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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by confused-in-TN on June 30, 2012, at 23:22:17
Long story short.was on this site years ago....sort of drifted away from it.Now I find myself in a strange situation. Have been seeing a new doc who has decided I'm bipolar. A switch from my last dd of mood disorder not otherwise specified(love that one) and generalized anxiety. Seems this new guy thinks everyone who has generalized anxiety is really bipolar. This despite my only "bipolar" symptoms are racing thoughts and a bad temper. I am now on depakote., Xanax, propranalol and ability. Mind you I work, socialize and recently survived the sudden death of my 56 year old husband. Any thoughts, comments or whatever? Best to all.
Posted by Phillipa on June 30, 2012, at 23:42:14
In reply to weird meds and diagnosis, posted by confused-in-TN on June 30, 2012, at 23:22:17
I'm so sorry to hear of the death of your husband what a horrible tragedy for you. I see you are not on an antidepressant? Do you feel you are depressed? I'd be anxious also with what you have been through. I'd think the racing thoughts are anxiety, have you tried a mood stabalizer like trileptal? As this also acts to aid an antidepressant. What med have you taken in the past. Welcome back to babble. Phillipa
Posted by confused-in-TN on July 1, 2012, at 0:03:53
In reply to Re: weird meds and diagnosis » confused-in-TN, posted by Phillipa on June 30, 2012, at 23:42:14
Thanks for the quick response. The loss of my husband hes been very hard. Today would have been his birthday. I am somewhat depressed but don 't know if its situational or something more. If I wasn't depressed it would probably mean I was over medicated. As for previous meds, how much time do you have. Paxil,prozac, seroquel, lamactil, klonopin, amitryptilin and more I can 't remember. Can 't take any sri as they send my anxiety level through the roof. Haven 't heard of the mood stabilizer you mention supposedly the depakote helps with that, but tell me more. Thanks again!
Posted by confused-in-TN on July 1, 2012, at 0:06:42
In reply to Re: weird meds and diagnosis » confused-in-TN, posted by Phillipa on June 30, 2012, at 23:42:14
Thanks for the quick response. The loss of my husband hes been very hard. Today would have been his birthday. I am somewhat depressed but don 't know if its situational or something more. If I wasn't depressed it would probably mean I was over medicated. As for previous meds, how much time do you have. Paxil,prozac, seroquel, lamactil, klonopin, amitryptilin and more I can 't remember. Can 't take any sri as they send my anxiety level through the roof. Haven 't heard of the mood stabilizer you mention supposedly the depakote helps with that, but tell me more. Thanks again!
Posted by jane d on July 1, 2012, at 1:25:43
In reply to weird meds and diagnosis, posted by confused-in-TN on June 30, 2012, at 23:22:17
> Long story short.was on this site years ago....sort of drifted away from it.Now I find myself in a strange situation. Have been seeing a new doc who has decided I'm bipolar. A switch from my last dd of mood disorder not otherwise specified(love that one) and generalized anxiety. Seems this new guy thinks everyone who has generalized anxiety is really bipolar. This despite my only "bipolar" symptoms are racing thoughts and a bad temper. I am now on depakote., Xanax, propranalol and ability. Mind you I work, socialize and recently survived the sudden death of my 56 year old husband. Any thoughts, comments or whatever? Best to all.
Welcome back.
I wouldn't worry too much about the change of diagnosis. Ideas are constantly changing over what symptoms to lump together in a diagnosis. And it only matters if it points to a treatment that works. Do you think the Depakote (mood stabilizer) is helping?
Have you talked to your doctor about what each of the other drugs are supposed to do for you? Do you think they are doing it?
Overall it sounds like you're doing pretty well.
By the way trileptal is just another mood stabilizer very similar to depakote.
Posted by jane d on July 1, 2012, at 1:34:47
In reply to Re: weird meds and diagnosis » confused-in-TN, posted by jane d on July 1, 2012, at 1:25:43
By the way, if you've changed the name you post here with you need to post a notice saying that on the administration board. You do not need to say what your old name was or give any explanation.
