Posted by jay on December 24, 2001, at 7:21:38
In reply to WHAT TO DO ABOUT BIPOLAR II ????, posted by Geezer on December 23, 2001, at 13:45:06
> DX: Bipolar II,Atypical Depression and Dysphoric Hypomania.
>
> TCAs not acceptable due to adverse side affects.
> SSRI's not acceptable due to ASTHENIA.
> Wellbutrin did nothing, Remeron too sedating, Serzone too sedating, Effexor-will not try due to adverse side affects and Horrable withdrawal. Provigil is nothing more than the rebound depression portion of Dex. Can't take Stims. due to previous abuse. Can not find a pdoc with the intestinal fortitude to try selegiline or Parnate.
> Current Meds:
> Dakakote 750mg.
> Klonopin 1mg
> Ambien 10mg
> Zoloft 25mg
> (I know these are low doses but increases only add to the Asthenia)
> Any suggestions?
Hi:Just a couple of guesses...but it has been suggestedfor BP2 folks to try adding a couple of mood stabalizers together. That way you may be able to lower the Depakote dose. You could try adding Lamactil or Lithium, or or any of the mood stabalizers.
I found Depakote to be helpful only if I was taking a good stimulating a.d. combo, which included both Wellbutrin and Effexor at good, theraputic doses. Otherwise, the Depakote made me depressed as hell. It is the synergistic effect that helps, and though you may have had side-effects from each one individually, you may find the combinations balance each other out. I am a bit skeptical about just using one a.d., especially just an SSRI.
You could also look at adding an atypical antipsychotic. Zyprexa seems the popular choice, but it is best for you to try and find the one you like the best.
Some of the data now seem to indicate it is the combo of meds with various effects on different chemicals that make them work. Since we are all so unique, it is going to take some deep experimenting. Once you get a "bang on" combo, though, you will likely find a major world of difference. Go for it, and you may be very, very suprised! Let us know how you make out.
P.S. Just to note, the two things I think you should really look at are 1)adding a stimulating a.d. to your current combo 2)adding another mood stabalizer.
Jay
poster:jay
thread:87755
URL: http://www.dr-bob.org/babble/20011222/msgs/87801.html