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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 37. This is the beginning of the thread.
Posted by audrey on September 2, 2002, at 21:48:31
Hi,
I've recently been diagnosed with bi-polar II, and am in the middle of a hypomanic episode. I'll spare you the gory details...
Anyway, I was wondering if anyone would please share with me their experiences taking mood-stabilizers. The only meds I know about are lithium and depakote. I would like to hear the pros and cons people have endured taking those meds as well as any information about other meds that are used to treat hypomania.
Any input would be incredibly appreciated.
Thank you,
Audrey
Posted by rainbowlight on September 3, 2002, at 0:02:09
In reply to Medication experiences for hypomania/bi-polar II, posted by audrey on September 2, 2002, at 21:48:31
I take Lamictal as a mood stabilizer. By far it has been the best one for me and keeps me on an even keel. Lithium caused alot of mood flattening for me.
Posted by BarbaraCat on September 3, 2002, at 3:17:14
In reply to Re: Medication experiences for hypomania/bi-polar II, posted by rainbowlight on September 3, 2002, at 0:02:09
I'm taking subtherapeutic dose of lithium and 3000 mg neurontin. It's helped stabilize the frantic frazzled state that my otherwise delightful hypomania skids into. Rainbow, I've been considering Lamictal for a long time now and would welcome a detailed account of your experiences with it. I'm especially interested because of it's antidepressant effect. Has it been energizing, anxious? Did you get the rash? I also tried Topomax for a while to counter the weight gain from Remeron and lithium but it made me feel irritated and antsy.
> I take Lamictal as a mood stabilizer. By far it has been the best one for me and keeps me on an even keel. Lithium caused alot of mood flattening for me.
Posted by Ritch on September 3, 2002, at 9:19:02
In reply to Medication experiences for hypomania/bi-polar II, posted by audrey on September 2, 2002, at 21:48:31
> Hi,
>
> I've recently been diagnosed with bi-polar II, and am in the middle of a hypomanic episode. I'll spare you the gory details...
>
> Anyway, I was wondering if anyone would please share with me their experiences taking mood-stabilizers. The only meds I know about are lithium and depakote. I would like to hear the pros and cons people have endured taking those meds as well as any information about other meds that are used to treat hypomania.
>
> Any input would be incredibly appreciated.
>
> Thank you,
> Audrey
Hi Audrey,I have been dx'ed BP-II for over 20 years. I was on lithium first. It worked reasonably well, it was just tough to tolerate due to GI distress it caused-but good for depression and mild psychotic symptoms. I am on Depakote now, which doesn't bother my stomach, but it has a tendency to cause more tiredness and weight gain than lithium (but is the most potent antimanic I have tried). Tried Neurontin for a couple of years-seemed to work better for anxiety than hypomania, good as an adjunct for mixed-state agitation and social anxiety associated with bipolar depression. I have tried some others.. Tegretol, Trileptal, Topamax, Gabitril, but due to side effects didn't have much experience with them to comment on their efficacy.
hope this helps,
Mitch
Posted by crepuscular on September 3, 2002, at 11:10:11
In reply to Medication experiences for hypomania/bi-polar II, posted by audrey on September 2, 2002, at 21:48:31
low-dose atypical antispychotics seem to work well as mood stabilizers. That said, BPII's seem to be particularly vulnerable to EPS/TD.
I speak from both personal experience and seeing lots of posts here.
The drug companies really need to figure out how to treat bipolar disorders. at this point in medical history, it's just a mess. kinda like the disorder.
Posted by amber_spirit on September 3, 2002, at 12:00:20
In reply to Re: Medication experiences for hypomania/bi-polar II, posted by crepuscular on September 3, 2002, at 11:10:11
Take this with a grain of salt - this is all my
understanding from my own experience and info.Depakote is supposed to be a good anti-manic but
may dampen mood and energy.Lamictal is supposed to have good ad properties
and is somewhat energizingAnti-psychotics can be calming
Personal experience:
The depakote took away what I call the "hysterical"
part of my episode (From what people describe I
think it was a mixed episode and this was the
manic part of it) It decreased the agitation,
crying, and out-of-control feeling. But, it didn't
help with my energy and mood much. Lamictal alone
helped mood but at the same time increased the
agitation, etc. So, taking them together has been
working well. The Seroquel just gives me a calm
feeling and takes away any edge left there at the
end of the day. It also helps me sleep.Amber Spirit
Posted by BarbaraCat on September 3, 2002, at 13:08:06
In reply to Medication experiences for hypomania/bi-polar II, posted by audrey on September 2, 2002, at 21:48:31
Your 'gory details' would be welcomed here. Sometimes its very therapeutic to know that I'm not the only one squirming and that we're all kind of in this together.
