one of those who cannot tolerate it. Maybe at a lower dose and then i could add Wellbutrin or another MS. My pdoc is consevative-ish and wants me to stay at 450 'til Friday. Sorry I couldn't wait. I need my brain, inspiration, motivation....I think I've experienced touches of hypomania (euphoric kind)too - harder to sleep, buying a house thing, giddy/silliness. Really lithium has put me into another dimension.
I see my pdoc on the 21st. However, we may see each other before then b/c I want to go on Antabuse. But at this point, I don't care. I have no strong opinions one way or another - I feel too far beneath my skin.
> And i think it's wise to not make any, um, HUGE decisions (like buying a house) at this time in your life. Maybe give it another year or so when you are more stable, and your thesis is done, etc. One thing at a time. (what are you studying? I forget.)**I'm studying transpersonal psychology and life coaching. (yeah I know, surprise surprise) at least my topic is relevant (bipolar spectrum disorders).
Thanks for the advice re: Topamax. last thing I need is more deja vu feeling and stupidity. Hits the temporal lobe? Um interesting....I hadn't considered this when thinking about meds.
> I started my depakote at 250mg last night. I feel pretty drugged this morning. Ughh. I know it will fade, though. Not sure what my titration schedule is. My doctor is going low and slow. I'm still taking 25mg of Lamictal. If the rash shows again, then it goes bye bye.*That was one thing I felt on Depakote was sedation and an early afternoon fatigue/crash (even with waking at 11/12ish). I've heard that it goes away and you can play with the timing of doses etc. Will you up the Lamictal again if no rash? You could always add Wellbutrin as well or instead to give you energy and ward off depression. You still have options little Katy! Don't despair - and likewise for me.
That ultradian cycling is for the birds....I've experienced that too - it was more in the summer months. Since winter, i've had more of the depression. How do you feel today?
take good care-
Hugs-
Katia
Posted by fluffy on January 8, 2004, at 17:27:08
In reply to Lithium » fluffy, posted by katia on January 8, 2004, at 15:39:50
Hey Katia--
You seem better today. Your grammar and organization of thoughts was a bit off a couple of days ago, and today it seems more together. Yeah--Lithium was a bit too potent a brew for me, too. Too bad. Seems like it would be such a pleasant, simple solution (it being a very traditional cure).
Today I feel_________. I think it's funny about your mood chart--not knowing where your mood fits. (it's like there should be another blank that says "drugged out of my mind". That's what I'd fill in today i think.
i don't know what's up with my limbs. For whatever reasons, when I try a new mood stabilizer, I've had these really physical side effects...heavyness in my limbs, looseness of my grip, stiffness in my hands...this is scary!!
Today, after the first depakote dose, my hands feel like they've fallen asleep (or just after--they feel heavy and uncoordinated). It really scares me. I don't want to tell my doctor until it is really a problem. I really don't want to discontinue another drug so soon. So we'll see if this clears up in a week or so. How long does the full dose of Depakote take to build up in your system? Isn't it faster than most mood stabilizers?Other than the heavy hands--I'm depressed as sh*t. I had to take a crying break today instead of a lunch break. All I could think about is why my doctors would even want to keep me alive--and how cruel it is to even do that to someone who is suffering. I've been pretty f*uckin' depressed this week. I just want to be better, but I'm tired of suffering. I have intermittently thought of going to the hospital. But really, I don't know what difference it would make for me right now. I just know my thoughts are really negative right now, and I'm not functioning so well. I feel like "Hal" in 2001 Space Odyssey when the astronauts start to disconnect his wires..."I can feel it".
I'm sure in two days I'll be chipper and bouncing around the house, cleaning and sewing, busy as a bee. This is so confusing.
Thanks for your posts Katia. I really need a buddy who can handle hearing this crap.
you take care, too. hugs and more hugs,
Katy
Posted by AMD on January 8, 2004, at 18:20:13
In reply to Lithium » fluffy, posted by katia on January 8, 2004, at 15:39:50
Katia,
I feel for you; I am going through the same thing. For three months of on-again, off-again lithium therapy, I've felt at various points racy headed, gloomy, stuporous, slow, sleepy, and just plain frustrated. (I also take 40 mg Celexa and just added Lamictal.)
Is this the lithium, lingering depression, or a bad hangover from a high BAL three months ago?
Is this feeling reversible, or will it persist until my mind just 'gets used to it'?Well, I'll assume it's not alcohol related, in which case the only real cause seems to be the lithium. Been on between 300mg - 900mg daily, and have various stages of 'brain fog'. I like that phrase: it really describes how I feel at times.
