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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by upsndowns on March 7, 2005, at 11:00:49
I am reaching my wit's end at this point in my treatment. I have been diagnosed with BPII after a very long road of being non-responsive to every antidepressant there is, as well as just about every single mood stabilizer....I am exquisitely sensitive to side effects. I currently am taking 5mg Abilify, can't take more and can't take less; 20 mg Buspar because the Abilify makes me anxious as anything I have ever taken; Ambien, Tranxene....about 30-45mg/day; Synthroid and a sliver of Serzone because I do not seem to do without it...oops, I mean Nefazadone, along with a bunch of vitamins, fish oil and other supplements. Is there anyone out there who can relate to my problems and offer an sort of advice? I go to a wonderful psychopharmacologist who has tinkered and tweaked to get us where we are, but I feel that there has to be a way to control the anxiety...more than 20mg of Buspar is toxic to me...and the pacing and occasional panic without going off the Abilify. I also cannot take any kind of SSRI or Lithium. Any suggestions?
Posted by HappyGirl on March 7, 2005, at 12:15:07
In reply to BPII but nothing seems to help, posted by upsndowns on March 7, 2005, at 11:00:49
Hi;
In my opinion through the experience, ... in Bipolar II, Zyprexa is better efficacy than Ability. Because, the latter is said to induce 'Anxiety' and 'jittery feelings while the Zyprexa has 'calming effect' that in turn helps you to decerease 'Anxiety' you're going through.Abilify is widely used for Bp I rather for Bp II, from reading others. In my guess, probably Abilify might be more for 'true manic,' not 'hypomanic' with Bp II. On the otherhand, the Zyprexa has both efficacy on hypomania and depressive side of Bp II. Thus, most of Bp II prefer the Zyprexa over the Abilify.
That said, ... Serzone/Nefadozone which I was on before switched to the Trazodone is really good for 'Anxiety' brought on by depressive side of Bp II. Buspar, ... I have NO clue to judge, but some saying the Buspar is more for milder form of Anxiety, i.e., Anxiety without any complex M.I. problems. Since Bp II is somehow a complex M.I., then you might get better result with the Serzone or similar drugs, ... just in my opinion. However, there must be a good reason for your pdoc. to have rx'ed Buspar and Abilify, ... but it won't hurt to ask your pdoc. regarding 'two' meds., Zyprexa and Serzone or Trazodone at your next appt.
H.G.
Posted by Maxime on March 7, 2005, at 14:44:33
In reply to Re: BPII but nothing seems to help, posted by HappyGirl on March 7, 2005, at 12:15:07
Anafranil might help you as you exhibit the same symptoms as a close friend of mine who is also BP2 (so am I but I manifest it differently). It will help with the anxiety and pacing.
I'm sorry you are going through such a rough time with meds, but I can empathize.
Maxime
Posted by upsndowns on March 7, 2005, at 19:09:25
In reply to Re: BPII but nothing seems to help, posted by Maxime on March 7, 2005, at 14:44:33
Thank you so much for the input. I have been alleging that it is the Abilify that causes this anxiety and a mild sort of akathesia all along, but have been told not so.....the answer is trust your gut. I will ask about all the suggestions here and see what he says. The depression side of the personality seems to be predominant, with swings that occur anywhere from every two to three days to every two months or so and the hypomania is more on the irritability end and becoming so nasty I want to just lock myself in a closet and make everyone go away. I haven't had a truly good day in years. There has to be a better way.
Posted by HappyGirl on March 7, 2005, at 22:04:35
In reply to Re: BPII but nothing seems to help, posted by upsndowns on March 7, 2005, at 19:09:25
Hi:
Your very 'last' quote sounds like 'dysphoric'/(severe form of anger) that is very prominent if you have Bp II, not at the beginning of dx'ed Bp II, but it comes along with other Bp symptoms, sooner or latter. Also, it's said to be a part of 'hypomanic' symptoms, believe it or not. I, too sufferred from it before the Zyprexa was added. Even, with the Zyprexa, it didn't eliminate the way I wanted to. However, it eventually went away with time. Then, you might need patience along with determination to get it through.The Abilify is not all bad for some of Bp II, because it has 'stimulant' effect to boost your energy, motivation and the like you need in order to lead everyday's life. However, if you're more prone to get 'Anxiety,' then the Abilify might be NOT for you. But, some of Bpers take both Abilify and Zyprexa in minimum dosages. The Zyprexa is, so to speak, one of 'quickest-fix' miracle drugs, however one 'drawback' is a 'weight gain.' I'm NOT on this, tho'. Everyone reacts different on different drugs, I can the least. Then, in this regard you may need to consider before asking your pdoc.
