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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 278 to 302 of 948. Go back in thread:
Posted by fluffy on July 26, 2003, at 14:47:34
In reply to Re: Attn: Dali, posted by katia on July 26, 2003, at 14:09:32
Dear Katia,
I have no experience with Depakote. It's never been a med that my doc wanted to try on me. I think it's because it is helpful with mania, but not depression (that I know of). I don't get full blown mania, just major depression and hypomania. It has a reputation for causing weight gain. However, as far as I know, it helps relieve mixed states and rapid cycling. Sounds like you've got some of that going on.
But if you ask me, Lamictal would be the drug of choice. It's not a miracle drug--it may not work on everyone. But for me it's been a life saver. Have you tried any other mood stabilizers? Lamictal is also reputed to quell mixed states and rapid cycling. On top of that, it has an antidepressant effect. Other people prefer Tegretol, Depakote of Lithium alone or with the addition of an antidepressant. But given your record with them, I wouldn't reach for antidepressants until you give a mood stabilizer a good run.
Have you had a good, long talk about this with a psychiatrist that you trust? I'm certainly not a professional, but I can tell you my experience and share from the research I've read.
AD's put me in a terrible mixed state and made me feel worse. I also didn't know what the hell was wrong until it became full blown. I searched and searched, and figured it out. (i'm bipolar II or cyclothymic w/ major depression).
Tell me what meds you've tried before. Any lithium in there? Any other anti-epilepsy stuff?
Take lots of care,
Katy
Posted by fluffy on July 26, 2003, at 15:06:27
In reply to Re: Attn: Dali, posted by fluffy on July 26, 2003, at 14:47:34
Hi Barbara Cat--
I can so relate to the dancing thing--dancing on the floor (of course in a really sexy way) with no-one else. I can't count how many times I did that in my most manic state. I'm talking Christina Agulera booty and hip thrusting action, with a throng of hooting men egging me on. (usually this was after about 5-6 coctails)
The last time I was manic, I built a stair-case for my loft, refinished and chromed a table, weather stripped my doors, and sewed new curtains all in one day.
I'm sure lots of folks on this thread can relate.
Barbara Cat--your stories are always interesting.
Katy
Posted by katia on July 26, 2003, at 15:39:24
In reply to Re: Dancing Queen, posted by fluffy on July 26, 2003, at 15:06:27
> Hi Barbara Cat--
>
> I can so relate to the dancing thing--dancing on the floor (of course in a really sexy way) with no-one else. I can't count how many times I did that in my most manic state. I'm talking Christina Agulera booty and hip thrusting action, with a throng of hooting men egging me on. (usually this was after about 5-6 coctails)
>
> The last time I was manic, I built a stair-case for my loft, refinished and chromed a table, weather stripped my doors, and sewed new curtains all in one day.
>
> I'm sure lots of folks on this thread can relate.
>
> Barbara Cat--your stories are always interesting.
>
> Katy
Barb Cat and Katy,
Yes, it's soooo good to be able to laugh at it and to know I'm not the only dancing queen too, when I've been cringing at memories too embarrassing to talk about.. that wasn't really me?!
Posted by katia on July 26, 2003, at 15:52:26
In reply to Re: Attn: Dali, posted by fluffy on July 26, 2003, at 14:47:34
Dear Katy,
> Dear Katia,
>
> I have no experience with Depakote. It's never been a med that my doc wanted to try on me. I think it's because it is helpful with mania, but not depression (that I know of). I don't get full blown mania, just major depression and hypomania. It has a reputation for causing weight gain. However, as far as I know, it helps relieve mixed states and rapid cycling. Sounds like you've got some of that going on.
>
> But if you ask me, Lamictal would be the drug of choice. It's not a miracle drug--it may not work on everyone. But for me it's been a life saver. Have you tried any other mood stabilizers?No, this will be the first (Depakote).
>Lamictal is also reputed to quell mixed states and rapid cycling. On top of that, it has an antidepressant effect. Other people prefer Tegretol, Depakote of Lithium alone or with the addition of an antidepressant. But given your record with them, I wouldn't reach for antidepressants until you give a mood stabilizer a good run.
