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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 butternut on May 23, 2006, at 19:54:19
I have a PDoc appt scheduled next week and plan to request a mood stabilizer. I am thinking I want to ask for Lamictal first in order to ward off weight gain. I have already gained a lot of weight from Zoloft, which made me tired and crave sugar all the time. Any recommendations on what to try first? My PDOC once said he would put me on Geodon if I ever exhibited bipolar symptoms. I don't want to go that route, because it seems like a mood stabilizer should be step one, then we can add on other things.
My official diagnosis is recurring major depression, but my PDOC and I suspect bipolar as I have a family history of it. My panic attacks and depressions go way back to elementary school and have at times been in remission, but they always come back. I do not have any highs , but I do seem to change from irritable and easily frustrated and enough energy to exercise for a few weeks to tired, depressed, anxious, and obsessively worrying for several weeks. I tend to change mood around my period. My most difficult symptom is getting very frustrated and angry with myself--not thin enough, organized enough, etc. Maybe it's mixed episodes, I dont know. I can go from calm to throwing things and crying in about 10 seconds flat. My anger is always w/things rather than people. For example, the other day I was having trouble with my portable cd-player, and it took all the willpower I had not to get a baseball bat and smash it to bits. The ONLY reason I didn't do it was because that would be something one of my "crazy" relatives would do. This isn't normal. After years of dreading it, I think I'm finally ready to accept a bipolar diagnosis if it means the right medicine can help me get on w/life. I appreciate any advice on a first-line treatment.
Posted by heaven help me on May 23, 2006, at 21:04:18
In reply to First choice mood stabilizer?, posted by butternut on May 23, 2006, at 19:54:19
Hi- I have a lifelong list of mood struggles similar to what you just described. I would fight it in my mind, always working WAY TOO HARD to keep myself at a "normal" place (ie: NOT actually taking the baseball bat to the CD player even though I should have...) Lots of other "symptoms" but I was always able to do what I called "mind over mind" it into control. Then I hit a year a few back of utter sleeplessness that drove me to the Dr.s office (I had abhorred the idea of meds!). We tried a couple years of Anti-Depressants, none of which worked, most made me feel jittery or sick or crazy. He finally tried bipolar meds and they really have made a HUGE difference. Things are not perfect but let me tell you, the mental WORK is gone. I am so releived, much more rested, even happy at times. Who would have thought? Anyway, I take:
Lamictal 200mg
Geodon 120mg
Restoril for sleep
and things are going well...The only nuisance is some jitteryness in the eves, which the recent addition of Magnesium Phosphate has helped enormously with. I have a terrible case of vertigo too but we all suspect an inner ear infection and not meds for that.
Blessings
Mary
Posted by Phillipa on May 23, 2006, at 21:25:59
In reply to Re: First choice mood stabilizer?, posted by heaven help me on May 23, 2006, at 21:04:18
Did you have side effects on the Geodon and lamictal and what were they? As my pdoc prescribed them today. And do you take the lamictal in the am or pm Love Phillipa
Posted by heaven help me on May 23, 2006, at 21:54:34
In reply to Re: First choice mood stabilizer? » heaven help me, posted by Phillipa on May 23, 2006, at 21:25:59
I take them both in the pm. Lamictal was always that way, the Geodon I do because it makes me really tired. I haven't really noticed Lamictal side effects (I've been on several other meds with it before so who knows for sure). The Geodon I think makes me a little jumpy/agitated in the evenings (waiting for the next dose?) But it has become tolerable, and the Magensium Phosphate helps with that. I think if it were not for the vertigo I have I would be feeling great. We all think the vertigo is an inner ear infection and are just waiitng on that one
Blessings
Mary
PS: I really appreciate you, you are always so kind.
Posted by Phillipa on May 23, 2006, at 21:57:42
In reply to Re: First choice mood stabilizer?, posted by heaven help me on May 23, 2006, at 21:54:34
Thanks Mary my doc said in the am so I think I'll post a thread. Love Phillipa
Posted by blueberry on May 24, 2006, at 6:36:20
In reply to First choice mood stabilizer?, posted by butternut on May 23, 2006, at 19:54:19
Just an opinion, but I think lamictal is an excellent first choice. I mean, all of the mood stabilizers can be helpful. Since choosing a med really is a guessing game and mileage varies, I think lamictal at least stacks the odds in your favor. For example, when you see statistics that people with epilepsy who were also depressed started lamictal and 86% of them had an improvement in mood, those statistics are hard to find with other mood stabilizers.
Posted by B2chica on May 24, 2006, at 11:28:35
In reply to First choice mood stabilizer?, posted by butternut on May 23, 2006, at 19:54:19
i do think that a mood stabilizer will help you out no matter your dx. it does sound like a very logical step.
you mention mood shifts around your period. have they ever considered PMDD? this is serious and i think you should talk about it with your doctor.have you ever tried therapy? i Really think you should consider this.
has anyone ever mentioned BPD to you? just wondering. sometimes i think it's way over diagnosed but with you switching moods so quickly and so intensly plus the self-degredation anger toward yourself makes me think this a possibility. and therapy will definately help you through this (along with mood-stabilizer).and just because your family members have mental illness history does not mean you are 'destined' for it.
but i think you are right on the money with your last statement. you said you are willing to accept BP dx if it means getting on the right meds. this is the key. not the diagnosis but the meds used to treat the symptoms.
i would try for something like wellbutrinXL, lamictal and a benzo, maybe klonipin-lasts a little longer than xanax, but xanax is really fast acting.
best wishes
b2c
Posted by butternut on May 25, 2006, at 20:53:06
In reply to Re: First choice mood stabilizer? » butternut, posted by B2chica on May 24, 2006, at 11:28:35
Thanks for your thoughtful reply. He has not diagnosed me with it, but my current doc believes that PMDD is actually a bipolar illness that reveals itself due to the stress of hormonal changes. WHen I took Zoloft it supressed my PMS.
