Posted by fluffy on September 26, 2003, at 10:51:20
In reply to Re: Barb-cat...or anyone who can help me decide » fluffy, posted by BarbaraCat on September 25, 2003, at 19:08:06
Hi Barb-cat!
***Here we are again! Sorry to the others who's thread we've descended upon...hopefully this is interesting info. How was your vacation? I'm going to answer your questions one by one to clarify to you and myself what my thoughts are....
> So sorry you're feeling crummy, Katy. These ups and downs are so crappy. I sure wish there was a definitive test that could tell us what will work instead of the human dart board method.
***Yes--it is crummy. I was lamenting to my bipolar friend last night about the med trial thing. I said that it feels like we're being offered 5 black pools to jump in, but one or both of them could save you--or they could swallow you whole!--but you won't know until you jump in.
>
> I also am feeling kinda down, little energy, lack of focus and direction. I know if I put a little effort into exercising it would help and take off on it's own steam, but I just don't wanna. I feel too clunky and poopy to navigate the neighborhood. But I know it'll pass eventually - they always do and I come out and think, well, that really wasn't so terrible, it was just the dirty lens I was looking through. But even so, I'd rather be feeling better NOW.***Oh--I know!! I've been dragging myself out of bed in the mornings...I can barely get myself through my yoga. But I always feel better after. Sorry you are feeling low, too. POO POO!!
>
> It sounds like you're not taking lithium any more? I personally think that Lam on it's own isn't enough to handle bipolar depression and you're going to need something else, whatever that may be. But who knows how it is at higher doses? I'm just at 125mg and I've talked with others on this board who say that it really took off at 250mg.
***Nope--no more Li. It just wasn't worth it. I felt like I was 80 yrs. old and confused as hell!! Yeah--actually it occurred to me that maybe just a little bump in the Lam dose would do the trick. So if an addition of a mood stabilizer doesn't work, then maybe another bump up on the Lam.> I have no experience with trileptal, but I just communicated with someone on this board, perhaps this thread even, who mentioned she was on 500mg lamictal and trileptal, and loved it, and needed that much Lam. I'm going to research trileptal and if it looks tolerable I'll talk to my pdoc about it. I'm concerned about lithium's effects on my thyroid and it sounds like you had other bad effects from it. Although it's been a good drug for me, I feel like I need a change of scenery in the med department.
***My decision tree is this: Try the trileptal with Lam. If it don't work, then try Depakote with Lam. If it don't work, but helps my sleep but makes me feel sluggish, then I'll kick the benzo and try an AD or up the Lam. Last resort is the AP's I think.
***It's tough, eh?? You'll never know unless you try...but I hate all that stuff about switching drugs and then coming back to them--"they won't work as well as they did before". As if we needed any more bad news!! But if you switch, I really hope it works better for you. Let us know what and if any changes happen.
> I can't say one way or the other about Lam and Wellbutrin. I was taking Wellbutrin and Zoloft for a while and felt terribly speedy and unstable on it. I just felt wired and still depressed. This was before my bipolar dx so it wasn't a good combo for me without a mood stabilizer. But who knows how Wellbutrin would be with Lam? It's not an SSRI so it might be worth a try, especially if you're feeling like you're dragging. Another thought: you're sure you're bipolar? When is the last time you had a manic/hypomanic swing? Could your manic episodes have been something else? I remember you were on Zoloft for awhile and had pretty good luck with it? If you're actually unipolar depressed, then perhaps an AD along with Lam or another mood-stabilizer would be the way to go.
***Actually, the Zoloft didn't do a damned thing. It was shortly after a mixed state on Lexapro that I was put on the zoloft instead. My doc was convinced that I was unipolar. When I stopped the Zoloft, I felt much better. Too many drugs tap-dancing on my serotonin receptors!! Not good! Then I just had about 4 more months of a bad, but not suicidal depression. THEN I got the bipolar diagnosis.
**I haven't had a CLEAR CUT, long lasting hypomanic episode in awhile. But I definitely had one before my last depressive episode last summer. Couldn't sleep a wink, in love with 3 guys at a time, arguing with people, etc.... Since the SSRI business, I seem to be rapid cycling, and I have a day or two days of hypomania..racing thoughts and irritability, no sleep. Then I have mini depressive episodes for a couple of days. If I'm lucky, then I'll have a normal day or two.
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> Have you ever taken one of the antipsychotics like seroquel, zyprexa, risperdal? Sometimes these act like a mood stabilizer and help where other's don't, but have other side effects, mainly weight gain. I was on Zyprexa for awhile when I was going through the worst of my pre-bipolar dx depressions. This was along with Zoloft. It didn't do a thing for me, but others have good things to say about it.***Hmmm. No--haven't tried the AP's yet. I guess if I get into some deep doo-doo it would be worth a trial.
>
> I was greatly helped this past winter after my Mom died by adding Nortriptyline for 3 months. I didn't like the dry mouth and I developed tremors (these diminished somewhat eventually) which is why I quit but it pretty much saved my life. Sometimes TCA's will work when all else fails in a severe depression. I've read many posts here from people who recommend Nortrip very highly and I agree.***No TCA's yet either. Haven't had a major depressive episode since Lamictal...just rapid cycling, like cyclothymia stuff.
>
> And finally - have you ever tried an opiate like hydrocodone(Vicodin) and felt better immediately? I've gotten on some threads here where there's an effort going on to convince the psychiatric folks that opiates are a potent and quick acting antidepressant and probably better than anything on the market currently. I've been helped alot by taking a Vicodin when I just couldn't stand it anymore but felt I was resorting to junkie-dom. It turns out there's very good reason why it relieves mental anguish - pain is pain, after all. There are new ways of dealing with the tolerance and addiction problems as well. The only major drawback I can see is the dang constipation thing. Ah, so many choices.***I can't say I'm ready for the opiates yet. I do have some vicodin in my cubby from when I had a kidney stone. Nope, not yet.
Let me know what comes out of this - keep in touch, girlfriend. - Barbara
***But of course, Barb-cat!! You as well.
Lovins,
Katy
poster:fluffy
thread:238206
URL: http://www.dr-bob.org/babble/20030923/msgs/263465.html