I think that's my pdoc reasoning too. He also did not want to start me on Lamictal due to the small possibility of the fatal rash. I had actually suggested Lamictal due to the good response I've heard from on this board.
>
> Have you had a good, long talk about this with a psychiatrist that you trust? I'm certainly not a professional, but I can tell you my experience and share from the research I've read.
>
> AD's put me in a terrible mixed state and made me feel worse. I also didn't know what the hell was wrong until it became full blown. I searched and searched, and figured it out. (i'm bipolar II or cyclothymic w/ major depression).Yep, I know all about those confused mixed states.
> Tell me what meds you've tried before. Any lithium in there? Any other anti-epilepsy stuff?
> > KatyThe ADs I've tried are Celexa and Zoloft (did nada for me) and Effexor and Serzone, both put me in a hypomanic mixed state and not much more. I was on Neurontin for a brief few weeks taken occassionaly for sleep. that was mixed with the Celexa. No lithium. In fact, nothing but what I've described above.
We'll just see. i'll give it a go with the Depakote. I'm going to buy a scale b/c I'm not gaining weight (it's a bit different for women, esp. when you've already got a body image problem) when there is so much more out there. I'm already at my fat limit due to the Zoloft.
warmly,
Katia
Posted by fluffy on July 26, 2003, at 16:33:15
In reply to Depakote » fluffy, posted by katia on July 26, 2003, at 15:52:26
Katia--
Your medication history is almost exactly the same as mine. Add some Paxil and Trazodone, then subtract the Serzone. In fact, you are fairly medication naive compared to some people I've read about. It's still frustrating though!!--esp. if you are depressed. I felt the same way.
The first mood stabilizer i was put on was Tegretol. It wouldn't lift the low grade depression that was lingering. I switched to a new doctor who specializes in mood disorders. Sometimes older and more conservative psychiatrists opt for the "gold standards" (lithium, depakote or tegretol) before anything else.
Now as for the reputed rash. Your doc is being rather skiddish if you ask me. In fact, Depakote can also cause this rash. (same probability) If you are having body image problems, and you gain weight or get depressed again, then Depakote may not be the best bet.
Keep a mood chart if you aren't already. It's kind of a drag, but it illustrated for me if a drug was working or not. When my chart went to a straight line (for a number of normal days instead of jagged ups and downs, I knew the drug was working).
Let us know your progress. Lots of luck!
Katy
Posted by Barbara Cat on July 27, 2003, at 0:04:29
In reply to Re: Attn: Dali, posted by fluffy on July 26, 2003, at 14:47:34
Lithium and Lamictal work well for me. The only other mood stabilizer is neurontin which doesn't seem to do much. I've been intrigued by Depakote because of it's rep as being very calming and mellow and good for anxious states. But the weight thing has kept me away. I've been on every one of the SSRI and SNRI's. They'd work for awhile but then the godawful mixed states black depressions would always break through. So up we'd go with the dosage with no relief. I was also getting twitchy, like little discharges were firing, like those jerks before you fall asleep. If you suspect yourself bipolar, be very cautious with ADs and do not take them alone.
About the dancing queen, wasn't it fun, though? I mean, what chutzpah, what audacity, what energy! Who'd get the stodgy CEO up and dancing otherwise? When it's really on, it's contageous inspired magic. It could be wonderfully sexy. No doubt there were many sitting there wishing they had the moxie. If I could only channel it and say Hah! Thatsa me and too bad if you don't like it! But noooo, I ruin it all by getting all ashamed and whimpery. I'm really working on looking at it like 'Wow, girl, you can be one hot mama!', rather than 'Eyeeeu, you pathetic slutty hag!' Do you ever wonder if Christine Aguillar, Madonna, etc. are permanently manic? Is that how they do it? And have you seen Beyonce recently on the steps of New York city hall? Shaking her booty wearing a teensy little skirt with just a little thong thingie underneath advertising her goods. Of course, they don't have to face the old salt mine employees either but I can't imagine them losing sleep over being an out of control slut.
I'm not saying I admire crude behavior, but a bumper sticker gave me hope: 'No fascinating woman ever got that way by being a good girl'. And by the way, I no longer have a profession. Fibromyalgia put an end to burning myself out doing a job that 'just wasn't me' - whoever that is.