Posted by Peter S. on September 3, 2002, at 18:27:02
In reply to Re: Medication experiences for hypomania/bi-polar II » audrey, posted by BarbaraCat on September 3, 2002, at 13:08:06
I've been taking Lamictal and Neurontin together for a while. When I first started taking Lamictal, the effect was almost immediate. I felt better more consistantly than I've ever felt. I noticed a drop after a week so I increased the dosage. I am finally up to 600mg and 900-1200 mg of Neurontin. I have'nt yet figured out these meds. I seem to crash for a couple of days and then it works. I take 400 mg of Lamictal in the a.m. plus 300 mg of Neurontin. I notice the effect in about an hour. It is an energized, wired feeling- not exactly anti-depressant but speedy. I actually find it a little unpleasant, but it is definitely an improvement over straight depression. I've experimented with Carbamazipine but this doesn't seem to help with the cycles. Someone said depakote is useful- maybe I'll try it.
Anyway this combination is the best thing I've found. It doesn't work consistantly, but at least it works. There are no side effects at all which is great.
Peter
> Your 'gory details' would be welcomed here. Sometimes its very therapeutic to know that I'm not the only one squirming and that we're all kind of in this together.
Posted by BarbaraCat on September 3, 2002, at 22:15:32
In reply to Re: Medication experiences for hypomania/bi-polar II, posted by Peter S. on September 3, 2002, at 18:27:02
Are you also taking another antidepressant concurrently, or is this it for your med cocktail? BTW, I was taking 1800mg Neurontin for a while and then just recently upped it to 2700mg and sometimes more. It's helped alot with creating a nice smooth feeling. Perhaps a tad more neurontin will counteract the unpleasant buzz you mention.
> I've been taking Lamictal and Neurontin together for a while. When I first started taking Lamictal, the effect was almost immediate. I felt better more consistantly than I've ever felt. I noticed a drop after a week so I increased the dosage. I am finally up to 600mg and 900-1200 mg of Neurontin. I have'nt yet figured out these meds. I seem to crash for a couple of days and then it works. I take 400 mg of Lamictal in the a.m. plus 300 mg of Neurontin. I notice the effect in about an hour. It is an energized, wired feeling- not exactly anti-depressant but speedy. I actually find it a little unpleasant, but it is definitely an improvement over straight depression. I've experimented with Carbamazipine but this doesn't seem to help with the cycles. Someone said depakote is useful- maybe I'll try it.
>
> Anyway this combination is the best thing I've found. It doesn't work consistantly, but at least it works. There are no side effects at all which is great.
>
> Peter
>
> > Your 'gory details' would be welcomed here. Sometimes its very therapeutic to know that I'm not the only one squirming and that we're all kind of in this together.
>
>
Posted by jay on September 3, 2002, at 23:52:43
In reply to Re: Medication experiences for hypomania/bi-polar II, posted by Peter S. on September 3, 2002, at 18:27:02
> I've been taking Lamictal and Neurontin together for a while. When I first started taking Lamictal, the effect was almost immediate. I felt better more consistantly than I've ever felt. I noticed a drop after a week so I increased the dosage. I am finally up to 600mg and 900-1200 mg of Neurontin. I have'nt yet figured out these meds. I seem to crash for a couple of days and then it works. I take 400 mg of Lamictal in the a.m. plus 300 mg of Neurontin. I notice the effect in about an hour. It is an energized, wired feeling- not exactly anti-depressant but speedy. I actually find it a little unpleasant, but it is definitely an improvement over straight depression. I've experimented with Carbamazipine but this doesn't seem to help with the cycles. Someone said depakote is useful- maybe I'll try it.