I DO feel depressed, but in some ways I think the lithium is actually making me that way.
So much hunch is it's the lithium itself causing the brain fog. It's not just that, either. I've been unmotivated, slow, and just not myself. No passion for work, like usual, for example. Anhedonia but not to an extreme.
The most annoying aspect has been this odd 'tingling' in the back of my head when I attempt to concentrate. I suddenly feel tired and just want to whack myself on the side of the head to 'snap out of it'. Nothing gels quickly, and when I'm really on the lithium I have trouble grasping abstract concepts, like calculus.
It's endlessly frustrating... and it's worrying just waiting to snap out of it. I keep thinking I've f****'d up my brain permanently now. But this is day one of NO lithium, after two consistent weeks on about 600 mg/day, so we'll see if I feel any better come the weekend.
Curious to see how you feel, too.
Adam
> Hi Katy,
> It's so good to hear from you again! I too think about you and Barb a lot. I wonder where she is? Even though it's good to take a break, I missed you guys.
> I cannot get through this brain fog. I was trying to write yesterday. uh what a joke. Instead of flowing beautifully like it does, it's like i was coughing up chunks of words to eventually form a sentence and then I'd have to look at it again and again and then forget what I was doing. Wowie! lithium is by far the strongest beast I've yet to ingest. Two days after I went to 900mg, I got the rash and had to stop lam. I think that the two (as Barb's post much earlier stated when you were going on Li) Lam and Li act well together, but w/o Lam. the brain fog set in pretty hard. I decreased my dose to 225mg last night. We'll wait and see in five days if my fog lifts. It's definitely quelled my agitation/irritability. But I've lost too much in the process - i don't feel. On my mood chart, all I can document is meds and sleep hours. I haven't a clue what to put for mood. I guess I'm one of those who cannot tolerate it. Maybe at a lower dose and then i could add Wellbutrin or another MS. My pdoc is consevative-ish and wants me to stay at 450 'til Friday. Sorry I couldn't wait. I need my brain, inspiration, motivation....I think I've experienced touches of hypomania (euphoric kind)too - harder to sleep, buying a house thing, giddy/silliness. Really lithium has put me into another dimension.
> I see my pdoc on the 21st. However, we may see each other before then b/c I want to go on Antabuse. But at this point, I don't care. I have no strong opinions one way or another - I feel too far beneath my skin.
>
> > And i think it's wise to not make any, um, HUGE decisions (like buying a house) at this time in your life. Maybe give it another year or so when you are more stable, and your thesis is done, etc. One thing at a time. (what are you studying? I forget.)
>
> **I'm studying transpersonal psychology and life coaching. (yeah I know, surprise surprise) at least my topic is relevant (bipolar spectrum disorders).
>
> Thanks for the advice re: Topamax. last thing I need is more deja vu feeling and stupidity. Hits the temporal lobe? Um interesting....I hadn't considered this when thinking about meds.
>
> > I started my depakote at 250mg last night. I feel pretty drugged this morning. Ughh. I know it will fade, though. Not sure what my titration schedule is. My doctor is going low and slow. I'm still taking 25mg of Lamictal. If the rash shows again, then it goes bye bye.
>
> *That was one thing I felt on Depakote was sedation and an early afternoon fatigue/crash (even with waking at 11/12ish). I've heard that it goes away and you can play with the timing of doses etc. Will you up the Lamictal again if no rash? You could always add Wellbutrin as well or instead to give you energy and ward off depression. You still have options little Katy! Don't despair - and likewise for me.
> That ultradian cycling is for the birds....I've experienced that too - it was more in the summer months. Since winter, i've had more of the depression. How do you feel today?
> take good care-
> Hugs-
> Katia
Posted by Karen_kay on January 8, 2004, at 19:55:54
In reply to Re: What? Non-flexible talons??? Never!, posted by fluffy on January 8, 2004, at 10:42:59
Hey all!
I totally agree! For some reason I'm very lucky in that I tolerate medications very well with little side effects. Topamax did cause cognitive slowing, to the point that I confused the letter "e" with the letter "I"...This whole mess is so confusing, isn't it?? But, I had to wait it out. And Topamax isn't the medication for everyone. It just happens to be the one that works for me.It's a really stressful time for you right now katia, with your thesis and meds and life in general. But I agree with Katy that you shouldn't make any big decisions like purchasing a house (congrats though!! What a big step!!) in the midst of all of this. I'd put it off for a bit longer. The market fluctuates and your chance will come again when you don't have as much going on in your life. Who knows, maybe next year at this time the same house will be up on the market for 10% less? That would be great!!
