![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 10 to 34 of 34. Go back in thread:
Posted by Ritch on March 6, 2003, at 22:11:08
In reply to Can depakote elevate mood?, posted by linkadge on March 6, 2003, at 17:57:24
> I know its effective for mania,
> how good is it for depression ?
> Better than lithium ??
>
>
> LinkadgeDepakote *aggravates* my recurrent seasonal atypical major depressions compared to lithium (because it intensifies the somnolence and appetite probs), however during the remainder of the year when I am clearly rapid-cycling, sudden intense crashes seem to be lessened compared to lithium (I guess that would be some kind of ultradian feature). The only time I have noticed a mood "elevation" with it is the first day or two I increase the dose in response to bad anxiety/agitation. So I attribute that to a temporary mood elevation due to anxiety reduction.
Posted by Ritch on March 6, 2003, at 22:18:19
In reply to Re: how is lithium for depression?, posted by cybercafe on March 6, 2003, at 21:42:41
> > > just wondered how it compared to SSRIs
> > > or perhaps Zyprexa?
> >
> > I was off all meds once and floundering in a really nasty depression (for several weeks) and started 600mg/day and I was in remission within two weeks. I don't know if it would help a unipolar depressive as well. It doesn't zonk you out like an AP can. Doesn't cause startup agitation like an SSRI. I still couldn't do lithium monotherapy and feel relief from depression. It just went from "moderate" to "mild".
> >
>
> thanks for responding
>
> i hear zyprexa works for depression, but doesn't seem to be doing too much for me
> ...i wonder if lithium would do more for the depression, and interfere less with ritalin
>
> i wonder how much 2.5 mg of zyprexa effects ritalin ... doesnt' seem like too muchI would ask your doctor about the idea. It makes good sense to me. Lithium has better antipsychotic properties than the antimanic AED's.
Posted by Ron Hill on March 6, 2003, at 22:49:37
In reply to Re: how is lithium for depression?, posted by cybercafe on March 6, 2003, at 21:44:03
Cybercafe,
> I know lamictal initially seems like a good drug, but it seems to poop out for most, no?
I've not heard this before, nor have I read this in the literature. That doesn't mean that Lamictal poop-out doesn't exist, but simply that I am not aware of it.
I did a short trial of Lamictal several years ago and I really liked the way the medication felt in my brain. However, I developed a bad rash and, therefore, I discontinued the trial.
-- Ron
Posted by KrissyP on March 7, 2003, at 23:05:03
In reply to Can depakote elevate mood?, posted by linkadge on March 6, 2003, at 17:57:24
Hiya,
I was told that Lithium is the #1 med to balance out mania, I can't take it-I'd gain too much weight-with it being a SALT and all. I gained 30 Lbs in a month on Depakote, and I was losing globbs of hair-NOT FUN.
Just my experience..........
Good luck
Kristen------------------------------------------------- I know its effective for mania,
how good is it for depression ?
Better than lithium ??
Linkadge
Posted by BarbaraCat on March 8, 2003, at 21:26:50
In reply to how is lithium for depression?, posted by cybercafe on March 5, 2003, at 23:32:42
Lithium acts as an augmenter but doesn't have enough punch to act on it's own. It's like a magic potentiator for other meds. None of my ADs work without i. On it's own it's nothing but I really notice it when I don't take it and quickly spiral into an agitated mixed states depression. I'm taking Nortryptaline and lamictal in addition. Lamictal and lithium were not enough to cope with a severe suicidal depression after my mom was killed, hence the Nortrypt. So far, they're all working like a charm. The sum is better than the parts. - Barbara
Posted by JaneB on March 9, 2003, at 7:02:05
In reply to Re: how is lithium for depression? » cybercafe, posted by BarbaraCat on March 8, 2003, at 21:26:50
Posted by BarbaraCat on March 9, 2003, at 16:09:59
In reply to How much of each med? (nm) » BarbaraCat, posted by JaneB on March 9, 2003, at 7:02:05
Here's my brew:
AM
300mg Lithium
50mg LamictalPM
300mg Lithium
25mg Lamictal
75mg NortriptylineI start destabilizing after a few days off Lithium. 600mg is a pretty paltry dose but I was concerned about it because it's made my hypothyroid condition worse. I obviously need it for my BPII. Don't know if I can do without Lamictal yet. I'll try to titrate down once the stress of handling my Mom's estate is over with.
