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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 HappyGirl on April 22, 2014, at 10:14:28
Hello:
I've been on four different meds. to control my BP II with rapid cycler for more than 15 years, ... Zyprexa/Olanzapine 5 mg., Bupropion 150 mg. bid, Trazodon 100 mg. one for before bed. along with Lithium 300 mg. tid.
Recently, however my mood-swing getting more often during the day, then I increased double-dosage to 10 mg.(2/5mg. per day) and my mood-swing getting better.
However, 'morning sluggishness,' my depression is still there. I can not tolerate any of SSRIs.
Just wondering whether there is/are new form of anti-depressants which might alleviate the depression side of my Bipolar II?
Thanks for any help on this in advance.
Posted by Louisiana Sportsman on April 22, 2014, at 14:12:49
In reply to Any new Anti-depressant is available?, posted by HappyGirl on April 22, 2014, at 10:14:28
Zyprexa/Olanzapine 5 mg., Bupropion 150 mg. bid, Trazodon 100 mg. one for before bed. along with Lithium 300 mg. tid.
>
> Recently, however my mood-swing getting more often during the day, then I increased double-dosage to 10 mg.(2/5mg. per day) and my mood-swing getting better.
>
> 'morning sluggishness,' my depression is still there. I can not tolerate any of SSRIs.
> alleviate the depression side of my Bipolar II?
>The olanzapine 10mg. is likely the main culprit here for the morning sluggishness.
There is an atypical antipsychotic approved for bipolar depression, that is fairy new, called Latuda (lurasidone [Sunovion]). I believe it superior to all APs.
Check out this study that compares Latuda to Zyprexa:
http://www.ds-pharma.com/ir/library/presentation/pdf/eir20110125_1.pdf
*insulin, glucose, lipid, and weight change are positive with Latuda and very negative with Zyprexa
Also, Latuda has:
*least QT interval prolongation, no warning about it required
*little weight gain, some studies showed weight loss compared to placebo
*less metabolic risk; better with cholesterol, hdl, ldl, triglycerides, prolactin and glucose, some studies showed loss in all categories compared to placebo
*little sedation, some studies showed less sedationI'd consider switching your AP before adding in an anti-depressant, and I believe the best choice is Latuda. Talk to your doctor.
Posted by phidippus on April 24, 2014, at 18:35:57
In reply to Any new Anti-depressant is available?, posted by HappyGirl on April 22, 2014, at 10:14:28
>Lithium 300 mg. tid.
I doubt this provides any therapeutic value.
>my mood-swing getting more often during the day, then I increased double-dosage to 10 mg.
Why did you decide to raise your Zyprexa rather than your Lithium-this may be the reason your depression is still there. Zyprexa does nothing to treat the depressive aspects of your disorder, but Lithium does.
>Just wondering whether there is/are new form of anti-depressants which might alleviate the depression side of my Bipolar II?
There are a couple of things you can do: 1. Raise your Lithium-this may help with your depression 2. Add on Lamictal, 200 mgs-This is another mood stabilizer with strong antidepressant qualities. 3. Add on Riluzole.
Why can't you tolerate SSRIs?
Eric
Posted by LouisianaSportsman on April 25, 2014, at 20:48:07
In reply to Re: Any new Anti-depressant is available? » HappyGirl, posted by phidippus on April 24, 2014, at 18:35:57
I just assumed her lithium would be in the therapeutic range per a blood test, I'm not really familiar with the dosages of lithium.
Riluzole is pretty affordable under my insurance, but I don't have a stabilization problem. Always something I've wanted to try. Looks good on paper, but I've read mostly negative anecdotal reports about it.
Posted by phidippus on April 26, 2014, at 20:05:39
In reply to Re: Any new Anti-depressant is available? » phidippus, posted by LouisianaSportsman on April 25, 2014, at 20:48:07
Riluzole shows some positive results in treating bipolar depression.
I was on a for a bit and found it helped with my mood.
Eric
Posted by Zyprexa on April 28, 2014, at 23:31:03
In reply to Any new Anti-depressant is available?, posted by HappyGirl on April 22, 2014, at 10:14:28
Hi, happygirl!
Have not seen you on here in a while. They have a 7.5mg zyprexa. Or you can cut the pills. I take 15mg zyprexa now, with sertraline,that's my AD.I also take wellbutrin for sluggish ness. And lots of caffeine, seems to do the trick. I'm also taking perphenazine now. Do you take the zyprexa generic now? I do I kinda like it better. It has no weight gain. I take teva.
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