Barbara
Posted by katia on July 27, 2003, at 0:40:56
In reply to Dancing queen and proud of it!, posted by Barbara Cat on July 27, 2003, at 0:04:29
> Lithium and Lamictal work well for me. The only other mood stabilizer is neurontin which doesn't seem to do much. I've been intrigued by Depakote because of it's rep as being very calming and mellow and good for anxious states. But the weight thing has kept me away. I've been on every one of the SSRI and SNRI's. They'd work for awhile but then the godawful mixed states black depressions would always break through. So up we'd go with the dosage with no relief. I was also getting twitchy, like little discharges were firing, like those jerks before you fall asleep. If you suspect yourself bipolar, be very cautious with ADs and do not take them alone.
And by the way, I no longer have a profession. Fibromyalgia put an end to burning myself out doing a job that 'just wasn't me' - whoever that is.
> BarbaraDo you think that the fibromyalgia is connected to or as a result of your BP state (mainly the depressed side) and/or the medications?
as far as depakote, I do need some calming agent, but not so much that I get into a lethargic inertia low grade depression. I'm worried about that aspect. Like I don't want just the "manic" side taken away. But I need the depression addressed too. Hopefully depakote will do this.??? I"m just at my end and exhausted and can't go through another year of trying different meds to no avail.....I need to get it right soon. No more steam left....
katia
Posted by Barbara Cat on July 27, 2003, at 11:29:46
In reply to Re: Dancing queen and proud of it! » Barbara Cat, posted by katia on July 27, 2003, at 0:40:56
Hi Katia,
If you haven't tried lamictal, give it a whirl. Even if you try something else, such as Depakote, I can't say enough for lam's energizing, calming antidepressant quality. It took me about a year to work up to 200mg, which seems the magic number for antidepressant action. I coasted along at 75mg thinking it was enough, but 200mg, even though jittery at first, has made a huge difference. I was literally dying before hitting upon lamictal/lithium combo. I like lithium, but Depakote is the undisputed second. NOW HEAR THIS. I just heard that Depakote has been released in a new extended version that doesn't cause the weight gain. Tell your doc this since it's very new news.Now, is fibro connected to bipolar - good question. It sure can cause mental unhingeing, whatever your predisposition is. No one knows what causes fibro since it's a group of symptoms rather than a single pathology, a system breakdown caused by physical, emotional or environmental stress, but no one knows for sure. The symptoms are the same but the underlying trigger is different from person to person.
My personal belief, at least for me, is it's a disregulation of the HPA-axis caused by years of intense stress. There also may be a genetic component to it. My father seemed to have symptoms of fibro, widespread pain and fatigue. He was most likely bipolar as well (as was 1/2 his large family), alternating between severe depressions and violent rages. I had an extremely difficult childhood, very abusive (thankfully no overt sexual). Many object to the theory of it being stress induced, saying it's physical with the emotional coming later, but there's too much evidence that most fibro sufferers have had severe stressors in childhood. The stress hormones damage parts of the brain that regulate sleep, fear, thyroid, sex hormones - the gamut. Lack of deep stage IV sleep seems to be the main culprit. Having a bipolar condition doesn't help since it's so draining and stressful in it's own right, and who sleeps well during mania? But I don't know what causes what. It's interrelated, they exacerbate each other.
I do know that at times of extreme stress in the past I thought 'No one can live through this and not be damaged. Something has to give.' In my case, it eventually did, and it's fibro. But, you know, it's been a blessing. It's forced me to remove myself from soul-sucking conditions and situations. It's a great stress barometer. At the cost of my life, I cannot give in to that habitual fearful despair. My life's quest now is not fame, fortune and excitement, but just living a simple harmonious existence. But jeeze, my bod can sure put me through alot of grief. The latest is intense itching all over, inside and out. I feel like I have fleas (I don't). - Barbara
> Do you think that the fibromyalgia is connected to or as a result of your BP state (mainly the depressed side) and/or the medications?
> as far as depakote, I do need some calming agent, but not so much that I get into a lethargic inertia low grade depression. I'm worried about that aspect. Like I don't want just the "manic" side taken away. But I need the depression addressed too. Hopefully depakote will do this.??? I"m just at my end and exhausted and can't go through another year of trying different meds to no avail.....I need to get it right soon. No more steam left....
