![[dr. bob]](/dr-bob-sm.gif)
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 never2late on January 21, 2012, at 23:36:58
On my last visit with my Pdoc we discussed how I am having periods of the day when I feel positive productive and relatively free from my anxiety. Then there are other times when I feel depressed, restless, anxious and unmotivated.
He said to wait for the effexor to adjust in my system and said that if these fluctuations during the day continue I might be a good fit for a valproate type anticonvulsant.
I havent been diagnosed with bipolar disorder. But I am having shifts in my mood from positive to negative during the day everyday. I descried it to my doctor as if I was free of depression and anxiety for a few hours only to fall back into it again. This happens at least one to three times a day.
I just dont get why I am not having consistency with my mood and how adding this would help. I am going to ask my doctor all this when I see him, but I like to be as informed as possible about my treatment.
Anyone have any experiences with "The valproates" which I guess would be Depakote from my internet searches. Any experiences with it either as an add on or taken by it self would be helpful.
Posted by sleepygirl2 on January 22, 2012, at 0:54:20
In reply to The valproates, posted by never2late on January 21, 2012, at 23:36:58
Do you take effexor twice a day? Is it the xr kind?
I find it leaves my system pretty darn quickly.
Posted by never2late on January 22, 2012, at 3:12:29
In reply to Re: The valproates » never2late, posted by sleepygirl2 on January 22, 2012, at 0:54:20
> Do you take effexor twice a day? Is it the xr kind?
> I find it leaves my system pretty darn quickly.Nope just once a day now up to 150 mg XR. It makes me tired about 4 hours after I take it so I take it in the late afternoon. I feel sluggish in the mornings it is difficult to get out of bed. Then the mood swinging starts.
Do you take XR in split doses? I knew it had a short half life or whatever but I thought XR took care of that part of it. I mean isnt that the point of an XR med?
Although when I usually take xr meds like when I took adderall xr or even with the concerta I take now I find that it never lasts as long as they say it is supposed to- for instance adderall XR is supposed to last 8 hours and concerta 10 hours- I usually get about half of that.
Posted by SLS on January 22, 2012, at 5:13:52
In reply to The valproates, posted by never2late on January 21, 2012, at 23:36:58
1. Perhaps you are underdosed on the Effexor. 150 mg is low, and usually insufficient for more severe depressions. I would look into this first.
2. Low-dosage (300-600 mg) lithium can stabilize one's depressive mood even if they are unipolar.
3. Valproate might help if your illness falls somewhere along the bipolar spectrum - "soft bipolar". Valproate can leave someone feeling somewhat more depressed, though. It is hard to know in advance who will be affected this way. Weight-gain and hair-loss are possible side effects that affect a minority of people. You must perform blood tests before beginning valproate and then several times up to 6 months to check for liver abnormalities.
If your doctor feels that strongly about it, perhaps you should give valproate a try. You can stop it at any time if you don't like what's happening. I can give no guarantees that increasing the Effexor up to 300 mg will help, but it seems like the logical thing to do. The post-dose tiredness might dissipated after awhile. 300 mg of lithium is low and unlikely to produce any toxic effects (thyroid, kidneys), even when used long-term.
- Scott
Posted by Phillipa on January 22, 2012, at 9:51:15
In reply to Re: The valproates » never2late, posted by SLS on January 22, 2012, at 5:13:52
Scott why does lithium effect the thyroid? How is it different that it does this to an endocrine gland? Phillipa
Posted by sleepygirl2 on January 22, 2012, at 10:49:05
In reply to Re: The valproates, posted by never2late on January 22, 2012, at 3:12:29
I take xr, 150, in the mornings. I used to split the dose, even with xr, before the insurance company said that wasn't indicated, so they wouldn't pay for it.
I start to feel irritable, weepy, if I delay the dose for a couple of hours.
I just dont think it's working up to 24 hours.
I used to take a higher dose, but I think it made my mood swing a bit, so now I take less with lamictal.
Posted by SLS on January 22, 2012, at 11:26:42
In reply to Re: The valproates » SLS, posted by Phillipa on January 22, 2012, at 9:51:15
> Scott why does lithium effect the thyroid? How is it different that it does this to an endocrine gland? Phillipa
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1584230/
- Scott
Posted by Christ_empowered on January 22, 2012, at 12:41:36
In reply to Re: The valproates » Phillipa, posted by SLS on January 22, 2012, at 11:26:42
I personally would not take depakote in the midst of a depressive episode. I've had to take depakote a few times for psychotic mania, and each time it not only knocked out the mania and psycohsis, it knocked me into drugged-up dysphoria/depression.
I'd personally just try to ramp up the effexor a bit. I had a friend on a lot...375, maybe? There's literature on higher doses. You have lots of leeway. Or maybe switch to cymbalta. I didn't care for it, but its easier to get to the 60-120 target (see, there's some leeway, but not nearly as much as with effexor) and I seem to recall it lasting all day, every day.
Posted by Phillipa on January 22, 2012, at 20:48:40
In reply to Re: The valproates » Phillipa, posted by SLS on January 22, 2012, at 11:26:42
Scott thanks no goiter autoimmune. Phillipa
Posted by never2late on January 22, 2012, at 22:33:44
In reply to The valproates, posted by never2late on January 21, 2012, at 23:36:58
Thanks for the feedback everyone.
Hair falling out not a good side effect. I am I probably will increase the effexor past 150. I think the reason he suggested it is that in addition to the mood swings I have also been having alot of muscle tension. From what I read valporates are sodium channel blockers which might give me some relief from my achyness and muscle tension ( all occuring prior to starting effexor).
Actually they have lessened since effexor but are still present.
The mood swinginess is really annoying it becomes very difficult to do the things I need to do in my day.
Before I let him prescribe it Ill discuss the other options that you guys listed- and im sure hell have some too. Hes a pretty good doc.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.