Posted by cybercafe on July 5, 2002, at 5:25:29
In reply to Re: thank you, posted by EmilyAnn on July 4, 2002, at 15:51:21
> > ***:) the disclaimer is all good. I understand hon! You do seem very well educated on this subject. I think that's very important. We need to know about our illness and the treatments. I do value the opinions and
Yeah it's easy to become well educated when you have so much time on your hands -- and you're motivated to get better :)
> > What would you like to know? I can't tell you what's worked for me 100%, cuz nothing has yet ;)
> > **Is that common? That not med works 100%...I guess it is because therapy is an important component too.I dunno! That's something I'd like to know....
I do think 60 - 70% of people do well enough on their first med to not feel like they need to try another... that sounds promising
> >***The Gapapentin is Neurotin. I was on that for about a month and a half. Still on it, but tapering off...in about a week I'll be off. It seems strange the my new psych would not have me on a mood stabilizer. What I've read on BPIIHow did gabapentin work for you? Make you feel better at all? What type of dose were you taking?
>>shows that a mood stabilizer is crucial and that you have to watch how much of an anti-depressant you take b/c it can induce mania.
Yeah especially for BP type I. If type II just means you get hypomania, it doesn't seem as dangerous. I'm sure it must vary on a person to person basis (and how quickly you can see your doc if you have a problem)
>>But, he said that there are many mood stabilizers I haven't tried and if I need it, we'll try them. It just sucks that I have to try all these meds just to be functional! It's a bit
... well who knows... i'm just happy they're learning more about the meds out there, and inventing better ones too...
plus i expect genome discoveries will allow for much more powerful drugs with much fewer side effects..>>frustrating, as all of you proably know. I'll research Parnate and see what's up with it. I just want to know what's out there so I can work with my psych. in finding the best meds for me (in case the new tx doesn't work).
.... yeah it would be nice to have a systematic method of deciding which drugs to take in which order....
> > ***it's weird. I sleep too much too at times. Esp. when I am depressed. but other times I just can't sleep at all. I guess that's when i'm cycling. Wouldn't it be better to have the 'fun' mania? LOL. Just kidding. But sometimes feeling grandious seems better than being so dang irritalbe and agitated. But all of it is difficult.hey it would definately be better to have the fun mania... as long as you don't go completely nuts .... though i guess it might make it harder to come down... Ug... never is ever simple :(
> >***the mood stabilizers I've tried (depakote and neurotin) have not worked with respect to the cycling. It seems that all meds work for me maybe at 40% and I am able to function a bit better, then they just stop working. I don't
how long do they work for? ... i often wonder if the effets i am getting are just placebo :(
>>think I need an anti-psycotic b/c I 've never experienced those type of symptoms (thank God, my friend who has BP w/ psychotic features, says it bites but his meds are working fine for him now). Do the anti-psychotic meds have any other benefits rather than stopping psychosis?
...yes... zyprexa, for example, is anti-depressant, anti-manic, anti-anxiety, mood-stabilizing ... and anti-psychotic...
some use it alone, some use it with ADs for anti-depressant effect...
> > Alcohol prevents your liver from metabolizing medication for... I believe 56 hours minimum. That's 2.5 days. So if you are drinking every 2.5 days, or more frequently, you may as well just take no medication
> ***Dang, I didn't know that! Hmm, no wonder it was worse when I was drinking alot!.. it's bad stuff man... i definately wouldn't want to risk compromising the effectiveness of my meds...
> ***I've been sober for 5 months (b/c of the program I am in and w/ God's help). It's partly more difficult now b/c I have nothing to 'self-medicate' when I get anxious or depressed. Does that make sense? But when I was drinking, my moods were all messed up too...but I didn't care b/c I was drunk
...it's good you're not drinking anymore...
... i never found i could drink alone, .. but yeah it did help me when i was socializing...> >***no offense taken hon! You are so helpful and very sensitive to others. Great qualities. Are you in a helping profession?
.. i'm flattered that you think so :) ...
...i'd go to med school, but i am way too squeemish :) ...
.. who knows, maybe pharmacy + psychology...
