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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by sigolene on May 7, 2006, at 12:42:00
I'm bipolar II rapid cycling, but mosty depressed. I take lamictal 200mg since 4 mounth, and bupropion (wellbutrin) since 8 weeks. But I don't feel better. I wonder if someone could give me an advice, if I should continue burpropion or not, in case of rapid cycling bipolar II ?
Posted by linkadge on May 7, 2006, at 19:20:45
In reply to bipolar rapid cycling: AD or not AD ?, posted by sigolene on May 7, 2006, at 12:42:00
You might keep the lamictal and replace the wellbutrin with something different.
Linkadge
Posted by patrickhh on May 9, 2006, at 8:48:52
In reply to bipolar rapid cycling: AD or not AD ?, posted by sigolene on May 7, 2006, at 12:42:00
> I'm bipolar II rapid cycling, but mosty depressed. I take lamictal 200mg since 4 mounth, and bupropion (wellbutrin) since 8 weeks. But I don't feel better. I wonder if someone could give me an advice, if I should continue burpropion or not, in case of rapid cycling bipolar II ?
You might try to drop the Wellbutrin altogether and see if the Lamictal is holding you. Lamictal has antidepressant properties as well, and typically if you can get your rapid cycling stablized, often your depression will improve as well.I'd try to stay away from SSRI's and the like if possible. They seem to be the worst for triggering rapid cycling. Wellbutrin was probably prescribed to you because it has the least chance of causing that.
If all else fails, you can try adding an SSRI or SNRI...just make sure your mood is stabilized first before you add one. And if adding an SSRI stats maknig you feel agitated, it might not be the drug for you.
Posted by curtm on May 9, 2006, at 14:14:53
In reply to bipolar rapid cycling: AD or not AD ?, posted by sigolene on May 7, 2006, at 12:42:00
I take Lamictal 400mg, then recently added Wellbutrin 150mg and I started flipping out. I was getting more manic by the day. If it weren't for the great people here, I might not have known what was going on. I have since discontinued the Wellbutrin.
I hope that you don't have any adverse effect like I did. Pay very close attention to any progressive mood changes.
Posted by patrickhh on May 10, 2006, at 11:28:41
In reply to Re: bipolar rapid cycling: AD or not AD ? » sigolene, posted by curtm on May 9, 2006, at 14:14:53
Curt, what symptoms were you having on the Wellbutrin?
> I take Lamictal 400mg, then recently added Wellbutrin 150mg and I started flipping out. I was getting more manic by the day. If it weren't for the great people here, I might not have known what was going on. I have since discontinued the Wellbutrin.
>
> I hope that you don't have any adverse effect like I did. Pay very close attention to any progressive mood changes.
Posted by curtm on May 10, 2006, at 12:41:33
In reply to Re: bipolar rapid cycling: AD or not AD ? » curtm, posted by patrickhh on May 10, 2006, at 11:28:41
Well let me give a short history first.
Think of it as a song, try to sing along...(to the tune of "Michael row your boat ashore"
Had bad depression
Saw family physician
no luck w/ ssri's
referred to psychstarted wellbutrin
got a lot better
not quite enough
wellbutrin "topped out"felt moody
wife said so too
called pdoc- likely bipolar
switched to lamictalgot a little better
still moody sometimes
called pdoc again
suggets adding wellbutrinI said no, not yet
got a real low mood
added wellbutrin
started bringing me up(chorus, verse one:)
shot right past "normal"
progressed into mood spikes
of anger, unpredictable
over little thingsbecoming aggressive, irritable
getting hrder to control
start having mixed reactions
became overly energeticfelt so euphoric
acting very silly
feels like trippin'
don't know whyfelt dazed, confused
severe anxiety, lost
drank some beers
to come down faststopped wellbutrin
called pdoc again
siad wellbutrin is
least likely to cause thatsaid I did the right thing
or in a couple more days
i would probably have to be
taken to the psych wardlooking into something new
to replace or add to lamictal
cant wait to go back
maybe get even better(end)
Posted by patrickhh on May 12, 2006, at 11:59:44
In reply to Re: bipolar rapid cycling: AD or not AD ? » patrickhh, posted by curtm on May 10, 2006, at 12:41:33
Nice way of putting it! LOL! Might try augmenting the Lamictal with a low dose of lithium. That's very effective for many folks. And in low doses, you don't really have to worry about the long term side effects with lithium.
