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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by holymama on August 3, 2005, at 16:19:56
I am on Lithium 900 mg
Wellbutrin 400 mg
plus a sleeping pill and an ativan for anxiety once in a while. I am DEPRESSED.I went off all my meds a couple of months ago to get off the bleeping antidepressants I was on that I think may have kept me rapid cycling for the past two years.
So, I can't try antidepressants. THey make me manic and cycle.
Antipsychotics -- I tried two (while on antidepressants, mind you) and they did weird things to me. One flipped me into mania, the other sent me into a agitated depression that sent me to the hospital.
Lamictal gave me the rash.
SO what next???
I've been in this state of mild/moderate depression for 5 months. It's getting really old, and I have no idea what my new doctor is going to want to try with me.
Do I have more options????????????????? ECD is definitely something I would try if there is nothing else.
~~Autumn~~
Posted by partlycloudy on August 3, 2005, at 17:38:45
In reply to What to try next for stubborn Biplar?, posted by holymama on August 3, 2005, at 16:19:56
Have you tried the SNRI's - Effexor, Cymbalta? I'm BP2 and do well on Cymbalta with Topamax as a mood stablizer.
I am depressive with mild and short manic episodes.
p.s. have you selected a new p-doc? Make sure you bring her/him a list of what you have tried, if you can remember. My memory has become rather muddy - thank goodness I have posted so often here and I can look posts up!And also - please remember that this is not an illness that we are able to attempt to completely recover from. The meds, when they work properly and allow us to function to the best of our abilities, are also what allow us to LIVE as normally as possible. It is such a mean trick that nature plays upon us when we take suitable medications and feel relatively normal. We can't rely on that feeling to carry on if we choose to stop taking the medications. That is what landed me in such dire depression, finally. I took AD's for months, until I felt well and my GP agreed I was well, then would taper off, only to crash. Increasingly the periods of being medication free and feeling well became shorter and shorter - and I do not blame my GP - or her Nurse Practioner - for not picking up on the clues. they were very subtle and slow in coming.
with best wishes,
partlycloudy
Posted by linkadge on August 3, 2005, at 17:59:33
In reply to Re: What to try next for stubborn Biplar? » holymama, posted by partlycloudy on August 3, 2005, at 17:38:45
Does wellbutrin make you cycle ?
Linkadge
Posted by holymama on August 3, 2005, at 20:44:44
In reply to Re: What to try next for stubborn Biplar?, posted by linkadge on August 3, 2005, at 17:59:33
Thanks both of you for responding.
I have never tried any of the SNRI's. I guess I don't know much about them. They scare me because they still affect Serotonin (correct?) and the SSRIs seem to have given me much trouble. Do people react very differently from them versus the SSRI's? I tell you, SSRIs have a big EVIL attached to them for me.
Linkadge, I don't know if Wellbutrin makes me cycle. I've been off the SSRIs now for almost 2 months and the hope of everyone is that it won't. So far, I'm feeling pretty stabley depressed with a few days happiness thrown in here and there. I don't know if that's a cycling or what the heck it is. WHat do you know about Wellbutrin causing cycling?
Thanks for putting up with my interrogations.
~Autumn~
Posted by barbaracat on August 4, 2005, at 23:02:01
In reply to Re: What to try next for stubborn Biplar?, posted by holymama on August 3, 2005, at 20:44:44
I'm bipolar and have suffered holy hell for years before I was dx'd as not just unipolar depression. Lithium at 750mg saved my life but I was still depressed. Scared to retry ADs because of bad experiences with SSRIs sans lithium, I finally resorted to very low microdosing of Cymbalta.
The 30mg standard starting dose made me psychedelic in a bad way. Now I open the capsule and take 8mg. It's helped immensely. I really need an AD because when I don't the depression is always in the background. Now I look forward to life. As long as you're taking a stabilizine amount of an effective mood stabilizer, an AD shouldn't be a problem in small doses, especially since lithium potentiates the effect. I'd stay away from Effexor or Paxil. Too hard to withdraw. Zoloft is a good one. I found Wellbutrin to be way too edgy for me.
