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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by Sheilac on October 2, 2013, at 16:54:53
Since I've broken my foot, I've had a series of steroid shots.
Bad move. Been super irritable, a few rage attacks, etc. steroids are bad for bipolars!
Gone back to 600mg Trileptal and 3 mg Klonopin and this has helped - Trileptal effects my vision terribly, but helps.
Since I'm still a wack job, I'm going back to 80mg of Geodon for added to stability, since it gave me stability before. I know I can always go higher on Trileptal if need be as well - and get stronger glasses!
I was already having hypomania from Adderall use, now steroids induced mania, I need more stability. 80mg of Geodon is supposed to be good for this. It helped before! Just no more Adderall this time.
At least my doc will be happy I went back on Trileptal, even if I have to wear glasses!
Any thoughts?
I know I've changed med dosages too much lately, but the series of steroids REALLY threw fuel on the already burning fire. I refused oral steroids because of this, the shots were too much!
Definitely, no more Adderall.
Posted by baseball55 on October 2, 2013, at 19:29:14
In reply to Steroid shots - NUTS now, posted by Sheilac on October 2, 2013, at 16:54:53
Why steroid shots for a broken foot? Why not just put a walking cast on the foot? Also - multiple steroid shots? Isn't three the maximum?
Posted by Phillipa on October 2, 2013, at 22:34:06
In reply to Re: Steroid shots - NUTS now, posted by baseball55 on October 2, 2013, at 19:29:14
I did google the steroid shots too and used for tissue inflammation. So I also question the steroid shots? A Walking boot if not bad or pins in breaks? Phillipa
Posted by phidippus on October 2, 2013, at 23:20:01
In reply to Steroid shots - NUTS now, posted by Sheilac on October 2, 2013, at 16:54:53
Steroids can feel like mania, make you very intense. I'd recommend 120 mg of Geodon.
It takes a lot of adderall to cause mania. You'd be hallucinating before anything else.
Eric
Posted by Sheilac on October 3, 2013, at 14:52:34
In reply to Re: Steroid shots - NUTS now » Sheilac, posted by phidippus on October 2, 2013, at 23:20:01
There is a lot of inflammation, even after 2 steroid shots and daily anti inflammatories.
Eric, I miss the tiny dose of 5mg Adderall XR. I just don't know how I can take it. Very frustrating.
Trileptal is stabilizing.
Cons: Trileptal also effects my asthma, makes my breathing worse, and effects my vision. Pros: doesn't cause weight gain.
80mg of Geodon is vastly different (and stabilizing) than 40mg Geodon, which is de-stabilizing. I became unstable & had a rage attack the ONE day I did not take 5mg Adderall with 80mg Geodon. Don't understand that. Maybe a higher dose of Geodon would have prevented that? Can Geodon be used at a higher dose for stabilization. 5mg Adderall shouldn't have been enough to push me over the edge.
Maybe an even higher dose of Geodon (120mg) with Klonopin and I can tolerate the Adderall. That would make everything very simple. That would be great.
The only reason I'm taking Geodon is for BP depression, I just stumbled upon the stability with 80mg.
I can't tolerate any ADs for depression. None.
I may get a 2nd opinion from my husbands neurologist, but I don't know if he likes AAPs (he took my husband off Risperdal). He MAY say ok to me using Geodon, especially for BPII.
My doc isn't much help at this point. She likes Buspar, Trileptal, Klonopin and Adderall.
Posted by phidippus on October 3, 2013, at 15:05:58
In reply to Re: Eric and others..., posted by Sheilac on October 3, 2013, at 14:52:34
>Eric, I miss the tiny dose of 5mg Adderall XR. I >just don't know how I can take it. Very >frustrating.
5 mg is not going to destabilize you. You have a high degree of anxiety about your meds.
>Trileptal is stabilizing.
What other mood stabilizers have you tried? And what is your current dose of the trileptal?
>Maybe a higher dose of Geodon would have >prevented that? Can Geodon be used at a higher >dose for stabilization.
Higher doses of Geodon tend to be more stabilizing.
Eric
Posted by Sheilac on October 3, 2013, at 15:42:30
In reply to Re: Eric and others... » Sheilac, posted by phidippus on October 3, 2013, at 15:05:58
I liked Depakote sprinkles in capsules - can't remember dose.
Lithium was good, but caused thyroid nodule - scary, doc made me stop.
Loved 2.5mg Zyprexa - doc doesn't like due to weight gain.
Lamictal was ok, never gave stabilization - just AD effects. Higher dose caused mouth blisters & canker sores.
Right now I'm on 600mg of Trileptal. Even at 300mg it effects my vision, but it's good even at 300mg. Trileptal will calm me down very quickly.
I just don't understand why Adderall (and poor man's sub - caffeine), would cause such mood instability. Adderall tends to do it more so. I guess that's a clear indication of needing more stabilization before Adderall.
The diff today with 80mg Geodon on board is a world of difference. Less irritability. Adderall would help in a weird way with irritability. I tend to feel less tired and more focused, thus less irritable. Fine line.
I do have a lot of anxiety in general, you're right. I'd just like to be stable and not go off track with too much coffee or a tiny dose of Adderall.