And your posts do seem to be much more flowing and suggest that "everything is coming back." Give it a bit more time. It will come together. And you'll find the right combination. It just takes some time.
Sending you all warm thoughts!!!
Karen
Posted by katia on January 8, 2004, at 22:36:56
In reply to Re: Lithium, posted by fluffy on January 8, 2004, at 17:27:08
Hi Katy,
Yes, I'm slightly better, but i'm still drugged feeling/stuporish. (try doing bikram yoga like this it's a riot - before you know it the entire class has passed you by). I'm really really tired.
As far as the Depakote titration, I think you can go to the max right away.
> Today I feel_________. I think it's funny about your mood chart--not knowing where your mood fits. (it's like there should be another blank that says "drugged out of my mind". That's what I'd fill in today i think.**Yes, I'm drawing big ? marks thru my lithium stupor days. The plus side is my agitation/irritability has subsided considerably. But I don't have access to me. I didn't realize my grammar was off! I wonder what/how others think/see me?
> i don't know what's up with my limbs. For whatever reasons, when I try a new mood stabilizer, I've had these really physical side effects...heavyness in my limbs, looseness of my grip, stiffness in my hands...this is scary!!
> Today, after the first depakote dose, my hands feel like they've fallen asleep (or just after--they feel heavy and uncoordinated). It really scares me. I don't want to tell my doctor until it is really a problem. I really don't want to discontinue another drug so soon. So we'll see if this clears up in a week or so. How long does the full dose of Depakote take to build up in your system? Isn't it faster than most mood stabilizers?**I kinda have that now - big stiff bear claw :-)Clumsy like and slow.
> Other than the heavy hands--I'm depressed as sh*t. I had to take a crying break today instead of a lunch break. All I could think about is why my doctors would even want to keep me alive--and how cruel it is to even do that to someone who is suffering. I've been pretty f*uckin' depressed this week. I just want to be better, but I'm tired of suffering. I have intermittently thought of going to the hospital. But really, I don't know what difference it would make for me right now. I just know my thoughts are really negative right now, and I'm not functioning so well. I feel like "Hal" in 2001 Space Odyssey when the astronauts start to disconnect his wires..."I can feel it".**Oh dear katy, I hear you. You will get better - so will I! Our experiences are so similar it's uncanny.
>
> I'm sure in two days I'll be chipper and bouncing around the house, cleaning and sewing, busy as a bee. This is so confusing.
>
Keep in touch.
Love,
Katia
Posted by katia on January 8, 2004, at 22:56:31
In reply to Re: Lithium » katia, posted by AMD on January 8, 2004, at 18:20:13
Hi Adam!
Thanks for the post! You sound just like me. I'll respond below with *** in front.
> I feel for you; I am going through the same thing. For three months of on-again, off-again lithium therapy, I've felt at various points racy headed, gloomy, stuporous, slow, sleepy, and just plain frustrated. (I also take 40 mg Celexa and just added Lamictal.)
** Hi, I'm sitting here reading your post and spacing out and then re-reading it...ok. What is your diagnosis? I'm somewhere around bipolar II/Mixed/rapid cycler yet with big swings one way or the other in a year...and rapid cycling within those either ups or downs. So as you read from my post, I just stopped Lamictal. I was on 200mg for over a month and on Lam. total for about four months. I started Lithium over two weeks ago at 450mg. When I upped to 900mg the second day I woke up with a rash all over my body. Pdoc took me off of Lamictal. and since I've downed my Li. to 225mg. As of yesterday that's what it's at. My pdoc told me it takes 5 full days for lithium levels to drop. So if you just got off of Lithium yesterday, you wouldn't really feel it yet.
> Is this the lithium, lingering depression, or a bad hangover from a high BAL three months ago?**What is a BAL?
> Is this feeling reversible, or will it persist until my mind just 'gets used to it'?
** Are you asking the question as tho' you are on Lithium? i.e. Will it go away while you're on Lithium? I hope so. or Are you permanently brain damamged? THAT'S MY FEAR. I'm worried I won't get back my zest, my feeling, my motivation, inspiration, intuition, creativity, my drive etc.
> Well, I'll assume it's not alcohol related, in which case the only real cause seems to be the lithium. Been on between 300mg - 900mg daily, and have various stages of 'brain fog'. I like that phrase: it really describes how I feel at times.
**When did you drink and how much?
> I DO feel depressed, but in some ways I think the lithium is actually making me that way.**Could very well be.
> So much hunch is it's the lithium itself causing the brain fog. It's not just that, either. I've been unmotivated, slow, and just not myself. No passion for work, like usual, for example. Anhedonia but not to an extreme.**You just described me. It's not like a painful voidness of depression - it's just "eh - life? I can take it or leave it".
