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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by Nik Markwell on July 27, 2008, at 19:12:40
I am mostly manic with some depression (oversleep at times). Mania is hypomania to mania. Is this bipolar 1 or 2? Also what is the best medicine to treat mania?
I tried Lamictal and it gave me depression I've never had before. Im ready to get off.
Posted by Racer on July 27, 2008, at 21:04:20
In reply to Quick Question About Mania and Medication, posted by Nik Markwell on July 27, 2008, at 19:12:40
If you experience full-blown mania, and it's not solely triggered by medications, then that would be Bipolar I. Bipolar II is limited to hypomania. If your mania/hypomania is triggered by medications, that is usually considered "Bipolar III," but can also be considered "bipolar resulting from a medical condition" or something to that effect.
As for what medication is best, the most accurate answer is the most vague -- the best medication is the one which works for you. That's because there's so much variance in the effects of the various psych meds out there. Lithium is generally considered the Gold Standard of anti-manics, but it comes with a variety of side effects, and some people get a better overall result from other medications like Abilify, Zyprexa, Lamictal -- which you've already tried -- Lyrica, etc. The best advice I can offer on the topic is to say it's worth making a detailed record of the effects you're having with it, and take that to your doctor. Often, doctors can narrow down the choices of medications based on the side effects a patient is experiencing or those which a patient is least tolerant of.
I hope that helps a bit, and wish you good luck.
Posted by blueboy on July 28, 2008, at 11:41:36
In reply to Quick Question About Mania and Medication, posted by Nik Markwell on July 27, 2008, at 19:12:40
> I am mostly manic with some depression (oversleep at times). Mania is hypomania to mania. Is this bipolar 1 or 2? Also what is the best medicine to treat mania?
>If you ever get manic (psychotic), it is Bipolar I by definition. The dividing line can be difficult to assess.
> I tried Lamictal and it gave me depression I've never had before. Im ready to get off.
Wow. I've heard of this, but it always freaks me out. The primary indication for Lamictal is bipolar I disorder primarily expressed as depression. (It is widely prescribed for BP II but, surprisingly, this use is still considered "off label".)
I imagine your pdoc started you on it, even though your chance of success might be low, because the side effects can be mild to nonexistent. If you respond to it, it is the best thing since cut bread.
But with a primary complaint of mania/hypomania, not to mention such a weird side effect, it would seem your chances of response to another drug like depakote or lithium might be higher.
One other possibility is that the depression is not a side effect of the Lamictal. I have several times made the mistake of thinking that a symptom is a side effect of a drug, when it was actually just a weird bump in my random cycling that would have occurred whether or not I took the drug.
I really can't give you any advice except to tell you not to jump to conclusions, and do work with your pdoc. And remember, unless you are in a lifetime depressive state, "The sun'll come out tomorrow".
This is the end of the thread.
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