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Dr. Bob is Robert Hsiung, MD,
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Posted by med_empowered on February 18, 2006, at 13:36:20
hi! sorry about your current problems. I don't know why your doc is proposing loxapine as a possible solution. Personally, I wouldn't do it, especially if you're also taking Lithium (lithium **might** cause increased problems when mixed with antipsychotics; in some patients given haldol/lithium combos, for instance, there were cases of permanent brain damage). Loxapine really isn't meant for depression; Asendin (amoxapine) partially breaks down into loxapine and is sometimes useful for depression, but it can cause EPS/TD, so its not the greatest option.
Anyway, some bipolar people respond well to drugs like Wellbutrin, which have some norepinephrine and dopamine action but very little serotonin action. Why this should be, no one really knows. Stimulants (Ritalin, Provigil, Adderall) are sometimes helpful in certain cases of depression; in bipolar, you run the risk of cycling, but if nothing else is working..it could be worth a shot.
Some combos could be worth trying, like the "California Rocketfuel" (effexor plus remeron, I believe). You could also try an AD with add-ons--buspar, benzos, low-dose stimulant, low-dose atypical neuroleptic, etc. Adding another mood stabilizer might help, too, but there might be more pronounced effects on cognition than if you just opted for an antidepressant.
Good luck!
Posted by bipolarspectrum on February 18, 2006, at 20:05:29
In reply to To bipolarspectrum..., posted by med_empowered on February 18, 2006, at 13:36:20
Hey med,
thanx for the message... u bring up some great ideas... right now im currently adding lamictal to the lithium/seroquel regime... lanmictal used to make me hypomanic when i took it by itself... but it doesnt seem to be doing so now (keepin my fingers crossed)... thanx for ur advice!
bps
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