>
> The most annoying aspect has been this odd 'tingling' in the back of my head when I attempt to concentrate. I suddenly feel tired and just want to whack myself on the side of the head to 'snap out of it'. Nothing gels quickly, and when I'm really on the lithium I have trouble grasping abstract concepts, like calculus.**honey even when NOT on lithium I can't grasp concepts like calculus!!! But I'm having trouble grasping any concept! I also feel tired - really tired. The only way to say it is I am trapped in a stupor. I also want to whack myself over the head - it's that feeling like "snap out of it! wake up!". I just squint as though that'll help with my cognitive processes!
>
> It's endlessly frustrating... and it's worrying just waiting to snap out of it. I keep thinking I've f****'d up my brain permanently now. But this is day one of NO lithium, after two consistent weeks on about 600 mg/day, so we'll see if I feel any better come the weekend.
>
**Definitely keep in touch with your progress. Are you off of Lithium for good? Did you even feel this brain fog at 300mg? What are you onto next? Just the Celexa and Lamcital?
take care!
Katia
Posted by katia on January 8, 2004, at 23:03:08
In reply to Re: What? Non-flexible talons??? Never! » fluffy, posted by Karen_kay on January 8, 2004, at 19:55:54
Thanks Karen,
How long did your cognitive stuff last? I'm not so sure how healthy that impulse was to buy the house....but it's best to wait...yes i agree.
take care,
Katia
Posted by fluffy on January 9, 2004, at 10:25:56
In reply to Re: Lithium » katia, posted by AMD on January 8, 2004, at 18:20:13
Hi AMD--
I also wonder what BAL is??
As for your Lithium brainfog--YES IT WILL GO AWAY!! I promise you. It may take a few days, but I noticed within a couple of days after discontinuing that my normal functioning was back. (even if I was cycling again...at least I felt something, and I could write a paragraph!) It was really frustrating for me to know that I COULD write before, and the smarts were in there, but I was being blocked access to my thoughts. I never thought I would be a Lithium nay-sayer until I tried it.
When i first got diagnosed, I used to think that the people who went off their meds were just stubborn. But man--I sure have learned the hard way how frustrating this is!
Don't you wish that the doctors had to take some of this stuff to understand how annoying it is to feel so blah? They think it's fine if you don't feel morbidly depressed or manic, and that's it. They're off the hook. (luckily, I've found a doctor who won't put up with me feeling icky-poo-poo b/c he knows I won't stick with the drug in the long run anyway). In the mean time, though, searching for the drug that works and doesn't do that is proving daunting.
Best of luck to you. If you need to vent some more, this group we have going is very good.
take care,
Katy(bipolar II, rapid cycling
Currently on 250mg depakote, 25mg Lamictal,
2g omega 3's, Temazepam for sleep)
Posted by fluffy on January 9, 2004, at 10:37:42
In reply to Re: Lithium » fluffy, posted by katia on January 8, 2004, at 22:36:56
Hey Katia--
It may not last, but I woke up feeling a bit better today. My muscles aren't as loose. I do seem to have tingly hands and muscle-stuff when I start the anti-convulsants...(i looked at what happened with my Lamictal start up last year--I wrote down that my hands and face were tingling for the first week or so). Maybe it was just a temporary drug start-up thing. I guess if I keep cycling, I'll just up my dose until (hopefully) it stops. The great thing about rapid cycling is that you know really fast if you are responding to a drug! And it's great that Depakote works so fast if it will work at all.
How's today? Your grammar wasn't really bad--it was more like just typing errors and disorganized thoughts. don't worry! I didn't mean to criticize--only point out that you seem to be doing better.
lovins,
Katy
Posted by AMD on January 9, 2004, at 14:13:55
In reply to Re: Lithium » AMD, posted by katia on January 8, 2004, at 22:56:31
Katia,
My responses to your responses below. I've prefaced them with ### (soon I fear we will run out of symbols).
> ** Hi, I'm sitting here reading your post and spacing out and then re-reading it...ok. What is your diagnosis? I'm somewhere around bipolar
### My diagnosis is BPII, with a history of major
### depression. (Well, significant episodes.)
### I'm not sure I agree with the diagnosis: my
### personality exhibits some of the
### traditional 'symptoms' of hypomania. That's
### just how I am!### Questions for you: how did you feel on the
### Lamictal? Did it affect your cognition for
### better/worse? Did it help with your
### depression? Was it effective for the
### cycling? (I am on the fourth day: still
### taking just 25mg/day.)I started Lithium over two weeks ago at 450mg. When I upped to 900mg the second day I woke up with a rash all over my body. Pdoc took me off of Lamictal. and since I've downed my Li. to 225mg. As of yesterday that's what it's at. My pdoc told me it takes 5 full days for lithium levels to drop. So if you just got off of Lithium yesterday, you wouldn't really feel it yet.
