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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 38 to 62 of 948. Go back in thread:
Posted by nora scott on May 12, 2001, at 15:56:49
In reply to I need to buy more dexedrine , posted by nora scott on June 2, 2000, at 20:22:24
This is still the case as of May 2001, so xxx
thanks!
Posted by Heidi Garraghty on August 2, 2001, at 11:47:46
In reply to Cyclothymia & mood stabilizers, posted by andrewb on August 7, 1999, at 10:33:51
Apparently, people have had very good experiences with Wellbutrin for this, 150 mg at the low dose, since it helps with the depression but does not spur manic episodes, although in your case, that doesn't sound as if it would be too bad.
Wellbutrin is the lightest of the drugs, I think. From a clinical perspective, its most serious side effect, seizures, is only a concern for individuals who have a history of anorexia and bulemia. Even so, there are some alternative viewpoints out there that suggest any of these drugs, including Wellbutrin, have serious effects with certain people--including extreme mood alteration--and you don't, of course, know if you're one until you start taking it. Doctors may be insufficiently educated or open-minded to patient reports of such changes, so it's a risk-filled choice.
It sounds to me as though your symptoms are very mild and probably aid you (in your mild mania) more than you are hindered (in your mild depression), so is it really necessary to medicate into a plateau?
Posted by Sheree73 on August 27, 2001, at 9:31:30
In reply to Re: Cyclothymia mood stabilizers, posted by Heidi Garraghty on August 2, 2001, at 11:47:46
I have just been diagnosed with Cyclothymic disorder. When I read the description of this diagnosis, I allmost expected to see a picture of me...or at least my name. It is accurate.
I've been battling with mood instability for years but recently it's been getting out of hand. I have major crying jags, loss of motivation, extreme bouts of sadness & loneliness and severe insomnia (with nightmares if & when I do sleep).
Last week I saw an intelligent & perceptive psychiatrist for the 1st time. She's the one who diagnosed me & she prescribed Neurontin (& Ambien for the insomnia).
Neurontin is a mood stabilizer. Effexor, an antidepressant seemed to have no positive effect-my symptoms of depression skyrocketed.
It's way too early to tell since I've taken Neurontin for less than a week now but I actually felt some degree of relief within 24hrs. This is great! It took months to determine that Effexor was a failure!
I'm still a bit concerned that "stabilizing" my moods will take away too much of the elation/joy/euphoria that I have enjoyed. But the trade off - bouts of what feels like - severe depression are too much for me.
Good luck in finding what works for you. I hope this is helpful or at least interesting to anyone out there who's suffering or knows anythone who is.
Posted by ThatGuyJohn on September 7, 2001, at 17:05:40
In reply to Cyclothymia & mood stabilizers, posted by andrewb on August 7, 1999, at 10:33:51
Hey. I've been looking around for info on this subject as well. My condition is essentially major depression with hypomania. Like a lot of you here, I sort of came to enjoy the highs. I make a living in a creative field, and I think that tendency toward mild mania has helped me at times.
Now here's my question: I first came to see my shrink when I was really in a hole, and suicidal. We talked for a while and he suggested that I may have a cyclical problem, but without any tendency toward really dangerous full-blown mania.
He prescribed Wellbutrin, which from everything I've been reading, can activate mania. But it really evened me out. The depression was soon under control to the point that talk therapy could do me some good, but I didn't feel any of the mania that I have since learned is typical of this drug.
Since then, a few years ago, I have had some anxiety attacks, so we added Celexa and Trazodone to the mix. That combination in particular seems to have a very sedating effect, and I feel a lot less "spikey" the day after.
Anybody else have an experience like mine, stabilizing on simple anti-ds?
Posted by SalArmy4me on September 8, 2001, at 3:26:43
In reply to Re: Cyclothymia mood stabilizers, posted by ThatGuyJohn on September 7, 2001, at 17:05:40
A doc on Psychopharmacology Tips says bipolars (and probably cyclothymics too) do well on Wellbutrin:
From Psychopharmacology Tips: http://www.dr-bob.org/tips/split/Possible-indications-of-bi.html
From: LJGROLD@aol.com (L.James Grold M.D.)
Date: Fri, 16 Feb 1996 20:40:31 -0500
Subject: Possible indications of bipolarityI have come to the same conclusion on several patients with recurrent depressions starting in adolescence. I also have found in such patients that venlafaxine and buproprion with a mood stablizer like divalproex to be very helpful in smoothing out the moods and in preventing more cycles.
Posted by ThatGuyJohn on September 8, 2001, at 11:51:52
In reply to Re: Cyclothymia mood stabilizers » ThatGuyJohn, posted by SalArmy4me on September 8, 2001, at 3:26:43
Hey, thanks for that link, Sal. I am very new to this site, and just beginning to get a sense of the resources available here.
