Posted by barbaracat on December 12, 2004, at 16:06:40
In reply to Re: Lithium + ADs? » barbaracat, posted by smith562 on December 11, 2004, at 21:26:08
The question of are the blahs related to the meds or depression is a good one. It could be a little of both, but it sounds like you have an anxiety component and vegetative listless depression is definitely not typical with agitated depression (if that's what your's typically is).
I was on Zoloft for many years and it worked off and on pretty well. But it did cause alot of flattening of mood which at first was great because I was pinging like a live wire with anxiety, but then it got to be very boring. I couldn't cry appropriately or feel much of anything. I sat through an aunt's funeral trying to feel something but mainly feeling bored. The Klonopin is of course adding to your malaise but I'd guess it's the Zoloft.
Are you BP-II? In which case 100mg Zoloft or any SSRI could be problematic. For me, finally admitting I was BP and adding Lithium was like a blessed relief and everything worked better - not perfect though because I still get depressed and anxious, just not the awful mixed states kind.
After trying alot of things, I've found a pharmaceutical brand of St. John's Wort to be the best preventative for depression. It's put out by HBC Protocols and is the best I've found in quality and price. My husband has benefitted greatly from it as well and he didn't even realize he was chronically dysthymic until he started feeling better.
But if you're in a skid or in a definite depression, then SJW will not be enough. Christmas is a very hard time for me since I lost my Mom 2 years ago this month. I was feeling the signs of anxiety, weeping, fatigue, sleeplessness, despair that is much different than appropriate mourning. I started taking 100mg Wellbutrin along with SJW, lithium and occasionally neurontin and ativan. I think it's helping - I notice a definite improvement. No flattening of mood, anxiety or sexual side effects. But I have to watch for signs of hypomania which WB is rumored to cause. On the other hand, I've been reading research papers on how WB has proven to be a very successful AD for bipolars.
So, if you were me, I'd experiment with less zoloft and more lithium. Whatever you can do to reduce the zoloft and Klonopin will help the blahs, and lithium is an antianxiety and AD in its own right. It seems around 900mg is the upper limit of what I can tolerate of lithium, but that's just me. More than that and I get tremors and cognitive problems.
As for the Klonopin, you have to reduce that very slowly, if that's what you want to do, as I'm sure you and your pdoc are aware. Gabapentin, or Neurontin is good for the transition period. I like it also for general anxiety relief, as long as I keep the dose low and don't take it on a regular basis, it's much better than a benzo. Good luck and happy holidays.
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> I seem to need a small dose of lithium to make my ads work (450 mgs). I was on nardil 60 alone ... but I think it made me hypomanic. Now I am on zoloft 100 and lithium 450 and klonopin 1 ... but I feel apathy. My mood is calmer and less anxious, but flat and unmotivated. Have you had this problem? ... is it the meds or the depression?
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> Thank You,
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> Smith
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> > I think you'll find that with lithium, whatever you take will work better and you'll need less. It seems to be a potentiator. Lithium also has a neurogenesis and protective effect in that it actually grows dendrites in the brain. Non-bipolar longevity buffs take low doses of it for this advantage. I feel very fortunate that I can tolerate it because I feel it's doing good for me beyond the miracle it's done for my mood disorder.
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poster:barbaracat
thread:425540
URL: http://www.dr-bob.org/babble/20041211/msgs/428407.html