![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by BarbaraCat on February 26, 2002, at 0:13:46
So, I got my shipment of adrafinil from the UK and started taking it hoping to have a taste of the miracle some of us had experienced here on this board. Prior to beginning the Adrafinil, I'd had a 10 year mediocre response from SSRI's and had recently gone on lithium and upped klonopin with just a teensy bit of Remeron (Remeron had pooped out badly and I'd been trying to see if I could do without AD's since they made me feel bad by themselves). All was going well, brain beginning to unfry, feeling pretty good, if still a bit delicate.
After 2 days on Adrafinil I began to feel such an inner tension (one of it's reputed side effects). I kept at it for 1-1/2 weeks hoping it would get better. I kept spiraling into a very uncomfortable, agitated place, virtually undoing the soothing balm the new lithium/klonopin had been providing. It brought on a melancholic hypomanic state (no, this is not a contradiction). Needless to say, I stopped. This was about 3 weeks ago.
Even after stopping, I was sobbing everywhere I went, and I believe that the agitation caused by the Adrafinil was enough to unbalance my poor chemistry. So I upped the lithium from 100 to 300 mg and started back on 30 mg. Remeron. That combo seems to be the ticket and I am feeling great. I think those of us tending toward the Bipolar II side should be VERY CAREFUL of strong norepiniphrine drugs. This has been a valuable lesson for me. Now I KNOW I'm BP-II whereas before I just suspected it. - Barbara
Posted by JohnX2 on February 26, 2002, at 0:25:13
In reply to Adrafinil NO, lithium + Remeron YES, posted by BarbaraCat on February 26, 2002, at 0:13:46
Congratulations!Bipolar II is such a tough ride.
What was your experience on lithium like?
I'm also bipolar II and have been through the
medicine wringer.
I think I have been a bit stubborn about going
the lithium route. I feel so worn down from all
the medicines I've taken and I just look at all
those side effects, but my pdoc seems really good
and is hot for the medicine. I've had this chronic
headache pain and I have about 80% of my mood disorder
under control mainly from Lamictal. I just don't know if
I want to trade off more side effects for more mood stabilization.
What do you think?Thanks,
John
> So, I got my shipment of adrafinil from the UK and started taking it hoping to have a taste of the miracle some of us had experienced here on this board. Prior to beginning the Adrafinil, I'd had a 10 year mediocre response from SSRI's and had recently gone on lithium and upped klonopin with just a teensy bit of Remeron (Remeron had pooped out badly and I'd been trying to see if I could do without AD's since they made me feel bad by themselves). All was going well, brain beginning to unfry, feeling pretty good, if still a bit delicate.
>
> After 2 days on Adrafinil I began to feel such an inner tension (one of it's reputed side effects). I kept at it for 1-1/2 weeks hoping it would get better. I kept spiraling into a very uncomfortable, agitated place, virtually undoing the soothing balm the new lithium/klonopin had been providing. It brought on a melancholic hypomanic state (no, this is not a contradiction). Needless to say, I stopped. This was about 3 weeks ago.
>
> Even after stopping, I was sobbing everywhere I went, and I believe that the agitation caused by the Adrafinil was enough to unbalance my poor chemistry. So I upped the lithium from 100 to 300 mg and started back on 30 mg. Remeron. That combo seems to be the ticket and I am feeling great. I think those of us tending toward the Bipolar II side should be VERY CAREFUL of strong norepiniphrine drugs. This has been a valuable lesson for me. Now I KNOW I'm BP-II whereas before I just suspected it. - Barbara
Posted by TSA West on February 26, 2002, at 1:19:38
In reply to Re: Adrafinil NO, lithium + Remeron YES » BarbaraCat, posted by JohnX2 on February 26, 2002, at 0:25:13
Dear netizen,
You could just fight the Lithium side-effects with supplemental medications: Propranolol for the tremor, Cimetidine for the stomach upset, caffeine for the sedation, Emetrol for nausea.
Why you would want to attempt Lithium treatment of the 20% that is missing in your emotional health? Because emotional pain hurts more than physical annoyances....With the kindest regards,
--------------TSA WEST------------------------
Posted by JohnX2 on February 26, 2002, at 3:17:09
In reply to Lithium yes » JohnX2, posted by TSA West on February 26, 2002, at 1:19:38
Hi TSA West,
Thanks for your thoughts.
I retested Wellbutrin after adding Topamax
to my Lamictal and I seemed to tolerate it
well. I actually felt pretty good and got
an AD response after 2 weeks. But I did this
on the sly from my pdoc and he got mad and took
me off it. He is
so anti-anti-depressant for bipolar. I just dont
think I can take adding to many more medicines
and my liver seems to have just about had it.
I thought maybe I could go back and retest ADS
that worked and pooped out and were tolerable
before I started mood stabilizers before resorting
to lithium. I'm currently retesting Serzone to
help me ween off Klonopin. It gave me a nice
AD response before but made me feel drugged out.
This time Serzone is not making me feel drugged
out. The pdoc actually bought into Serzone because
it fixes my headaches and will help get me off
Klonopin.Anyways I came a long way to get a medicine regimen
that has NO side effects. Seems like I should put
in a last gasp to get that 20 % with just one more
tolerable med. Just my thought.Thanks for your thoughts on ways to make lithium
a bit more tolerable. I really felt just aweful
on Paxil and Effexor. It was a total nightmare.