I kinda questioned the logic of taking a straight anti-d when I have that tendency to swing up. But my best friend's little brother was treated with an activating drug for his attention deficit hyperactivity disorder. This kid was a bundle of energy to begin with -- but on the meds he actually evened out.
And I had the same immediate, really good response to Wellbutrin that the doc describes. In less than a week, I felt fantastic. I chalked it up to a placebo response then. Uh-oh... :-)
So, BPs have a uniquely screwy chemistry, different from depressives? I don't know a lot about biochemistry, but am I right in drawing that conclusion? (And "screwy" probably isn't a diagnostic term, right?)
I am sober, no recreational drugs or booze for 9 years, but a pal gave me a couple Klonopin for a very long flight. And it did nothing to sedate me. Maybe I'll just down a handful of speed next time, and I'll be out like a light.JUST KIDDING!
Posted by lostsailor on September 16, 2001, at 17:14:24
In reply to Re: Cyclothymia mood stabilizers, posted by ThatGuyJohn on September 8, 2001, at 11:51:52
Hey, here's a little info. Of the newer anti-depressents, only Wellburerin is really indicated often in the literature. Often, people with bp are given an ad only during a depressive episode and than taken off when it subsides or resolves it self. My doc, and I did the wellbutin/ celexa thing for quite a while, but I am also kept on a mood stabelizer (currently Neurontin)
As for Trazadone, I had a doc once tell me that he would not give to a dog. My shrink prescribes it often for sleep and I used it for a year , but could no longer tolerate the "hangover" I would have in the morning. I tried a bunch of meds for insomnia and found that benadryl worked the best. I told him that and wrote a script for aterax (both aterax and visteral are the same a benadral and are give to some for anxiety)so my insurence would cover the cost. Hope this was a help! In Peace, ~Tony> Hey, thanks for that link, Sal. I am very new to this site, and just beginning to get a sense of the resources available here.
>
> I kinda questioned the logic of taking a straight anti-d when I have that tendency to swing up. But my best friend's little brother was treated with an activating drug for his attention deficit hyperactivity disorder. This kid was a bundle of energy to begin with -- but on the meds he actually evened out.
>
> And I had the same immediate, really good response to Wellbutrin that the doc describes. In less than a week, I felt fantastic. I chalked it up to a placebo response then. Uh-oh... :-)
>
> So, BPs have a uniquely screwy chemistry, different from depressives? I don't know a lot about biochemistry, but am I right in drawing that conclusion? (And "screwy" probably isn't a diagnostic term, right?)
>
> I am sober, no recreational drugs or booze for 9 years, but a pal gave me a couple Klonopin for a very long flight. And it did nothing to sedate me. Maybe I'll just down a handful of speed next time, and I'll be out like a light.
>
> JUST KIDDING!
Posted by Carter on December 14, 2001, at 14:50:40
In reply to Re: Cyclothymia mood stabilizers, posted by lostsailor on September 16, 2001, at 17:14:24
> Hey, here's a little info. Of the newer anti-depressents, only Wellburerin is really indicated often in the literature. Often, people with bp are given an ad only during a depressive episode and than taken off when it subsides or resolves it self. My doc, and I did the wellbutin/ celexa thing for quite a while, but I am also kept on a mood stabelizer (currently Neurontin)
> As for Trazadone, I had a doc once tell me that he would not give to a dog. My shrink prescribes it often for sleep and I used it for a year , but could no longer tolerate the "hangover" I would have in the morning. I tried a bunch of meds for insomnia and found that benadryl worked the best. I told him that and wrote a script for aterax (both aterax and visteral are the same a benadral and are give to some for anxiety)so my insurence would cover the cost. Hope this was a help! In Peace, ~Tony
>
> > Hey, thanks for that link, Sal. I am very new to this site, and just beginning to get a sense of the resources available here.
> >
> > I kinda questioned the logic of taking a straight anti-d when I have that tendency to swing up. But my best friend's little brother was treated with an activating drug for his attention deficit hyperactivity disorder. This kid was a bundle of energy to begin with -- but on the meds he actually evened out.
> >
> > And I had the same immediate, really good response to Wellbutrin that the doc describes. In less than a week, I felt fantastic. I chalked it up to a placebo response then. Uh-oh... :-)
> >
> > So, BPs have a uniquely screwy chemistry, different from depressives? I don't know a lot about biochemistry, but am I right in drawing that conclusion? (And "screwy" probably isn't a diagnostic term, right?)
> >
> > I am sober, no recreational drugs or booze for 9 years, but a pal gave me a couple Klonopin for a very long flight. And it did nothing to sedate me. Maybe I'll just down a handful of speed next time, and I'll be out like a light.