Posted by confused-in-TN on July 1, 2012, at 9:49:19
In reply to new posting names » jane d, posted by jane d on July 1, 2012, at 1:34:47
Meds do seem to help. At least I'm not the total mess I was for awhile. Sometimes I think they work to well as my emotions can seem a bit blunted. Haven't been as sad as I fe I should be and sometimes am over my husbands death. But that may be normal. Depakote does help with my anger issues. Still don't think I've suddenly become bipolar or that all anxiety is a symptom of it and not a specific problem in its own right.. best to all
Posted by Phillipa on July 1, 2012, at 19:24:25
In reply to reply to those who replied.thanks and continue! » jane d, posted by confused-in-TN on July 1, 2012, at 9:49:19
I agree with you anxiety can and often is a separate issue. Too many dx of bipolar. I think it's the new "IN" diagnosis. Phillipa
Posted by confused-in-TN on July 10, 2012, at 13:32:05
In reply to Re: reply to those who replied.thanks and continue! » confused-in-TN, posted by Phillipa on July 1, 2012, at 19:24:25
> I agree with you anxiety can and often is a separate issue. Too many dx of bipolar. I think it's the new "IN" diagnosis. Phillipa
Where has everyone gone? Had hoped for a bit more continuing feedback. Have an appointment with the new doc next week. Don't think I like this guy and his snap judgements about a patient he's seen for 30 minutes. Hope he doesn't try to change mess...been through that enough for two lifetimes. Take care everyone.
Posted by novelagent on July 11, 2012, at 18:50:01
In reply to weird meds and diagnosis, posted by confused-in-TN on June 30, 2012, at 23:22:17
It doesn't matter if you have bipolar or not. The bipolar meds will slow down your racing thoughts over time, so it doesn't matter. You should probably ask to switch from Xanax to Klonopin. If you're taking xanax just once a day, your bloodstream will always be on a rollercoaster, and thia produces more side effects...
you'll want to be on a steady state of klonopin, which is better to be on, because it leaves the bloodstream slower, in case you ever need to go off it.
Your doctor may be wise to suspect it's bipolar, because bipolar causes racing thoughts and anxiety. Do you ever find yourself having forced speech (ever?)
It sounds like you need to have more confidence in your doc. He's smart, it sounds, and may be on to something. I wouldn't worry so much about the diagnosis as the recovery from it. That's what you should be focused on, not second-guessing-- with all due respect, he's not exactly sounding like a quack here, I'd give him some time.
> Long story short.was on this site years ago....sort of drifted away from it.Now I find myself in a strange situation. Have been seeing a new doc who has decided I'm bipolar. A switch from my last dd of mood disorder not otherwise specified(love that one) and generalized anxiety. Seems this new guy thinks everyone who has generalized anxiety is really bipolar. This despite my only "bipolar" symptoms are racing thoughts and a bad temper. I am now on depakote., Xanax, propranalol and ability. Mind you I work, socialize and recently survived the sudden death of my 56 year old husband. Any thoughts, comments or whatever? Best to all.
Posted by confused-in-tn on July 12, 2012, at 9:00:51
In reply to Re: weird meds and diagnosis » confused-in-TN, posted by novelagent on July 11, 2012, at 18:50:01
> It doesn't matter if you have bipolar or not. The bipolar meds will slow down your racing thoughts over time, so it doesn't matter. You should probably ask to switch from Xanax to Klonopin. If you're taking xanax just once a day, your bloodstream will always be on a rollercoaster, and thia produces more side effects...
>
> you'll want to be on a steady state of klonopin, which is better to be on, because it leaves the bloodstream slower, in case you ever need to go off it.
>
> Your doctor may be wise to suspect it's bipolar, because bipolar causes racing thoughts and anxiety. Do you ever find yourself having forced speech (ever?)
>
> It sounds like you need to have more confidence in your doc. He's smart, it sounds, and may be on to something. I wouldn't worry so much about the diagnosis as the recovery from it. That's what you should be focused on, not second-guessing-- with all due respect, he's not exactly sounding like a quack here, I'd give him some time.