Posted by Sheilac on October 3, 2013, at 15:47:24
In reply to Re: Eric and others..., posted by Sheilac on October 3, 2013, at 15:42:30
You said it would take a lot of Adderall to cause mania. I'm guessing a rage episode/quick temper, probably means I just wasn't sufficiently stabilized to even be taking a low dose of Adderall.
Unless stimulants can cause rage.
Posted by phidippus on October 3, 2013, at 15:51:47
In reply to Re: Eric earlier post..., posted by Sheilac on October 3, 2013, at 15:47:24
>I'm guessing a rage episode/quick temper, probably means I just wasn't sufficiently stabilized to even be taking a low dose of Adderall.
This is more likely to be psychological than psychiatric.
At 5 mg, you really shouldn't worry about taking Adderall.
Eric
Posted by phidippus on October 3, 2013, at 15:56:24
In reply to Re: Eric and others..., posted by Sheilac on October 3, 2013, at 15:42:30
>Right now I'm on 600mg of Trileptal.
That's a little low. Why are you afraid of therapeutic doses?
>I just don't understand why Adderall (and poor man's sub - caffeine), would cause such mood instability.
It shouldn't and probably doesn't. Maybe you're mistaking the stimulant effects for mania.
Eric
Posted by Sheilac on October 3, 2013, at 16:18:13
In reply to Re: Eric and others... » Sheilac, posted by phidippus on October 3, 2013, at 15:56:24
The screaming fits of rage would indicate to me that something's not right with the Adderall. Possibly me NOT taking it one day caused me to feel some withdrawal. I usually feel irritable towards the end if the day when Adderall wears off. My reg doc thinks I need more Adderall.
What is the therapeutic dose of Trileptal - 1200mg? I would be exhausted and really need Adderall then! Plus, I'd be very depressed on a high dose of Trileptal.
You're right. I should be afraid about taking meds.
Posted by phidippus on October 3, 2013, at 16:45:05
In reply to Re: Eric and others..., posted by Sheilac on October 3, 2013, at 16:18:13
>The screaming fits of rage would indicate to me that something's not right with the Adderall.
I still think its psychological. 5 mg of Adderall is hardly even therapeutic. Its just not enough to affect the nervous system in a way that would impact your behavior.
Maybe you were just in a rage-y mood that day and if any drug is to blame, its the low trileptal. Yes, 1200 mg is a good therapeutic range.
Eric
Posted by Sheilac on October 3, 2013, at 17:00:35
In reply to Re: Eric and others... » Sheilac, posted by phidippus on October 3, 2013, at 16:45:05
Well, the steroids are definitely effecting me. I usually feel better, calmer, less irritable when I take 300mg Trileptal at a time. I think I need to take it 3x a day (instead of 2x). I'm an angry mess right now.
In the future, when I'm more stabile, I'll revisit the Adderall.
For now, I need (according to my husband) my Trileptal, Geodon & Klonopin - stability.
I should have taken a lunchtime dose of Trileptal and I probably wouldn't have become nutty this afternoon.
These steroids are making me hot and irritable.
My doc will be so freakin happy to know I'm taking my Trileptal.
Posted by phidippus on October 3, 2013, at 18:26:17
In reply to Re: Eric, posted by Sheilac on October 3, 2013, at 17:00:35
I recommend 1200 mg of Trileptal and 120 mg of Geodon.
Eric
Posted by Sheilac on October 3, 2013, at 18:55:19
In reply to Re: Eric » Sheilac, posted by phidippus on October 3, 2013, at 18:26:17
So does my husband!
Thanks, Eric.
Posted by SLS on October 3, 2013, at 20:38:37
In reply to Re: Eric » Sheilac, posted by phidippus on October 3, 2013, at 18:26:17
> I recommend 1200 mg of Trileptal and 120 mg of Geodon.
>
> EricThat's a good suggestion.
Sheila: Perhaps you can put a plan together with your doctor that includes these higher dosages. It is important that you continue to take these drugs at the prescribed dosages for an extended period of time while you are monitored by your doctor.
Try not to obsess about drugs. You may end up sabotaging your treatment. Perhaps you can call your doctor if you encounter problems rather than taking it upon yourself to deviate from the treatment plan.
The nature of your bipolar illness is one of neurobiological instability. Unfortunately, you may be making things worse with your constant pulsing of drugs. The brain is not a machine. It is a biological system. Drugs can produce enduring and sometimes irreversible changes in its function. How can you hope to feel better every day unless you stabilize your drug exposure every day?
- Scott
Posted by Sheilac on October 4, 2013, at 8:27:17
In reply to Re: Eric » phidippus, posted by SLS on October 3, 2013, at 20:38:37
Scott, good points. You guys are right.
It's interesting to me how 600mg a day of Trileptal used to work and all of a sudden I get steroid shots and 600mg doesn't work as good. The steroids really threw me off and showed that I probably wasn't on a stable dose to begin with.
Now I just have to get used to being stable - my brain a little slower in a normal way and not constantly racing. That's hard to get used to, but something my husband will appreciate.
Thank you! I appreciate being able to talk things out with you all on this board.
Posted by Sheilac on October 4, 2013, at 17:43:37
In reply to Re: Scott, posted by Sheilac on October 4, 2013, at 8:27:17
I can't sleep when I go above 60mg of Geodon.
80-120mg of Geodon makes sleeping very hard.
Any suggestions?
Last night I took 6mg melatonin. I slept on and off. Not great.
I need my sleep.
This is the end of the thread.
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