> >
> > JUST KIDDING!Hi to who ever reads this. This is the first time I have offered any of my own experience about my psychosis...cyclothymia, just like the rest. First off let me say that I take a very humorous approach to myself. I mean I am serious, but my friends and refer to my meds as my "crazy pills" and when I have a therapy appointment, it's an appointment with my "crazy doctor." Anyway, I have been actively treated for about a year and a half (both with medications and psyhcotherapy). And I looked at this site several times. My psychiatrist put me on Wellbutrin AND Zyprexa (to even me out fast), I was in a not so good place. The wellbutrin has and continues to work for me. However, a word of caution about Zyprexa, if you take Zy be prepared to have all of your energy zapped out. It really muted my personality. When I told my dr. this, we went down from 5mg to 2.5mg. I also gained about 15 pounds with the Zyprexa...which I was happy about. Well when I came off of the zyprexa, just two months later, I had no idea of the side effects that would ensue. I became nauseated...all the time. I felt like crap. I had no idea that I would have withdrawl from it. My 15 lbs. dropped right back off...quickly. I was worried about it so I tried to research on the net, but like this subject all together there is little information out there. After I 'recovered' from that, my doc wanted me to go on a mood stabilizer...Depakote. When she told me about it she highlighted the side effects and the fact that I would have to have my blood checked regularly to ensure it wasn't damaging my liver. That scared the crap out me...not the part about having my blood checked...burning out my liver. So I made a proposal..."Let's see how things go with just the wellbutrin for a while and we'll go from there." She agreed and until about June I was only on Wellbutrin. Then I noticed my moods changing more and my irritability coming out. I even snapped at the boss a couple of times. Luckily for me, he's a rapid cycling unipolar and completely understood. So I called my doc. and she called in the Depakote for me. I've been taking it ever since and I have to say it has worked pretty well. I do have my occasional mood, but for the most part I am level. Now the down side of the Depakot is it really makes me drowsy. It's pretty powerful. I take it at night before bed (as prescribed) and I sometimes still have a tough time getting up...but I don't have that 'hung-over' feeling. It's just sleepy. A hint to anyone taking it, or about to...I try to take it early in the evening. If I am in for the evening I usually take it around 8:00. But I am sure it will react with most of us differently. Sorry that was so long. Good luck to all. Just one more thing. To those of you who only let your closest friends in on your secret; isn't it interesting to hear how people talk about others who aren't so guarded? I have been in the company of people who have said, in a group, things like "I think she needs to have her medication adjusted." Or "He needs to have his dosage pumped up." All the while standing right beside them is one such individual taking said medications. Just a side thought.
Posted by Mitch on December 14, 2001, at 19:53:56
In reply to Re: Cyclothymia mood stabilizers, posted by Carter on December 14, 2001, at 14:50:40
> Hi to who ever reads this. This is the first time I have offered any of my own experience about my psychosis...cyclothymia, just like the rest. First off let me say that I take a very humorous approach to myself. I mean I am serious, but my friends and refer to my meds as my "crazy pills" and when I have a therapy appointment, it's an appointment with my "crazy doctor." Anyway, I have been actively treated for about a year and a half (both with medications and psyhcotherapy). And I looked at this site several times. My psychiatrist put me on Wellbutrin AND Zyprexa (to even me out fast), I was in a not so good place. The wellbutrin has and continues to work for me. However, a word of caution about Zyprexa, if you take Zy be prepared to have all of your energy zapped out. It really muted my personality. When I told my dr. this, we went down from 5mg to 2.5mg. I also gained about 15 pounds with the Zyprexa...which I was happy about. Well when I came off of the zyprexa, just two months later, I had no idea of the side effects that would ensue. I became nauseated...all the time. I felt like crap. I had no idea that I would have withdrawl from it. My 15 lbs. dropped right back off...quickly. I was worried about it so I tried to research on the net, but like this subject all together there is little information out there. After I 'recovered' from that, my doc wanted me to go on a mood stabilizer...Depakote. When she told me about it she highlighted the side effects and the fact that I would have to have my blood checked regularly to ensure it wasn't damaging my liver. That scared the crap out me...not the part about having my blood checked...burning out my liver. So I made a proposal..."Let's see how things go with just the wellbutrin for a while and we'll go from there." She agreed and until about June I was only on Wellbutrin. Then I noticed my moods changing more and my irritability coming out. I even snapped at the boss a couple of times. Luckily for me, he's a rapid cycling unipolar and completely understood. So I called my doc. and she called in the Depakote for me. I've been taking it ever since and I have to say it has worked pretty well. I do have my occasional mood, but for the most part I am level. Now the down side of the Depakot is it really makes me drowsy. It's pretty powerful. I take it at night before bed (as prescribed) and I sometimes still have a tough time getting up...but I don't have that 'hung-over' feeling. It's just sleepy. A hint to anyone taking it, or about to...I try to take it early in the evening. If I am in for the evening I usually take it around 8:00. But I am sure it will react with most of us differently. Sorry that was so long. Good luck to all. Just one more thing. To those of you who only let your closest friends in on your secret; isn't it interesting to hear how people talk about others who aren't so guarded? I have been in the company of people who have said, in a group, things like "I think she needs to have her medication adjusted." Or "He needs to have his dosage pumped up." All the while standing right beside them is one such individual taking said medications. Just a side thought.