Nortriptyline has been the greatest blessing of all. It's been a miracle med for me - an old tricyclic workhorse of all things! I've been on all the SSRI's and SNRI's never thought I'd 'stoop' to something not on the cutting edge. I'm also taking a load of vitamins and now that I'm feeling better am able to exercise everyday. Exercise is without doubt the most potent antidepressant but when I'm seriously feeling like poo-poo it's the last thing I can manage.
Posted by JaneB on March 9, 2003, at 18:25:40
In reply to Re: How much of each med? » JaneB, posted by BarbaraCat on March 9, 2003, at 16:09:59
> Here's my brew:
>
> AM
> 300mg Lithium
> 50mg Lamictal
>
> PM
> 300mg Lithium
> 25mg Lamictal
> 75mg Nortriptyline
>
> I start destabilizing after a few days off Lithium. 600mg is a pretty paltry dose but I was concerned about it because it's made my hypothyroid condition worse. I obviously need it for my BPII. Don't know if I can do without Lamictal yet. I'll try to titrate down once the stress of handling my Mom's estate is over with.
>
> Nortriptyline has been the greatest blessing of all. It's been a miracle med for me - an old tricyclic workhorse of all things! I've been on all the SSRI's and SNRI's never thought I'd 'stoop' to something not on the cutting edge. I'm also taking a load of vitamins and now that I'm feeling better am able to exercise everyday. Exercise is without doubt the most potent antidepressant but when I'm seriously feeling like poo-poo it's the last thing I can manage.I'm having a real hard time with Lexapro. My daughter keeps telling me nortriptyline worked great for her during postpartum but she couldn't continue beause of weight gain. Therefore, I have been afraid to try it. Why was the Lamictal added and why do you want to discontinue it? I tried it once briefly and couldn't tolerate it (headaches and nightmares.) I have really given the Lexapro a fair trial (since Dec.) I'm needing an alternative. Doctor suggested adding Neurontin but it makes me so dizzy. Thanks for your input.
JaneB
Posted by BarbaraCat on March 10, 2003, at 2:06:24
In reply to Any side effects? » BarbaraCat, posted by JaneB on March 9, 2003, at 18:25:40
Hi Jane,
No weight gain, au contraire. But read on. I've been on most of the newer SSRI's and their analogues since mid 80's. I'd be fine for a while, then poop-out, and every increase would create a nasty agitated depression. I realized I had classic Bipolar II symptoms in late 2001, at which time I was on Remeron (talk about weight gain! I packed on 30 pounds in 6 months.) Same thing, worked fine and then supercrash. My pdoc suggested adding lithium as an augmenter. It helped alot, but I hated the weight gain and felt a SSRI type drug was exacerbating my mixed states episodes. I dropped Remeron and never looked back.So about 1 year ago I started lithium and lamictal which worked fine except nothing would budge my weight. Lithium also is detrimental to my long-standing hypothyroidism (weight gain, increased depression). So I increased the thyroid med but didn't notice much difference. I was doing OK until this past December when my Mother died suddenly under very traumatic circumstances. It was a surreal and very intense time and I slipped off the edge of sanity. I went through what seems like forever but was actually about 6 weeks of suicidal despair and frenzy. Was very very close to spending time under observation.
Since we'd run out of options, my pdoc suggested Nortriptyline and within 3 weeks I was literally saved. Side effects? The only bothersome one is cotton mouth which does not usually go away. I tote water bottles everywhere and suck on Ricola's. I've heard about the weight gain, but it's been just the opposite for me. A few years ago I invested in an expensive rebounder, a mini trampoline. Never used it. I dragged it into my living room where I have to literally walk over it, and have been using it ferociously. I've lost 25 lbs in LESS THAN 1 MONTH!
I can honestly say that the Nortrip has given me back my life force and that spark has inspired me to work out like hell. I could barely drag myself to the bathroom before. So no, I have no problem with the weight thing at all. There is no substitute for exercise. We hate to hear it, but we've got to just accept it. Nothing else will budge that pudge. The secret is to find a way to move your fanny that you'll truly enjoy. I highly recommend a rebounder (the good ones only - about $200).
Posted by Ron Hill on March 10, 2003, at 10:26:38
In reply to Re: Any side effects? » JaneB, posted by BarbaraCat on March 10, 2003, at 2:06:24
Hi Barbcat,
>I was doing OK until this past December when my Mother died suddenly under very traumatic circumstances.
