![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 2 to 26 of 26. Go back in thread:
Posted by SLS on June 25, 2015, at 9:35:07
In reply to Lyrica..head in a vise headaches, posted by Phil on June 25, 2015, at 8:10:26
> I was taking 75mg a.m. 75 p.m. Wake up with head pounding. Taking Tylenol and ibuprofen all day long. Doc said just take morning dose. Headache is not as bad today.
> Second problem: this sh*t isn't weight neutral for me. After dropping from 900mg Seroquel to 400mg I'm still gaining weight. My GP has me on 2000mg of Metformin. It's useless this time around. I expect to be taken off of it too.
> I'm sure my doctor will have another pill.What improvements would you like to see in your condition?
Major Depressive Disorder?
Bipolar Disorder?
Generalized Anxiety Disorder?
Post Traumatic Stress Disorder?
Other?
- Scott
Posted by Phil on June 25, 2015, at 10:00:28
In reply to Re: Lyrica..head in a vise headaches » Phil, posted by SLS on June 25, 2015, at 9:35:07
I'm not stable #1. Lyrica has not been weight neutral for me. If I can't lose weight then it will end up being a deal killer. Also, bipolar depression, constant sleeping. It has helped on the sleeping part.
I'm at the point that I'll drop any med I have to to lose weight. It's more a threat to my health than bipolar at this point. I'll suffer if that's what it takes. Just keep clonazepam and Lamictal and ask my doctor to get creative.
Posted by SLS on June 25, 2015, at 12:36:59
In reply to Re: Lyrica..head in a vise headaches » SLS, posted by Phil on June 25, 2015, at 10:00:28
> I'm not stable #1. Lyrica has not been weight neutral for me. If I can't lose weight then it will end up being a deal killer. Also, bipolar depression, constant sleeping. It has helped on the sleeping part.
> I'm at the point that I'll drop any med I have to to lose weight. It's more a threat to my health than bipolar at this point. I'll suffer if that's what it takes. Just keep clonazepam and Lamictal and ask my doctor to get creative.I'm sure you know that Parnate is a good choice for difficult cases of bipolar depression. I lose a bit of weight when I take it. I lose lots of weight when it is combined with desipramine.
How do you react to methylphenidate (Ritalin, Concerta, Metadate, Focalin)?
Interestingly, some people become less anxious and irritable when taking amphetamine. I guess this would be considered a "paradoxical" reaction.
- Scott
Posted by Phil on June 25, 2015, at 13:06:22
In reply to Re: Lyrica..head in a vise headaches » Phil, posted by SLS on June 25, 2015, at 12:36:59
I've done good in the past with Ritalin and others. Concerta sucked. I'm wary of Adderall. I burned some friendships on it but my doc left me at 60 mg while discontinuing Lithium. I really don't know what happened but I got really angry. All email, mostly viscous. But I also thought that I was being cornered by two people telling me stuff they shouldn't have. If you're cornered, you fight. I dunno.
I've thought about asking my doc for Ritalin. Scott, is it a more mellow ride than Adderall. I'm not sure that mellow if the right word. I don't remember flipping out on it.
While I've got you I have another question or story. 1. Misdiagnosed with unipolar dep. for 20 years. But on antidepressants the whole time. 2. Messy nervous breakdown at work in '04. 3. Psychiatrist sent me home and said rest, get 15 minutes of sun a day. I laughed, never got that much sun. Two days later a 30 day hypomania kicked in. Worked in the sun 12 hours a day. Endless ideas - boundless energy. Did the breakdown trigger this or had I not 'noticed' smaller episodes in the past? My current doctor felt that I was manic on my first med, amitriptyline. After he said that I thought, of course, I remember.
Posted by SLS on June 25, 2015, at 14:39:24
In reply to Re: Lyrica..head in a vise headaches » SLS, posted by Phil on June 25, 2015, at 13:06:22
I'll need to think about this for a little while.
The sunlight thing is interesting. It could have produced a shift in your circadian rhythm. Advancing the biological clock can trigger mania. It might be worth looking into whether a sudden rise in vitamin D could account for your experience. I favor the first explanation at this point.
Acute stress can trigger mania. Your "nervous breakdown" at work might be an indicator that such stressors were present. Combining circadian dysruptions and extreme psychosocial stress would be a recipe for the induction of a manic shift in brain function. Being on an antidepressant may have sealed the deal.