> katia
>
Posted by fluffy on July 27, 2003, at 11:31:06
In reply to Re: Depakote, posted by fluffy on July 26, 2003, at 16:33:15
To Katia--I totally understand the end of your rope feeling. The good news is: If the antidepressants didn't work on you, then chances are that the mood stabilizers WILL WORK. Unfortunately, psychiatry is still a crude science, involving lots of trial and error. You may hit the nail on the head with Depakote. It may work really well for you. Everyone is different. The other good news is: if Depakote does not work alone, you will probably know within at least a month. With SSRI's you'd have to wait a full 6-8 weeks. You may have to try another drug, and the process can be very daunting. But just know that there is a drug or combo of drugs that WILL WORK! It may take more time, and there may be disappointments.
I didn't believe that anything would work for me. I felt my brain was permanently flawed, and that I couldn't ever be "fixed". I'd been on Lexapro for 6 weeks--went manic, then zoloft+neurontin for another 6 weeks--felt spacey and mixed, then Tegretol--2 more months of low grade depression. And this was after 3 previous months of mixed states and major depression. You can be very sure that I felt that NOTHING would work. After finding a doctor that listened to me and was very informed about bipolar disorder, I found the right drug.
Be very pro-active with your doctor and trust yourself and how you are feeling. I wanted to feel better so badly (when I was in EXACTLY the same boat as you) that I often convinced myself that I was feeling better, and under-reported that I was still depressed. So I suffered through 2-3 months more of low grade depression. If you don't feel it's working, then TELL YOUR DOCTOR!! Be very assertive with him/her. Only you know how you are feeling.
And lastly--take time to care for yourself. Chances are you've been beating yourself up for awhile now. TAKE LOTS AND LOTS OF CARE!
Katy
Posted by fluffy on July 27, 2003, at 12:08:05
In reply to Re: Dancing queen and proud of it! » katia, posted by Barbara Cat on July 27, 2003, at 11:29:46
The latest is intense itching all over, inside and out. I feel like I have fleas (I don't). - Barbara
You know Barbara--I had that very same weird thing happen to me in college. I tried to explain it to someone, and they said "maybe you have scabies". But i didn't. It went away in a day or so. Is that what fybromalgia is?
Katy
Posted by katia on July 27, 2003, at 16:05:21
In reply to Re: Dancing queen and proud of it! » katia, posted by Barbara Cat on July 27, 2003, at 11:29:46
Hi Barbara,
Were you on Lithium only for awhile (and it needed an augment?) and then added the Lamictal? When you say that you thought you were Ok at 75mgs what made you realize you could be better?The fibro sounds painful. I too have felt at times of extreme despair and agnony there is no way my body is getting out of this unaffected. I"m just waiting for the bomb to drop for me. My body defin. has its aches and pains for no reason and normally correlated with stress levels; sometimes it really feels like I"m dying b/c my body hurts so badly. I've thought about fibro before as the reason. Who knows!? It could easily be just an over stressed body due to high strung emotions reacting in a "normal" way. What have your symptoms been?
I have asked my pdoc about the extended release version of Dep. as I've heard about that too. I'm waiting to hear back from him.
warmly,
Katia
> Hi Katia,
> If you haven't tried lamictal, give it a whirl. Even if you try something else, such as Depakote, I can't say enough for lam's energizing, calming antidepressant quality. It took me about a year to work up to 200mg, which seems the magic number for antidepressant action. I coasted along at 75mg thinking it was enough, but 200mg, even though jittery at first, has made a huge difference. I was literally dying before hitting upon lamictal/lithium combo. I like lithium, but Depakote is the undisputed second. NOW HEAR THIS. I just heard that Depakote has been released in a new extended version that doesn't cause the weight gain. Tell your doc this since it's very new news.
>
> Now, is fibro connected to bipolar - good question. It sure can cause mental unhingeing, whatever your predisposition is. No one knows what causes fibro since it's a group of symptoms rather than a single pathology, a system breakdown caused by physical, emotional or environmental stress, but no one knows for sure. The symptoms are the same but the underlying trigger is different from person to person.