I saw some of your posts regarding your Mom’s passing a few months ago, but I was unable to respond at the time. I am truly sorry for your loss, Barb.
> Since we'd run out of options, my pdoc suggested Nortriptyline and within 3 weeks I was literally saved. Side effects? The only bothersome one is cotton mouth which does not usually go away.
Interesting. First, and foremost, I'm really excited that you have found something that is working. Second, TCA's have a reputation of causing mood instability in BP II patients and, thereby, inducing hypomania. Not the case with you, huh? Just goes to show that blanket statements do not apply in all cases.
You have been taking the TCA for about two months now, right? No hint of hypomania, correct?
>There is no substitute for exercise. We hate to hear it, but we've got to just accept it. Nothing else will budge that pudge.
I agree. Exercise can keep the pudgy factor in check and, even more importantly; exercise plays a key role in keeping the brain healthy. Here's a short quiz: What do exercise, ECT, rTMS, and effective AD medications all have in common? Answer: They all increase BDNF (brain derived neurotrophic factor). An increase of BDNF is correlated to a decrease in depression.
-- Ron
Posted by BarbaraCat on March 10, 2003, at 12:27:20
In reply to Re: BP II taking a MS and TCA. Any side effects? » BarbaraCat, posted by Ron Hill on March 10, 2003, at 10:26:38
Hi Ron,
Thanks for your always enjoyable posts. No full-blown hypomania yet however I have noticed a definite and welcomed increase in energy and drive and some speeding thoughts since starting Nortrip. This is usuallly a warning sign of hypomania, and although very nice, can quickly become a disorganized mixed-states hell. What keeps it from careening into full-blown hypomania (shopping sprees, cleaning marathons) has been lithium, and of late bouncing on that rebounder til I'm ready to drop. So I can say that the threat of hypomania is present but held in check by lithium and to a lesser degree lamictal.I stopped Lithium for a week or so last month while on Nortrip because of the hypothyroid concern and soon began fragmenting and becoming increasingly obnoxious and hypercritical of my husband. Poor man, good thing he loves me. Within 2 days of restarting I smoothed out - this was a good reality check of how Lithium has become necessary to my sanity.
I'm sure you also know that Lithium has been shown to increase BDNF and act in other brain protective ways. Do you know anything about Lithium Orotate vs. our standard Lithium carbonate? It's been showing up in some over the counter products (Serenity is one) and binding it with orotic acid purports to more easily cross the bbb, hence the need for less thus reducing side effects. Probably a marketing ploy, but if true, it sounds intriguing.
Posted by Ron Hill on March 10, 2003, at 13:30:38
In reply to Re: BP II taking a MS and TCA. Any side effects? » Ron Hill, posted by BarbaraCat on March 10, 2003, at 12:27:20
Barb,
> I stopped Lithium for a week or so last month while on Nortrip because of the hypothyroid concern and soon began fragmenting and becoming increasingly obnoxious and hypercritical of my husband. Poor man, good thing he loves me.
I also am very lucky to have a spouse that loves me. Most women would have kicked me to the curb two minutes after she saw my first dysphoric mood state.
> I'm sure you also know that Lithium has been shown to increase BDNF and act in other brain protective ways.
I knew that lithium has neuroprotective properties, but I didn't know that it increases BDNF. Thanks for the information. This being the case, I'm surprised that lithium does not provide more AD efficacy. Maybe the BDNF verse depression relationship is not a direct correlation.
>Do you know anything about Lithium Orotate vs. our standard Lithium carbonate? It's been showing up in some over the counter products (Serenity is one) and binding it with orotic acid purports to more easily cross the bbb, hence the need for less thus reducing side effects. Probably a marketing ploy, but if true, it sounds intriguing.
I've heard of it but I've not looked into it (yet). My first reaction is that a Li ion, is a Li ion, is a Li ion. But maybe there is more to it than I know.
-- Ron
Posted by BarbaraCat on March 10, 2003, at 17:02:17
In reply to Re: Is Lithium Orotate merely a marketing ploy? » BarbaraCat, posted by Ron Hill on March 10, 2003, at 13:30:38
Here you go, Ron. A good article on lithium and BDNF.
http://hdlighthouse.org/see/drugs/lithium2.htm
I didn't realize that exercise increased BDNF, so thanks for that info.
