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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by slinky on February 7, 2005, at 3:29:45
Hello.
I've stopped Lithium..I have 2 tabs left and just can't take them.
I'm questioning my diagnosis of bipolar because...
Lithium made me very agitated- but I was level mooded..but stuck in the inner agitative state and wanted to self harm most of the time.
Limactal also agitation and allergy.
Depakote was ok for a few days then made me aggresive
Zyprexa..just remember a constant obbsession with food and always hungry.
Can't remember any other med except gabapentin is my lifesafer.
I'll probably try tegretol next?
Is anyone else having theses paradoxical reactions to mood stabilisers..does these reactions suggest I'm not bipolar???
Sorry for the questions..just very confused and depressed
Posted by HappyGirl on February 7, 2005, at 8:58:00
In reply to No more Lithium + questioning dx, posted by slinky on February 7, 2005, at 3:29:45
Hi:
Most likely you have 'Bipolar Disorder,' Type II that is more depressive side than hypo-manic one, as having read your reaction to 'Lithium' quote. The reason why you feel aggitated, self-harm behaviours is NOT enough anti-depressant effect in your system.Litium is one of 'best' mood-stabilizer as far as I know, ... however Lithium *alone* does NOT alleviate the symptoms, particularly the despressive side although it sounds to me like the hypo-manic side is somehow under control. Some saying Bp depression is much harder and challengeable to control in comparion with unipolar depression.
In my suggestion, to talk with your pdoc. about your need of A.D., preferrably NOT 'SSRI' med., rather another/different class of anti-depressant, because SSRIs might cause to bring up 'manic' episode on you if you're NOT really cautious on it. Some people withstands a 'small-dosage' SSRIs, like 'Effexor,' in conjuction/mixed with other form of A.D.
H.G.
Posted by Ritch on February 7, 2005, at 10:19:05
In reply to No more Lithium + questioning dx, posted by slinky on February 7, 2005, at 3:29:45
> Hello.
>
> I've stopped Lithium..I have 2 tabs left and just can't take them.
> I'm questioning my diagnosis of bipolar because...
> Lithium made me very agitated- but I was level mooded..but stuck in the inner agitative state and wanted to self harm most of the time.
> Limactal also agitation and allergy.
> Depakote was ok for a few days then made me aggresive
> Zyprexa..just remember a constant obbsession with food and always hungry.
> Can't remember any other med except gabapentin is my lifesafer.
> I'll probably try tegretol next?
> Is anyone else having theses paradoxical reactions to mood stabilisers..does these reactions suggest I'm not bipolar???
> Sorry for the questions..just very confused and depressed
>
Hi Slinky, I also have responded very well to gabapentin. Many people report lithium as really activating. So, it probably isn't a good fit for you. However.. you did mention that Depakote was ok for a few days and then made you aggressive... Hmm. Maybe you were on too high a dose? Depakote kicks in rapidly. I take 375mg a day and I have to reduce it to 250mg a day for a while every so often because I will get tired and sullen feeling (and the twitchies.. you know about those!). Tegretol would be worthy of trying. I had to bail out on my latest Trileptal trial. Three strikes it's out-had nausea on 75mg at bedtime so bad I nearly puked after four days on it. I guess that one's permanently off my list. Maybe I don't have bipolar either? Maybe brain damage-NOS :)
Posted by CareBear04 on February 7, 2005, at 11:22:21
In reply to Re: No more Lithium + questioning dx » slinky, posted by Ritch on February 7, 2005, at 10:19:05
ritch-- wow, that's such a low dose of depakote. did it really help you? i was on 250mg twice a day, and i thought that was too low. the drs said it was a good dose for me because i was about 100lbs, not very big. i was only on it for 2-3 weeks, so i didn' treally see a difference. but if that small a dose can really help, maybe it's worth another try? please let me know. thanks.
