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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by sac on May 12, 2004, at 12:31:13
I'm currently on Lamictal 150 mgs. w/ Prozac 20 mgs. for bipolar II. I've been on numerous mood stabilizer, AD's, etc. and am becoming desperate again. It seems my Prozac has pooped out. I feel no AD effect at all. I tried upping the Lamictal and only got over-stimulated (in a bad way) if I up the Prozac I know within a week my mood with lift but I risk switching into hypomania and thus worsening the whole cycle. Anything above 20 mgs. Prozac makes me hypomanic. My doc has suggested Geodon (due to some delusions also) Gabitril, or depakote. Which one do I pick? and why does it seem that these mood stabilizers only make me feel worse as in MORE depressed??? I am a 35 year old full-time mom to two small children and my whole life has been taken over by my moods. I just want to feel good again. Can anyone help?
Posted by chemist on May 12, 2004, at 13:08:26
In reply to Question for chemist or anyone re: AD poop-out, posted by sac on May 12, 2004, at 12:31:13
> I'm currently on Lamictal 150 mgs. w/ Prozac 20 mgs. for bipolar II. I've been on numerous mood stabilizer, AD's, etc. and am becoming desperate again. It seems my Prozac has pooped out. I feel no AD effect at all. I tried upping the Lamictal and only got over-stimulated (in a bad way) if I up the Prozac I know within a week my mood with lift but I risk switching into hypomania and thus worsening the whole cycle. Anything above 20 mgs. Prozac makes me hypomanic. My doc has suggested Geodon (due to some delusions also) Gabitril, or depakote. Which one do I pick? and why does it seem that these mood stabilizers only make me feel worse as in MORE depressed??? I am a 35 year old full-time mom to two small children and my whole life has been taken over by my moods. I just want to feel good again. Can anyone help?
before going about geodon or depakote or gabitril: how much did you go up to on lamictal when it pushed you in hypomanic? all the best, chemist
Posted by sac on May 12, 2004, at 19:28:35
In reply to Re: Question for chemist or anyone re: AD poop-out » sac, posted by chemist on May 12, 2004, at 13:08:26
Thanks for responding.
I went up to 200 mgs. of Lamictal for 4 weeks and I did not have any improvement in my depression only I was more agitated so I backed down to 150mg. Currently on 150 mgs. Lamictal, 20 mgs. Prozac and 10mg. Serax (as needed).
Posted by chemist on May 12, 2004, at 22:58:10
In reply to Re: Question for chemist or anyone re: AD poop-out » chemist, posted by sac on May 12, 2004, at 19:28:35
> Thanks for responding.
>
>
> I went up to 200 mgs. of Lamictal for 4 weeks and I did not have any improvement in my depression only I was more agitated so I backed down to 150mg. Currently on 150 mgs. Lamictal, 20 mgs. Prozac and 10mg. Serax (as needed).that's what i wanted to know, i.e., how much lamictal...how's about going down on prozac and back up to 200 on the lamictal? is that an option you have tried? you are fighting antidepressant vs. mood stabilizer (of questionable efficacy, but the positive aspects seem to indicate it is the real deal), and you seem to be overly-stimulated, which means that the lamictal is either ineffective for manic cycles OR may be inducing them in concert with the prozac. not uncommon at all for an AD + mood stabilizer, but clearly not working as planned. is the diagnosis definitive, and have you treid lamictal in conjunction with a primary mood-stabilizer, e.g. lithium or depakote or even tegretol? all the best, chemist
Posted by sac on May 13, 2004, at 7:07:30
In reply to Re: Question for chemist or anyone re: AD poop-out » sac, posted by chemist on May 12, 2004, at 22:58:10
> > > that's what i wanted to know, i.e., how much lamictal...how's about going down on prozac and back up to 200 on the lamictal? is that an option you have tried? you are fighting antidepressant vs. mood stabilizer (of questionable efficacy, but the positive aspects seem to indicate it is the real deal), and you seem to be overly-stimulated, which means that the lamictal is either ineffective for manic cycles OR may be inducing them in concert with the prozac. not uncommon at all for an AD + mood stabilizer, but clearly not working as planned. is the diagnosis definitive, and have you treid lamictal in conjunction with a primary mood-stabilizer, e.g. lithium or depakote or even tegretol? all the best, chemist
No, the diagnosis is not definitive. At one time my pdoc was saying that I have rapidly re-current resistant unipolar depression. For 14 years I was on antidepressants and they helped tremendously and I had no problem. After the birth of my second child three years ago, I had a hypomanic (possibly manic) episode I was on Prozac at the time at 40 mgs(which I know now is too high for me). The episode involved extreme agitation, irritability, rage, and some delusions. At the same time, I felt depressed. (Mixed episode?) Since that time, I have been unstable with mood cycling between depression and hypomania. I tried Lithium and felt very strange on it. I liked Depakote ER initially but could not go beyond 250 mgs. without feeling terribly depressed. The only mood stabilizer I have been able to be on at a reasonably good dose is the Lamictal. However, I have had this over-stimulation problem when I go above 150mgs. I have not tried lowering my prozac, though, basically because I am terrified that I'll feel worse. I have my suspicions that the Prozac is worsening the overall course of this illness. But I don't know how to get off it. My Pdoc wanted me to try Gabitril at night to calm me down because I am starting to spiral into depression. I tried this for three days and felt worse???? My Pdoc is out of the country for 1 month so I am desperate. I upped my Prozac to 30mgs. (I know this is crazy) but I am trying to get out of this depression that is descending upon me. I appreciate so much, your response because I have been following these boards for a long time and I know you know what you are talking about. Perhaps I should scrap the Gabitril idea and go back to the Lamictal 200mgs with 10mgs prozac?