One more question perhaps you know the answer. I don't know if this is still the party line, but the action of lithium was supposed work by inhibiting inositol uptake. This surprises and confuses me because inositol is normally beneficial for depression (especially in myo-inositol form). Some studies say 'yes it helps BP' other say stay away from it. Do you know anything about this? I've got a dozen bottles of pharm grade myo-inositol that are confused about their purpose in life (so are we all it seems).
Also, was that you taking SAM-e? Are you still? I (400mg) am and it seems to help with focus and fibro pain, but I'm wary of anything that could incite hypomania. However, for my husband who gets low level dysthymia it works very well at 400mg.
Posted by Ron Hill on March 11, 2003, at 11:47:28
In reply to Re: Lithium and BDNF » Ron Hill, posted by BarbaraCat on March 10, 2003, at 17:02:17
Barbcat,
> Here you go, Ron. A good article on lithium and BDNF.
Good article. Thanks for the link.
> One more question perhaps you know the answer. I don't know if this is still the party line, but the action of lithium was supposed work by inhibiting inositol uptake. This surprises and confuses me because inositol is normally beneficial for depression (especially in myo-inositol form). Some studies say 'yes it helps BP' other say stay away from it.
It is my understanding that some of lithium's anti-manic qualities may be attributed to its interaction with inositol. Inositol is thought to help relieve depression (in some cases), but it can also contribute to the onset of mania. I've not done much research on inositol, so I don't know much about the topic. If I remember correctly, IsoM knows about inositol. I was taking it several months ago to see if it would help my then present depression. However, I quit when I read the same thing that you did (i.e.; that the action of lithium is thought to work, in part, by inhibiting inositol uptake).
> Also, was that you taking SAM-e? Are you still? I (400mg) am and it seems to help with focus and fibro pain, but I'm wary of anything that could incite hypomania. However, for my husband who gets low level dysthymia it works very well at 400mg.
SAM-e got the boot about ten months ago. After five months of good AD benefit, 200 mg/day of SAM-e started to induce extreme irritability (flash rage). I dropped down to 100 mg/day, but it still caused irritability. I took a break from it and tried it again, but it still caused flash rage.
Barb, as you know, I'm BP II and I've been taking Lithobid for three-and-one-half years. Lithobid does a good job of controlling my hypomania but does little or nothing for the depressive side of my disorder. After I kicked the SAM-e to the curb last spring, my depression began to return. However, the depression did not become debilitating until November when I fell into a very deep atypical depression that I could not get out of.
My wife is used to me going into depressions periodically, but when it extended into the third month, she called my pdoc to make an appointment. This forced me to crawl to my keyboard and begin to do some research in preparation for the appointment. That's when I came across some information on Enada NADH (coenzyme 1).
A little more than six weeks ago I added Enada NADH to my 600 mg/day of Lithobid and it has provided remarkable effectiveness for my BP II atypical depression (low motivation, anergy, anhedonia, hypersomnia) and extreme irritability (dysphoric mood states). It took a little trial-and-error to figure out the correct dose. Ironically, if I take too high of a dose it actually induces irritability.
It’s still too early in the trial to be making predictions regarding its long-term effectiveness, but it is currently working remarkably well. My motivation is back, my energy is up, my love of life has returned, I’m not sleeping all the time, and I’m no longer a rage-alcoholic. Needless to say, my wife prefers the “new and improved me”.
Barb, click on the link below if you want to read about what I’ve learned via my dosing trial-and-error:
http://www.dr-bob.org/babble/20030306/msgs/206934.html
If you or your husband want to know more about Enada NADH, let me know and I’ll sent you some links.
-- Ron
Posted by BarbaraCat on March 11, 2003, at 14:10:19
In reply to Re: SAM-e is out and Enada NADH is in » BarbaraCat, posted by Ron Hill on March 11, 2003, at 11:47:28
Ron,
Yes, I would like your dosing regimen. I was taking NADH for a while because its supposed benefit to fibromyalgia and chronic fatigue. I recall that it did perk things up considerably but it was so expensive at that time that I could no longer justify the expense with the effect. My depressions usually go from vegetative to agitated so I never know which middle ground is safe. I think I'll try it again for my husband. He gets into 'the gray zone' where he sits around and plays computer solitaire for hours and hours, no motivation, sighs alot. He doesn't realize he's really depressed until I mention it.I'm sorry to hear about your slide into depression. Sometimes there's nothing to be done about it except wait for the chemicals to shift and trust that they will. Of course, one of the hallmarks of depression is no trust. Given the choice I'd take anergic over agitated anyday. At least you can sleep through the worst of it, instead of pacing and wailing which I tend towards.