I feel so worn down from meds. I just dont know
if I could justify another trial of a medication
that would make me feel physically ill. These
chronic headaches that I'm trying to
finish treating have really worn me down. I just
don't need any more pain. The mood crap is bad
enough. Ugh.Sorry this is so long. I seem to be on a lot
of rants today.Best Regards,
John
> Dear netizen,
>
> You could just fight the Lithium side-effects with supplemental medications: Propranolol for the tremor, Cimetidine for the stomach upset, caffeine for the sedation, Emetrol for nausea.
> Why you would want to attempt Lithium treatment of the 20% that is missing in your emotional health? Because emotional pain hurts more than physical annoyances....
>
> With the kindest regards,
>
> --------------TSA WEST------------------------
Posted by BarbaraCat on February 26, 2002, at 11:31:42
In reply to Re: Adrafinil NO, lithium + Remeron YES » BarbaraCat, posted by JohnX2 on February 26, 2002, at 0:25:13
Hi John,
I also bucked and screamed before going on lithium. I'd heard about the renal side effects, tremors, need for blood level work, wiping out the highs, etc. My pdoc's rationale was approaching it as purely an AD augmentor, rather than treating bp-II, since he had not yet considered that was my problem. I too had AWFUL experiences with paxil and effexor. Ugh!The thing that finally pursuaded me to give it a try were some recent publications stating Lithium's neuroprotective effects and ability to regrow neurons. There are even people without affective disorders taking it for it's alleged anti-aging benefits. There were some discussions here about a month ago. The possibility that lithium is actually good for my brain exerts it's own psychological benefits.
I can't really address your headache issue since that has never been one of my complaints. Also, if the lamactil is working, I'd hesitate about adding something else that may not address your headache. But here is my experience: I'm only taking 300 mg rather than the recommended 900+ bipolar amount so I'm not noticing anything other than looser bowels (not a problem, believe me). I don't know if I'm getting a robust 'anti-bipolar' response, however it has made all the difference in my response to Remeron and I suspect in the klonopin as well. It seems to act like a 'spark plug'. As long as it's working I'll stay at this level, but am prepared to increase if need be.
I also was on Serzone for a while and didn't like it because of the all-day fog and it made me feel more depressed. I'm taking Remeron because it is anti-anxiety, but acts also on norepinephrine. I've been on all the SSRI's and their analogs, most TCA's, and I can honestly say I like Remeron the best, but ONLY with Lithium since without Li it poops out like all the others. I can actually say that on this combo Remeron 30 mg, lithium 300 mg and klonopin as needed, I'm at about 90%. The other 10% will come from my renewed enthusiasm for exercise. It's been a loooooooong time since I've been able to claim that and I pray it lasts this time!
I'm looking into L-taurine, an amino acid, that I'm hearing good things about as far as it's anti-seizure 'irritible brain soothing' properties (500 mg 2x day). Will let you know. You might also consider taking silymarin (artichoke extract) in liquid form for your liver. It's being used for various liver diseases with good results. Can get it at a health food store. Good luck. - Barbara
Posted by JohnX2 on February 26, 2002, at 15:46:30
In reply to My Lithium Response » JohnX2, posted by BarbaraCat on February 26, 2002, at 11:31:42
L-Taurine doesn't cross the blood brain barrier
very easily, but here is another suggestion that
I have looked into. It is Acamprosate.
This is n-acetyl-homo-taurine. This is a molecular
carrier for the amino acid taurine that readily
crosses the blood brain barrier. It is generally
used in Europe for alcohol withdrawl, but I have
seen that they are looking into clinical studies
for use in bipolar disorder. The medicine is both
Gabaergic and a mild NMDA antagonist. It has few
side effects. Lamictal has recently been studied
and found to increase brain concentrations of the
amino acid taurine, so I think there could be
good rationale for Acamprosate itself working well
as a mood mender. Unfortunately it is not currently
available in the US, it is in clinical trials.
It is available in Europe with a prescription.Regards,
John
>
> I'm looking into L-taurine, an amino acid, that I'm hearing good things about as far as it's anti-seizure 'irritible brain soothing' properties (500 mg 2x day). Will let you know. You might also consider taking silymarin (artichoke extract) in liquid form for your liver. It's being used for various liver diseases with good results. Can get it at a health food store. Good luck. - Barbara
Posted by BarbaraCat on February 26, 2002, at 16:11:42
In reply to Re: My Lithium Response » BarbaraCat, posted by JohnX2 on February 26, 2002, at 15:46:30
Interesting. What I've read up on acamprosate talks mainly about it's anti-alcohol craving, but I can see the tie-in with bipolar. Thanks for the info.
>
> L-Taurine doesn't cross the blood brain barrier
> very easily, but here is another suggestion that
> I have looked into. It is Acamprosate.
> This is n-acetyl-homo-taurine. This is a molecular
> carrier for the amino acid taurine that readily
> crosses the blood brain barrier. It is generally
> used in Europe for alcohol withdrawl, but I have
> seen that they are looking into clinical studies
> for use in bipolar disorder. The medicine is both
> Gabaergic and a mild NMDA antagonist. It has few
> side effects. Lamictal has recently been studied
> and found to increase brain concentrations of the
> amino acid taurine, so I think there could be
> good rationale for Acamprosate itself working well
> as a mood mender. Unfortunately it is not currently
> available in the US, it is in clinical trials.
> It is available in Europe with a prescription.
>
> Regards,
> John
>
>
> >
> > I'm looking into L-taurine, an amino acid, that I'm hearing good things about as far as it's anti-seizure 'irritible brain soothing' properties (500 mg 2x day). Will let you know. You might also consider taking silymarin (artichoke extract) in liquid form for your liver. It's being used for various liver diseases with good results. Can get it at a health food store. Good luck. - Barbara
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.