>
> My personal belief, at least for me, is it's a disregulation of the HPA-axis caused by years of intense stress. There also may be a genetic component to it. My father seemed to have symptoms of fibro, widespread pain and fatigue. He was most likely bipolar as well (as was 1/2 his large family), alternating between severe depressions and violent rages. I had an extremely difficult childhood, very abusive (thankfully no overt sexual). Many object to the theory of it being stress induced, saying it's physical with the emotional coming later, but there's too much evidence that most fibro sufferers have had severe stressors in childhood. The stress hormones damage parts of the brain that regulate sleep, fear, thyroid, sex hormones - the gamut. Lack of deep stage IV sleep seems to be the main culprit. Having a bipolar condition doesn't help since it's so draining and stressful in it's own right, and who sleeps well during mania? But I don't know what causes what. It's interrelated, they exacerbate each other.
>
> I do know that at times of extreme stress in the past I thought 'No one can live through this and not be damaged. Something has to give.' In my case, it eventually did, and it's fibro. But, you know, it's been a blessing. It's forced me to remove myself from soul-sucking conditions and situations. It's a great stress barometer. At the cost of my life, I cannot give in to that habitual fearful despair. My life's quest now is not fame, fortune and excitement, but just living a simple harmonious existence. But jeeze, my bod can sure put me through alot of grief. The latest is intense itching all over, inside and out. I feel like I have fleas (I don't). - Barbara
Posted by katia on July 27, 2003, at 16:15:54
In reply to Re: Depakote, posted by fluffy on July 27, 2003, at 11:31:06
Hi Katy,
Thanks for your words of encourgement!
Yes, we do have a similar med history. So it took awhile for you to figure out you're bipolar too? The ssri's just flatten me out and deaden me, the SNRIs like Effexor and SErzone made me mixed and moody. high and low together and then high and low and the cycle continued! My moods felt even far more volatile than when on nothing, except when I'm in a major depression (which normally has mixed undertones).
I've been on nothing for about two weeks now and I've lost that slightly manic feeling (from Serzone) and now I'm feeling just mildly to mod low, some irritation. So I'm hoping that the mood stab. do the trick for me. I've got so much potential! I'm sick of wasting it and not being able to channel it!
Was Tegretol the first mood stab. (besides the neurontin) that you were on specifically for your BP? It sounds like it took away the up side and left you mildly low. That's what I'm afraid of. But what did it for you after that then? What are you on now? and is it working? Sorry if you've already described this in an earlier thread, it's just so hard to follow them all.
thanks!
Katia
Posted by fluffy on July 27, 2003, at 17:05:59
In reply to Re: Depakote » fluffy, posted by katia on July 27, 2003, at 16:15:54
Was Tegretol the first mood stab. (besides the neurontin) that you were on specifically for your BP? It sounds like it took away the up side and left you mildly low. That's what I'm afraid of. But what did it for you after that then? What are you on now? and is it working? Sorry if you've already described this in an earlier thread, it's just so hard to follow them all.
> thanks!That's ok Katia--this thread has turned into about 5 at once. Yes--Tegretol was the first mood stabilizer I was put on (after a *tiny* dose of Neurontin (100mg). I never got to a high enough dose of Tegretol to see if it would help my depression. I didn't trust my current psychiatrist who kept insisting that I was having major depression (DUHHH!) and kept loading me full of SSRI's. Even though I became fully manic/mixed, he insisted I was just depressed. I started to suspect that I might be bipolar. I had to beg and plead for a mood stabilizer trial. He started me off on Tegretol, but wouldn't believe me when I told him I was feeling depressed still. Needless to say, he was arrogant and very difficult to work with.
When I went to my new doc and told him I was on Tegretol, and I was still depressed, he promptly gave me two drugs to choose from: Lamictal or Lithium.
I think he did this for two reasons.
One--I was depressed, and the other mood stabilizers don't have a good antidepressant profile. Many people report a "flat" feeling. I'm not sure if I was still depressed or if the Tegretol was the culprit.
Two--I am currently going to a mood disorder clinic, and they sometimes hire their patients to be guinea pigs for science, testing new and old drugs and supplements. At the time, they were enrolling people with BPII, currently depressed to ramdomly try Lithium or Lamictal to determine which drug worked best. I fit that profile to a tee. I got the Lamictal. Free appointments, free Lamictal. It has worked really well for me so far. If I have breakthrough stuff, I'll probably try augmenting with Li. But for the time being, I've found what I feel is going to be the main work horse of my coctail.
