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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Budgie on November 11, 2003, at 14:30:19
Hi everyone.
I've been MIA for a while. Kinda had a bit of a breakdown and had to go to the ER. Nothing terrible (and they did literally nothing at the ER anyway), but it got me to switch doctors finally.
The new diagnosis is BP2, or some variant of the sort. After doing lots of research, it makes a lot of sense, and makes me realize just how blind, conservative, skeptical, and demeaning my old doctor was...
But anyway, I'm on 40mg (sometimes 30 when I feel "overcharged") Parnate and 1mg Klononpin (at least temporarily). We're talking about either Lithium or Lamictal. Anyone have experience with either of these combos?
Is Lithium anywhere near as sedating as Zyprexa? Schoolwork will just not allow me to be a zombie.
Does one work better/worse with MAOIs?
We're thinking that the Parnate (first AD that's ever *really* worked for me) actually played a role in potentiating my crisis. How should this be factored in?
Also should say I've got pretty bad social anxiety, at least when I'm depressed. Does one help with this at all? Is staying on the Klonopin with a mood-stablizer and an AD a good or bad idea?
Thanks for any help. I'll probably end up posting some of these questions again individually at some point.
Thanks,
Budgie
Posted by wsj on November 11, 2003, at 23:09:20
In reply to Bi-Polar 2...Parnate and Lithium/Lamictal?, posted by Budgie on November 11, 2003, at 14:30:19
glad your back budgie! good you found better pdoc! parnate is working for you? your taking the klonopin for sleep? you had to go up to 1mg to sleep? this was my first day on parnate. i'm currently taking .75 klonopin for sleep.
wsj
Posted by mattdds on November 12, 2003, at 0:50:56
In reply to Bi-Polar 2...Parnate and Lithium/Lamictal?, posted by Budgie on November 11, 2003, at 14:30:19
Budgie (Chris),
What's up man? Glad to see you back here.
It's interesting you say "breakdown", can you describe in more detail the symptoms that brought you to the ER? Did you have symptoms of mania?
I'm curious because I wound up in the ER with panic attacks a couple years back. The diagnosis was panic disorder, GAD and major depression.
I wonder if I could be diagnosed with BP II as well, by some docs. I've eluded most of the online screenings, if I do "have it", but perhaps I have a more subtle type like cyclothymia. I do notice cycles of feeling noticeably better than most and a little worse than most, over different periods of time. I'm not sure this bothers me enough to seek treatment for it though. I've never had acute, classic mania in any way though.
I'm curious as to how you do on mood stabilizers, do keep me informed! You sound a lot like me, for some reason.
One of the times that I wound up there, however, was not for an acute panic attack - I just felt so wound up and irritated that I couldn't take it anymore. They did very little except tell me there was nothing physically wrong, and off I went with 3 days worth of lorazepam (Ativan, a benzodiazepine).
You mentioned lithium, lamictal and the AP's. Has your doc mentioned Depakote? From my limited knowledge of BP, I understand that Depakote is more suited for BP II, and lithium for BP I.
How is the Klonopin working?
If the docs are thinking that Parnate may have played a role in your attack, will they keep you on it?
Glad you're back, hope you feel better!
Matt
Posted by Budgie on November 12, 2003, at 10:38:42
In reply to Bi-Polar 2...Parnate and Lithium/Lamictal? » Budgie, posted by wsj on November 11, 2003, at 23:09:20
Hey, thanks for the welcome. It's good to know one's been missed...I haven't been following the posts much recently. What made you finally decide to take the plunge into Parnate? How do you feel on it so far? I think for the first couple of weeks I was so worried about every little thing, wondering if this or that was because of the MAOI.
I'm still digging it. Like I said, it actually has worked for the depression, and I'll trade some of the unpleasant physical SE's for the lack of any mental/cognitive SE's any day. But also, as I mentioned in my post, I think it may have also aggravated an underlying condition, which may actually be a good thing if we can start addressing it instead of letting it fester.