Being on Adderall and having an acute mixed-state hypomania emerge upon the discontinuation of lithium would suggest that you are indeed bipolar and that lithium might remain a good mood stabilizer for you. If long-term toxicity (kidneys; thyroid) becomes a concern, you could try something like Trileptal as a substitute. I mention Trileptal because I like what I have seen with it - particularly with mixed-states. It is a very tolerable drug, and weight gain is usually not a problem. Just be aware that hyponatremia (too little sodium in the blood stream) is an infrequent adverse effect that it can be easily monitored for with blood tests. Lamictal sucks for mania. It helps for depression, and possibly rapid cycling. Trileptal + Lamictal make a good combination. You might not even need an antidepressant. However, I would not discontinue what you are already taking at this juncture.
If you need me to clarify anything I wrote or you have more questions, please don't hesitate to ask.
- Scott
Posted by Phil on June 25, 2015, at 15:40:43
In reply to Re: Lyrica..head in a vise headaches » Phil, posted by SLS on June 25, 2015, at 14:39:24
> I'll need to think about this for a little while.
>
> The sunlight thing is interesting. It could have produced a shift in your circadian rhythm. Advancing the biological clock can trigger mania. It might be worth looking into whether a sudden rise in vitamin D could account for your experience. I favor the first explanation at this point.But I was manic before I stepped into the sun. I've talked about this a lot. When I opened my door that morning, I couldn't wait to start yard work. Heavy duty stuff. Knee high weeds etc. Asking my neighbor if I could detail her car. Telling another, damn you're fine. Asking another neighbor if I could work on his yard...it looked like a jungle then, after I got finished, looked like Pebble Beach golf course. I just don't do those things. Otherwise it was the best month of my life. It happened in April. A really bad time for suicides although I was definitely not suicidal.
>
> Acute stress can trigger mania. Your "nervous breakdown" at work might be an indicator that such stressors were present. Combining circadian dysruptions and extreme psychosocial stress would be a recipe for the induction of a manic shift in brain function. Being on an antidepressant may have sealed the deal.That. ^^^^ I've also had say 10 days of 2 hours sleep a night and not realizing it. Not in a long time though.
He took me off of Lithium 'out of the blue.' I later asked him why. He said because of my tremors(I couldn't write) I don't buy it. I had tremors for years. I don't know that I got the full story but he wasn't concerned with my blood work.
>
> Being on Adderall and having an acute mixed-state hypomania emerge upon the discontinuation of lithium would suggest that you are indeed bipolar and that lithium might remain a good mood stabilizer for you. If long-term toxicity (kidneys; thyroid) becomes a concern, you could try something like Trileptal as a substitute. I mention Trileptal because I like what I have seen with it - particularly with mixed-states. It is a very tolerable drug, and weight gain is usually not a problem. Just be aware that hyponatremia (too little sodium in the blood stream) is an infrequent adverse effect that it can be easily monitored for with blood tests. Lamictal sucks for mania. It helps for depression, and possibly rapid cycling. Trileptal + Lamictal make a good combination. You might not even need an antidepressant.I thought antidepressants were a bad idea w/ bipolar...unless I was stabilized. He hasn't even discussed one and I haven't brought it up.
However, I would not discontinue what you are already taking at this juncture.
I'm staying the course for now. Would Lamictal, Clonazepam, Trileptal be a good combo with added Ritalin? As I dropped the dose on Lyrica I'm back to 2 hour naps(today). Although the headache is not as bad as it was..yet, anyway.
>
> If you need me to clarify anything I wrote or you have more questions, please don't hesitate to ask.My doctor still has bipolar I for me. I think there's some truth to that but I feel that I'm BPII. To me, it's the most accurate. I need to ask him about that again. I've never had a mania where anyone, including myself, was in danger. Although I had a half-hearted suicide attempt but I felt more hypomanic(even giddy) when it happened. I wasn't depressed. That episode landed me in the psych ward after I called him. The doctor there lowered my Lithium and Seroquel. When I saw my doc the next time, he upped both doses back to where they were. ACKKK.
I'm definitely bipolar..no doubt, but the lines are blurry to me. I don't think about it much. I just want to get better. BTW, the Lyrica is stimulating to me. I'm writing a lot more than usual.