A depressive side of the Bp II is VERY hard for anyone to challenge, ... I admit to say through the experience. Even, a hypomanic side of my Bp II has been 'almost' wiped out from my system, but the depressive one is still 'tough one' to get rid of. Then, you're NOT alone. For this, my pdoc. rx'ed Serzone(now, Trazodone) first and then Wellbutrin sr added. At first, it did a 'trick' on my depression. However, it's still there once awhile when my stress-level getting 'high.' Then, some level of life-change along with psychological adjustment is a must, ... that is my case, tho'. I guess everyone has different approach to overcome in this regard. Reading books along with Support Net like here, on this board is beneficial on both, psychological and educationally.
Hopefully, you'll find a new 'good' med. combo. and feel better soon.
H.G.
Posted by upsndowns on March 8, 2005, at 8:18:43
In reply to Re: BPII but nothing seems to help » upsndowns, posted by HappyGirl on March 7, 2005, at 22:04:35
Zyprexa is sounding more and more like something I want to talk to the pdoc about, except for the weight gain issue, which only leads to more depression for me, no surprise there. I also do not remember if I mentioned that it is Concerta, which I take in 18mgs, which helps with my focus and concentration, but not to a particularly great level. If I could go off the serzone I would, but it leaves me bereft. Perhaps one of the meds suggested in all the answers here will allow me to do that.
Posted by D minor on March 8, 2005, at 12:10:55
In reply to Re: BPII but nothing seems to help, posted by upsndowns on March 8, 2005, at 8:18:43
Hi,
I had a similar experience with Abilify, above 5 mgs I'm running around in circles pulling my hair, literally. So I take 5 mgs of Abilify and 400 mgs of Seroquel. I think Seroquel is an excellent AP because it has strong anti-anxiety effects that allow me to take the Abilify. Plus it doen't have the weight gain profile of Zyprexa. (I had a friend who, on Zyprexa, gained so much weight she was beyond recognition, but everyone is different).For my depression I take Wellbutrin, and it works well. I hear that a lot of BPers are prescribed Wellbutrin. It's good in that it is slightly activating so it gives you some energy to get through the day.
For a mood stablizer I took Topamax. I took myself off of it (against dr.s advice) because I don't think I need it. But Topamax caused me to loose 25 lbs. And all my doctors have said it's a good drug to augment ADs as well as for its mood stabilizing effects.
Just letting you know what has worked for me in the hopes that it might help.
Good Luck!
dm
Posted by upsndowns on March 8, 2005, at 12:44:21
In reply to Re: BPII but nothing seems to help, posted by D minor on March 8, 2005, at 12:10:55
thanks for the concern. I too have the tearing my hair out scenario if I go over 5mg of abilify, but have not tried any additional AP's at all. As I may have, or should have, mentioned in my original post, I cannot take any, and I mean any, of the mood stabilizers they all have negative and detrimental side effects with me and no positive effects that would warrant trying to live with the SE's. I have taken Wellbutrin in the past, but it causes me to get hypomanic as well as for my hair to fall out....not a pretty sight believe me and it only contributes to depression rather than alleviate it. Interestingly, my sister is also unable to take Wellbutrin. I will ask my pdoc about varying or addding to the AP in particular and perhaps I can eliminate some of my other meds such as the anxiolytic ones. I like the idea that Seroquel does not have the weight gain profile of Zyprexa.
Posted by mayajade on March 8, 2005, at 17:03:23
In reply to BPII but nothing seems to help, posted by upsndowns on March 7, 2005, at 11:00:49
I can relate. I also have BPII, antidepressants don't work or make me hypomanic. I have tried at least one of everything in every class of drug, nothing helped. My main problems are depression and anxiety. I started Gabitril (tiagibine) about 15 months ago, and it is the only drug that has helped me. For the entire year of 2004 I did not have an episode of depression (unheard of!). Also my anxiety was greatly reduced. I did have an episode of depression in Jan. 2005, but it was not as bad as in the past and resolved by the end of the month (with some extra support but no additional drugs). Of course, no drug works for everyone. It is frustrating that it can take so long to find what works for you (took me 10 years). Good luck - I hope you find relief.
