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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Mike634 on August 1, 2004, at 19:40:18
I have found that sometimes just reading what someone else had taken is helpfull so I thought I would post my meds.
First episode was 6 1/2 years ago at end of college -very depressed with some mixed. Bounced around on depakote, effexor, clonopin for a few months. Then it seemed that lithium (1200) and depakote (3000) calmed me down. exercised like crazy for a couple months to get me out of the depression. Was a bit hypomanic then but was off meds for year and a half.
Then fell into awfull awfull depression for 16 months. Tried paxil, then lithium (messed up thyroid at 1500), risperdol (made me an absolute zombie), clonopin, stelezine. No progress. Then tried depakote (only needed 2000 this time to get therapeutic level) which seemed to help. Then took myself off everything else except dep. and added effexor -37.5, 75, 150 and finally 300. Miracle! In a month completely recovered, perhaps too much -- made me a little hypomanic, and took myself off meds. No withdrawel from effexor
Off meds for another year until falling into moderate depression two years ago. Got depakote on board with zyprexa and made many trials with effexor and wellbutrin. This time however, they just caused me to get atypical, painfull mania. Added lamictol after a year which has helped with mixed states. Tried effexor again- was OK at 37.5 and 75 but made me go manic at 150. Tried adding Geodon and trileptal. That made my mind completely useless. Got off the trileptal and had horrible withdrawel from the geodon. Didnt sleep for three days, muscle rigidity, just awfull.
Actually tried adderal about 9 months ago because of some ADD but kept me up at night. Stopped depakote because my doctor wanted to try a different mood stabilizer. (then just taking zyprexa 5.0 and lamictol 100) Tried Keppra but somehow made me feel awfull mania pain. Then tried zonegran as the mood stabilizer. Added strattera for ADD but seemed to make me more depressed so stopped it. Then tried effexor again. This time it made me more depressed! NO joke, very strange, I was convinced however, that things were interecting with the zonegran. Something about that med I didnt like- was convinced my IQ had dropped since I started it, and was just crying all the time. Now I am on lithium 900 lamictol 150 zyprexa 5. Stable, but STILL quite depressed. Its a strange depression, I am not like emotionally depressed, but I cant concentrate, cant read well, not smart, cant multi-task, anhedonia, and just not interested in much- its like having profesional depresssion or something. Convinced that an antidepressent has to be added to end this.
My doctor is excellent and has his own web-site on bipolar- good info is anyone is interested:http://home.comcast.net/~pmbrig/BP_pharm.html
well, hope that little story is informative to anyone---
Posted by HappyGirl on August 2, 2004, at 9:04:23
In reply to just though I would post what BPmeds I have taken, posted by Mike634 on August 1, 2004, at 19:40:18
Hi:
It's quite interesting to read your post, ... except 'stopped med. mix' several times during your BP journey. Because, I have some similarly to your dx. BP II with rapid cycler for the past 5 and a half years. During those years, I, too suffered 'depression' and 'hypo-manic' alternatively, ... from milder to severely. Then, I totally understand your 'some' frustration mixed with 'optimistic' attitude towards your illness, Bp.Concerning your current state, ... 'quite depressed' despite 'stability.' In my opinion, it's VERY hard to say 'I'm stable,' if you're still sufferring from the depressive episodes. It's needed to be 'stable,' both sides of the Bp, ... depressive and hypomanic. In your case, it sounds to me like you've got stabilized just 'hypomanic' part. I understand that your admiration and praise for your pdoc. as one of the best expert Bp pdoc., however I just wonder why he/she does NOT offer an 'excellent' help on the depressive side of your Bp. Being/having Bp II, I know VERY well what a tough job a pdoc. is able to research/find a right anti-dep. for Bper's like us. Finding a right/appropriate ADs must be quite challenge for both pdocs. and us, Bp II. Because, unlike unipolar/depression only, Bp II has some complexities to deal with due to the nature of this illness. In my knowledge, most of pdocs. is CAPABLE to handle a hypomanic side of Bp, but a depressive of the Bp seems to need MORE attention and research in order to rx appropriate AD for us, Bp II.
I, too currently have been 'overhauling' AD med., because one of ADs, Serzone started some 'negative effect,' ... intense thirst. Then, my pdoc.(one of the best pdocs. in this region where I live) rxed 'Trazodone,' however due to sedative effect(I get easilyt 'sedating,' BTW), I'm not able to take the 300 mg. Traz. he intially rxed. Then, I've been taking Traz. and Serzone combo. along with Wellbutrin SR 200 mg.(good for ADD) per day. This combo. seems working on me pretty well, ... not perfect, but much happier than just 'mono' AD.
If you have any good idea as to 'anti-dep.', I'm very interested to hear from you, a fellow Bp II.
H.G.
Posted by Mike634 on August 2, 2004, at 17:45:39
In reply to Re: just though I would post what BPmeds I have taken, posted by HappyGirl on August 2, 2004, at 9:04:23
We have been making attempts at treating the depressive part of it - its just been hard because of the mania that they cause. Yea, when I said stable that was just because I wasnt really in a mixed or cycling state - although not cured or much better than before.