Hi Carter,
The bizarro thing I can add is I am bipolarII and so is my BOSS (and a couple of other coworkers-it seems that BP folks coalesce somehow)! Everybody knows about my boss's meds/troubles, but I haven't told anyone where I work. You are right-once people in a workgroup know about it they start ascribing any change as something related to meds not working, different meds, skipping meds, etc. I just don't want to be treated as a chemical abstraction.
Now I am on Neurontin/Klonopin/Wellbutrin/Celexa and it thus far has been the best combo for me. Depakote seems to aggravate depression. Lithium is OK, but it dulls my cognitive functioning too much. I find that the Wellbutrin *can* induce some irritability-but in my case I just become more assertive and don't take crap.
Mitch
Posted by Carter on December 17, 2001, at 8:01:24
In reply to Re: Cyclothymia mood stabilizers » Carter, posted by Mitch on December 14, 2001, at 19:53:56
> > Hi to who ever reads this. This is the first time I have offered any of my own experience about my psychosis...cyclothymia, just like the rest. First off let me say that I take a very humorous approach to myself. I mean I am serious, but my friends and refer to my meds as my "crazy pills" and when I have a therapy appointment, it's an appointment with my "crazy doctor." Anyway, I have been actively treated for about a year and a half (both with medications and psyhcotherapy). And I looked at this site several times. My psychiatrist put me on Wellbutrin AND Zyprexa (to even me out fast), I was in a not so good place. The wellbutrin has and continues to work for me. However, a word of caution about Zyprexa, if you take Zy be prepared to have all of your energy zapped out. It really muted my personality. When I told my dr. this, we went down from 5mg to 2.5mg. I also gained about 15 pounds with the Zyprexa...which I was happy about. Well when I came off of the zyprexa, just two months later, I had no idea of the side effects that would ensue. I became nauseated...all the time. I felt like crap. I had no idea that I would have withdrawl from it. My 15 lbs. dropped right back off...quickly. I was worried about it so I tried to research on the net, but like this subject all together there is little information out there. After I 'recovered' from that, my doc wanted me to go on a mood stabilizer...Depakote. When she told me about it she highlighted the side effects and the fact that I would have to have my blood checked regularly to ensure it wasn't damaging my liver. That scared the crap out me...not the part about having my blood checked...burning out my liver. So I made a proposal..."Let's see how things go with just the wellbutrin for a while and we'll go from there." She agreed and until about June I was only on Wellbutrin. Then I noticed my moods changing more and my irritability coming out. I even snapped at the boss a couple of times. Luckily for me, he's a rapid cycling unipolar and completely understood. So I called my doc. and she called in the Depakote for me. I've been taking it ever since and I have to say it has worked pretty well. I do have my occasional mood, but for the most part I am level. Now the down side of the Depakot is it really makes me drowsy. It's pretty powerful. I take it at night before bed (as prescribed) and I sometimes still have a tough time getting up...but I don't have that 'hung-over' feeling. It's just sleepy. A hint to anyone taking it, or about to...I try to take it early in the evening. If I am in for the evening I usually take it around 8:00. But I am sure it will react with most of us differently. Sorry that was so long. Good luck to all. Just one more thing. To those of you who only let your closest friends in on your secret; isn't it interesting to hear how people talk about others who aren't so guarded? I have been in the company of people who have said, in a group, things like "I think she needs to have her medication adjusted." Or "He needs to have his dosage pumped up." All the while standing right beside them is one such individual taking said medications. Just a side thought.
>
> Hi Carter,
>
> The bizarro thing I can add is I am bipolarII and so is my BOSS (and a couple of other coworkers-it seems that BP folks coalesce somehow)! Everybody knows about my boss's meds/troubles, but I haven't told anyone where I work. You are right-once people in a workgroup know about it they start ascribing any change as something related to meds not working, different meds, skipping meds, etc. I just don't want to be treated as a chemical abstraction.
>
> Now I am on Neurontin/Klonopin/Wellbutrin/Celexa and it thus far has been the best combo for me. Depakote seems to aggravate depression. Lithium is OK, but it dulls my cognitive functioning too much. I find that the Wellbutrin *can* induce some irritability-but in my case I just become more assertive and don't take crap.
>
> MitchHey Mitch.