Have you tried doing a search on this site about Depakote and its efficacy on depression?
best,
Katy
Posted by fluffy on July 27, 2003, at 17:30:34
In reply to Re: Depakote, posted by fluffy on July 27, 2003, at 17:05:59
Posted by fluffy on July 27, 2003, at 17:41:42
In reply to Katia--helpful article re: Lamictal, Li, Depakote, posted by fluffy on July 27, 2003, at 17:30:34
Posted by Barbara Cat on July 28, 2003, at 0:33:09
In reply to Re: Dancing queen and proud of it! » Barbara Cat, posted by katia on July 27, 2003, at 16:05:21
Katia,
To answer your questions, I actually started lithium to augment Remeron. Rem started out great and then pooped as all my SSRIs have done over the years. Lithium supercharged it right from the start for 3 months, then the usual fizzle. Through this board, I realized my symptoms were bipolar and not major depression. I stopped Remeron and was on lithium only (along with thyroid and other meds not directly related to mood). All was fine for about 2 months and then I began to have depression. I didn't want to increase lithium from 600mg because it had done well and I was afraid of it clobbering my thyroid further than it already was. But I was still depressed, although not like my prior awful pre-lithium mixed-states depressions. So I went on lamictal very slowly getting up to 75mg. Any more than that caused anxiety so I stopped increasing it.Lamictal 75mg and lithium 600mg worked pretty well (I was still mildly depressed but didn't realize it at the time). Then my Mom died from getting hit by a car in December and it was too much for me. I was also dealing with fibro as well (more info below). It was a rough time and I went on nortriptyline to bring me out of an severe depression. It indeed brought me back from the brink, but caused annoying side effects like cotton mouth, weight gain, constipation. So I decided to do a trial and tapered off nortrip. I was still taking 600mg lithium and 75 lamictal all this time. I bumped up lamictal mainly to offset any withdrawal from nortriptyline but was pleasantly surprised at how my mood was positively affected. I'd heard how lamictal really kicks in around 200mg as an antidepressant but always was hesitant to try it because of former anxiety, which I didn't experience this time around. I'm now at 150mg and feeling pretty darn good. One thing, however, that I've just found out tonight is that increasing sometimes brings on a case of the itchies. I've been scratching like I have fleas and feel like I'm going to go bonkers. I'm going to start a new thread on this. There were some threads a year ago, but it might be time to resurrect it. I hear it goes away, which I sure hope, cause this is the first combo that's really worked.
OK, fibromyalgia. The best I can describe it is how it feels to have a very bad flu where the muscles ache all over (not the joints), you feel totally wiped out but have insomnia, irritable bowel alternating between explosions and constipation, confusion and foggy thinking, incoordination, morning stiffness, anxiety and depression (it affects brain centers). These are uniform across the board with fibro folks. Mainly, most of the physical symptoms are there all the time in a mild to moderate form, but during the dreaded 'flares' which can last 2-3 weeks in bed, these symptoms are severe. Moderate exercise, avoidance of stress (hah!) and getting sleep are the keys to prevention, but sometimes a flare hits anyway and it can feel pretty hopeless. Add bipolar to this and yikes! However, the last flare not too long ago was the first where I wasn't despondent and this is since I've been on the higher dose of lamictal. So, that's why I hope I can continue with a med combo that's helped alot with my mood, even though it hasn't really made much impact on my fibro physical symptoms.
Sure hope you don't have fibro, but if you think you do, please converse with me. I'm more than happy to help if I can - been sleuthing this out for 3 years. Besides, it's a real bear to get diagnosed by your standard primary care doc. Good research has been done that's shedding some light, but it's still not taken seriously by too many doctors who tend to avoid what they don't understand. - Barbara
Posted by Barbara Cat on July 28, 2003, at 0:38:31
In reply to Katia--helpful article re: Lamictal, Li, Depakote, posted by fluffy on July 27, 2003, at 17:30:34
It's good to see lamictal being validated like that. It will be interesting to hear about lamictal+depakote experiences. Lithium's side effects concern me (thyroid, kidney) and if Dep is as effective without those problems, hey, I'm ready.