>
> Anyway this combination is the best thing I've found. It doesn't work consistantly, but at least it works. There are no side effects at all which is great.
>
> PeterHi Peter:
Do you only take the Neurontin once a day? (I couldn't quite tell from your post.) It is a med with a very short half-life, meaning it only stays in your system for a fraction of the day. Please let us know...and regardless I am sure we can figure out a plan.
Best wishes
Jay
Posted by BarbaraCat on September 4, 2002, at 0:53:23
In reply to Re: Medication experiences for hypomania/bi-polar II » Peter S., posted by jay on September 3, 2002, at 23:52:43
Hi Jay,
What is a therapeutic dose of Neurontin? I'm taking 900mg 3x/day and feel that I could probably go higher. I'll get a lovely blissed deep peace state with each increase, but unfortunately it only lasts a couple days. It seems to be a safe drug, but I start feeling like a junkey when I'm gobbling handfulls of the yellow pills 3-4 times a day. Any extended release on the horizon that you know of?
Posted by rainbowlight on September 4, 2002, at 3:40:37
In reply to Re: Medication experiences for hypomania/bi-polar II » rainbowlight, posted by BarbaraCat on September 3, 2002, at 3:17:14
I began taking Lamictal and Remeron at the same time. The only trouble I have with the Lamictal is that it is energizing to me, so much so that I have to use a sleeping pill to go to sleep every night. Also, the first few days on it I had a really bad headache in the back of my head. Pdoc said that was normal and it did go away after a few days. I have never had the rash. My pdoc says the rash usually shows up in your mouth first. I have heard that if you titrate the med up very slowly it helps to keep from getting the rash.
Posted by Peter S. on September 4, 2002, at 13:23:58
In reply to Re: Medication experiences for hypomania/bi-polar II » Peter S., posted by BarbaraCat on September 3, 2002, at 22:15:32
Thanks for the responses.
I'm not taking any any antidepressants currently. I was taking a small dose of prozac (10mg)- but it didn't seem to effect the cycles. I've had a hypomanic response to both Prozac, Zoloft, and Wellbutrin before.
Because of the cycling, I've been experimenting with taking 400mg of Lamictal and 600mg of Neurontin in the am. Then 200 mg of Lamictal and 300 mg at around 1:00 pm. I notice the effect begin to wear off around 4 or 5. Maybe I should spread out the Neurontin more or increase the dose. I guess other people are really on high doses of Neurontin- my pdoc is going by the book (900 max for Neurontin and 600 max for Lamictal). I think the half life of Lamictal is 24 hours- anybody know if this is true? What is the max people have taken of Lamictal? I have noticed no side effects so I wonder if it reasonable to go higher- are there any studies that have showed potential harm?
Anyway any input is most appreciated!
> Are you also taking another antidepressant concurrently, or is this it for your med cocktail? BTW, I was taking 1800mg Neurontin for a while and then just recently upped it to 2700mg and sometimes more. It's helped alot with creating a nice smooth feeling. Perhaps a tad more neurontin will counteract the unpleasant buzz you mention.
>
> > I've been taking Lamictal and Neurontin together for a while. When I first started taking Lamictal, the effect was almost immediate. I felt better more consistantly than I've ever felt. I noticed a drop after a week so I increased the dosage. I am finally up to 600mg and 900-1200 mg of Neurontin. I have'nt yet figured out these meds. I seem to crash for a couple of days and then it works. I take 400 mg of Lamictal in the a.m. plus 300 mg of Neurontin. I notice the effect in about an hour. It is an energized, wired feeling- not exactly anti-depressant but speedy. I actually find it a little unpleasant, but it is definitely an improvement over straight depression. I've experimented with Carbamazipine but this doesn't seem to help with the cycles. Someone said depakote is useful- maybe I'll try it.
> >
> > Anyway this combination is the best thing I've found. It doesn't work consistantly, but at least it works. There are no side effects at all which is great.