It sounds like NADH is doing the trick. I've recently read that it's helping Parkinson's patients as well because it works primarily on increasing dopamine and to a lesser extent NE. Have you ever tried a pstim along with your med regimen? I personally like the idea of NADH better than an amphetamine, however, you might have a real need for that dopamine zing.
Posted by Ron Hill on March 12, 2003, at 10:56:26
In reply to Re: SAM-e is out and Enada NADH is in » Ron Hill, posted by BarbaraCat on March 11, 2003, at 14:10:19
Barbcat,
> Yes, I would like your dosing regimen.
Looks like I accidentally confused you, Barb. The link I included in my previous post will take you to a discussion of what I've learned so far regarding my Enada NADH dosing schedule. For convenience, I will repeat the link here.
http://www.dr-bob.org/babble/20030306/msgs/206934.html
-- Ron
Posted by Bela on May 28, 2004, at 11:17:36
In reply to Re: Lamictal Poop-out? » cybercafe, posted by Ron Hill on March 6, 2003, at 22:49:37
Does anyone know any more about whether Lamictal and other bipolar mood stabilizers experience poop-out like the ADs?
Bela
> Cybercafe,
>
> > I know lamictal initially seems like a good drug, but it seems to poop out for most, no?
>
> I've not heard this before, nor have I read this in the literature. That doesn't mean that Lamictal poop-out doesn't exist, but simply that I am not aware of it.
>
> I did a short trial of Lamictal several years ago and I really liked the way the medication felt in my brain. However, I developed a bad rash and, therefore, I discontinued the trial.
>
> -- Ron
Posted by BarbaraCat on May 28, 2004, at 13:04:42
In reply to Re: Lamictal Poop-out?, posted by Bela on May 28, 2004, at 11:17:36
I don't think lithium poops, but it does have a negative effect on the thyroid. My experience is that lamictal does poop. However, I was initially able to hold steady with very small dose increases for long periods of time. After 18 months, depression kept breaking through anyway and I too developed itching and a pre-rash condition (which I eventually got bigtime from another drug) and had to discontinue it. Had to stop lithium as well because it was aggravating my hypothyroidism. Currently, I'm taking 900mg Neurontin daily as a preventative and more when I'm feeling wired. For me, it's been a great med and helps alot as long as I take breaks from it to avoid tolerance. I also take L-Taurine and Magnesium Taurate and fish oil and think these are helping as mood stabilizers. - Barbara
> Does anyone know any more about whether Lamictal and other bipolar mood stabilizers experience poop-out like the ADs?
> Bela
>
>
>
>
> > Cybercafe,
> >
> > > I know lamictal initially seems like a good drug, but it seems to poop out for most, no?
> >
> > I've not heard this before, nor have I read this in the literature. That doesn't mean that Lamictal poop-out doesn't exist, but simply that I am not aware of it.
> >
> > I did a short trial of Lamictal several years ago and I really liked the way the medication felt in my brain. However, I developed a bad rash and, therefore, I discontinued the trial.
> >
> > -- Ron
>
>
Posted by Bela on May 28, 2004, at 14:19:05
In reply to Re: Lamictal Poop-out? » Bela, posted by BarbaraCat on May 28, 2004, at 13:04:42
> Thanks, Barbara. The poop-out and sexual dysfunction are the worst part of these drugs. Did you develop any decent coping mechanisms during the depression periods? I don't have the mania, just the depression.
I don't think lithium poops, but it does have a negative effect on the thyroid. My experience is that lamictal does poop. However, I was initially able to hold steady with very small dose increases for long periods of time. After 18 months, depression kept breaking through anyway and I too developed itching and a pre-rash condition (which I eventually got bigtime from another drug) and had to discontinue it. Had to stop lithium as well because it was aggravating my hypothyroidism. Currently, I'm taking 900mg Neurontin daily as a preventative and more when I'm feeling wired. For me, it's been a great med and helps alot as long as I take breaks from it to avoid tolerance. I also take L-Taurine and Magnesium Taurate and fish oil and think these are helping as mood stabilizers. - Barbara
>
> > Does anyone know any more about whether Lamictal and other bipolar mood stabilizers experience poop-out like the ADs?
