Posted by Scott L. Schofield on April 18, 2000, at 9:58:36
In reply to Re: Any happy, stable rapid cyclers out there? , posted by Jan on April 17, 2000, at 23:15:54
> I am a rapid cycler "in remission" I guess you could call it. I never take antidepressants to lower the chance of an episode. I'm bipolar 1 on Tegretol and Lithium and Seroquel at present. I spent over 3 years on Depakote ending in 3 hospitalizations and 100 pounds of excess weight. I find that with each episode of rapid cycling, it gets worse. As in quicker changes and more severe. But I am getting wiser as to how to handle myself, to some extent. I go weeks sometimes without a problem that lasts typically a week.
Hi Jan.How are you today?
Are you happy with the way things are going? If so, please disregard the rest of the following:
Are you still cycling?
Can you describe your cycle in detail:
1. How often does the cycle run its full course?
2. In what order do the different phases occur?
- Normal -> Mania -> Depression
- Normal -> Depression -> Mania
3. How long does each phase last?
4. For what reason were you hospitalized?
5. How would you describe your manic state?
- Euphoric?
- Psychotic?
- Mixed State?
- Hypomanic?
- What sorts of things do you do while in a manic state?
6. Do you feel that Tegretol is contributing to the improvement in you condition? Why?If you are still cycling, it is CRITICAL that you find a treatment to abolish or minimize it as much as possible. As you have already seen, things become worse if cycling is allowed to continue.
Treatment with a combination of mood-stabilizers is probably necessary. Lithium seems to be filling its role as well as can be expected in a rapid-cycling presentation. I would keep it. There is no reason why three mood-stabilizers cannot be used, and sometimes seems to be necessary when treating rapid-cyclicity.
Adding Tegretol was a good choice.Obviously, Depakote is not a good choice for you. I’m going to try to check out a paper recently written by the Department of Psychobiology of the NIMH division of the NIH. It was published in the Journal of Clinical Psychopharmocology. From what I understand, it is a summary of a decade’s worth of experience in treating difficult cases of depression and bipolar disorder. They always emphasize the utility of polypharmacy. I read some of their stuff a few years ago. They seemed to like the lithium-Tegretol combo, but commented that the addition of Neurontin or Lamictal may be a good idea if rapid-cycling continues.
If I manage to find the article, I’ll post something about it.
- Scott
poster:Scott L. Schofield
thread:30276
URL: http://www.dr-bob.org/babble/20000411/msgs/30445.html