>
> > Long story short.was on this site years ago....sort of drifted away from it.Now I find myself in a strange situation. Have been seeing a new doc who has decided I'm bipolar. A switch from my last dd of mood disorder not otherwise specified(love that one) and generalized anxiety. Seems this new guy thinks everyone who has generalized anxiety is really bipolar. This despite my only "bipolar" symptoms are racing thoughts and a bad temper. I am now on depakote., Xanax, propranalol and ability. Mind you I work, socialize and recently survived the sudden death of my 56 year old husband. Any thoughts, comments or whatever? Best to all.
> My biggest problem with the new deoc is that he arrived at the new dx after 30 minutes with me. The meds do help,(I take xanax 3 times a day, klonopin didn't help) and no I don't have pressured speech... though years ago before meds I sometimes did. We'll see how wed. visit goes and go from there. Best to all.
>
Posted by novelagent on July 12, 2012, at 21:41:03
In reply to Re: weird meds and diagnosis, posted by confused-in-tn on July 12, 2012, at 9:00:51
Since you had forced speech before meds, you definitely would be a candidate for a bipolar dx. That just isn't explained by generalized anxiety.
Benzos, like klonopin or xanax, have a mood stabalizing effect. When I had forced speech from drug-induced hypomania, taking a klonopin elliminated it.
I would stick with the antimanic regimen, unless your bipolar isn't really a problem, and you simply have anxiety and the anxiety doesn't go away after months of the mood stabalizer. I'd give it 3 months. And if you have no mood problems, like your mood never goes up or down... it's possible you could just have a case of cyclomythia, which is ambulatory (no medical care needed) form of bipolar.
or maybe even a mild case of hypomania, which is below mania, and is a sort of high-functioning mania-- but you'd probably be engaging in risky behavior sometimes if you had hypomania. When I had it, I had a verbal fight with a subway booth agent, and then jumped the turnstile after she refused to accept the fact I had already paid my fare on the outbound side of the platform....
long story short, the subway car was eventually stopped, and about a dozen subway cops walked through the train. (I had a bottle of alcohol I had bought for a party that night, and luckily, I had these massive pockets in my cycling shorts that zipped open to conceal it. I knew they were looking for a guy with a bottle of alcohol), from the radio dispatcher). Close call, but that was not me, as they say-- I wasn't acting myself. Also had racing thoughts, forced speech, etc. sometimes.
Anyhow, it sounds like whatever you have, it's a pretty mild case, and the old adage one pdoc gave me once was "if it's not broke, I don't fix it." He was referring to all the meds my prior doc had put me on all in order to avoid putting me on klonopin, which worked for my social anxiety.
The way benzos work, however, is that 2mg of Xanax is equal to 1mg of klonopin. Some doctors don't know this, and even erwoid.org has it as 1mg=1mg, but I've seen the peer-reviewed Medscape iPad app's medication guide, and its comparison table lists it as 2mg of xanax=1mg of klonopin. So if you were on the proper dose of klonopin, it would work-- benzos work that way-- they don't have superior efficacy, where some benzos work bettter than other benzos; it's purely a dosing game.
Besides, who doesn't want a klonopin wafer? And klonopin Wafers are generic, too! =)
Man, I miss my klonopin wafers.... even though they're generic, Medicaid in my state would never justify the extra cost... oh well (I have Medicare + Medicaid, and medicaid in my state pays for benzos). Well, good luck; I don't know enough about your situation to know whether your mania requires treatment, but it sounds like you have a good doc, and maybe you can work with him and give him some time. Just keep in mind these meds take weeks and weeks to work; Aricept didn't work for me for 3 months.
Posted by confused-in-tn on July 13, 2012, at 6:31:28
In reply to Re: weird meds and diagnosis, posted by novelagent on July 12, 2012, at 21:41:03
> Since you had forced speech before meds, you definitely would be a candidate for a bipolar dx. That just isn't explained by generalized anxiety.
>
> Benzos, like klonopin or xanax, have a mood stabalizing effect. When I had forced speech from drug-induced hypomania, taking a klonopin elliminated it.
