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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Ken Robinson on February 4, 2002, at 14:38:10
Hello all, I am a first-timer, I have bipolar I disorder. I am 42 years old. Was first diagnosed in 1977. I am a long cycler with about 6-9 months of year in depression and 1-3 months of mania that occur on a fairly regular yearly cycle. I think it fair to say that I am treatment resistant - meaning that I have not had much positve effect with medications. However have found that mood stabilizers control manic phase,either by completely eliminating or minimizing. The biggest problem for me comes with treating the depression and considering how much time I spend a year in depression, this is a great concern.
My current prescription is 15mg Zyprexa, 300mg Effexor and 20mg Ritalin. Ritalin is new started 1/7 although I have not taken much of it because it just seems to put me in a drug induced stupor.
I am once again frustrated with the medications not working. I have been on the Zyprexa and Effexor since June - 7 months now. I feel this a long enough trial and have communicated with my therapist and case manager that I don't think the current meds are working as they should.
I have a doctor appointment on the 7th of Feb - 3 days from now. I am going to tell the doctor that I want to try something else. To get off Zyprexa, Effexor and Ritalin. Lets dump the whole batch and start something new.
Today found some information on Topomax. I am considering suggesting we (Doctor and I)try this.
I am curious if any of you are or have taken Topomax and what your experiences have been. Also wondering about trying Depacote with a different Anti-depressant, one of SRRI class. I know the Depacote works for controlling my mania but does little if anything for the depression. I think that I have responded well to SRRI class in past but perhaps misdiagnosed myself as becoming manic. ( I tend to associate feeling good with mania). So doctor at the time quickly took me off. Have had this happen about 3 times now. Want to make sure I dont repeat that mistake again, if you tell them you think you are becoming manic they are quick to react. I wish they as quick when it comes to depression.Would like to hear from other treatment resistant bipolars to hear about your experiences with medications particulary if you have found the magic combination that works!
I am once again frustrated, but I am not going to give up and stop taking my meds this time. My mania are just too damn expensive. Last one that escaped my notice until after it was over cost me somewhere between $5K and $8K. $4K worth of debt and $4K manic spending spree trying to start another damn business. Trying to start a business seems to be my favorite manic obsession and I have indicated to several people that my doing so is a big warning sign.
I live in Tucson AZ, have been maried for 20 years and have a 14 year old daughter. Favorite current obsession is computers. (Love Hate relationship :) Last mania has given me 2 10x20 storage sheds full of used computer parts. I recieve disablity, but would like to get off, but would first like to get mood disorder under control, especially these damn long depressions. When I am depressed I have no motivation or confidence in self to work.Sorry for being so long winded here. I am been very reclusive for the past several months and I guess I am starting to get stir crazy!
Sincerly,
Ken Robinson
Posted by mr.scott on February 4, 2002, at 17:27:00
In reply to Bipolar wanting to try new medication, posted by Ken Robinson on February 4, 2002, at 14:38:10
> Hello all, I am a first-timer, I have bipolar I disorder. I am 42 years old. Was first diagnosed in 1977. I am a long cycler with about 6-9 months of year in depression and 1-3 months of mania that occur on a fairly regular yearly cycle. I think it fair to say that I am treatment resistant - meaning that I have not had much positve effect with medications. However have found that mood stabilizers control manic phase,either by completely eliminating or minimizing. The biggest problem for me comes with treating the depression and considering how much time I spend a year in depression, this is a great concern.
>
> My current prescription is 15mg Zyprexa, 300mg Effexor and 20mg Ritalin. Ritalin is new started 1/7 although I have not taken much of it because it just seems to put me in a drug induced stupor.
>
> I am once again frustrated with the medications not working. I have been on the Zyprexa and Effexor since June - 7 months now. I feel this a long enough trial and have communicated with my therapist and case manager that I don't think the current meds are working as they should.
>
> I have a doctor appointment on the 7th of Feb - 3 days from now. I am going to tell the doctor that I want to try something else. To get off Zyprexa, Effexor and Ritalin. Lets dump the whole batch and start something new.
>
> Today found some information on Topomax. I am considering suggesting we (Doctor and I)try this.
> I am curious if any of you are or have taken Topomax and what your experiences have been. Also wondering about trying Depacote with a different Anti-depressant, one of SRRI class. I know the Depacote works for controlling my mania but does little if anything for the depression. I think that I have responded well to SRRI class in past but perhaps misdiagnosed myself as becoming manic. ( I tend to associate feeling good with mania). So doctor at the time quickly took me off. Have had this happen about 3 times now. Want to make sure I dont repeat that mistake again, if you tell them you think you are becoming manic they are quick to react. I wish they as quick when it comes to depression.