>
>
> - Scott
Posted by Phil on June 26, 2015, at 8:25:22
In reply to Re: Lyrica..head in a vise headaches » Phil, posted by SLS on June 25, 2015, at 14:39:24
This was very helpful, Scott. Appreciate it.
Posted by SLS on June 26, 2015, at 8:50:53
In reply to Re: Lyrica..head in a vise headaches, posted by Phil on June 25, 2015, at 15:40:43
Just a quick follow-up:
I think your doctor is right regarding his diagnosis of Bipolar I. From your descriptions, your mania has demonstrated episodes of severity that do not occur in Bipolar II. Lithium seems to be particularly effective in Bipolar I.
Lack of sleep - sleep deprivation - can induce mania when it is not already present.
Mania often produces reduced need for sleep. 3 hours a day is very common as a maximum that still allows someone to feel rested and have boundless energy.
- Scott
Posted by Phil on June 26, 2015, at 11:18:56
In reply to Re: Lyrica..head in a vise headaches, posted by SLS on June 26, 2015, at 8:50:53
Awesome Scott, thanks. We have a tough diagnosis yet you speak with a consistent, educated voice. I'd love to see you blogging but there's only so much that one man can do.
Posted by SLS on June 26, 2015, at 12:36:39
In reply to Re: Lyrica..head in a vise headaches » SLS, posted by Phil on June 26, 2015, at 11:18:56
> Awesome Scott, thanks. We have a tough diagnosis yet you speak with a consistent, educated voice. I'd love to see you blogging but there's only so much that one man can do.
Thank you, Phil. That means a lot to me.
- Scott
Posted by Phil on June 28, 2015, at 16:10:14
In reply to Re: Lyrica..head in a vise headaches » Phil, posted by SLS on June 26, 2015, at 12:36:39
Headache wins. Can't take another day of this. Dropping to 75 mg didn't help. 800 mg of ibuprofen is what it takes to make it go away. I think it would have helped.
Posted by Lamdage22 on June 29, 2015, at 15:19:21
In reply to Re: Lyrica..head in a vise headaches » SLS, posted by Phil on June 25, 2015, at 10:00:28
> I'm at the point that I'll drop any med I have to to lose weight. It's more a threat to my health than bipolar at this point.
What a healthy realization. Congrats!
You are a lone species in this forum.
Posted by Lamdage22 on June 29, 2015, at 15:20:28
In reply to Re: Lyrica..head in a vise headaches » Phil, posted by SLS on June 25, 2015, at 12:36:59
Oh and now people are recommending speed to you.
Well just type in "meth heads" in google and see if you want that.
Posted by SLS on June 29, 2015, at 16:43:25
In reply to Re: Lyrica..head in a vise headaches, posted by Lamdage22 on June 29, 2015, at 15:20:28
> Oh and now people are recommending speed to you.
That could be bad. I don't know who or what you are talking about, but why would that be bad for Phil specifically?
In which post did someone recommend to Phil that he take "speed"? Would you please post the URL link here?
Here is an example:
http://www.dr-bob.org/babble/20150520/msgs/1079973.html
Thank you.
- Scott
Posted by Phil on June 29, 2015, at 18:46:27
In reply to Re: Lyrica..head in a vise headaches, posted by Lamdage22 on June 29, 2015, at 15:20:28
I think you might be misunderstanding something. I always make my own decisions. Me and my doctor. I ask for help here but I don't stop here. We all get frustrated, don't we? There's nothing to see here. There's no need to get upset.
Posted by Lamdage22 on June 30, 2015, at 2:25:03
In reply to Re: Lyrica..head in a vise headaches » Lamdage22, posted by SLS on June 29, 2015, at 16:43:25
Well isnt amphetamine technically speed?
Posted by SLS on June 30, 2015, at 7:17:07
In reply to Re: Lyrica..head in a vise headaches, posted by Lamdage22 on June 30, 2015, at 2:25:03
> Well isnt amphetamine technically speed?
Yes. I am curious who recommended amphetamine to Phil?
Even so, I don't think it is terribly helpful to infer that anyone taking D-amphetamine for mental illness is a "meth head" (methamphetamine). Methylphenidate is not methamphetamine. They are very different drugs chemically and functionally.
- Scott
Posted by Phil on June 30, 2015, at 13:39:55
In reply to Re: Lyrica..head in a vise headaches » Lamdage22, posted by SLS on June 30, 2015, at 7:17:07
I've been on practically every stimulant made, including meth 35 years ago. Never looked like a meth addict. I had some control. I used it off and on for a few years. I think it's the worst drug on the planet. I was lucky.