I wasn't sure if anyon would respond. The responses are so sparse. Thanks for giving me more information about WB. Another thing that I forgot to mention about Zyprexa...it really affected my cognitive abilities. I like to think that I am a well educated guy and an eloquent speaker. My major in college was communications and I pride myself on how well I communicate; I also work in the field. Well Zyprexa slapped that right out of me. In conversations with my boss (we actually became really good friends outside the office too) I was unable to complete my thoughts. I couldn't retrieve words from my memory. That was bad b/c at the time my job depended upon my being able to explain a semi-complicated subject matter accurately in a way that it was easily understood by the people I was talking to. Luckily I was able to keep that under control, but in my personal life...it really sucked. I'd like to ask this question, and if you don't want to answer I COMPLETELY understand, but I live in Southeastern United States. What about you? Not that it really matters. I just thought that it may help to establish dialog. I think you can never have too many people to talk to about our experiences.
Posted by Mitch on December 17, 2001, at 9:54:47
In reply to Re: Cyclothymia mood stabilizers, posted by Carter on December 17, 2001, at 8:01:24
> I wasn't sure if anyon would respond. The responses are so sparse. Thanks for giving me more information about WB. Another thing that I forgot to mention about Zyprexa...it really affected my cognitive abilities. I like to think that I am a well educated guy and an eloquent speaker. My major in college was communications and I pride myself on how well I communicate; I also work in the field. Well Zyprexa slapped that right out of me. In conversations with my boss (we actually became really good friends outside the office too) I was unable to complete my thoughts. I couldn't retrieve words from my memory. That was bad b/c at the time my job depended upon my being able to explain a semi-complicated subject matter accurately in a way that it was easily understood by the people I was talking to. Luckily I was able to keep that under control, but in my personal life...it really sucked. I'd like to ask this question, and if you don't want to answer I COMPLETELY understand, but I live in Southeastern United States. What about you? Not that it really matters. I just thought that it may help to establish dialog. I think you can never have too many people to talk to about our experiences.
I also have some major attentional problems and have been diagnosed with adult ADHD. Most mood stabilizers (esp. at higher doses) tend to aggravate cognitive dysfunction. Depakote and Lithium can really do me in. I found that Neurontin, Tegretol, and Trileptal gave me the fewest problems. In fact, Neurontin seems to *improve* my attention and cognitive abilities (as long as I keep the dose below 900mg/day).
As far as Zyprexa goes, I understand it is quite sedative and has a quite lengthy half-life. That may be the main problem with it(I haven't tried that particular one). I don't like to take antipsychotics for non-psychotic symptoms because of the risk of tardive dystonia/dyskinesia. However, I am very med-sensitive and a lot of other people will experience little problem with that and could benefit from them and I wouldn't want to discourage their use. FWIW, I found that Risperdal didn't cause as much trouble as some of the other AP's. When I was taking it-I took it only at bedtime, but it had benefits that extended through the next day without being too sedating. You might ask your doc about a flip to low-dose Risperdal from the Zyprexa for a while to see how that does instead.
Mitch
Posted by Carter on December 17, 2001, at 14:20:33
In reply to Re: Cyclothymia mood stabilizers-Zyprexa problems » Carter, posted by Mitch on December 17, 2001, at 9:54:47
> > I wasn't sure if anyon would respond. The responses are so sparse. Thanks for giving me more information about WB. Another thing that I forgot to mention about Zyprexa...it really affected my cognitive abilities. I like to think that I am a well educated guy and an eloquent speaker. My major in college was communications and I pride myself on how well I communicate; I also work in the field. Well Zyprexa slapped that right out of me. In conversations with my boss (we actually became really good friends outside the office too) I was unable to complete my thoughts. I couldn't retrieve words from my memory. That was bad b/c at the time my job depended upon my being able to explain a semi-complicated subject matter accurately in a way that it was easily understood by the people I was talking to. Luckily I was able to keep that under control, but in my personal life...it really sucked. I'd like to ask this question, and if you don't want to answer I COMPLETELY understand, but I live in Southeastern United States. What about you? Not that it really matters. I just thought that it may help to establish dialog. I think you can never have too many people to talk to about our experiences.
>
> I also have some major attentional problems and have been diagnosed with adult ADHD. Most mood stabilizers (esp. at higher doses) tend to aggravate cognitive dysfunction. Depakote and Lithium can really do me in. I found that Neurontin, Tegretol, and Trileptal gave me the fewest problems. In fact, Neurontin seems to *improve* my attention and cognitive abilities (as long as I keep the dose below 900mg/day).
>
> As far as Zyprexa goes, I understand it is quite sedative and has a quite lengthy half-life. That may be the main problem with it(I haven't tried that particular one). I don't like to take antipsychotics for non-psychotic symptoms because of the risk of tardive dystonia/dyskinesia. However, I am very med-sensitive and a lot of other people will experience little problem with that and could benefit from them and I wouldn't want to discourage their use. FWIW, I found that Risperdal didn't cause as much trouble as some of the other AP's. When I was taking it-I took it only at bedtime, but it had benefits that extended through the next day without being too sedating. You might ask your doc about a flip to low-dose Risperdal from the Zyprexa for a while to see how that does instead.