>
> Would like to hear from other treatment resistant bipolars to hear about your experiences with medications particulary if you have found the magic combination that works!
>
> I am once again frustrated, but I am not going to give up and stop taking my meds this time. My mania are just too damn expensive. Last one that escaped my notice until after it was over cost me somewhere between $5K and $8K. $4K worth of debt and $4K manic spending spree trying to start another damn business. Trying to start a business seems to be my favorite manic obsession and I have indicated to several people that my doing so is a big warning sign.
>
>
> I live in Tucson AZ, have been maried for 20 years and have a 14 year old daughter. Favorite current obsession is computers. (Love Hate relationship :) Last mania has given me 2 10x20 storage sheds full of used computer parts. I recieve disablity, but would like to get off, but would first like to get mood disorder under control, especially these damn long depressions. When I am depressed I have no motivation or confidence in self to work.
>
> Sorry for being so long winded here. I am been very reclusive for the past several months and I guess I am starting to get stir crazy!
>
> Sincerly,
>
> Ken RobinsonYou sound like a lithium + Lamictal type since you don't have rapid cycling and you're primarily depressed. Have tried those before?
Scott
Posted by JohnX2 on February 4, 2002, at 21:36:07
In reply to Re: Bipolar wanting to try new medication » Ken Robinson, posted by mr.scott on February 4, 2002, at 17:27:00
Hi Ken.
I concur with Scott.
Lamictal is an excellent anti-convulsant/mood stabilizer
with good anti-depressant properties for people with
bipolar with tricky depression. But it can trigger
(hypo)mania, so you better have a good anti-manic
agent attached to it based on your issues.Lamictal is tricky to get onto and requires very
careful and slow dosing at first so you need a
good pdoc but it is well worth the effort for a
lot of people (I am biased as it was the 1st med
to control my major depression and I am bipolar).
Anyways, Lamictal in general has low side effects once you
are at a stable dose too.As far as Topamax goes, I am taking the follow
medicine regimen:Lamictal 150 mg
Topamax 400 mg
Zyprexa 15 mg
Klonopin 1 mgThe Lamictal was started 1st and it got my
severe depression under control after a 2 yr
battle. I later added Zyprexa which helped a
little with dysphoric hypomanic symptoms. When
I recently added Topamax I got a REALLY pleasant
surprise, my residual dysphoric state was completely
anhilated. Also I had almost no side effects from
Topamax except benzo side effects.My experience on Topamax was quite unique in that most people
get cognitive downsides, but I didn't. I think
it works synergistically with the Lamictal. I
pinged people on this newsgroup to see if anyone
has tried the Topamax + Lamictal combo and I
seem to be the pioneer in this area, so you may
want to consider that option. Topamax alone
has a so-so record on (This is just my opinion
and also my pdocs).Anyways we wish you the best of luck.
Regards,
John
> > Hello all, I am a first-timer, I have bipolar I disorder. I am 42 years old. Was first diagnosed in 1977. I am a long cycler with about 6-9 months of year in depression and 1-3 months of mania that occur on a fairly regular yearly cycle. I think it fair to say that I am treatment resistant - meaning that I have not had much positve effect with medications. However have found that mood stabilizers control manic phase,either by completely eliminating or minimizing. The biggest problem for me comes with treating the depression and considering how much time I spend a year in depression, this is a great concern.
> >
> > My current prescription is 15mg Zyprexa, 300mg Effexor and 20mg Ritalin. Ritalin is new started 1/7 although I have not taken much of it because it just seems to put me in a drug induced stupor.
> >
> > I am once again frustrated with the medications not working. I have been on the Zyprexa and Effexor since June - 7 months now. I feel this a long enough trial and have communicated with my therapist and case manager that I don't think the current meds are working as they should.
> >
> > I have a doctor appointment on the 7th of Feb - 3 days from now. I am going to tell the doctor that I want to try something else. To get off Zyprexa, Effexor and Ritalin. Lets dump the whole batch and start something new.
> >
> > Today found some information on Topomax. I am considering suggesting we (Doctor and I)try this.