> >
> > Peter
> >
> > > Your 'gory details' would be welcomed here. Sometimes its very therapeutic to know that I'm not the only one squirming and that we're all kind of in this together.
> >
> >
>
>
Posted by Cindylou on September 4, 2002, at 13:52:48
In reply to Medication experiences for hypomania/bi-polar II, posted by audrey on September 2, 2002, at 21:48:31
Hi Audrey,
I've recently been diagnosed as BPII, and I'm having a hard time tolerating meds. Tried Lamictal -- could only get up to 75 mg. due to side effects, and it really didn't help me. (I probably needed more.)I'm now trying Geodon. I can only tolerate 20 mg. I'm not sure if it's helping or not! I seem to go up and down -- definitely not stabilizing yet (It's been about 3 weeks since I started.) At first it made me agitated at the end of the day, now I feel quite groggy. I'm sneaking some of my husband's Adderal to help with the foggy head. I know -- not smart to medicate myself. My pdoc is too hard to get ahold of. I'll see him Saturday and explain all this.
More info than you needed! Sorry for the rambling. I guess I just need someone to "listen" to me!
Hope you find a good med for you.
cindy
> Hi,
>
> I've recently been diagnosed with bi-polar II, and am in the middle of a hypomanic episode. I'll spare you the gory details...
>
> Anyway, I was wondering if anyone would please share with me their experiences taking mood-stabilizers. The only meds I know about are lithium and depakote. I would like to hear the pros and cons people have endured taking those meds as well as any information about other meds that are used to treat hypomania.
>
> Any input would be incredibly appreciated.
>
> Thank you,
> Audrey
Posted by audrey on September 5, 2002, at 15:51:26
In reply to Re: Medication experiences for hypomania/bi-polar II » audrey, posted by Cindylou on September 4, 2002, at 13:52:48
Thanks everyone for your input. I've done some research on the meds everyone mentioned, and I'm seeing my pdoc this evening. Over the last 5 days or so, I was really bad -- all of the sudden I would just get really irritated, and I would freak out. I was angry with my husband b/c he left a bunch of dirty clothes on the floor, so I ripped all the clothes off all the hangers in our closet and threw everything onto the floor so there was a huge heap of clothing in the closet, then I just laid on top of it and cried. How's that for gory details, BarbaraCat? Please tell me I'm not the only one who has these kinds of fits!! I feel so awful. Anyway, I called my pdoc, and he prescribed some emergency Zyprexia, an anti-psychotic, to get me through the last few days. Anyone else had any experience with it? It's helped a bit, but I'm still easily irritated. I just can't live like this! Thanks again for letting me know your med experiences.
Audrey
Posted by rainbowlight on September 6, 2002, at 1:25:44
In reply to Re: Medication experiences for hypomania/bi-polar II, posted by audrey on September 5, 2002, at 15:51:26
Hi Audrey. What you are describing sounds like agitation. I have had that many times and it is horrible. Hopefully your doctor will find you some meds that will help you feel more at ease. Let us know what happens at the doctors okay?
Posted by BarbaraCat on September 6, 2002, at 19:00:40
In reply to Re: Medication experiences for hypomania/bi-polar II, posted by audrey on September 5, 2002, at 15:51:26
No, Audrey, you're definitely not the only one who goes through experiences like these. Just one of my more memorable ones was when I punched a hole through a wall rather than my husband - and I barely felt it. When our nervous systems are strained beyond what is bearable, we just snap. It's a very understandable way to react to intense unrelenting stress.