>
> Mitch
I am no longer on the Zyprexa, but I hope others read this in order to have some information should they experience the same symptoms. As for my meds now, I am maxed out on Wellbutrin, 400 mg a day. And the Depkote, from what I understand, is low at 500 mg a day.I recently moved and had to leave both my Psychiatrist and my therapist. I really liked them both. We all worked well together. So now I am about to have my first appointment with a new Psychiatrist. I am a little nervous about it. And even more nervous about finding a therapist that fits. I haven't been to a therapy session in about 3 months and I can tell. The psycho therapy is good for me.
Have you ever had to make a switch with your psychiatrist or therapist? Or both? I didn't even ask if you see a therapist. Have you any words of advice in this matter?
~PS:
We had a holiday luncheon at the office today that I Organized and somehow the subject of psychology came up and once again "we" were slighted. I don't know why, but people's insensivity and ignorance still take me a little by surprise.
Posted by Mitch on December 17, 2001, at 23:32:25
In reply to Re: Cyclothymia mood stabilizers-Zyprexa problems, posted by Carter on December 17, 2001, at 14:20:33
> I am no longer on the Zyprexa, but I hope others read this in order to have some information should they experience the same symptoms. As for my meds now, I am maxed out on Wellbutrin, 400 mg a day. And the Depkote, from what I understand, is low at 500 mg a day.
>
> I recently moved and had to leave both my Psychiatrist and my therapist. I really liked them both. We all worked well together. So now I am about to have my first appointment with a new Psychiatrist. I am a little nervous about it. And even more nervous about finding a therapist that fits. I haven't been to a therapy session in about 3 months and I can tell. The psycho therapy is good for me.
>
> Have you ever had to make a switch with your psychiatrist or therapist? Or both? I didn't even ask if you see a therapist. Have you any words of advice in this matter?I saw the same therapist/pdoc for almost 20 years. I continued to travel to make appointments after I moved. Then all the new mood-stabilizing anticonvulsants came onto the scene in recent years and I wanted to experiment and my existing pdoc didn't like polypharmacy and "off-label" prescribing (for *some* good reasons), so I decided to start the experimentation with newer pdocs (no hard feelings toward my original doctor/therapist though). Overall, it was the right decision to make. I wouldn't get really uptight about switching pdocs, unless of course a lot of cash and wasted time is riding on it. The best advice is to follow your gut instincts. If you leave the initial session (see if you can get a free first session), and feel deeply that something's not clicking, just see someone else, don't put yourself through a bunch of crap you don't have to.
>
> ~PS:
> We had a holiday luncheon at the office today that I Organized and somehow the subject of psychology came up and once again "we" were slighted. I don't know why, but people's insensivity and ignorance still take me a little by surprise.That's why I don't discuss that stuff with my coworkers. This makes it tougher to make friends with your coworkers, but hey-if they don't bring up your behaviour and have accurate insight into your problems and acknowledge it to you, then they don't deserve to have that personal knowledge in my opinion (if they can't figure it out-they probably will not understand it anyways).
Mitch
Posted by S. Belmont on December 18, 2001, at 23:50:10
In reply to Re: Cyclothymia mood stabilizers, posted by Carter on December 17, 2001, at 8:01:24
Hi everyone. I was just recently diagnosed as cyclothymic, and I swear I have to be ADD also (although the clinician says all the ADD symptoms are part of cyclothymia). I just started taking wellbutrin 5 months ago and like some of you have noticed irratibility. Any advice you might have for a newbie would be greatly appreciated. Might I also add that its great to finally have people to talk to who have heard of this. So many ppl ask "whats that?" then i have to explain. Its quite a hassle. Thanks!
Posted by Carter on December 19, 2001, at 9:19:44
In reply to Re: Cyclothymia mood stabilizers, posted by S. Belmont on December 18, 2001, at 23:50:10
> Hi everyone. I was just recently diagnosed as cyclothymic, and I swear I have to be ADD also (although the clinician says all the ADD symptoms are part of cyclothymia). I just started taking wellbutrin 5 months ago and like some of you have noticed irratibility. Any advice you might have for a newbie would be greatly appreciated. Might I also add that its great to finally have people to talk to who have heard of this. So many ppl ask "whats that?" then i have to explain. Its quite a hassle. Thanks!
Hi Belmont!
I can't help you with the Wellbutrin irritability because it works for me. Or my mood stabilizer, Depakote, counters it. Have you talked with your psyst. about your side effects? It's a good idea to.
Now about having to explain to others...it's tough...I usually start by explaining that there are steps, Bi Polar I, Bi Polar II, and Cyclothymia. But you have to watch it. Some people really don't know how to react the minute you say bi polar. But don't feel bad about it, they are just not educated about the subject. I wasn't until I started therapy and such. The very best thing you can do is arm yourself with knowledge. And don't take what you do find as the "written in stone" truth. Not all websites are accurate. But I have found that in searching for info, I have ben successful when looking up bi polar. It's usually in there somewhere.