Posted by elleff on May 14, 2004, at 15:15:50
In reply to Re: Question for chemist or anyone re: AD poop-out » chemist, posted by sac on May 13, 2004, at 7:07:30
Dear Sac
My experience is that adding a small dose (ie 5 -10mg per day) of memantine (sold as Namenda in the USA, Ebixa here in Australia) is the most effective strategy for SSRI poop-out.
Posted by sac on May 14, 2004, at 21:59:46
In reply to Re: Question for chemist or anyone re: AD poop-out, posted by elleff on May 14, 2004, at 15:15:50
Thanks for your input. I will look into this also. -Stacey
> Dear Sac
>
> My experience is that adding a small dose (ie 5 -10mg per day) of memantine (sold as Namenda in the USA, Ebixa here in Australia) is the most effective strategy for SSRI poop-out.
Posted by chemist on May 18, 2004, at 1:15:30
In reply to Re: Question for chemist or anyone re: AD poop-out » chemist, posted by sac on May 13, 2004, at 7:07:30
> > > > that's what i wanted to know, i.e., how much lamictal...how's about going down on prozac and back up to 200 on the lamictal? is that an option you have tried? you are fighting antidepressant vs. mood stabilizer (of questionable efficacy, but the positive aspects seem to indicate it is the real deal), and you seem to be overly-stimulated, which means that the lamictal is either ineffective for manic cycles OR may be inducing them in concert with the prozac. not uncommon at all for an AD + mood stabilizer, but clearly not working as planned. is the diagnosis definitive, and have you treid lamictal in conjunction with a primary mood-stabilizer, e.g. lithium or depakote or even tegretol? all the best, chemist
>
> No, the diagnosis is not definitive. At one time my pdoc was saying that I have rapidly re-current resistant unipolar depression. For 14 years I was on antidepressants and they helped tremendously and I had no problem. After the birth of my second child three years ago, I had a hypomanic (possibly manic) episode I was on Prozac at the time at 40 mgs(which I know now is too high for me). The episode involved extreme agitation, irritability, rage, and some delusions. At the same time, I felt depressed. (Mixed episode?) Since that time, I have been unstable with mood cycling between depression and hypomania. I tried Lithium and felt very strange on it. I liked Depakote ER initially but could not go beyond 250 mgs. without feeling terribly depressed. The only mood stabilizer I have been able to be on at a reasonably good dose is the Lamictal. However, I have had this over-stimulation problem when I go above 150mgs. I have not tried lowering my prozac, though, basically because I am terrified that I'll feel worse. I have my suspicions that the Prozac is worsening the overall course of this illness. But I don't know how to get off it. My Pdoc wanted me to try Gabitril at night to calm me down because I am starting to spiral into depression. I tried this for three days and felt worse???? My Pdoc is out of the country for 1 month so I am desperate. I upped my Prozac to 30mgs. (I know this is crazy) but I am trying to get out of this depression that is descending upon me. I appreciate so much, your response because I have been following these boards for a long time and I know you know what you are talking about. Perhaps I should scrap the Gabitril idea and go back to the Lamictal 200mgs with 10mgs prozac?
>based on your negative experience with gabitril, it sounds reasonable *to me* that you discontinue it, although you might try to secure an appointment with your pdoc's stand-in while she/he is out of town, as is par for the course....let us know, and all the best, chemist
Posted by SLS on May 18, 2004, at 7:01:55
In reply to Re: Question for chemist or anyone re: AD poop-out » sac, posted by chemist on May 18, 2004, at 1:15:30
> based on your negative experience with gabitril, it sounds reasonable *to me* that you discontinue it, although you might try to secure an appointment with your pdoc's stand-in while she/he is out of town, as is par for the course....let us know, and all the best, chemistI had a crummy experience with Gabitril. I tried it as a treatment for bipolar depression. It produced anxiety and made my depression somewhat worse. From what I have seen so far, Gabitril is not very useful as a psychotropic. Perhaps time will prove otherwise.
- Scott
Posted by sac on May 18, 2004, at 20:57:56
In reply to Re: Question for chemist or anyone re: AD poop-out, posted by SLS on May 18, 2004, at 7:01:55
>
> > based on your negative experience with gabitril, it sounds reasonable *to me* that you discontinue it, although you might try to secure an appointment with your pdoc's stand-in while she/he is out of town, as is par for the course....let us know, and all the best, chemist
>
> I had a crummy experience with Gabitril. I tried it as a treatment for bipolar depression. It produced anxiety and made my depression somewhat worse. From what I have seen so far, Gabitril is not very useful as a psychotropic. Perhaps time will prove otherwise.
>
>
> - Scott
Yes, I really don't like the Gabitril. My Pdoc keeps pushing it but I find my anxiety is worse on it and my mood really depressed. Do you have any experience with Neurontin? I tried that in the past and liked the calming feeling but I'm reading some scary posts about it now like with worsening rapid cycling, etc.
Posted by SLS on May 19, 2004, at 8:38:16
In reply to Re: Question for chemist or anyone re: AD poop-out » SLS, posted by sac on May 18, 2004, at 20:57:56
> Do you have any experience with Neurontin? I tried that in the past and liked the calming feeling but I'm reading some scary posts about it now like with worsening rapid cycling, etc.
I have never heard of Neurontin precipitating rapid cycling. Maybe you can direct me to the posts you found scary. I think Neurontin can work well for some anxiety disorders and is also helpful when added to Lamictal when treating bipolar depression.
- Scott
This is the end of the thread.
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