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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Bryn B on July 5, 2012, at 14:17:15
Sorry for posting again! Clearly I haven't been leaving my apartment much...
Saw a new pdoc today. While I realize there are many meds I haven't tried and know all about trial and error w/ psych meds, it's tiring. I didn't expect him to diagnose me in one visit either, but it's frustrating that I've been dealing w/ this for so long and can't get a clear idea of whether it's unipolar or bipolar depression. (This guy wants to give it time, especially since substance abuse clouded my past.)
So, he's adding a low dose of Lithium, and later Nortriptyline to my current 20 mg dose of Lexapro. I'm on Tramadol, too, which works better than anything ever has for my mood, but the pdoc wants me to get off of it. He mentioned Subutex as a possibility in the future as I respond well to Tramadol & bc of past issues w/ addiction. (Basically, he won't prescribe Tramadol just for mood and subsequent pain.)
I'm confused; it's been so hard to find a good doc, and extremely costly w/o insurance. It's also exhausting to explain your history, etc. and build a relationship w/ someone new.
Thoughts on Lithium? And/or Nortiptyline (and Lexapro)? And on establishing a good relationship w/ your pdoc? I feel kinda defeated...
Posted by Phillipa on July 5, 2012, at 15:57:30
In reply to Lithium, Nortriptyline + Pdocs, posted by Bryn B on July 5, 2012, at 14:17:15
Subutex is used instead of tamadol. Form of help with withdrawal med. Lithium used to be used a lot in patients with substance issues. I'm guessing your new doc is thinking alone the lines of using substances to self medicate bipolar. But lexapro doesn't trigger mania? Hope those with bipolar chime in. Phillipa
Posted by Emily Elizabeth on July 5, 2012, at 18:43:36
In reply to Lithium, Nortriptyline + Pdocs, posted by Bryn B on July 5, 2012, at 14:17:15
I have had some (although not complete) success with Lithium. It is known for (and I have found it helpful for) reducing suicidal thoughts.
One thing I would suggest that is helpful when starting a new med (particularly if there is concern about bipolarity) is mood charting. Optimism.com is a site that a lot of people find helpful for that.)
Since doing some reading on bipolar II, I have learned about ithe idea that adding an antidepressant to a mood stabilizer might undermine the mood stabilizer. This theory intrigues me and seems to make sense with regard to my own experiences. Worth asking pdoc what he thinks of this.
Hang in there!
Best,
EE
Posted by Bryn B on July 6, 2012, at 8:40:53
In reply to Re: Lithium, Nortriptyline + Pdocs, posted by Emily Elizabeth on July 5, 2012, at 18:43:36
thanks philppa & ee.
phillipa: I don't get manic from ads, but they seem to stop working after I hit a certain point.
ee: good idea re: mood charting, I've been doing something kind of similar.
thanks to you both!
Posted by schleprock on July 14, 2012, at 19:19:51
In reply to Lithium, Nortriptyline + Pdocs, posted by Bryn B on July 5, 2012, at 14:17:15
My life was ruined through a concommitant use of Nortriptyline and Lithium. An interim pdoc I was seeing insisted that I was bi-polar because i suffer from both depression and anxiety, and made some wild promises about switching from Nortriptyline to Lithium. The only results were severe panic attacks that I still suffer to this day (a little over three years later).
Giving Lithium a try was the literally the single worst mistake I've ever made in my life. I would advise against it.
Why not just go under the assumption that it's unipolar depression, treat that accordingly, and see what happens. At the worst you'll have solved half your problem.
Posted by brynb on July 14, 2012, at 21:48:22
In reply to Re: Lithium, Nortriptyline + Pdocs, posted by schleprock on July 14, 2012, at 19:19:51
I'm skeptical too. Lithium helped for the first week, but now I feel worse and have some really unsavory side effects (even at the lowest dose--300 mg). I am tapering off of Tramadol (I was taking 100 mg daily, now I'm at 50), and I haven't started Nortriptyline yet. I'd rather stay on Tramadol vs taking Nortriptyline; they're very similar, but with Tramadol, I haven't experienced any side effects.
I was on Trileptal for a brief period several years ago and responded well to it, yet my pdoc insisted I try Lithium. I'm seeing him this week and will address these concerns.
How long were you on Lithium for and when did the side effects kick in?
thanks...
b
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