I was taking Ambien for sleep for about two weeks. Ever since they gave me the Klonopin, there hasn't been any need for that. The Klonopin was actually kind of an emergency/temporary measure to settle me down a bit after my experience. My God, though, it's helped the social anxiety...
Why are you on Klonopin in the first place? Sleep or anxiety? It seems to be a great combination with Parnate.
Let's keep each other updated,
Chris
Posted by Budgie on November 12, 2003, at 11:30:10
In reply to Re: Bi-Polar 2...Parnate and Lithium/Lamictal? » Budgie, posted by mattdds on November 12, 2003, at 0:50:56
> Budgie (Chris),
>
> What's up man? Glad to see you back here.
>
Thanks, Matt. How've you been doing? Still just on the Klonopin? No major worries?> It's interesting you say "breakdown", can you describe in more detail the symptoms that brought you to the ER? Did you have symptoms of mania?
>
You know, I still can't say what it exactly was/is. Definitely not mania, per se, at least in the classic conceptualization. After an initial incredible response to the Parnate- best I felt since a carefree kid, I think- I started sliding downhill and couldn't figure out what the @#$% it was. I'd get these intense waves of anxiety and depression, feel better, then slip again back down further each time. I came to realize that I couldn't attribute each switch to anything in particular, only maybe trivial things sometimes. That was really scary in itself- not knowing what was causing me to be all over the place. Anyway, I just felt like I was on the verge of losing total control over things...One morning I woke up and I just knew I was either going to lose it completely and freak out of my skin or just kill myself if I kept trying to hold it in, keep it composed, you know? So I guess I didn't quite hit the "breakdown" point, but I knew it wasn't far away and I had to do something about it. It was the weekend, so I had my fiancee take me to the ER, hoping that I could see a psychiatrist who could do something for me until I could meet with my doc again. I was there ALL day, talked to four different people, none of whom did anything for me. One social worker did mention something about bi-polar, though, and that got me really thinking. Anyway, I left more furious than anything.
> I'm curious because I wound up in the ER with panic attacks a couple years back. The diagnosis was panic disorder, GAD and major depression.Was this your first exposure to these things, or were they severe attacks of something that you already knew was wrong? When I was 19 I had my first panic attacks- out of the blue. If I had known better, I would have gone to the hospital and asked someone what was going on. Wish I had...
>
> I wonder if I could be diagnosed with BP II as well, by some docs. I've eluded most of the online screenings, if I do "have it", but perhaps I have a more subtle type like cyclothymia. I do notice cycles of feeling noticeably better than most and a little worse than most, over different periods of time. I'm not sure this bothers me enough to seek treatment for it though. I've never had acute, classic mania in any way though.
>
Yeah, I'm really cautious about it, too, actually more out of respect for those who obviously have full-blown, classic manic-depression. But I look at my family history (one case of BPI with many hospitalizations, and what I see as an obvious tendency/undiagnosis in many other relatives, other mental illnesses, etc.), when I look at the periods between my major depressions, and even the qualities of the depressions themselves- and I can't ignore the extreme behaviors and basic instability that have constituted my life since I was a teenager. The kicker has been my horrible responses to AD monotherapy (especially SSRIs), and the positive response I had to Zyprexa (taken for anxiety, but as you know is also indicated for controlling mania).
> I'm curious as to how you do on mood stabilizers, do keep me informed! You sound a lot like me, for some reason.
>
> One of the times that I wound up there, however, was not for an acute panic attack - I just felt so wound up and irritated that I couldn't take it anymore. They did very little except tell me there was nothing physically wrong, and off I went with 3 days worth of lorazepam (Ativan, a benzodiazepine).
>
> You mentioned lithium, lamictal and the AP's. Has your doc mentioned Depakote? From my limited knowledge of BP, I understand that Depakote is more suited for BP II, and lithium for BP I.