> > Bela
> >
> >
> >
> >
> > > Cybercafe,
> > >
> > > > I know lamictal initially seems like a good drug, but it seems to poop out for most, no?
> > >
> > > I've not heard this before, nor have I read this in the literature. That doesn't mean that Lamictal poop-out doesn't exist, but simply that I am not aware of it.
> > >
> > > I did a short trial of Lamictal several years ago and I really liked the way the medication felt in my brain. However, I developed a bad rash and, therefore, I discontinued the trial.
> > >
> > > -- Ron
> >
> >
>
>
Posted by BarbaraCat on May 28, 2004, at 15:28:36
In reply to Re: Lamictal Poop-out?, posted by Bela on May 28, 2004, at 14:19:05
> > Thanks, Barbara. The poop-out and sexual dysfunction are the worst part of these drugs. Did you develop any decent coping mechanisms during the depression periods? I don't have the mania, just the depression.
>
**Yowza, that's a topic! I'll try to be succinct, but yes, I'm finally getting a handle on my mood disorder. Most of it revolves around maintaining hope and building my tolerance muscles every chance I can get and giving myself biophysical support. (Slowly) getting off lithium and lamictal and letting 'er rip was very difficult and I had some intense mixed states depressions and psychosis emerging all Winter. It had been breaking through for some time and no meds were 'getting rid of it'. I was trying to keep on top of nutrition, sleep, exercise, good food because I go downhill fast when I don't, but it was hard to do anything but hang on during this time. I had to process alot of deep emotional pain that was ready to come up and out. I did ALOT of crying, sobbing, grieving and wrote it all down in my journal - Journal as Therapist - the best therapist I've ever had. I was pretty much a basket case which is difficult if one is working, but I'm not right now so could fall apart righteously and spectacularly. This was old buried stuff that I was terrified of experiencing, but it was like a dam burst and no meds were stopping it. So that had to happen. It was time. I think it has to happen eventually with anyone who is carrying old deep pain and trauma, but probably not necessary to get that wild or intense.But even though the wild mixed states phase subsided I was still getting depressed and have set out to figure out why. What I've learned has to do with 'methylation' and how many of us are genetically deficient in this important step to support neurotransmitter production. Substances that help are SAM-e, 800 mg folic acid, sublingual methylcobalamin (neuro form of B12), B2. This regimen has been helping my mood. I also take 1T Carlson's Finest fish oil daily, as well as Jarrow's Pharmaceutical Inositol powder. l-Taurine helps anxiety. I take the Magnesium Taurate form of Mg also.
Recently I started St. John's Wort once again since I had a decent response years ago from it and felt I still needed that extra neurotransmitter support. It felt a little too activating and I was concerned about hypomania so stopped but I'm noticing the difference. I feel it was helping - without the sexual side effects. I'm searching for the best brand for me. Was taking Nature's Way Perika, which is one of the lab test pharmaceutical brands, but I'm going to try a full spectrum oil infused brand (Flora) to see if all the herbal components will work more smoothly than just the single active compound.
I'm FORCING myself to get outside for a walk everyday - it's crucial to my mood. When I let this slide, my mood, energy level, sleep, slides down with it. Getting at least 7 hours sleep is essential so I take Ambien and herbal sleep remedies, otherwise I'm awake all night and get wired/tired jaggies. Alot of water and high doses (6-10G) Vitamin C has been very effective as well. Getting rid of toxic sludge is very important and lots of water and keeping things 'regular' is really important so I use a great product called 'Fiberzon' from Amazon Herb Co. (a psyllium/herbal blend that you have to mail order) but a good psyllium or flax seed product would probably work as well. My thyroid was low too from the lithium and I was feeling it, so I increased my thyroid med (Westhroid natural source) and it's helped my metabolism in general.
Even so, with all these things I still get times of intense sadness, tiredness, physical pain and other depression symptoms. The world situation sucks and brings me down, but this is a pretty normal response, I think, as long as I can halt the downward spiral into despondency. I just try to keep trusting that all things pass, and force myself to get in an exhausting walk and do a little praying while I'm out there. It always helps even if I don't start feeling better immediately.