Posted by med_empowered on August 5, 2005, at 2:14:23
In reply to Re: What to try next for stubborn Biplar? » holymama, posted by barbaracat on August 4, 2005, at 23:02:01
hey! For most people with a bipolar disorder (myself included) depression is actually the *major* problem. Bipolar depressive episodes tend to last longer, be more intense, are more likely to have psychotic features, and sometimes resist repeated AD trials. That said...I think maybe a mood-stabilizer switch would help. Lithium seems to reduce suicide rates, but its really a *much* better anti-manic agent than it is an anti-depressant. Trileptal works nicely for some people, without blood tests. One combo that worked OK for me was Trileptal+Abilify+celexa (and then sleeping pills and klonopin as needed). I don't like antipsychotics very much--they tend to flatten out my mood-- but some people swear by them; Geodon and Abilify, in particular, have pronounced antidepressant effects (Zyprexa does, too, but I think the weight gain/diabetes risk makes Zyprexa a bit too risky, when there are other options). Then, for your anti-depressant, its good to think in terms of *augmentation* rather than focusing on an individual drug. If you're lethargic, adding Provigil or a traditional stimulant such as Ritalin or Dexedrine can be helpful...in those with bipolar, you need to watch out for cycling, but it can be very effective. Another option would be to add something to the Wellbutrin...celexa/lexapro, cymbalta, etc....and then further augment the combo with Buspar. There's some evidence that adding Buspar to an antidepressant speeds up reaction time and reduces some ill-effects of anti-depressants (like SSRI-induced anxiety). When all else fails, you can still use tricyclics. They have a bad reputation for causing cycling in bipolar, but they can still be useful as long as you're monitored and your mood-stabilizer is at an optimal dose. Tofranil-PM helped me a good bit; for treatment resistant depression, Sinequan, Surmontil, and Asendin are popular. Asendin is kind of a 2-for-1 medication; its an anti-depressant with some anti-psychotic properties. When it works, it usually works within 4-14 days. The only problem is that you get antipsychotic-style side effects, including the risk of TD. Good luck!
Posted by holymama on August 5, 2005, at 6:24:43
In reply to Re: What to try next for stubborn Biplar?, posted by med_empowered on August 5, 2005, at 2:14:23
WOW
Thank you all for all of the suggestions. I guess there are some options for me other than ECT.
My worry though, is in trying ANY antidepressants that do much at all to my serotonin levels. Even on good amounts of mood stabilizers (Lithium and Trileptal), I've rapid cycled out of control on ADs.
Does anyone know which of these or other drugs would give me antidepressant effects without touching serotonin?
We're hoping Wellbutrin might not make me cycle because the effects on serotonin are minimal.
Thank you all VERY MUCH. I have an appointment with my new pdoc on Monday, and she doesn't know how strongly I react to things. I want to be armed with some info when I go in.
Posted by med_empowered on August 5, 2005, at 9:00:48
In reply to Re: What to try next for stubborn Biplar?, posted by holymama on August 5, 2005, at 6:24:43
hey! I would *seriously* recommend avoiding ECT. Most of the available data is either old (read: "One Flew Over the Cuckoo's Nest" old) *or* funded by the ECT industry (believe it or not, ECT is a $5 Billion industry in the US). I've known people who've done it by the book, and its not that great, I think. I think one option for an anti-depressant would be Surmontil; its a tricyclic, but its "different". Kind of like Asendin, it has some neuroleptic effects...unlike Asendin though, it doesn't seem to cause EPS or TD. Its not potent enough to treat schizophrenia (except in high doses), but at the usual depression-level doses it can help in a "relaxing" manner, instead of stimulating you to the point of madness. Another option would be to go ahead with aggressive depression treatment, and also get an RX for "as-needed" antipsychotics. This is apparently catching on, although right now its being done a lot for people with Borderline Personality disorder. Anyway, since antipsychotics can tone down mania really quickly, popping an atypical when you sense a problem could prevent the situation from getting out of hand. As always, my preference would be for abilify--its weight neutral, diabetes risk is minimal, and it won't turn you into an over-sedated zombie--but any atypical could work...zyprexa @ 2.5-5mgs might be a good call (Geodon has a rep for causing mania in some people...and seroquel can be *intensely* sedating). Again...I wish you luck. You'll find something.
Posted by barbaracat on August 5, 2005, at 9:50:25
In reply to What to try next for stubborn Biplar?, posted by holymama on August 3, 2005, at 16:19:56
Dear Autumn,
Re-reading your original post, it seems like anxiety is a factor. I know personally that if anxiety gets out of control it will most definitely spin me into an agitated depression.You mention Serotonin as something to shy away from because of it causing possible rapid cycling, but I wonder if your current combo is a little too devoid of serotonin and adding to your depression. Wellbutrin is heavy on dopamine and norep. Dopamine has inverse effects on Se, so you may be getting a bit imbalanced in your neurochemicals.