> Well let me give a short history first.
> Think of it as a song, try to sing along...
>
> (to the tune of "Michael row your boat ashore"
>
> Had bad depression
> Saw family physician
> no luck w/ ssri's
> referred to psych
>
> started wellbutrin
> got a lot better
> not quite enough
> wellbutrin "topped out"
>
> felt moody
> wife said so too
> called pdoc- likely bipolar
> switched to lamictal
>
> got a little better
> still moody sometimes
> called pdoc again
> suggets adding wellbutrin
>
> I said no, not yet
> got a real low mood
> added wellbutrin
> started bringing me up
>
> (chorus, verse one:)
> shot right past "normal"
> progressed into mood spikes
> of anger, unpredictable
> over little things
>
> becoming aggressive, irritable
> getting hrder to control
> start having mixed reactions
> became overly energetic
>
> felt so euphoric
> acting very silly
> feels like trippin'
> don't know why
>
> felt dazed, confused
> severe anxiety, lost
> drank some beers
> to come down fast
>
> stopped wellbutrin
> called pdoc again
> siad wellbutrin is
> least likely to cause that
>
> said I did the right thing
> or in a couple more days
> i would probably have to be
> taken to the psych ward
>
> looking into something new
> to replace or add to lamictal
> cant wait to go back
> maybe get even better
>
> (end)
>
>
>
Posted by curtm on May 12, 2006, at 12:15:02
In reply to Re: bipolar rapid cycling: AD or not AD ? » curtm, posted by patrickhh on May 12, 2006, at 11:59:44
>> Nice way of putting it! LOL! Might try augmenting the Lamictal with a low dose of lithium. That's very effective for many folks. And in low doses, you don't really have to worry about the long term side effects with lithium.
** However I don't want anything that will make me drowsy or too lethargic and I don't want anything that will over-stimulate me. I have had a severe addiction to stimulants previously and am afraid of getting really hyperactive on stimulants. Might trigger addiction again.
Is this asking for a needle in a haystack?Will lithium do any of that?
Maybe a placebo is what I need...
Posted by Lithia on May 13, 2006, at 10:31:58
In reply to Re: bipolar rapid cycling: AD or not AD ? » patrickhh, posted by curtm on May 12, 2006, at 12:15:02
> Will lithium do any of that?
>
> Maybe a placebo is what I need...For what is is worth, lithium is not in the least bit sedating for me. I still need sleeping pills. But then again, I am predominantly manic and need a sledge hammer for any kind of sedation. I also do believe that AD's can trigger rapid cycling. Effexor did it for me.
Lithia
Posted by curtm on May 13, 2006, at 22:54:01
In reply to Re: bipolar rapid cycling: AD or not AD ?, posted by Lithia on May 13, 2006, at 10:31:58
>> I also do believe that AD's can trigger rapid cycling. Effexor did it for me.
Do you mean Effexor triggered rapid cycling or do you mean Effexor helped your mood? Wellbutrin triggered it for me.
Are you taking Lithium? Is it working? I am predom manic too. I feel lke I am going to freak almost every afternoon (that is why I have been splitting my 400mg Lamictal dose to 200g twice a day.
Posted by Lithia on May 14, 2006, at 6:54:11
In reply to Re: bipolar rapid cycling: AD or not AD ? » Lithia, posted by curtm on May 13, 2006, at 22:54:01
Effexor initially pulled me out of a depression fast, then induced mania and ultra rapid-cycling.
I am BP1, on lithium now for a week. It's not doing much yet, bad or good at 900 mg per day but it hasn't been long enough to aquire a therapeutic blood level. I'm still pretty manic.
I took wellbutrin once many years ago for 2 weeks and it put me into the first mania with psychotic features I had ever had. I heard voices. Not fun.
Lith
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