... or i could go into law, and help people sue for mental health services.. that would be cool.. er.. rewarding.. :)problem... if you have substance abuse problems, maybe your doc is reluctant to give you a benzo, but there are other meds available (possibly not as good, but a hell of a lot better than nothing)
> > ***thank you :0) the benzodiapines addictive? I had better steer clear of those then!.... i guess you can always ask your doc what they think...... up here in canada worse case scenario i could get a doc to start out by giving me only 5 days supply... but i suppose you don't have free doctors in the states?? ... how does medicaid work anyways?? ...
> > ***Hell yeah! I think I need to be more assertive w/ my doctors. I tried explaing things to her, but I think I get caught up in the fact that she is a doctor and knows more than me. But, I know myself and what is and is not working...so darn it, I should stick up for myself, huh? Hopefully I will be able to w/ my new Doc.
... i dunno.... i mean you have to deal with this stuff 24/7 and your doc just can't always be there.... so it seems really important that they let you know where you're heading.. and what to expect... i'm sure all doctors would find that reasonable...
> > ***I agree. :) And yeah, anything is better than 0% effective! I am just so fearful that soemthing else won't work or even worse make me sicker.... yeah i hear you.... sometimes i wonder if it might not be better to try something more dangerous under the close supervision of a doctor just to convince myself that drugs do in fact work.... then after a number of weeks go onto something safer...
> *** MAOI's are a bit tricky aren't they? I mean don't you have to watch your diet with those? Well I guess that's a fair trade off for being able to function. I'm happy for you that the Parnate seems to be working for ya. :)
... i havn't really cut anything out of my diet except for marmite .... and i watch out for aged cheese ... which i havn't really come across yet :)
but individual results may vary of course...
> > If you're looking for antidepressants, I can give you a long list of different drugs and strategies you can go over with your doctor
> > **thank you :)Disclaimer: I'm not sure how effective each med or med combo is, so I just guessed :)
Systematic Approach for Choosing an Antidepressant
Consider contributing medical conditions that may contribute to or cause the depressed state.
Use treatment appropriate to the subtype of depression (e.g., nortriptyline in melancholia). (i.e. different symptoms correlate with different neuroreceptor types)
Ensure adequate antidepressant dosage (or if available serum levels) and duration of treatment (at least equal to 4 weeks and 6 preferred).
If a patient had a partial response to an antidepressant and doesn't have significant side effects than increase the dose.
If a patient had no response to an antidepressant than the drug should be discontinued and an antidepressant from another class tried.
If nonresponsive at this point, then a trial with a different class of antidepressant might be attempted or augmentation with lithium or thyroid might be attempted.
Electroconvulsive treatment can be considered after any of these steps.
Lower potential meds:
Stimulant / ADD meds
Anti-Parkinson meds
Anti-cortisol (high urine free cortisol depressives)
Nefazodone
Steroids (only for steroid-induced depression?)
rTMS (repetitive trans-cranial stimulation) (short term relief only?)
Fair response:
Bupropion
Lamictal
Antipsychotic
Lithium
Quite good:
MAOI
Lithium Augmentation
Antipsychotic Augmentation
Lamictal Augmentation
Other Mood stabilizers (Carbamazepine? Keppra?)
Thyroid T3 or T4 Augmentation (increases norepenephrine receptor sensitivity?)
ECT
Opiods (buprenorphine?)Possibly Dangerous:
MAOI + TCAHigh Doses Lethal:
MAOI + TCA + stimulant
MAOI + stimulant
MAOI + stimulant + thyroid hormoneReally Last Resort:
SSRI + Stimulants
SSRI + MAOI
Unknown:
VNS (Vagus Nerve Stimulation)
MST (Magnetic Stimulation Therapy)
> ***I just started the Welbutirn (this time) yesterday (wed).Oh... yeah it's still a little early :)
> > ***you HAVE been of help. and I truly appreciated it.
Thanks :)
> ***I understand. When I can force myself to leave the house, it's usually a good thing that I'm around friends. But it's hard...most of my friends are in the alcoholism recovery program taht I'm in and they are totally great and I love them all, but some do not understand my mental illness and that's difficult.
Hmmm... I don't expect people to understand my illness... I just expect them to be able to have a decent sense of humour :)
poster:cybercafe
thread:111312
URL: http://www.dr-bob.org/babble/20020628/msgs/111458.html