The only stim I want to try again is Ritalin but not yet. I want to see what happens with Seroquel 400mg, clonazepam 1.5mg and lamotrigine 300mg. Today is my first day off of Lyrica and I feel fine.
Posted by Lamdage22 on June 30, 2015, at 14:54:30
In reply to Re: Lyrica..head in a vise headaches » Lamdage22, posted by SLS on June 30, 2015, at 7:17:07
> > Well isnt amphetamine technically speed?
>
> Yes. I am curious who recommended amphetamine to Phil?
>
> Even so, I don't think it is terribly helpful to infer that anyone taking D-amphetamine for mental illness is a "meth head" (methamphetamine). Methylphenidate is not methamphetamine. They are very different drugs chemically and functionally.
>
>
> - ScottWell then i misunderstood.
Id still never take stuff like that.
Posted by Phil on June 30, 2015, at 15:22:43
In reply to Re: Lyrica..head in a vise headaches, posted by Lamdage22 on June 30, 2015, at 14:54:30
"Id still never take stuff like that."
No one asked you to. Same thing I said about Lamictal and antipsychotics.
Posted by 10derheart on June 30, 2015, at 16:24:37
In reply to Re: Lyrica..head in a vise headaches, posted by Lamdage22 on June 30, 2015, at 14:54:30
I think maybe you might if your life was a wreck from uncontrolled ADD/ADHD
and you were desperate to be able to function,
to remember anything short term,
to organize anything,
to complete anything,
to start anything,
to not live in overwhelming clutter,
to not lose your keys day after day, after day, after day....,
to not make your teenaged child act as your parent
to read for more than 5 mins without being bored,
to not glance at each and every "squirrel,"
to tolerate all the million noises no one else hears,
to not leave a store without your groceries after being overwhelmed by choices, colors, stuff,
and so very much more.You might. That was me prior to 2002. Ritalin produced a near-miracle where I was in tears when my mind calmed and my thoughts quit swirling and I could ATTEND or not, to WHAT I CHOSE....and I had tears in my eyes, saying, "You mean THIS is what other people's minds are like??!!""
Yeah, you might take "stuff like that." I understand it must be hard to imagine if you have never experienced the extreme efficacy of a stimulant, doing what it is prescribed to do.
My thought is... never say never.
Posted by 10derheart on June 30, 2015, at 16:26:19
In reply to Re: Lyrica..head in a vise headaches » Lamdage22, posted by SLS on June 30, 2015, at 7:17:07
Posted by 10derheart on June 30, 2015, at 16:28:09
In reply to Re: Lyrica..head in a vise headaches, posted by Phil on June 30, 2015, at 13:39:55
That sounds good, Phil. Keep the faith. I like how you just press on, against all odds. I like that you hang around here. I keep looking for your posts.
Posted by SLS on June 30, 2015, at 19:31:44
In reply to Re: Lyrica..head in a vise headaches, posted by Phil on June 30, 2015, at 13:39:55
> I've been on practically every stimulant made, including meth 35 years ago. Never looked like a meth addict. I had some control. I used it off and on for a few years. I think it's the worst drug on the planet. I was lucky.
> The only stim I want to try again is Ritalin but not yet. I want to see what happens with Seroquel 400mg, clonazepam 1.5mg and lamotrigine 300mg. Today is my first day off of Lyrica and I feel fine."That sounds good, Phil. Keep the faith. I like how you just press on, against all odds. I like that you hang around here. I keep looking for your posts."
I agree with 10derheart.
Good luck, Phil.
- Scott
Posted by Phil on June 30, 2015, at 21:30:35
In reply to Re: Lyrica..head in a vise headaches » Phil, posted by 10derheart on June 30, 2015, at 16:28:09
Thanks 10derheart and Scott. I wish things were easier. I wish my first psychiatrist was right 30 years ago when he said, 'we should get you through this in six months.' I googled him a few weeks ago. Dr Potterf in San Antonio. He had died at the age of 72 and I'm still taking pills. He was a great guy. Bad with time, but a good guy. RIP Dr P.
http://www.legacy.com/obituaries/sanantonio/obituary.aspx?n=raymond-potterf&pid=169806534&;
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.