> > I am curious if any of you are or have taken Topomax and what your experiences have been. Also wondering about trying Depacote with a different Anti-depressant, one of SRRI class. I know the Depacote works for controlling my mania but does little if anything for the depression. I think that I have responded well to SRRI class in past but perhaps misdiagnosed myself as becoming manic. ( I tend to associate feeling good with mania). So doctor at the time quickly took me off. Have had this happen about 3 times now. Want to make sure I dont repeat that mistake again, if you tell them you think you are becoming manic they are quick to react. I wish they as quick when it comes to depression.
> >
> > Would like to hear from other treatment resistant bipolars to hear about your experiences with medications particulary if you have found the magic combination that works!
> >
> > I am once again frustrated, but I am not going to give up and stop taking my meds this time. My mania are just too damn expensive. Last one that escaped my notice until after it was over cost me somewhere between $5K and $8K. $4K worth of debt and $4K manic spending spree trying to start another damn business. Trying to start a business seems to be my favorite manic obsession and I have indicated to several people that my doing so is a big warning sign.
> >
> >
> > I live in Tucson AZ, have been maried for 20 years and have a 14 year old daughter. Favorite current obsession is computers. (Love Hate relationship :) Last mania has given me 2 10x20 storage sheds full of used computer parts. I recieve disablity, but would like to get off, but would first like to get mood disorder under control, especially these damn long depressions. When I am depressed I have no motivation or confidence in self to work.
> >
> > Sorry for being so long winded here. I am been very reclusive for the past several months and I guess I am starting to get stir crazy!
> >
> > Sincerly,
> >
> > Ken Robinson
>
> You sound like a lithium + Lamictal type since you don't have rapid cycling and you're primarily depressed. Have tried those before?
>
> Scott
Posted by anniebananie on February 5, 2002, at 22:00:07
In reply to Bipolar wanting to try new medication, posted by Ken Robinson on February 4, 2002, at 14:38:10
>
> Would like to hear from other treatment resistant bipolars to hear about your experiences with medications particulary if you have found the magic combination that works!
Ken,I wouldn't call it magic, but lamictal's been the only mood-stabilizer that's done anything for my depression. And it doesn't make me foggy, sleepy or stupid.
Good luck,
Annie
Posted by Ken Robinson on February 6, 2002, at 18:27:02
In reply to Re: Bipolar wanting to try new medication » mr.scott, posted by JohnX2 on February 4, 2002, at 21:36:07
Hi John,
Thanks for the response, Tried Lamictal a while back but developed a rash within 1st week and they took me off. I recently stopped, about 2 weeeks ago now, taking Effexor and Ritalin and I seem to be feeling better than when I was on them. Now just on Zyprexxa 15mg. Will be seeing Doc tommorow and ask to try Topomax - since I seem to be feeling better than before maybe the Zyprexa is working - does help me sleep too.
I am curious, what is the Klonopin for. Also when you said 2 year battle with severe depression, is that how long it took for the Lamictal to work?
Sincerely,
Ken Robinson
Posted by Ken Robinson on February 6, 2002, at 18:31:32
In reply to Re: Bipolar wanting to try new medication » Ken Robinson, posted by anniebananie on February 5, 2002, at 22:00:07
> Ken,
>
> I wouldn't call it magic, but lamictal's been the only mood-stabilizer that's done anything for my depression. And it doesn't make me foggy, sleepy or stupid.
>
> Good luck,
> AnnieHi Annie,
Just curious as to what other medications you had tried. Don't know that Lamictal is an option for me since I developed a rash within 1 week and they took me off of it. And I was seeming to have a positive response, other than the rash :(
Ken
Posted by ST on February 6, 2002, at 22:13:59
In reply to Bipolar wanting to try new medication, posted by Ken Robinson on February 4, 2002, at 14:38:10
> >I know the Depacote works for controlling my mania but does little if anything for the depression.< <
Yes, Depakote is mostly for keeping a lid on mania while your SSRI should help with the depression.
I'm on 500 mg Depakote, 300 mg Wellbutrin (have you tried it?) and 225 mg of Effexor. I am mostly depressed with very short, mild hypomanic episodes. I understand that feeling where as soon as you start to "feel good" on a new med you think it might be mania!
Good luck!