This will probably get bounced to Alternative, but that's been my focus and I think it's finally paying off. Good luck and please keep me posted on how you're doing. - Barbara
Posted by momO3 on June 1, 2004, at 11:49:47
In reply to Re: Lamictal Poop-out? » Bela, posted by BarbaraCat on May 28, 2004, at 15:28:36
Barbara,
It's good to see that you are still around! I haven't posted in quite some time.. I don't know if you remember me? Mom 0'3 - Holly (now Mom O'4)
So Sorry to hear about your mother... I hope you are doing ok.
I was looking at your post about the Nortriptyline and was curious if you are still taking it? Didn't you used to take some of the stimulants?
I am still on the Lamictal and have been pretty happy with it, but I keep switching ADS... still haven't found one that doesn't put me into mixed-states...
Anyway, just thought I would touch base...
Holly
Posted by Bela on June 1, 2004, at 12:02:58
In reply to Re: Lamictal Poop-out? » Bela, posted by BarbaraCat on May 28, 2004, at 15:28:36
Dear Barbara,
Thanks for all the useful information. It sounds complicated but obviously worth the effort. Right now, I am wrestling with going back on Lexapro (10 mg) to augment the Lamictal. But again, I hate the side effects. I find myself thinking along the SSRI lines after going a week or more on very little sleep and getting no lift from 150 mg of Lamictal.
Bela
> > > Thanks, Barbara. The poop-out and sexual dysfunction are the worst part of these drugs. Did you develop any decent coping mechanisms during the depression periods? I don't have the mania, just the depression.
> >
> **Yowza, that's a topic! I'll try to be succinct, but yes, I'm finally getting a handle on my mood disorder. Most of it revolves around maintaining hope and building my tolerance muscles every chance I can get and giving myself biophysical support. (Slowly) getting off lithium and lamictal and letting 'er rip was very difficult and I had some intense mixed states depressions and psychosis emerging all Winter. It had been breaking through for some time and no meds were 'getting rid of it'. I was trying to keep on top of nutrition, sleep, exercise, good food because I go downhill fast when I don't, but it was hard to do anything but hang on during this time. I had to process alot of deep emotional pain that was ready to come up and out. I did ALOT of crying, sobbing, grieving and wrote it all down in my journal - Journal as Therapist - the best therapist I've ever had. I was pretty much a basket case which is difficult if one is working, but I'm not right now so could fall apart righteously and spectacularly. This was old buried stuff that I was terrified of experiencing, but it was like a dam burst and no meds were stopping it. So that had to happen. It was time. I think it has to happen eventually with anyone who is carrying old deep pain and trauma, but probably not necessary to get that wild or intense.
>
> But even though the wild mixed states phase subsided I was still getting depressed and have set out to figure out why. What I've learned has to do with 'methylation' and how many of us are genetically deficient in this important step to support neurotransmitter production. Substances that help are SAM-e, 800 mg folic acid, sublingual methylcobalamin (neuro form of B12), B2. This regimen has been helping my mood. I also take 1T Carlson's Finest fish oil daily, as well as Jarrow's Pharmaceutical Inositol powder. l-Taurine helps anxiety. I take the Magnesium Taurate form of Mg also.
>
> Recently I started St. John's Wort once again since I had a decent response years ago from it and felt I still needed that extra neurotransmitter support. It felt a little too activating and I was concerned about hypomania so stopped but I'm noticing the difference. I feel it was helping - without the sexual side effects. I'm searching for the best brand for me. Was taking Nature's Way Perika, which is one of the lab test pharmaceutical brands, but I'm going to try a full spectrum oil infused brand (Flora) to see if all the herbal components will work more smoothly than just the single active compound.
>
> I'm FORCING myself to get outside for a walk everyday - it's crucial to my mood. When I let this slide, my mood, energy level, sleep, slides down with it. Getting at least 7 hours sleep is essential so I take Ambien and herbal sleep remedies, otherwise I'm awake all night and get wired/tired jaggies. Alot of water and high doses (6-10G) Vitamin C has been very effective as well. Getting rid of toxic sludge is very important and lots of water and keeping things 'regular' is really important so I use a great product called 'Fiberzon' from Amazon Herb Co. (a psyllium/herbal blend that you have to mail order) but a good psyllium or flax seed product would probably work as well. My thyroid was low too from the lithium and I was feeling it, so I increased my thyroid med (Westhroid natural source) and it's helped my metabolism in general.