I haven't heard many glowing reports of Buspar, but it might have just enough anti-anxiety effects by providing some Se. I'd certainly stay away from atypicals. I had the same reactions to them as you - groggy and then agitated depression. Ugh.
My personal favorite TCA is nortriptyline. It brought me out of a black despairing mixed states after my mother suddenly died 2 years ago. I have to stay on lithium, no ifs ands or buts, but nortrip was a godsend for the depression. I'd be on it today if it weren't for the sx's - dry mouth, constipation. I felt like I was drying up despite gallons of water. However, that was just my ultra-sensitivity coming up. Princess and the pea.
I really like Cymbalta. Heavy on the norep and about equal on se. It does not cause cycling for me and has kept me stable and feeling pretty good. But I strongly suggest starting off quite slowly by emptying a capsule into a container and taking pellets - 10 to start - and working up from there. A bit of a hassle, but 8mg or 80 pellets seems to be the magic dose for me.
We bipolars are so danged sensitive when it comes to ADs. I think we're typically overdosed by well-meaning pdocs who give us the standard dose for non bipolars. Microdosing of ADs has been effective for many of us.
Good luck. I know how frustrating this is. Oh, and get yourself some fish oil. It really helps. The liquid kind is best because you need at least 1 tablespoon. I like Carlson's Best which I get from iherb.com. And definitely B vitamins. You need B6 to make se. Consider getting your hormones checked too. If they're out of balance no amount of ADs are going to work for long. Best bet is seeing a naturopath that specializes in natural hormone therapy. Stay away from the synthetics. - Barbara
> I am on Lithium 900 mg
> Wellbutrin 400 mg
> plus a sleeping pill and an ativan for anxiety once in a while. I am DEPRESSED.
>
> I went off all my meds a couple of months ago to get off the bleeping antidepressants I was on that I think may have kept me rapid cycling for the past two years.
>
> So, I can't try antidepressants. THey make me manic and cycle.
>
> Antipsychotics -- I tried two (while on antidepressants, mind you) and they did weird things to me. One flipped me into mania, the other sent me into a agitated depression that sent me to the hospital.
>
> Lamictal gave me the rash.
>
> SO what next???
>
> I've been in this state of mild/moderate depression for 5 months. It's getting really old, and I have no idea what my new doctor is going to want to try with me.
>
> Do I have more options????????????????? ECD is definitely something I would try if there is nothing else.
>
> ~~Autumn~~
>
Posted by holymama on August 5, 2005, at 11:40:26
In reply to Re: What to try next for stubborn Biplar? » holymama, posted by barbaracat on August 5, 2005, at 9:50:25
thanks everyone, there is a ton of stuff out there. After spending two years rapid cycling on AD/mood stabilizer combos, I was so darn happy to get off the Paxil, (and before that, lexapro), that I was suspicious of causing the cycling. I had to finally go off paxil cold turkey to do it. I have a hard time getting off the ADs; once I start one, even a small tapering makes me violently depressed. I decided to go cold turkey and go into the hospital instead. So I'm cautious about what I add to my little cocktail, you see.
What Barbara said about Bipolars being really sensitive to ADs and needing to microdose is an idea that is new to me. It's something to keep in mind.
What is a TCA???
Posted by barbaracat on August 5, 2005, at 12:30:10
In reply to Re: What to try next for stubborn Biplar?, posted by holymama on August 5, 2005, at 11:40:26
A TCA is a tricyclic antidepressant. The older ones before SSRIs came out. They work better for some people but have more side effects. The side effects tend to diminish with time but Ms. Princess and the Pea (me) has a hard time with things like that.
Some ADs are notoriously hard to get off. Paxil and Effexor are among the hardest. Even though it's miserable and drawn-out, always taper off slowly. I don't doubt you had to be hospitalized going cold turkey. Some people get a small tapering down amount of Prozac during this period. It has a long half life and can smooth the ride while getting off the others which have a very short half-life and this causes many of the withdrawal problems.
If you were on ADs when you were not on lithium it's also no wonder you had a hard time. I didn't know I was bipolar, resisted the diagnosis actually, and SSRIs kept pooping out and causing awful reactions. When they pooped the dose would go higher and I ended up in the hospital.
Lithium has made all the difference in my life. It actually augments the effect of ADs so you generally don't need as much and the dose stays more stable. Microdosing is not something that you'll easily find references to on the internet, but a few of us bipolars on this board have discovered that it works for us.