Thank you for the reminder that a family history is not a guarantee of illness. I have a very hard time letting go of that fear. My ill relatives (bipolar, schizophrenia) worsened with time and became pretty much non-functional--couldn't carry on relationships, work, have a hobby, etc.
I'd like to think that I'd manage my illness better, and so have a better prognosis, but who knows? Do you have a family history of mental illness? Does it frighten you or do you feel you are driven more by will than by genetics?Only my current doc suspects bipolar is a possiblity. Several docs over the years have blown off my fears of bipolar because I have never had a classic manic episode. It bothered me that they diagnosed me with panic disorder because I was not having attacks, more like a panic state with depersonalization that did not cease 24-7 for days until I could get a tranquilizer. In retrospect I wonder if these were/are my brain's version of mania or mixed episode.
I eventually stumbled onto a doctor who thought my anxiety had an OCD quality, and a zoloft-klonopin combo kept me very happy for many years. I went off due to weight gain, and struggled for a few years until I went back on it. I've again gained lots of weight. Afer also feeling apathetic and tired and clenching my jaw constantly, I weaned off two months ago.
I see the doctor next Wednesday and plan to ask for Lamictal. If he says no for some reason, I think my second choice will be Lithium.
Posted by B2chica on May 26, 2006, at 8:45:56
In reply to Re: First choice mood stabilizer?b2chica, posted by butternut on May 25, 2006, at 20:53:06
>>Thanks for your thoughtful reply. He has not diagnosed me with it, but my current doc believes that PMDD is actually a bipolar illness that reveals itself due to the stress of hormonal changes. WHen I took Zoloft it supressed my PMS.
very interesting...had not heard this???
how old are you? just wondering because of typical onset times for certain mental illnesses. sorry about your family members. i don't have a family history and can't imagine how frightening it must be to in a sense live with reminders of WHAT you could 'get'. i know it's hard but remember you are you.
and it sounds like you are doing a very good job of managing and keeping on top of your symptoms.
and i understand that 'panic' state for 24/7 i had something similar and it drove my pdoc nuts cuz it didn't seem to 'fit' anywhere and no meds were really taking care of it.
you know, of all the drugs they can create that can effect our intricate brain why aren't they able to make these same drugs Without the weight gain side effect. as if we don't have enough probs already. it's like we all have to choose....well being and weight gain, or suffering. it really bites.
i gained about 50 on zyprexa...but it was the only thing that helped...and i could get pretty out of it, so i'm glad it worked without fogging me up. but what a compromise.good luck at your doc appt next week.
b2c.
Posted by detroitpistons on May 26, 2006, at 11:41:14
In reply to First choice mood stabilizer?, posted by butternut on May 23, 2006, at 19:54:19
My doctor put me on Lamictal when I started becoming hypomanic. Overall, it's a great med. It did succeed in calming me down a tad, but in my opinion, Lamictal was the wrong choice for my particular situation. It takes several weeks to get up to the right does, and it is NOT a very good antimanic agent. I'm still having breakthrough symptoms of irritable hypomania.
If you are not hypo/manic, however, Lamictal is a great choice for the depression end of things. Lamictal is more of a maintenance drug for people who's primary problem is depression. This is true with me too, but when I was getting hypomanic, he should have given me something like Depakote for acute mania.
> I have a PDoc appt scheduled next week and plan to request a mood stabilizer. I am thinking I want to ask for Lamictal first in order to ward off weight gain. I have already gained a lot of weight from Zoloft, which made me tired and crave sugar all the time. Any recommendations on what to try first? My PDOC once said he would put me on Geodon if I ever exhibited bipolar symptoms. I don't want to go that route, because it seems like a mood stabilizer should be step one, then we can add on other things.
>
> My official diagnosis is recurring major depression, but my PDOC and I suspect bipolar as I have a family history of it. My panic attacks and depressions go way back to elementary school and have at times been in remission, but they always come back. I do not have any highs , but I do seem to change from irritable and easily frustrated and enough energy to exercise for a few weeks to tired, depressed, anxious, and obsessively worrying for several weeks. I tend to change mood around my period. My most difficult symptom is getting very frustrated and angry with myself--not thin enough, organized enough, etc. Maybe it's mixed episodes, I dont know. I can go from calm to throwing things and crying in about 10 seconds flat. My anger is always w/things rather than people. For example, the other day I was having trouble with my portable cd-player, and it took all the willpower I had not to get a baseball bat and smash it to bits. The ONLY reason I didn't do it was because that would be something one of my "crazy" relatives would do. This isn't normal. After years of dreading it, I think I'm finally ready to accept a bipolar diagnosis if it means the right medicine can help me get on w/life. I appreciate any advice on a first-line treatment.
This is the end of the thread.
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