A word of caution: be careful who you tell. The only people I have told about myself are family and a handful of close friends.
I wonder, statistics say that in men this often develops in the mid to late twenties. I was 26 when I was diagnosed. Anyone else in their twenties?
Posted by Mitch on December 19, 2001, at 9:20:51
In reply to Re: Cyclothymia mood stabilizers, posted by S. Belmont on December 18, 2001, at 23:50:10
> Hi everyone. I was just recently diagnosed as cyclothymic, and I swear I have to be ADD also (although the clinician says all the ADD symptoms are part of cyclothymia). I just started taking wellbutrin 5 months ago and like some of you have noticed irratibility. Any advice you might have for a newbie would be greatly appreciated. Might I also add that its great to finally have people to talk to who have heard of this. So many ppl ask "whats that?" then i have to explain. Its quite a hassle. Thanks!
Hi,
Is the Wellbutrin the only med you are on? If it otherwise works ok you may need to add a little mood stabilizer and that should decrease irritability. Probably the most tolerable ones would be either a low-dose of Neurontin or Depakote. Certain "types" of ADD can benefit from "mood stabilizers" anyhow.
Mitch
Posted by S. Belmont on December 21, 2001, at 22:38:31
In reply to Re: Cyclothymia mood stabilizers » S. Belmont, posted by Mitch on December 19, 2001, at 9:20:51
mitch, yes its the only thing i'm on. for some reason i thought that it was some kind of mood stabalizer. but like i said im new so i dont really know. i find that when it diesnt work so well if i back off and lower my dosage for about a week then go back to my normal dose it works like a charm. anyone else notice this?
Posted by Mitch on December 22, 2001, at 9:49:45
In reply to Re: Cyclothymia mood stabilizers, posted by S. Belmont on December 21, 2001, at 22:38:31
> mitch, yes its the only thing i'm on. for some reason i thought that it was some kind of mood stabalizer. but like i said im new so i dont really know. i find that when it diesnt work so well if i back off and lower my dosage for about a week then go back to my normal dose it works like a charm. anyone else notice this?
s.b.,
That is interesting that you are diagnosed as cyclothymic and only on an antidepressant. As far as the WB goes I think it is more of a psychostimulant than an antidepressant. It is a phenylethylamine-a class of chemicals which amphetamines belong to (I think). It's sister drug Tenuate (diethylpropion) is a Sch. IV controlled substance and is used for weight loss. Given all of that-it makes sense that you are probably building a "tolerance" to its stimulating qualities. If you back off the dose you lose a little tolerance to that, and when stepping the dose back up you re-experience the stimulating qualities of it. I am not sure if that is good or bad. Some might find that indicative of a tendency to abuse stimulants. I noticed some "start-up" mild euphoria when I started taking Adderall. But, it lasted only about three days or so and was associated with insomnia. Then it went away and I was just clear-headed and focused-with no cycling. I didn't feel a need to increase dose after I "adjusted" to it. I did "miss" that mild euphoria a little, but my attentive improvement was so dramatic that the low-dose I was taking (5mg) felt quite adequate for me. The problem I have with stims and stim-like AD's, however, is they tend to aggravate my GAD/OCD-like hyperfocusing at times and worsen ruminations. So, what do you do when your attention is generally wiped out, but if you take a stim you wind up focusing too much on the wrong things??
Mitch
Posted by manowar on December 24, 2001, at 10:26:16
In reply to Re: Cyclothymia mood stabilizers » S. Belmont, posted by Mitch on December 22, 2001, at 9:49:45
Hi,
I'm diagnosed with Cyclothymia, and the only "mood stabilizer" that has worked for me has been Klonipin. Everything else I've ever tried has given me terrible side effects.