For whatever reason, our chemistry and genetics seem to make it difficult to clear certain meds out of our system and they end up circulating longer and building up causing the various serotonin syndromes and noradreline anxieties from too high concentrations. Micro dosing takes care of this since lithium and the bipolar chemistry seems to potentiate the meds.
I can now get by with about 1/4 or less than the typical dose of SSRIs that would be prescribed for unipolar depression. More than that wigs me out badly. This doesn't extend to benzos unfortunately. I need to keep my anxiety levels very cool and calm and so I take the standard dose of ativan and ambien for sleep. Although ANY med changes character and has an effect at a very small dose. I can take a sliver of a benzo and feel it definitely affect me with a different feel. All so interesting.
I really urge you to look into your hormone profile, thyroid especially. If they are out of whack you'll have all the symptoms of a serious mood disorder that no psych meds can help with.
> thanks everyone, there is a ton of stuff out there. After spending two years rapid cycling on AD/mood stabilizer combos, I was so darn happy to get off the Paxil, (and before that, lexapro), that I was suspicious of causing the cycling. I had to finally go off paxil cold turkey to do it. I have a hard time getting off the ADs; once I start one, even a small tapering makes me violently depressed. I decided to go cold turkey and go into the hospital instead. So I'm cautious about what I add to my little cocktail, you see.
> What Barbara said about Bipolars being really sensitive to ADs and needing to microdose is an idea that is new to me. It's something to keep in mind.
> What is a TCA???
>
Posted by MidnightBlue on August 5, 2005, at 15:15:51
In reply to Re: What to try next for stubborn Biplar? » holymama, posted by barbaracat on August 5, 2005, at 12:30:10
Barbaracat,
Question if you don't mind. You said you resisted the bipolar dx. Were you "obviously" manic or hypomanic at times? or was it because you did not respond to SSRIs well? I have a long long history of severe depression. At one point Lithium was suggested along with 1000 depakote (for migraines) 350 Wellbutrin and Ambien. I flat out said no. I was sick of the doctor stacking up drugs that just make me apathetic and fat. He said he did not think I was/am bipolar. That was about 4 years ago. I wasn't eager to jump on the Remeron bandwagon either because of weight gain.
MB
> Lithium has made all the difference in my life. It actually augments the effect of ADs so you generally don't need as much and the dose stays more stable. Microdosing is not something that you'll easily find references to on the internet, but a few of us bipolars on this board have discovered that it works for us.
>
> For whatever reason, our chemistry and genetics seem to make it difficult to clear certain meds out of our system and they end up circulating longer and building up causing the various serotonin syndromes and noradreline anxieties from too high concentrations. Micro dosing takes care of this since lithium and the bipolar chemistry seems to potentiate the meds.
>
> I can now get by with about 1/4 or less than the typical dose of SSRIs that would be prescribed for unipolar depression. More than that wigs me out badly. This doesn't extend to benzos unfortunately. I need to keep my anxiety levels very cool and calm and so I take the standard dose of ativan and ambien for sleep. Although ANY med changes character and has an effect at a very small dose. I can take a sliver of a benzo and feel it definitely affect me with a different feel. All so interesting.
>
> I really urge you to look into your hormone profile, thyroid especially. If they are out of whack you'll have all the symptoms of a serious mood disorder that no psych meds can help with.
>
>
Posted by barbaracat on August 5, 2005, at 16:42:50
In reply to Re: What to try next for stubborn Biplar? » barbaracat, posted by MidnightBlue on August 5, 2005, at 15:15:51
I resisted a BP dx because I didn't want the stigma of what I thought at the time meant 'crazy'. I'd read Patty Duke's account and others and I didn't think I fit the description of their type of manic. But my depressions were also different from the typical ones and stumped most pdocs I'd seen, along with the fact that I didn't do well on SSRIs or any other type of psych med.
I'd have the garden variety sort of depressions, apathetic, lethargic, cynical, grey. But then there would be the truly horrific nightmarish ones, agitated, wailing, despairing, psychotic. And the intense crippling anxiety. I didn't realize these types were bipolar mixed-states depressions.
SSRIs would help at first but then quickly poop and raising the doses would make things worse with panic attacks. The black agitated depressions would always break through no matter how high a dose I went (and probably contributed to it).
As for mania, I did recognize that I'd had times of super energy, multiple plans going on, quick mercurial thinking, but I didn't know about hypomania. I associated mania with the wild florid types you read about. So I didn't think I fit the mold and taking lithium was an admission to something I wasn't ready for.