Posted by HappyGirl on March 8, 2005, at 17:27:37
In reply to Re: BPII but nothing seems to help, posted by upsndowns on March 8, 2005, at 12:44:21
Hi:
In regard to 'mood stabilizer,' ... I remember in your very first post,... you are UNABLE to take any traditional M.S.s, such as Depakote, Lithium and Tegretol/Trileptal. However, some of Bpers actually search for 'more' other areas to get 'M.S.s' effects, such as Keppa(sp?), Zonegram(sp?) and among other options. Those 'two' meds. might be used primarily other illnesses, such as 'Parkison Disease,' ... but I'm not quite sure to say tho'.
It's strange your pdoc. haven't research 'more deep/wide areas' to find 'M.S.s' for you. Because, in Bp, whether Bp I or Bp II, mood-stabilizer is critical to get stabilized, at least close to that neighborhood.In my knowledge, ... most of A.P.s has some 'M.S.' property along with all-around-efficacy on Bp condition. Try to ask your pdoc. among other A.P. combo. along with other 'M.S.' med. Also, after the Zyprexa with weight gain, some goes to the 'Geodon' that is a VERY close A.P. to the Zyprexa, ... plus 'no weight gain' to worry about.
The Serzone/Nefadozone, ... I was on 'mass' dosage around 450-600 mg. tid, and did well for awhile. This med. has also 'appetitie suppressant' for me, ... but probably not for you seeing your contemplation on the Serzone. Trazodone, too makes me decrease food-intake, although giving me thirsty during daytime.
I, too agree with you about asking your pdoc. other med. options after collecting all informations you got here, on this board. Besides this, above, you'd find some helpful, useful and informative posters regarding Bp meds. by scolling up this board.
Please keep us posted your progress.
H.G.
Posted by upsndowns on March 9, 2005, at 9:08:15
In reply to Re: BPII but nothing seems to help » upsndowns, posted by HappyGirl on March 8, 2005, at 17:27:37
thank you all for your insight and expertise...no one knows better than those of us who are living this what it is like. I have printed out all the messages and will condense them down when I see my pdoc next week. As noted, I cannot take any mood stabilizers nor SSRI's and am very sensitive to the tiniest dose of most drugs, so it is very slow going, with a drib and a drab of everything, one thing at a time so we know if it causes a SE. I will keep you posted on what he says next week and see if there will be a change. Meanwhile, I am sometimes immobilized by anxiety, others in tears, frequently hostile and irritable and somehow, always mildly depressed even when the other symptoms are alleviated. Great way to live, huh?!
Posted by justbegun on March 10, 2005, at 13:57:20
In reply to Re: BPII but nothing seems to help, posted by upsndowns on March 9, 2005, at 9:08:15
BPII, too, or so my doc says... But I love my hypomania!
So much of your feelings rang true to me. Especially the irritability (who wouldn't be after putting up with all that med tinkering?)
Forgive me if I'm way off the mark, but I'm wondering if you might be a female in perimenopause? The interplay of hormonal changes with other brain chemistry is woefully under-studied but it has more of an effect than most drugs. So maybe something non-Rx might give you a different bang.
Posted by upsndowns on March 10, 2005, at 15:45:30
In reply to Re: BPII but nothing seems to help, posted by justbegun on March 10, 2005, at 13:57:20
Wish it were so, but perimenopause is long gone! Thanks for trying, though and enjoy those hypomanias, mine are a constant and not something I want to have hang around with very often. I know the brain hormones are a big part of things, but mine are in a different place.
Posted by theo on March 11, 2005, at 9:44:24
In reply to Re: BPII but nothing seems to help, posted by upsndowns on March 8, 2005, at 8:18:43
Does 18mg Concerta effect your anxiety much?
Posted by theo on March 11, 2005, at 9:45:46
In reply to Re: BPII but nothing seems to help, posted by D minor on March 8, 2005, at 12:10:55
Which version of Wellbutrin do you take, XL, SR?
Posted by upsndowns on March 11, 2005, at 11:56:01
In reply to Re: BPII but nothing seems to help » upsndowns, posted by theo on March 11, 2005, at 9:44:24
I am giving myself a day without concerta, which I take at 18mgs, to see if it has any effect whatsoever on the anxiety; I don't think it does, it helps me to focus a lot better and it would be something very hard to give up. I have just spent two days in bed so depressed that I have seen myself falling down flights of stairs and doing all sorts of mayhem, so I figure bed is the safest place for me. I do not take wellbutrin at all, haven't for years.
This is the end of the thread.
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