Posted by Krissy P on April 8, 2003, at 13:59:16
In reply to Re: Moodstabilizers or antipsychotics for BP II? » Krissy P, posted by Ron Hill on April 8, 2003, at 11:32:41
Ron, thank you for this info.
Ok, I felt depressed the 3 days I was on Trileptal, and my ankles swelled up something horrible. Now get this, my damn doc has had a week to get a C-Pass to my insurance company regarding the Trileptal, NO WORD.
I also had to get the Lamictal approved.
Yes, then why did she put me back on Celexa when a second before she took me off Effexor???
I am so sick of this, really, I mean do I need to find a new pdoc, do I stop all meds? I really wonder at this point!
Thanks again and take care Ron,
Kristen
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> 1) Commit yourself to a consistent exercise program. Track your workouts in your daily log (you are keeping a log, right?).
>
> 2) Go to class EVERYDAY and get your homework done. Your future depends on you doing well in school.
>
> 3) In my opinion, you still need to add more mood stabilization to your cocktail. Try to get your insurance company to pay for the Trileptal. If they won't, talk your pdoc into a low dose trial of a slow release lithium product.
>
> 4) I'm not a pdoc, so all of this is just a layman's opinion. However, if I were in your shoes, I would want to work toward the following cocktail:
>
> Establish a therapeutic dose level of a first or second-line moodstabilizer (e.g.; lithium, Depakote, or Trileptal). Since you did poorly on Depakote, this leaves the other two.
>
> Slowly ramp up the Lamictal dose and simultaneously discontinue the SSRI.
>
> Once stabilized on the moodstabilizer and Lamictal, slowly try to remove the AP.
>
> If the ramped-up dose of Lamictal does not provide enough antidepressant effect, then it may be necessary to add an MAOI or, perhaps, an OTC supplement that will treat the depressive side of your BP II.
>
> Lastly, I would then try to discontinue the benzo.
>
> Therefore, the target cocktail that I would shoot for, if I were in your shoes, would be a good moodstabilizer plus a ramped-up Lamictal dose with the possible need to add-on an MAOI or an OTC supplement to treat any residual depression. The difficult part, however, is getting from where you are now (medication-wise) to the target cocktail without getting your brainchemistry all jumbled up during the transition.
>
> This is merely my opinion, and opinions are like butt holes; everybody's got one.
>
> All my best to you Kristen.
>
> -- Ron
>
poster:Krissy P
thread:216188
URL: http://www.dr-bob.org/babble/20030407/msgs/217457.html