What is very interesting to me is that I've been getting intravenous vitamins and minerals through my naturopath - today was the second visit (I have fibromyalgia but he's approaching it in a very whole body manner). The last few days, and today while receiving the drip, were so calm, so fine, with good sustained energy and enormous patience for everyone, through traffic jams, etc. My doctor said that I apparently either can't absorb meds very well through my gut, or something else goes awry along the way, and the fact that I'm responding so well to I.V. means that my body has been starving for the basics, especially B vitamins, calcium and magnesium - the 'nervous system nutrients'. I've always known to take B vitamins and the others and have done so in huge doses, but something wasn't getting through. The difference in my mood and physical well-being is astounding. What I'm getting at is, perhaps what we're suffering from here is something as simple as not getting enough bio-available vitamins and minerals! Now, the next step is to figure out how to do this without resorting to an IV drip. At any rate, taking alot of extra B vitamins, calcium and magnesium is important for you during this time (a really good brand, not something like Centrum or other cheap brand). My prayers go out to you. - Barbara
Posted by audrey on September 6, 2002, at 22:37:40
In reply to Re: Medication experiences for hypomania/bi-polar II » audrey, posted by BarbaraCat on September 6, 2002, at 19:00:40
Thanks for your encouragement, BarbaraCat. It does indeed help to hear someone understands what I'm going through. My pdoc put me on Depakote (started today), so now all I can do is wait and see. I'm hopeful -- something has to help!
I'm interested in the fact that you seem to metabolize better intravenously. I take plenty of vitamins, because I'm vegetarian, so I hope I'm getting everything I need. My pdoc is going to have me get regular blood testing since Depakote can cause liver problems, so I'll have to monitor the other stuff too.
Thanks again, and good luck. It must be nice just having even a few days of feeling normal. I hope taking plenty of the extra vitamins will help as much as the IV.
Audrey
Posted by BarbaraCat on September 7, 2002, at 12:55:19
In reply to Re: Medication experiences for hypomania/bi-polar » BarbaraCat, posted by audrey on September 6, 2002, at 22:37:40
I'm semi-vegetarian in that I occasionaly eat fish and chicken. As you know, we don't get enough B12. A product you might want to try is a sublingual B12 in the methylcobolamin form. Most B12 is cyanocobolamin and not as bio-active in the brain as the methyl form. I use Source Naturals Methylcobolamin sublingual 1M cut in half (500 mg) that I get through www.IHerb.com. Please keep me posted how the Depakote is going. I guess you also know about the weight gain potential, so I'd encourage you keep your body moving. I'm struggling to budge the pudge I gained on Remeron and lithium.
Posted by Cindylou on September 7, 2002, at 22:14:35
In reply to Re: Medication experiences for hypomania/bi-polar II » audrey, posted by BarbaraCat on September 6, 2002, at 19:00:40
Hi,
Just thought I'd add that I also have tried the IV vitamins (my doctor calls them "Meyers Cocktails"). I had them once a week through the month of June, but then I moved out of state and couldn't find a doc who would give these IV vitamins. I had energy and well-being unlike ever before for the months of June and July, but crashed in August. I am assuming the IV vitamins were still taking hold throughout July, but then pooped out.I just found another alternative medicine M.D. in the new state where I live who provides IV vitamin therapy, and I am going to start again. He said the same thing about my digestive system being "out of whack" -- explaining why I cannot metabolize oral vitamins well, or, for that matter, meds. He tested me for a Candida infection that he thinks may be the cause of the digestive problems ... we'll see what happens when the results come back.
I wanted to respond to your post since we have such similar experiences.
Take care!
cindy
> No, Audrey, you're definitely not the only one who goes through experiences like these. Just one of my more memorable ones was when I punched a hole through a wall rather than my husband - and I barely felt it. When our nervous systems are strained beyond what is bearable, we just snap. It's a very understandable way to react to intense unrelenting stress.
>
> What is very interesting to me is that I've been getting intravenous vitamins and minerals through my naturopath - today was the second visit (I have fibromyalgia but he's approaching it in a very whole body manner). The last few days, and today while receiving the drip, were so calm, so fine, with good sustained energy and enormous patience for everyone, through traffic jams, etc. My doctor said that I apparently either can't absorb meds very well through my gut, or something else goes awry along the way, and the fact that I'm responding so well to I.V. means that my body has been starving for the basics, especially B vitamins, calcium and magnesium - the 'nervous system nutrients'. I've always known to take B vitamins and the others and have done so in huge doses, but something wasn't getting through. The difference in my mood and physical well-being is astounding. What I'm getting at is, perhaps what we're suffering from here is something as simple as not getting enough bio-available vitamins and minerals! Now, the next step is to figure out how to do this without resorting to an IV drip. At any rate, taking alot of extra B vitamins, calcium and magnesium is important for you during this time (a really good brand, not something like Centrum or other cheap brand). My prayers go out to you. - Barbara
Posted by audrey on September 7, 2002, at 23:58:16
In reply to Re: Medication experiences for hypomania/bi-polar » audrey, posted by BarbaraCat on September 7, 2002, at 12:55:19
Thanks for the B12 suggestion. It's definitely something I need to pay attention to. I recently had a complete physical with a ton of blood tests, and my doctor said everything looked great. But you mention methylcobalamin vs. cyanocobalomin, which makes me wonder if my brain is getting all the B12 it needs... I'll have to check it out. And I think I might also look into IV-vitamin treatment. I hear about a lot of athletes taking some kind of "sports IV," and I've been interested in it, since I run and swim competetively. It would be great to have energy consistently, not just when I'm being hypomanic!