Only after being on lithium when I was able to think clearly and those horrible increasing nightmare depressions stopped could I honestly admit to myself that indeed I had more than a few classic super duper manias, and they all looked very different. Some were like mystical ecstacies, some were out of control crazy behavior.
I used to drink to calm the anxiety and whoo boy, when alcohol and mania clash! Gasoline on fire! I have little memory of some real wild times my concerned friends told me about afterwards. What I also didn't know was that anxiety, irritability, rage and instense fear are forms of manic dysphoria.
As I got to learn about the condition, I could recognize my symptoms quite clearly as classic Bipolar I. You only need one out-there true manic episode to fit the BP-I dx, and I'd had many. And the fact that I fortunately respond to lithium so well confirms it for me. Why it took so long, after 30 years of seeing pdocs for it to be recognized is a mystery.
I absolutely hated depakote and don't blame you for saying no to all those meds at once. Remeron turned me into a carb and sweet guzzling machine and I don't even like sugar. Gained 40 pounds on it and it didn't even work. This was before lithium. But yes, it is hard to lose weight on Li. But exercising my fanny off to stay sane is worth it and works out the stress too.
Even if you're not bipolar, many new schools of though recommend taking a mood stabilizer along with an AD for the augmenting and the lessening of poop out. For me I seem to need both lithium and an AD because my depressions are so entrenched in my world view and I quickly go there with stress. Fortunately, now that I'm on lithium, the ADs work. - Barbara
>
> Question if you don't mind. You said you resisted the bipolar dx. Were you "obviously" manic or hypomanic at times? or was it because you did not respond to SSRIs well? I have a long long history of severe depression. At one point Lithium was suggested along with 1000 depakote (for migraines) 350 Wellbutrin and Ambien. I flat out said no. I was sick of the doctor stacking up drugs that just make me apathetic and fat. He said he did not think I was/am bipolar. That was about 4 years ago. I wasn't eager to jump on the Remeron bandwagon either because of weight gain.
>
> MB
> > Lithium has made all the difference in my life. It actually augments the effect of ADs so you generally don't need as much and the dose stays more stable. Microdosing is not something that you'll easily find references to on the internet, but a few of us bipolars on this board have discovered that it works for us.
> >
> > For whatever reason, our chemistry and genetics seem to make it difficult to clear certain meds out of our system and they end up circulating longer and building up causing the various serotonin syndromes and noradreline anxieties from too high concentrations. Micro dosing takes care of this since lithium and the bipolar chemistry seems to potentiate the meds.
> >
> > I can now get by with about 1/4 or less than the typical dose of SSRIs that would be prescribed for unipolar depression. More than that wigs me out badly. This doesn't extend to benzos unfortunately. I need to keep my anxiety levels very cool and calm and so I take the standard dose of ativan and ambien for sleep. Although ANY med changes character and has an effect at a very small dose. I can take a sliver of a benzo and feel it definitely affect me with a different feel. All so interesting.
> >
> > I really urge you to look into your hormone profile, thyroid especially. If they are out of whack you'll have all the symptoms of a serious mood disorder that no psych meds can help with.
> >
> >
>
Posted by MidnightBlue on August 5, 2005, at 21:12:18
In reply to Re: What to try next for stubborn Biplar? » MidnightBlue, posted by barbaracat on August 5, 2005, at 16:42:50
Barbaracat,
Thanks for answering me so completely. I don't think anyone could EVER find me as being Bipolar 1. A stretch for BP 2 or 3. I have had a few times where I concentrated hard and got a ton of work done over a week or two. This was YEARS ago. One pdoc even thought I might be ADD. I think my Dad has learning problems. I have had times where I think and speak rapidly and everything "clicks" and I have had anxiety problems.
When I was switching from 325mg of desiprimine to Wellburtin (sorry don't remember starting dose of Wellbutrin or how fast the switch, but it was fast) I was a bit hypomanic not sleeping well and anxious for a couple of days. I also came really close to committing suicide. Ever since I have feared switching meds. But I settled down into a full and rapid response after many months of depression. I no longer respond to Wellbutrin, but it did work well for quite a while. I have never responded to SSRIs and only had a partial response to desiprimine. Most SSRIs gave me migraine headaches. I seem to be sensitive to serotonin inducing drugs. I seem to have lost most of my migraines now that I'm older.
For what it is worth, my sis is on antidepressants and so is my Mom, but she says she uses it only for sleep. My dad tried them but they didn't help. I wondered if he was bipolar because of his temper, but I guess I'll never know.