- Somebody on this board had recomended parnate so I am going to ask my doctor about that. - Thats great if you can handle multiple AD without getting manic. As for now though, I think we are just going to get the lithium up and see what happens. Good to hear you have a combo at the moment that helps a bit. - I will post what happens as things proceed along- just got to hope for the best!
Posted by HappyGirl on August 2, 2004, at 19:51:06
In reply to Re: just though I would post what BPmeds I have taken, posted by Mike634 on August 2, 2004, at 17:45:39
Hi Mike:
Thanks for your response regarding AD and etc. I, too have been some trouble to find a right/appropriate ADs. For the past two and a half years, the Serzone(450 mg. most of the time)and Wellbutrin SR(from 100 mg. to 300 mg., but 200 mg. for the past six months) has been helping the depressive side of my Bp.I admit to say that this illness, Bp practically robbed me of most of my 'youth,' since I got this illness during my college years. However, I tried to manage myself as happy and busy as possible, ... however once awhile I want to 'cry' as hard as I could, because I'm not able to function as I did before Bp struck me unpredictably.
Back to the main issue, ... Bp II, ... I'm stable almost 90% on the hypo-manic side of my Bp II, however like other Bp II, the depressive side of my Bp is VERY tough to challenge. This is partly due to my inability to consume any of SSRIs, such as Effoxer that is pretty reputable among Bp II, especially in the morning hours.The current AD combo. Trazodone 100 mg. Serzone 150 mg. along with Wellbutrin SR 200 mg. seems working on my depression(mostly, I'd say 'Major Depression), however I may need more effective AD in the future. Because, in my knowledge ADs tends to get 'weaker' as the time goes, ... in other word, your system getting 'used' to those ADs.
For my 'manic' side that is mostly 'hyper' mixed with 'dysphoric,' I, too have been taking Zyprexa 5 mg. before the bed and Lithium 900 mg. tid. and this combo. has been alleviating most of my manic episodes. Once, on my 'dysphoric state,' I punched SO hard on my desk that I almost broke my hand. Since then, I've been cautious NOT reduce Zyprexa, from 5 mg. to 2.5 mg. I got some weight from the Zyprexa, but overall, it's offerring me 'tremendous' relief on my hypo-manic side. Also, both Zyprexa and Lithium never wear off like the ADs do, then I probably stick with this combo. for a long time as long as my system is able to withstand this combo.I'm truly glad to see your post regarding your personal experience in your BP jorney along with its med. regimen. Also, I, myself have been struggling with this illness, Bp II, I'm greatly interested in your progress.
H.G.
Posted by Mike634 on August 4, 2004, at 15:14:57
In reply to Re: just though I would post what BPmeds I have taken, posted by HappyGirl on August 2, 2004, at 19:51:06
Hey again HG,
Yea, donr feel alone if you have lost time to this- Iv given up a lot of tiime as well to this illness. Off an on for 6-7 years.-Some good times, but plenty of bad. It seems you take the same moodstabilizing regiment as I do. The zyprexa at 5 and lithium at 1200 that I take (we raised it today actually) seems to be doing a good job with the mania, but like you, antidepressents just dont work like they used to. I am just too sensitive to them I think- though today my doctor said we might consider paxil and prozac after we try a couple of other things. The subject of ect has actually come up for me-though its down the road a bit. Has that ever been suggested to you? I must admit I am a bit frightened by the idea of it.
I'm sorry that you still arnt functioning like you used to. I'v just got to believe that there is a solution for people like you and I. Good luck and I'l keep it posted how things are going for me-
Posted by HappyGirl on August 5, 2004, at 22:07:21
In reply to Re: just though I would post what BPmeds I have taken, posted by Mike634 on August 4, 2004, at 15:14:57
Hi:
>>>> The zyprexa at 5 and lithium at 1200 that I take (we raised it today actually) seems to be doing a good job with the mania<<<<<
--- Yes, ... I totally agree about this combo. is DEFINITELY 'super' among other combo. for 'Mania' I've been reading and hearing. Then, I plan to stick with this as long as I can. My Lithium dosage is 900 mg. t.i.d., and once I recall that I was on 1200 mg., even raised to the 1500 mg. when I was NOT on any anti-dept. However, it didn't help me any 'good' relief no matter how much I took. but, I certainly have the same opinion as yours in regard to the effectiveness for 'manic' side of the Bp.
>>>> like you, antidepressents just dont work like they used to. I am just too sensitive to them <<<<--- In terms of 'Sensitiveness' to anti-dep., I have the exact same problem as yours. As a matter of fact, I can not take any of SSRIs, due to the intolerance or just simply 'don't go with my system/chemical' well. Then, my choice on anti-dep. is quite limited. Thus, my pdoc. rxed 'Serzone' that is a kind designed to those who are not able to take any anti-dep. otherwise, ... a kind 'last chance' to choose an anti-dep. In that respect, I feel I was quite lucky to get this A.D. However, now the Trazodone that is similarity to the Serzone and it seems working on me pretty well. However, I have still 'down' days, about twice a week. Hopefully, more 'up'/feeling well days to come with the time. ----
<<<<< though today my doctor said we might consider paxil and prozac after we try a couple of other things. The subject of ect has actually come up for me-though its down the road a bit. Has that ever been suggested to you? I must admit I am a bit frightened by the idea of it. <<<<
--- I read that some of Bper's have been on the combo. 'Paxil and Prozac' with a good result. I truly hope that this combo. could alleviate your depressive episodes soon.