Take care of yourself,
Audrey> I'm semi-vegetarian in that I occasionaly eat fish and chicken. As you know, we don't get enough B12. A product you might want to try is a sublingual B12 in the methylcobolamin form. Most B12 is cyanocobolamin and not as bio-active in the brain as the methyl form. I use Source Naturals Methylcobolamin sublingual 1M cut in half (500 mg) that I get through www.IHerb.com. Please keep me posted how the Depakote is going. I guess you also know about the weight gain potential, so I'd encourage you keep your body moving. I'm struggling to budge the pudge I gained on Remeron and lithium.
Posted by Squiggles on September 8, 2002, at 18:37:48
In reply to Re: Medication experiences for hypomania/bi-polar II » audrey, posted by BarbaraCat on September 6, 2002, at 19:00:40
I was just reading these threads, and thought
you people might like to benefit from Dr. Phelps'
site on on all aspect of Bipolar Disorder;Here it is:
http://www.bipolarworld.net/Phelps/phelpsask.htm
take care
Squiggles
Posted by BarbaraCat on September 8, 2002, at 20:33:45
In reply to Re: Medication ... /bi-polar II (DR. PHELPS) » BarbaraCat, posted by Squiggles on September 8, 2002, at 18:37:48
Posted by BarbaraCat on September 8, 2002, at 21:04:02
In reply to Re: IV vitamins » BarbaraCat, posted by Cindylou on September 7, 2002, at 22:14:35
Hi Cindy,
Yes, Myer's Cocktail is the name, plus with extra antioxidants. I've been feeling great from them, lots of energy and well-being. Sure wish I could learn to concoct and give them to myself because they're soooo expensive. Hopefully your treatments at your new doctor will be covered by insurance. Supposedly, getting a series close in duration sparks and fans the healing flames, so to speak. That's what I'm hoping, cause I won't be able to afford too many more. It sure makes me ponder how compromised my (our) digestive systems must be and how little of the pills contents actually make it through.
Posted by Cindylou on September 11, 2002, at 17:31:48
In reply to Re: IV vitamins » Cindylou, posted by BarbaraCat on September 8, 2002, at 21:04:02
Hi Barbara,
I'm glad the Myer's are helping you! I can't wait to get started again -- my first appointment is Monday. I have a feeling my insurance won't cover it, though. Do you get yours through an actual I.V. (where it takes about an hour), or do you have someone sit with you and kind of push it your vein? (sounds gross, but I couldn't think of how else to describe it!) That's the way I did it at my old doctor's, and it only took 10 minutes. This new doc does the IV, and it takes an hour -- that's hard for me, since I have a 2- 1/2 year old and no sitter. Oh well, I'll find a way! It is so helpful.Hope you continue to feel better,
take care,
cindy
> Hi Cindy,
> Yes, Myer's Cocktail is the name, plus with extra antioxidants. I've been feeling great from them, lots of energy and well-being. Sure wish I could learn to concoct and give them to myself because they're soooo expensive. Hopefully your treatments at your new doctor will be covered by insurance. Supposedly, getting a series close in duration sparks and fans the healing flames, so to speak. That's what I'm hoping, cause I won't be able to afford too many more. It sure makes me ponder how compromised my (our) digestive systems must be and how little of the pills contents actually make it through.
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