>
Really? I hadn't heard that. I thought Depakote was better suited for mania, and it seems that BPII's struggle much more with depression. But yeah, I don't know.
> How is the Klonopin working?
>
It's a miracle for social anxiety; you were absolutely right! Great for sleep. I have no idea what the long-term plan is with it.
> If the docs are thinking that Parnate may have played a role in your attack, will they keep you on it?
>
I think we're reluctant to make too many changes at once. I am getting some benefit out of it, especially when balanced out with the Klonopin. Besides, what other AD's are really an option? Maybe if a mood-stablizer works, I could eventually go off all AD's. It would be nice not to worry about taking 20 different pills!> Glad you're back, hope you feel better!
Much appreciated! Talk to you soon...
Chris
>
> Matt
>
>
Posted by wsj on November 12, 2003, at 18:41:05
In reply to Re: Bi-Polar 2...Parnate and Lithium/Lamictal? » wsj, posted by Budgie on November 12, 2003, at 10:38:42
unpleasant physical SE's??? what are these?
took klon originally for anxiety > but have stayed on it for sleep. only day 2 on parnate but so far just tired.wsj
Posted by Budgie on November 15, 2003, at 12:36:28
In reply to Re: Bi-Polar 2...Parnate and Lithium/Lamictal? » Budgie, posted by mattdds on November 12, 2003, at 0:50:56
Hey Matt,
Just wanted to see if you're still out there, if you ever got my response. Hope you're doing well.
That's all. Talk to you later...
Chris
Posted by trillium on November 28, 2003, at 23:52:17
In reply to Re: Bi-Polar 2...Parnate and Lithium/Lamictal? » mattdds, posted by Budgie on November 15, 2003, at 12:36:28
Has anyone experienced significant relief from depression with the addition of lithium to a regime of Parnate, Klononpin, trazodone?
due to 6-mo slide into the deepest depression i've ever experienced, lithium added few days ago.
trillium
Posted by deloris on November 29, 2003, at 23:35:58
In reply to Re: Bi-Polar 2...Parnate and Lithium/Lamictal?, posted by trillium on November 28, 2003, at 23:52:17
Lithium helps me, tho I really did not want to take it, I have depression bad so they tell me, it helps when my head can't stand noises or outside interference, or like when someone is talking me and I can;t really understand what in the hell they are talking about cause i have a hard time concenrating, it does make you pee alot at first say first 3 months with my anyway. I took lamitcal previously but it didn't do nothing.
Posted by leopard on November 30, 2003, at 3:33:54
In reply to Bi-Polar 2...Parnate and Lithium/Lamictal?, posted by Budgie on November 11, 2003, at 14:30:19
> Have you considered Geodon?
Hi everyone.
>
> I've been MIA for a while. Kinda had a bit of a breakdown and had to go to the ER. Nothing terrible (and they did literally nothing at the ER anyway), but it got me to switch doctors finally.
>
> The new diagnosis is BP2, or some variant of the sort. After doing lots of research, it makes a lot of sense, and makes me realize just how blind, conservative, skeptical, and demeaning my old doctor was...
>
> But anyway, I'm on 40mg (sometimes 30 when I feel "overcharged") Parnate and 1mg Klononpin (at least temporarily). We're talking about either Lithium or Lamictal. Anyone have experience with either of these combos?
>
> Is Lithium anywhere near as sedating as Zyprexa? Schoolwork will just not allow me to be a zombie.
>
> Does one work better/worse with MAOIs?
>
> We're thinking that the Parnate (first AD that's ever *really* worked for me) actually played a role in potentiating my crisis. How should this be factored in?
>
> Also should say I've got pretty bad social anxiety, at least when I'm depressed. Does one help with this at all? Is staying on the Klonopin with a mood-stablizer and an AD a good or bad idea?
>
> Thanks for any help. I'll probably end up posting some of these questions again individually at some point.
>
> Thanks,
> Budgie
>
>
This is the end of the thread.
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