>
> I would stick with the antimanic regimen, unless your bipolar isn't really a problem, and you simply have anxiety and the anxiety doesn't go away after months of the mood stabalizer. I'd give it 3 months. And if you have no mood problems, like your mood never goes up or down... it's possible you could just have a case of cyclomythia, which is ambulatory (no medical care needed) form of bipolar.
>
> or maybe even a mild case of hypomania, which is below mania, and is a sort of high-functioning mania-- but you'd probably be engaging in risky behavior sometimes if you had hypomania. When I had it, I had a verbal fight with a subway booth agent, and then jumped the turnstile after she refused to accept the fact I had already paid my fare on the outbound side of the platform....
>
> long story short, the subway car was eventually stopped, and about a dozen subway cops walked through the train. (I had a bottle of alcohol I had bought for a party that night, and luckily, I had these massive pockets in my cycling shorts that zipped open to conceal it. I knew they were looking for a guy with a bottle of alcohol), from the radio dispatcher). Close call, but that was not me, as they say-- I wasn't acting myself. Also had racing thoughts, forced speech, etc. sometimes.
>
> Anyhow, it sounds like whatever you have, it's a pretty mild case, and the old adage one pdoc gave me once was "if it's not broke, I don't fix it." He was referring to all the meds my prior doc had put me on all in order to avoid putting me on klonopin, which worked for my social anxiety.
>
> The way benzos work, however, is that 2mg of Xanax is equal to 1mg of klonopin. Some doctors don't know this, and even erwoid.org has it as 1mg=1mg, but I've seen the peer-reviewed Medscape iPad app's medication guide, and its comparison table lists it as 2mg of xanax=1mg of klonopin. So if you were on the proper dose of klonopin, it would work-- benzos work that way-- they don't have superior efficacy, where some benzos work bettter than other benzos; it's purely a dosing game.
>
> Besides, who doesn't want a klonopin wafer? And klonopin Wafers are generic, too! =)
>
> Man, I miss my klonopin wafers.... even though they're generic, Medicaid in my state would never justify the extra cost... oh well (I have Medicare + Medicaid, and medicaid in my state pays for benzos). Well, good luck; I don't know enough about your situation to know whether your mania requires treatment, but it sounds like you have a good doc, and maybe you can work with him and give him some time. Just keep in mind these meds take weeks and weeks to work; Aricept didn't work for me for 3 months.Really have never had real manic symptoms. My primary issue is anxiety. Xanax works well for me where nothing else has. Can't take most antidepressant as they increase my anxiety horribly. Mind you I am not new to this. I've been dealind with it forr probably 15 years and have been on my current meds for at least 5 years. That's why the new diagnosis of bipolar disordernstrikes me as odd. Granted it doesn't really matter what you call it if you treat it correctly (except for insurance purposes, in which case bipolar is the kiss of death...) Best to all.
Posted by phidippus on July 14, 2012, at 14:26:50
In reply to weird meds and diagnosis, posted by confused-in-TN on June 30, 2012, at 23:22:17
What is this doc doing to you? Abilify already? propanalol? The Depakote is ok, but the rest is just too much.
Eric
Posted by confused-in-TN on July 24, 2012, at 15:42:24
In reply to Re: weird meds and diagnosis » confused-in-TN, posted by phidippus on July 14, 2012, at 14:26:50
> What is this doc doing to you? Abilify already? propanalol? The Depakote is ok, but the rest is just too much.
>
> EricAbility for depression..propranalol &xanax for anxiety and depakote for a mood stabilizer. Does sound like a lot doesn't it? One year anniversary of my husband's death is Thurs. Having a lot of anxiety/depression now. Guess that's normal. Everyone take care...helpful hints, advice always appreciated.
Posted by phidippus on July 24, 2012, at 17:07:52
In reply to Re: weird meds and diagnosis, posted by confused-in-TN on July 24, 2012, at 15:42:24
Abilify for depression is a weak choice. I would recommend something like Viibryd or Cymbalta.
Eric
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