MB
> I resisted a BP dx because I didn't want the stigma of what I thought at the time meant 'crazy'. I'd read Patty Duke's account and others and I didn't think I fit the description of their type of manic. But my depressions were also different from the typical ones and stumped most pdocs I'd seen, along with the fact that I didn't do well on SSRIs or any other type of psych med.
>
> I'd have the garden variety sort of depressions, apathetic, lethargic, cynical, grey. But then there would be the truly horrific nightmarish ones, agitated, wailing, despairing, psychotic. And the intense crippling anxiety. I didn't realize these types were bipolar mixed-states depressions.
>
> SSRIs would help at first but then quickly poop and raising the doses would make things worse with panic attacks. The black agitated depressions would always break through no matter how high a dose I went (and probably contributed to it).
>
> As for mania, I did recognize that I'd had times of super energy, multiple plans going on, quick mercurial thinking, but I didn't know about hypomania. I associated mania with the wild florid types you read about. So I didn't think I fit the mold and taking lithium was an admission to something I wasn't ready for.
>
> Only after being on lithium when I was able to think clearly and those horrible increasing nightmare depressions stopped could I honestly admit to myself that indeed I had more than a few classic super duper manias, and they all looked very different. Some were like mystical ecstacies, some were out of control crazy behavior.
>
> I used to drink to calm the anxiety and whoo boy, when alcohol and mania clash! Gasoline on fire! I have little memory of some real wild times my concerned friends told me about afterwards. What I also didn't know was that anxiety, irritability, rage and instense fear are forms of manic dysphoria.
>
> As I got to learn about the condition, I could recognize my symptoms quite clearly as classic Bipolar I. You only need one out-there true manic episode to fit the BP-I dx, and I'd had many. And the fact that I fortunately respond to lithium so well confirms it for me. Why it took so long, after 30 years of seeing pdocs for it to be recognized is a mystery.
>
> I absolutely hated depakote and don't blame you for saying no to all those meds at once. Remeron turned me into a carb and sweet guzzling machine and I don't even like sugar. Gained 40 pounds on it and it didn't even work. This was before lithium. But yes, it is hard to lose weight on Li. But exercising my fanny off to stay sane is worth it and works out the stress too.
>
> Even if you're not bipolar, many new schools of though recommend taking a mood stabilizer along with an AD for the augmenting and the lessening of poop out. For me I seem to need both lithium and an AD because my depressions are so entrenched in my world view and I quickly go there with stress. Fortunately, now that I'm on lithium, the ADs work. - Barbara
> >
>
>
> > Question if you don't mind. You said you resisted the bipolar dx. Were you "obviously" manic or hypomanic at times? or was it because you did not respond to SSRIs well? I have a long long history of severe depression. At one point Lithium was suggested along with 1000 depakote (for migraines) 350 Wellbutrin and Ambien. I flat out said no. I was sick of the doctor stacking up drugs that just make me apathetic and fat. He said he did not think I was/am bipolar. That was about 4 years ago. I wasn't eager to jump on the Remeron bandwagon either because of weight gain.
> >
> > MB
> > > Lithium has made all the difference in my life. It actually augments the effect of ADs so you generally don't need as much and the dose stays more stable. Microdosing is not something that you'll easily find references to on the internet, but a few of us bipolars on this board have discovered that it works for us.
> > >
> > > For whatever reason, our chemistry and genetics seem to make it difficult to clear certain meds out of our system and they end up circulating longer and building up causing the various serotonin syndromes and noradreline anxieties from too high concentrations. Micro dosing takes care of this since lithium and the bipolar chemistry seems to potentiate the meds.
> > >
> > > I can now get by with about 1/4 or less than the typical dose of SSRIs that would be prescribed for unipolar depression. More than that wigs me out badly. This doesn't extend to benzos unfortunately. I need to keep my anxiety levels very cool and calm and so I take the standard dose of ativan and ambien for sleep. Although ANY med changes character and has an effect at a very small dose. I can take a sliver of a benzo and feel it definitely affect me with a different feel. All so interesting.
> > >
> > > I really urge you to look into your hormone profile, thyroid especially. If they are out of whack you'll have all the symptoms of a serious mood disorder that no psych meds can help with.
> > >
> > >
> >
>
>
Posted by MidnightBlue on August 6, 2005, at 0:59:59
In reply to Re: What to try next for stubborn Biplar?, posted by MidnightBlue on August 5, 2005, at 21:12:18
This is the end of the thread.
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