### Day two, and I definitely feel a little more
### mentally alert. Still pangs of depression,
### and a lot of self-doubt, but not so bad.
### Perhaps a bit 'mixed' -- but I don't think
### so. That's just what I get for having
### that thought suggested to me.> > Is this the lithium, lingering depression, or a bad hangover from a high BAL three months ago?
>
> **What is a BAL?### Blood alcohol level: all this started after
### I (binge) drank enough to put myself in the
### hospital with a BAL of .25. That was about
### two months ago, and my medical checkup
### afterward was fine.** Are you asking the question as tho' you are on Lithium? i.e. Will it go away while you're on Lithium? I hope so. or Are you permanently brain damamged? THAT'S MY FEAR. I'm worried I won't get back my zest, my feeling, my motivation, inspiration, intuition, creativity, my drive etc.
### Bingo, my fears exactly. It's like I went
### from one person one day to a different
### person the next. Kind of hard to take with
### 26 years under my belt!> **honey even when NOT on lithium I can't grasp concepts like calculus!!! But I'm having trouble
### I can grasp them, it's just more difficult.
### I am used to reviewing a chapter I haven't
### read before class and then aceing the test.
### That kind of thing. I'm spoiled by being
### gifted!wake up!". I just squint as though that'll help with my cognitive processes!
### That's an interesting approach... =)
Are you off of Lithium for good? Did you even feel this brain fog at 300mg? What are you onto next? Just the Celexa and Lamcital?
### Yes, brain fog even at 300 mg, but nowhere
### near as badly as at 600 mg. For now, 40 mg
### Celexa, 25 mg Lamictal titrating up to 150 mg.Regards,
Adam
Posted by AMD on January 9, 2004, at 14:24:33
In reply to Re: Lithium, posted by fluffy on January 9, 2004, at 10:25:56
> Hi AMD--
>
> I also wonder what BAL is??
>
> As for your Lithium brainfog--YES IT WILL GO AWAY!! I promise you. It may take a few days,### That is so good to hear! I had been gradually
### decreasing the dose until yesterday, when I ### finally quit. Already my mind is a bit
### clearer, although I now fear I'll be obsessed
### with 'wondering' whether I am in fact
### back to my clear-thinking self. I will
### consider myself back to normal when these
### obsessions dissipate.back. (even if I was cycling again...at least I felt something, and I could write a paragraph!)
### They talk about the 'trade-off' -- for me
### I'd rather be a bit manic than unable to
### experience the highs and lows of life.> Don't you wish that the doctors had to take some of this stuff to understand how annoying it
### I think we need a directory of psychiatrists
### with mental illnesses themselves, organized
### by symptoms and medications used. I'd feel
### so much better talking to, and confident
### about, a doctor I knew had experienced
### the same symptoms I had, and that had taken
### the same medicines she's prescribing for
### those symptoms.### Lithium is the only medicine I've taken that
### really made me feel like I wasn't myself.
### And I hardly got started on it -- just took it
### on-and-off for one or two weeks at a time
### for two months.> (bipolar II, rapid cycling
> Currently on 250mg depakote, 25mg Lamictal,
> 2g omega 3's, Temazepam for sleep)### How is this combination working for you? I
### admit, I hesitate to take a lot of
### (prescription) drugs. I've now taken three
### in my lifetime (Celexa, Lithium, Lamictal)
### and I hope to be off the Lithium soon,
### gradually off the Celexa, and eventually
### off of everything.Adam
Posted by katia on January 9, 2004, at 15:33:29
In reply to Katia--feeling better today, posted by fluffy on January 9, 2004, at 10:37:42
Hi Katy,
Good news!! I'm so glad. And it's only the second day! But Depakote works fast. I went up to 750mg, but it's like everything, if it works for you at a lower level - why the hell not stay there? Are you upping your Lamictal too? Dep. doubles Lam levels. I think you'll get a nice hypomanic feeling if you up the Lam. more. (and Dep.).
I didn't take your comments as criticism. It's important to get feedback! Keep it coming.
I'm still feeling stupid, flat, (and fat!), and slow. I can't fall asleep before 3ish, but yet I'm exhausted feeling. I take more Seroquel now and then I wake up after 12. It's a crappy schedule I've been doing for over a year now.
that's me-
hugs-
katia
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