Posted by Raizelle on March 3, 2002, at 3:19:42
In reply to Re: Cyclothymia mood stabilizers, posted by manowar on December 24, 2001, at 10:26:16
Hey, I have recently been diagnosed as having bipolar II, though I kinda disagree and think I just have cyclothymia. My psychiatrist put me on 750 mg of depakote and said that it was real small dosage, I just started taking it and was curious about other people's experience with it.My psychiatrist wont put me on an anti-depressant for now cuz shes scared of me going manic. Personally, I think that when I'm manic I'm not that manic and I do great things, even if i don't manage to do them for real long periods of time...but that's because I start going down again. Is there anyway to keep highs without having lows? I think this forum is a great idea and don't know if anyone still reads this. I know this post is a little long winded...so I hope you all forgive me. Thanx.;)
Posted by Ritch on March 3, 2002, at 10:53:00
In reply to Re: Cyclothymia mood stabilizers, posted by Raizelle on March 3, 2002, at 3:19:42
> Hey, I have recently been diagnosed as having bipolar II, though I kinda disagree and think I just have cyclothymia. My psychiatrist put me on 750 mg of depakote and said that it was real small dosage, I just started taking it and was curious about other people's experience with it.My psychiatrist wont put me on an anti-depressant for now cuz shes scared of me going manic. Personally, I think that when I'm manic I'm not that manic and I do great things, even if i don't manage to do them for real long periods of time...but that's because I start going down again. Is there anyway to keep highs without having lows? I think this forum is a great idea and don't know if anyone still reads this. I know this post is a little long winded...so I hope you all forgive me. Thanx.;)
Hi,I don't think there is much chance of keeping the "highs" without the "lows". I've tried that in the past and it didn't work :-)
It is interesting that your psych will not prescribe *any* antidepressants for you. Have you taken any antidepressants before? Just wondering if they made you "hypomanic", hence your BPII diagnosis (that's my dx, too). By definition you need to have had at least one major depressive episode. If you think you are really cyclothymic-then you haven't had a major depressive episode (at least two weeks straight of several major symptoms). Depakote is used a lot. I've taken it before, still have some around. 750mg is probably an "average" dose. People with true cyclothymia find it works well at doses that help people for migraines (125mg-500mg/day). I never needed more than 500mg/day to keep hypomania away. Your pdoc is generally right that antidepressants aggravate the condition (they intensify the peaks/troughs in my cycling). However, I haven't heard of many BP'ers that can get by on them alone *all* the time. Let us know how it goes.good luck,
Mitch
Posted by JMO on March 7, 2002, at 13:04:12
In reply to Re: Cyclothymia mood stabilizers-Zyprexa problems » Carter, posted by Mitch on December 17, 2001, at 9:54:47
I'd like to ask this question, and if you don't want to answer I COMPLETELY understand, but I live in Southeastern United States. What about you? Not that it really matters. I just thought that it may help to establish dialog. I think you can never have too many people to talk to about our experiences.
mitch-
i'm in the southeast as well and recently diagnosed. i have an app't next week for a review of meds. i could really use some help!
Posted by Ritch on March 7, 2002, at 13:48:40
In reply to Re: Cyclothymia mood stabilizers-Zyprexa problems » Mitch, posted by JMO on March 7, 2002, at 13:04:12
> I'd like to ask this question, and if you don't want to answer I COMPLETELY understand, but I live in Southeastern United States. What about you? Not that it really matters. I just thought that it may help to establish dialog. I think you can never have too many people to talk to about our experiences.
>
> mitch-
>
> i'm in the southeast as well and recently diagnosed. i have an app't next week for a review of meds. i could really use some help!
Hi, I actually live in the Ozarks. But I have lived in Arkansas for many years (so that technically makes me a Southerner of sorts). I am not into posting email addresses and the like-but if you got any med questions or information you are certainly welcome to post and I would be glad to help if I can. Also, others might find the information useful.Mitch
Posted by Carter on March 8, 2002, at 8:29:58
In reply to Re: Cyclothymia mood stabilizers-Zyprexa problems » JMO, posted by Ritch on March 7, 2002, at 13:48:40
> > I'd like to ask this question, and if you don't want to answer I COMPLETELY understand, but I live in Southeastern United States. What about you? Not that it really matters. I just thought that it may help to establish dialog. I think you can never have too many people to talk to about our experiences.
> >
> > mitch-
> >
> > i'm in the southeast as well and recently diagnosed. i have an app't next week for a review of meds. i could really use some help!
>
>
> Hi, I actually live in the Ozarks. But I have lived in Arkansas for many years (so that technically makes me a Southerner of sorts). I am not into posting email addresses and the like-but if you got any med questions or information you are certainly welcome to post and I would be glad to help if I can. Also, others might find the information useful.
>
> MitchHi,
This is Carter and I just wanted to say that I am still checking the site too. And like Mitch I am more than happy to help if I can.
~Carter
Posted by JMO on March 8, 2002, at 9:21:14
In reply to Re: Cyclothymia mood stabilizers-Zyprexa problems, posted by Carter on March 8, 2002, at 8:29:58
> > > I'd like to ask this question, and if you don't want to answer I COMPLETELY understand, but I live in Southeastern United States. What about you? Not that it really matters. I just thought that it may help to establish dialog. I think you can never have too many people to talk to about our experiences.
> > >
> > > mitch-
> > >
> > > i'm in the southeast as well and recently diagnosed. i have an app't next week for a review of meds. i could really use some help!
> >
> >
> > Hi, I actually live in the Ozarks. But I have lived in Arkansas for many years (so that technically makes me a Southerner of sorts). I am not into posting email addresses and the like-but if you got any med questions or information you are certainly welcome to post and I would be glad to help if I can. Also, others might find the information useful.
> >
> > Mitch
>
> Hi,
>
> This is Carter and I just wanted to say that I am still checking the site too. And like Mitch I am more than happy to help if I can.
>
> ~Carter
thanks guys, i'm sure i'll have many questions after next week's app't. i'll be sure to keep you posted.
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