>
> Even so, with all these things I still get times of intense sadness, tiredness, physical pain and other depression symptoms. The world situation sucks and brings me down, but this is a pretty normal response, I think, as long as I can halt the downward spiral into despondency. I just try to keep trusting that all things pass, and force myself to get in an exhausting walk and do a little praying while I'm out there. It always helps even if I don't start feeling better immediately.
>
> This will probably get bounced to Alternative, but that's been my focus and I think it's finally paying off. Good luck and please keep me posted on how you're doing. - Barbara
Posted by EERRIICC on June 1, 2004, at 22:46:51
In reply to Re: Lamictal Poop-out? » Bela, posted by BarbaraCat on May 28, 2004, at 13:04:42
How long should I take desipramine for, before considering the trial a failure?
Posted by Bela on June 2, 2004, at 9:17:48
In reply to desipramine, posted by EERRIICC on June 1, 2004, at 22:46:51
> How long should I take desipramine for, before considering the trial a failure?
EERRIICC,
To whom are you addressing this question? I am not sure what it has to do with Lamictal poop-out?
Bela
Posted by BarbaraCat on June 2, 2004, at 15:21:26
In reply to Re: Hi Barbara Cat!, posted by momO3 on June 1, 2004, at 11:49:47
HI Holly!
>>I don't know if you remember me? Mom 0'3 - Holly (now Mom O'4)**I sure do remember you. We had some great chats a while back. Congrats about numero quatro! Must keep you really busy.
>
> So Sorry to hear about your mother... I hope you are doing ok.**It was very difficult, as anyone who has lost a much loved Mom knows. She was hit by a car while out walking so it was a shock, although at some level I'd been expecting it and so had she. I know she was ready, even though she was healthy and happy. I get a good peaceful feeling when I think of her and feel her presence, like I know it was her time.
That's life and we all go through difficult situations. But for someone teetering on the edge already (that would be me), major crises are destabilizing and heartbreaking and it takes longer to heal.
We've also been struggling with a very sick cat since December, our first kitten whom we are so bonded with. My little buddy and heart's delight. These critters take on alot of our stuff and I don't think it's a coincidence he got sick at exactly the one-year anniversary of her death. He pulled through a long drawn out crisis with some miracle treatments from our holitically oriented vet and I thought, prayed, he was on the mend. But just yesterday I took him in and his x-rays show advanced tumors throughout his little body. I'm quite aware that every day with him has been a gift and it's time to let go. But yet another major loss to contend with - and I'm not feeling very up to it.
Unfortunately, meds don't seem to be an option either. I came down with Stevens Johnson Syndrome in April from a drug unrelated to Lamictal, although I believe Lamictal 'primed the pump' for me since I was getting intense itching and skin sensitivity from it. I stopped taking Lamictal in January along with most all other psych meds. They just weren't working and I was getting severe side effects from everything. Getting Stevens Johnson was a wake-up call. Not quite sure of what, except that meds aren't for me and I have to find another way. Been praying alot and that seems to help more than anything - although I'd sure love to find that magic pill...
So you ask about Nortriptyline. It helped immensely with the depression I spun into after Mom's death. Pretty remarkable, actually. But I could not take the side effects of very dry mouth, dry eyes, constipation. I drink alot of water and it was never enough and I always felt dangerously parched. Don't let me discourage you from it because of my extreme over-sensitivity. It's a very good drug. Helped alot with anxiety too.
Lately, I'm feeling like I definitely need SOMETHING because life is seeming pretty harsh. I can take the depressions, but the mixed states stuff that starts creeping in has got to be nipped in the bud. It is so toxic and destructive. I've started and stopped and now started St. John's Wort again. It helped once before. Studies are showing that it works differently from an SSRI so I'm willing to give it the ol' college try again. Time will tell.
I'm doing all sorts of other nutritional support and high dose fish oil. I just don't know, Holly. I'm not always this down, but getting the news of my kitty has knocked the wind out of me and I was just getting back on my feet after SJS. I feel like I need to escape from life and trauma for a while to heal. But where is there such a place and can I afford it? Hope you're doing well, girlfriend. Keep in touch. - Barbara
>
> I was looking at your post about the Nortriptyline and was curious if you are still taking it? Didn't you used to take some of the stimulants?
>
> I am still on the Lamictal and have been pretty happy with it, but I keep switching ADS... still haven't found one that doesn't put me into mixed-states...
>
> Anyway, just thought I would touch base...
>
> Holly
This is the end of the thread.
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