Posted by katia on July 28, 2003, at 2:17:57
In reply to Good article, Fluffers! » fluffy, posted by Barbara Cat on July 28, 2003, at 0:38:31
> It's good to see lamictal being validated like that. It will be interesting to hear about lamictal+depakote experiences. Lithium's side effects concern me (thyroid, kidney) and if Dep is as effective without those problems, hey, I'm ready.
Fluffers and Barb,
god, I just looked at the website on that rare rash that can form from either Depakote and/or Lamictal. It's almost put me off trying either one now. really. It scared the **** out of me. I almost wish I hadn't seen that web site. It's on another link/thread. I'm really really worried about this. Do you know the statistics? I feel very disheartened now - like dep. and lam. are no longer choices for me and i'll be like this forever. Those rashes seem incomprehensible to live through. Any comments?
Fluffy, I haven't read that article yet, but will.
katia
Posted by Barbara Cat on July 28, 2003, at 11:00:54
In reply to Re: Good article, Fluffers! » Barbara Cat, posted by katia on July 28, 2003, at 2:17:57
Katia,
The serious rash, Stevens Jacobsen rash, is very rare and only happens when one raises lamictal too quickly. Some slight rash may occur but it is rarely a problem and goes away. The true rash is unmistakable with blisters, fever and chills, and rarely develops in some very susceptible persons at too high a dosage. Problems can be prevented by raising dosage by 12.5mg a week until desired level, usually 100-200mg (but many are on higher). One caveat is that Depakote can raise blood levels of lamictal and there's caution about combining the two at the usual therapeutic dosages.I've recently developed a very annoying whole body itch. I only yesterday, after surfing the web, found out this sometimes happens when lamictal is raised. I forgot about the slow titration and went up 25mg in one week. If it doesn't subside soon I'll go back down 25mg, see how I feel, and raise it sloooooowly if needed. I don't feel anything is getting damaged or compromised, especially when you consider the damage stress and depression can do.
All of these mood meds have their price, some with side effects much worse than others. Lamictal is by far the most benign I've encountered as long as you have patience with the dosage increase. If you're really concerned about the rash, you can titrate even slower than 12.5mg a week. If you can have the patience to do this (sometimes we just want to feel better NOW), the rash should truly be very low on your priority of concerns. - Barbara
>
> Fluffers and Barb,
> god, I just looked at the website on that rare rash that can form from either Depakote and/or Lamictal. It's almost put me off trying either one now. really. It scared the **** out of me. I almost wish I hadn't seen that web site. It's on another link/thread. I'm really really worried about this. Do you know the statistics? I feel very disheartened now - like dep. and lam. are no longer choices for me and i'll be like this forever. Those rashes seem incomprehensible to live through. Any comments?
> Fluffy, I haven't read that article yet, but will.
> katia
Posted by katia on July 28, 2003, at 14:28:08
In reply to Lamictal rash. No prob with care » katia, posted by Barbara Cat on July 28, 2003, at 11:00:54
Thanks Barbara,
I need to hear this. So in the meantime, I've also talked to my pdoc. He is just quoting statistics, which is again, rare for that deadly rash to occur. But, it can also occur with Depakote, right? So I'm not surewhat to do, esp. b/c Dep. and Lam. might not be able to work together.
I do trust him, but I also trust myself and this board. I do have to remember his is the one who studied this stuff for years. And his reasoning to start with Depakote is that it's "tried and true" as a pretty good mood stabilizer. And that his rationale is this will hopefully even out the "ups" so that I won't crash into the "downs". and that to see this result takes at least the length of a cycle. He works a lot with bipolar people and is pretty well known and respected. (i've been dxed as BP NOS - falling somewhere in between mixed and II).
and I can't help but feel my intuition is telling me to start on the Lamictal first. He suggested that I just start with the Dep. and see if I can even tolerate it, i.e. do I crash into severe depression within a week, am I too nauseous, do I gain weight, etc. and if I can, then we'll see if it works for me or not by I guess, waiting out a cycle. Problem is don't really know what a cycle is for me as I'm just plain moody as hell, mainly with the down. I am always taking the bull by the horns and making my own decisions disregarding real professional opinions even and I'm thinking maybe this time, listen to him first and then take the bull by the horns?