Sarah
Posted by SusanB on September 29, 2002, at 15:24:34
In reply to Re: Bipolar wanting to try new medication, posted by Ken Robinson on February 6, 2002, at 18:31:32
Dear Ken,
This is months after your original post and I'm not sure if you'll get this but this is my experience. I'm 52, also with a child (he's 13) and I've also been married for 20 years. My illness wasn't diagnosed until 8 years ago and I have been on every medication imaginable. A depression a year ago lasted for 8 months. It had become intolerable and a new doctor prescribed Adderall, a stimulant. Within one day, I felt better, and it didn't switch into a hypomania. I had already tried almost every mood stabilizer out there, including Lithium, Depakote, Tegretol, Lamictal, Neutrontin and others. None had worked. Eventually, we retried Depakote and it seems to be working. But once again, we are experimenting with medications for the depression. The Adderall seems to poop out but it is still having some effect. I am now on Depakote (750 mg), Adderall (60 mg), Wellbutrin (200--a larger dosaged changed my personality and I lost all patience), and Lexapro (10 mg.) This combination is not quite working. I don't think the Lexapro is doing anything (we're going to up the dosage, and we may have to change the Adderall. What I just wanted to tell you was that for me, taking a stimulant was a life-saver. My other doctor was so concerned about the hypomanias that he never truly focused on the depressions, which were lengthy and intense. Hope all these months later, you've found something that works for you.Susan
Posted by jdgjdg on February 18, 2004, at 0:44:58
In reply to Re: Bipolar wanting to try new medication » mr.scott, posted by JohnX2 on February 4, 2002, at 21:36:07
I'm searching for possibilities for bipolar meds as well. I'm new to the bipolar world, so I really know nothing except stories of bad side efffects. I also have OCD which has been treated successfully for about 2 years with Zoloft, then switching to Lexapro due to side effects(sleeping). I have had severe depression and manic episodes for the last 15 years aprox. Just got up the nerve to tell my psych. doc today about my symptoms. My depressions generally follow manic episodes of excessive spending, avoiding paying my household bills, promiscuity, insomnia, and uncontrollable mood swings. I will go from a manic or semi-manic state to complete hysteria and uncontrolable panic with hyperventelating and bawling my eyes out for no apparent reason. It has never been situational. I guess(being the vain woman that I am, lol)my main concern is excessive weight gain with lithium or the like. I would love to hear anyone's experiences with starting these medications. I realize it's different for everyone, but there must be some common threads. thanks for listening. I'm manic and rambling on and on, and on. Good night. jdgjdg
Posted by Tony P on February 19, 2004, at 2:14:12
In reply to Re: Bipolar wanting to try new medication, posted by jdgjdg on February 18, 2004, at 0:44:58
I agree with several previous posts that Lamictal is a really good one to try. I am (probably) Bipolar 2 or 3, definitely not classic BP 1, but my pdoc says he has had good experience with Lamictal and the whole spectrum of bipolar disorder. Very low side effect profile so long as you follow manufacturer's suggested S-L-O-W initial titration up. Once you get to 100-300 mg a day, the effects kick in very fast - a few days, not months.
Good antidepressant AND mood stabilizer, with some anti-anxiety properties in one pill - hard to beat! I had one hypomanic episode two days after I went from 50 to 100 mg/day, but a hefty dose of clonazepam and a small dose of Seroquel brought me down to earth in under 24 hrs.
I have been on 200 mg/day - the commonest dose - for about a month, with good though not spectacular results; just went up to 250mg/day this week and already feel more positive. I suspect (and hope) that as I gradually cut out the cocktail of other meds (benzos, Buspar, Imovane, OTC Robaxin) I have been on, that things will only get better.
I also have read here and elsewhere that for those who don't get adequate A/D response from Lamictal alone, it can be safely combined with almost any other A/D. I wonder in particular for myself about Wellbutrin, which by itself made me feel great but drove me manic at the full dose. Maybe it might be safe for me with the stabilizing effect of Lamictal. But first I will go with the Lamictal alone for a while.
Tony P
Posted by Emme on February 22, 2004, at 18:03:52
In reply to Re: Bipolar wanting to try new medication, posted by Ken Robinson on February 6, 2002, at 18:31:32
> Just curious as to what other medications you had tried. Don't know that Lamictal is an option for me since I developed a rash within 1 week and they took me off of it. And I was seeming to have a positive response, other than the rash :(
>
> KenWhat dose did you start at? Perhaps ask your doctor about a retrial at a super low starting dose and a super slow titration. (if you can stand waiting so long to reach a therapeutic dose.) You can get Lamictal in 5 mg tabs. I'm the board "poster gal" for Lamictal retrial. :) But it is something to at least throw out there and maybe think about.
This is the end of the thread.
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