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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by bipolarspectrum on January 31, 2005, at 12:01:25
Hi,
My bipoalr depression seems to only respond to lithium but the side effects are unbearable.. So, I'm gonna try to get around it with low dose lithium combined with something else.. anyone have any ideas? Lamotrigine makes me hypomanic by the way, and I dont like the ssri and snri's sexual side effects..
any opinions?
bps
Posted by linkadge on January 31, 2005, at 19:25:48
In reply to low-dose LITHIUM - what to combine it with?????, posted by bipolarspectrum on January 31, 2005, at 12:01:25
lithium and wellbutrin may be an idea. Or lithium + TCA. Lithium + nortryptaline has been extensivly studied - often times the best combination to use in post ECT relapse prevention.
Linkadge
Posted by MM on February 1, 2005, at 3:45:43
In reply to Re: low-dose LITHIUM - what to combine it with?????, posted by linkadge on January 31, 2005, at 19:25:48
My opinion probably doesn't count for much, as my understanding of brain chemicals and how they work and what exactly the meds do is fairly limited, but I am dx'd bipolar and the AD that has worked the best for me is Wellbutrin, which works on norepinephrine and dopamine and not serotonin (which I believe is not at all what needed to be messed with, or raised in my brain chemistry); Wellbutrin is also supposed to be tried first for Bipolar depression because it is the least likely to cause mania (or so I've read).
HTHMM
Posted by Phillipa on February 1, 2005, at 16:42:28
In reply to Re: low-dose LITHIUM - what to combine it with?????, posted by MM on February 1, 2005, at 3:45:43
Why is this so? I thought wellbutrin kind of worked as an "upper". Fondly, Phillipa
Posted by MM on February 1, 2005, at 18:12:34
In reply to Re: low-dose LITHIUM - what to combine it with????? » MM, posted by Phillipa on February 1, 2005, at 16:42:28
http://www.bipolarworld.net/Phelps/ph_2002/ph581.htm
This was the only link I could find after a short search...It doesn't mention what chemical mechanism makes Wellbutrin less likely to cause mania/rapid cycling, but I wonder if that's even known? I mentioned I think my problem isn't, or wasn't, with low Serotonin (or at least not that an SSRI or SNRI could fix...hate being on them) so maybe it has something to do with that because Wellbutrin is the only? one that doesn't touch Serotonin. Anyway, HTH.
Meg
Posted by CareBear04 on February 2, 2005, at 11:21:02
In reply to low-dose LITHIUM - what to combine it with?????, posted by bipolarspectrum on January 31, 2005, at 12:01:25
hi there,
i'm currently on lamictal and lithium. i had to take a hiatus for a few months from lithium. while i was on lamictal alone, like you, i had hypomanic states, one after another. lithium makes me feel safe, but i need levels between 0,8 and 1.2. lamictal gives me a greater range of mood, but since it doesn't prevent the highs, i was always afraid that the floor could drop out at any minute.as for what to combine lithium with-- zoloft or prozac work well for me. i think you said you don't like SSRIs, and for the most part, neither do i. lexapro and paxil nearly killed me. it might be worth a try to keep lamictal on with the lithium. i'm lowering my lamictal a bit now, but i have hope that with lithium on board, the mood swings from lamictal will be controlled without losing the mood lifting property that the lamictal provides. i take stimulants like adderall or ritalin for ADHD-type symptoms and for energy, but one problem with these is that lithium counteracts adderall maybe by inhibiting some of the dopamine release. wellbutrin with lithium wasn't that effective for me unless i went up to 450mg. one suggestion that i don't think was mentioned yet is effexor. i was on effexor and lithium together, but i think the combo plus klonopin and risperdal dulled me down too much. i blame most of it on the risperdal. i think effexor + lithium is worth trying, especially since effexor hits both serotonin and norepinephrine like some of the TCAs but without as many side effects. good luck!
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