Oh, by the way, I don't have insurance and I get my meds from Canada and this pharmacy there doesn't have the ER version yet.
Posted by starlight on July 28, 2003, at 15:07:21
In reply to Re: Dancing queen and proud of it! » Barbara Cat, posted by katia on July 27, 2003, at 16:05:21
That's so funny to me, I suffer from the same stuff. I have periods where everything is okay, but also have periods, more likely when I'm depressed, when my whole body aches. My knees, my back, it just hurts to be alive, and the fatigue is tough too. I think that's why I like to smoke pot occaisonally too - it eases those feelings. But then there are times when everything feels much better. That was what I liked when I tried both depakote and zoloft, was they both eased those feelings. But I think the lamictal has done that as well.
starlight
Posted by katia on July 28, 2003, at 15:27:52
In reply to Re: Dancing queen and proud of it!, posted by starlight on July 28, 2003, at 15:07:21
> That's so funny to me, I suffer from the same stuff. I have periods where everything is okay, but also have periods, more likely when I'm depressed, when my whole body aches. My knees, my back, it just hurts to be alive, and the fatigue is tough too. I think that's why I like to smoke pot occaisonally too - it eases those feelings. But then there are times when everything feels much better. That was what I liked when I tried both depakote and zoloft, was they both eased those feelings. But I think the lamictal has done that as well.
>
> starlightWhat was your experience on Depakote?
Katia
Posted by Barbara Cat on July 28, 2003, at 15:30:59
In reply to Re: Lamictal rash. No prob with care » Barbara Cat, posted by katia on July 28, 2003, at 14:28:08
Katia,
This is the first I've heard about a rash with Depakote. The only thing I can think of is that it's known to increase blood levels of lamictal, kinda acts synergistically with it. But if you go slow, I've also heard it's a great combo.If I were you, Katia, I'd definitely start with Depakote and add Lamictal as your pdoc suggests. The reason is that Lamictal can be activating, especially at first, and can bring on hypomania/mixed states without a more centering med (Depakote, lithium) to buffer it. We know how awful mixed states is! BTW, what is Bipolar NOS? Haven't heard of that dx, but it sounds like that's what I am too.
A while back I slowly cut back on lithium. I'm hypothyroid and was getting alarmed at how lithium was making it worse, as it's known to do. I was down to 300mg lithium every other day and taking 75mg lamictal, and began to feel wired and disjointed and frenzied. Added back the lithium and felt much, much better. For me, they seem to need each other. I've never taken Depakote, but heard that it can make you feel calm and centered. It's worth a try to see if it's enough and if not you can add Lamictal once you've got a good stable base. But promise yourself that you'll get good exercise every day because turning into a blimp is pretty depressing. I get loads of exercise when I'm not laid up with a fibro flare and can barely lose a pound. It's frustrating. But if I don't work out it takes only a week to add on 5 pounds. Don't let this stop you but look at it as a great excuse to use exercise as the best antidepressant around.
Posted by Barbara Cat on July 28, 2003, at 16:01:22
In reply to Re: Dancing queen and proud of it!, posted by starlight on July 28, 2003, at 15:07:21
Starlight,
How does pot affect you? I get kind of hyper on it and achey, like my muscles are knotted. I enjoy the enhanced creativity, but I think it makes me a bit hypomanic and not at all mellow.> That's so funny to me, I suffer from the same stuff. I have periods where everything is okay, but also have periods, more likely when I'm depressed, when my whole body aches. My knees, my back, it just hurts to be alive, and the fatigue is tough too. I think that's why I like to smoke pot occaisonally too - it eases those feelings. But then there are times when everything feels much better. That was what I liked when I tried both depakote and zoloft, was they both eased those feelings. But I think the lamictal has done that as well.
>
> starlight
Posted by starlight on July 28, 2003, at 16:33:15
In reply to Re: Dancing queen and proud of it! » starlight, posted by katia on July 28, 2003, at 15:27:52
I loved it - it was so calming - until it felt like it slowed down my metabolism. Having suffered previously from a severe eating disorder that is one side effect I refuse to tolerate.
starlight
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