Concerning 'ect,' I never got that road, because my depressive episodes consist mostly of 'fatigue,/want to sleep until noon' 'less-motivation,' 'lack-energy' and other 'non' serious form of depressive episodes. I never got 'suicial thoughts' due to my depression. Rather, I WANT to live, ... (laugh) and want to get *BETTER* to accomplish the things I missed due to Bp.We are still young, then hopefully the things are getting better by accessing more effective ADs soon.
H.G.
Posted by cpallen79 on August 7, 2004, at 23:19:07
In reply to Anti-Depressants for Depressive of the Bipolar, posted by HappyGirl on August 5, 2004, at 22:07:21
Hi, I myself do ok on antidepressants (if they works) except for one little problem... Lately I've become hypomanic on them... become highly sexual, outgoing, overenergized...yikes. I talked /w my pdoc on this, hence we're adding in trileptal. She's also now sure I'm mild BP II based on some of my history. I agree that SSRIs can be harsh for many BPS, however I know alot fo people who can tolerate them, just as long as they're on a mood stabilizer with them. For some BPs, an SSRI is a huge no-no.
> Hi:
> >>>> The zyprexa at 5 and lithium at 1200 that I take (we raised it today actually) seems to be doing a good job with the mania<<<<<
> --- Yes, ... I totally agree about this combo. is DEFINITELY 'super' among other combo. for 'Mania' I've been reading and hearing. Then, I plan to stick with this as long as I can. My Lithium dosage is 900 mg. t.i.d., and once I recall that I was on 1200 mg., even raised to the 1500 mg. when I was NOT on any anti-dept. However, it didn't help me any 'good' relief no matter how much I took. but, I certainly have the same opinion as yours in regard to the effectiveness for 'manic' side of the Bp.
>
> >>>> like you, antidepressents just dont work like they used to. I am just too sensitive to them <<<<
>
> --- In terms of 'Sensitiveness' to anti-dep., I have the exact same problem as yours. As a matter of fact, I can not take any of SSRIs, due to the intolerance or just simply 'don't go with my system/chemical' well. Then, my choice on anti-dep. is quite limited. Thus, my pdoc. rxed 'Serzone' that is a kind designed to those who are not able to take any anti-dep. otherwise, ... a kind 'last chance' to choose an anti-dep. In that respect, I feel I was quite lucky to get this A.D. However, now the Trazodone that is similarity to the Serzone and it seems working on me pretty well. However, I have still 'down' days, about twice a week. Hopefully, more 'up'/feeling well days to come with the time. ----
>
> <<<<< though today my doctor said we might consider paxil and prozac after we try a couple of other things. The subject of ect has actually come up for me-though its down the road a bit. Has that ever been suggested to you? I must admit I am a bit frightened by the idea of it. <<<<
>
> --- I read that some of Bper's have been on the combo. 'Paxil and Prozac' with a good result. I truly hope that this combo. could alleviate your depressive episodes soon.
> Concerning 'ect,' I never got that road, because my depressive episodes consist mostly of 'fatigue,/want to sleep until noon' 'less-motivation,' 'lack-energy' and other 'non' serious form of depressive episodes. I never got 'suicial thoughts' due to my depression. Rather, I WANT to live, ... (laugh) and want to get *BETTER* to accomplish the things I missed due to Bp.
>
> We are still young, then hopefully the things are getting better by accessing more effective ADs soon.
> H.G.
>
>
Posted by HappyGirl on August 8, 2004, at 0:49:06
In reply to Re: Anti-Depressants for Depressive of the Bipolar, posted by cpallen79 on August 7, 2004, at 23:19:07
Hi:
I agree about an SSRI theory in regard to Bp II. I see/read that some Bper's are quite successful on taking an SSRI or SSRIs in conjuction with mood-stabilizer, such as yours, 'Trileptal,' 'Depakote' and 'Lithium.' However, in my knowledge, other form of anti-dep., non-SSRIs are widely rxed for Bper's, because SSRIs are prone to cause 'hypomanic,' even on mood-stabilizer.
In regard to 'manic,' I've never experienced 'hyper-sexuality,' however in my manic state, I do 'OVER-productive' activities, then I LOVE those episodes. However, after manic episodes, I only find myself to sink in depressive episodes consisting of 'NO' energy, no-motivation and want to sleep all day long. For that/depressive side, my current anti-deps. regimen seems working on me, ... but qute 'slow' to the point, 'snail's pace,' but at least this AD combo. helps me being almost normal/back to myself. In this regard, I'm VERY grateful to my pdoc. who has known me for the past four years.
H.G.
This is the end of the thread.
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