Posted by Ritch on February 7, 2005, at 12:30:03
In reply to Re: No more Lithium + questioning dx » Ritch, posted by CareBear04 on February 7, 2005, at 11:22:21
> ritch-- wow, that's such a low dose of depakote. did it really help you? i was on 250mg twice a day, and i thought that was too low. the drs said it was a good dose for me because i was about 100lbs, not very big. i was only on it for 2-3 weeks, so i didn' treally see a difference. but if that small a dose can really help, maybe it's worth another try? please let me know. thanks.
Hi, I'm medication sensitive (to just about everything). Also, I've seen some websites and even some BP guidelines mention that the lower end of the dosage scale for bipolar II is 250mg/day and for cyclothymia the lower end can be as low as 125mg/day. Even psycheducation.org mentions the lower dose range for bipolar (generally) of 750mg (+/-375mg) per day. I was on 500mg/day for a couple of years previously. I've increased to 500mg/day at times since then. I was on Depakote 500mg/day + 20mg/day of Ritalin and that seemed to work rather well from what I remember. It seems I respond to the "migraine" range of dosing with Depakote the best. I will admit that 250mg is definitely not enough right now. In the winter when I get run down I have to reduce it or I will be sleeping all the time. If you were on it for 2-3 weeks and didn't notice it helping much that might be misleading. When I started taking it (as a switch from lithium), I was in the middle of a depressive episode and I noticed that it didn't seem to help and even seemed to make things *worse*. If you will get a good response to it.. you will not really see the difference unless you are high and your mind is all racey. It really settles that down really quick for me.
Posted by Tabitha on February 7, 2005, at 13:44:17
In reply to No more Lithium + questioning dx, posted by slinky on February 7, 2005, at 3:29:45
I don't respond well to mood stabilisers either. Neurontin (I think that's gabapentin) was the only one I tolerated, although it made me oversleep. I feel better on just a low dose of SSRI. The pdoc always said the same-- if you're still depressed you need to add mood stabiliser. Yet they never seemed to help my depression at all and had bad s/e (poor thinking, dizziness, nausea, oversleep). I finally gave up on them. My hypomanias are rare, brief, and not too troublesome so I just don't bother to medicate them. I don't think pdocs have a great solution for bipolar II mostly depressed.
Posted by terrics on February 8, 2005, at 19:10:20
In reply to No more Lithium + questioning dx, posted by slinky on February 7, 2005, at 3:29:45
Hi, I am on lithium AND lamictal...Also effexor. I have clonazepam if I need it..for anxiety. The combo is pretty good, although I was better when wellbutrin was included. I am telling you all this because the mood stabilizers help...and so do the anti-depressants and klonopin. (Just feel I need the wellbutrin back). The point is that I am dxd as borderline not bipolar yet I am still on mood stabilizers and they work...Maybe you need a better mix. terrics
Posted by Slinky on February 9, 2005, at 13:29:42
In reply to Re: No more Lithium + questioning dx » slinky, posted by terrics on February 8, 2005, at 19:10:20
Ihad 2 days of being hyper after quiting lithium and now more calmer
My current meds:
Neurontin
Paxil.
If my mood switches then I'll go for tegretol.
I feel like going off meds to discover what the real problem is.
I didn't realise how much weight I've put on.
and the rash I had is going.
Posted by CareBear04 on February 9, 2005, at 19:00:24
In reply to Re: Thanks everyone, posted by Slinky on February 9, 2005, at 13:29:42
slinky-- rash is definitely never a good sign. even without lithium, your other meds are pertty sedating aand they should keep you grounded. tegretol and teh aother anticonvulsants are good anti-manic meds.
Posted by Ritch on February 9, 2005, at 23:52:58
In reply to Re: Thanks everyone, posted by Slinky on February 9, 2005, at 13:29:42
> Ihad 2 days of being hyper after quiting lithium and now more calmer
> My current meds:
> Neurontin
> Paxil.
> If my mood switches then I'll go for tegretol.
> I feel like going off meds to discover what the real problem is.
> I didn't realise how much weight I've put on.
> and the rash I had is going.
>
Neurontin and Paxil? Sounds good. I was on nothing but Neurontin+Celexa+clonazepam for a couple of years and I didn't have any meltdowns. Seems like meds that work for anxiety associated with bipolar are the ones that work most generally.
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