![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 11 to 35 of 36. Go back in thread:
Posted by Ron Hill on November 7, 2007, at 21:15:15
In reply to Oh no!!!!!!! I am in big trouble!!!!Nardil Man!, posted by ace on November 3, 2007, at 0:19:58
Ace,
> first of all i am really sorry if i missed any messages someone posted at me last time...I think sorry to Ron is in order...I just have so much workload, but I don't want to ignotre anyone.
No problem, Ace. At the time, I fully understood that you were (and probably still are) overloaded with your studies.
> I have to get wisdom teeth out, and YES- i have to stop Nardil ...I agree with other posters; do some research and find a way that it can be done without temporarily taking yourself off of Nardil.
You may be different, but if I try to even slightly reduce my Nardil dosage, I quickly fall into depression. Realistically, I think it would take six months to a year to wean myself off of 90 mg of Nardil. However, you have increased and decreased your Nardil dosage in the past, so you might have a pretty good idea of what it would take.
If you do end up deciding to wean yourself off of Nardil for the surgery, maybe you could wait until summer break?
> ....(I am too young and handsome to die now:))
And humble too, aye Mate? ;-)
-- Ron
dx: Bipolar II, with ultra rapid cycling (15 days for one complete cycle), and mild Obsessive Compulsive Personality Disorder (OCPD)
600 mg/day Trileptal
200 mg/day Lamictal
875 mg/day Keppra
90 mg/day Nardil
7.5 mg/day Deplin
Posted by kaleidoscope on November 9, 2007, at 12:09:45
In reply to Re: Oh no!!!!!!! I am in big trouble!!!!Nardil Man! » ace, posted by Ron Hill on November 7, 2007, at 21:15:15
Hi Ron
What benefit do you get from Keppra? I guess I'm suspicious because there's virtually no evidence to support its use in psychiatry, although it's clearly useful in epilepsy.
Ed
Posted by Ron Hill on November 12, 2007, at 3:42:29
In reply to Re: Oh no!!!!!!! I am in big trouble!!!!Nardil Man! » Ron Hill, posted by kaleidoscope on November 9, 2007, at 12:09:45
> What benefit do you get from Keppra? I guess I'm suspicious because there's virtually no evidence to support its use in psychiatry, although it's clearly useful in epilepsy.
Ed, so sorry to be so slow to answer. I've been swamped with projects for the past few days and, therefore, I have not been on PB. Again, sorry to leave ya hanging.
Keppra does an astonishing job in the tx of my bipolar rapid cycling. Actually, there is quite a bit of open trial results and case study reports. I'll send you some links and discuss my personal experience with Keppra in detail within the next couple of days. Hopefully tomorrow, but it might be a couple of days.
I gotta hit the hay right now. Talk to you soon.
It's great to see you again, Ed. How is your anxiety disorder doing? Are you still using Paxil? What else? What does a benzo do to you? If you are on an antidepressant, there is something I’d like to mention.
Talk to you in a day or two.
-- Ron
dx: Bipolar II, with ultra rapid cycling (15 days for one complete cycle), and mild Obsessive Compulsive Personality Disorder (OCPD)
600 mg/day Trileptal
200 mg/day Lamictal
875 mg/day Keppra
90 mg/day Nardil
15 mg/day Deplin
Posted by tecknohed on November 12, 2007, at 6:00:55
In reply to Oh no!!!!!!! I am in big trouble!!!!Nardil Man!, posted by ace on November 3, 2007, at 0:19:58
Posted by kaleidoscope on November 12, 2007, at 15:34:36
In reply to Re: Oh no!!!!!!! I am in big trouble!!!!Nardil Man! » kaleidoscope, posted by Ron Hill on November 12, 2007, at 3:42:29
Hi Ron
> Ed, so sorry to be so slow to answer. I've been swamped with projects for the past few days and, therefore, I have not been on PB. Again, sorry to leave ya hanging.
No problem!
> Keppra does an astonishing job in the tx of my bipolar rapid cycling. Actually, there is quite a bit of open trial results and case study reports.
I've see some open trials. I meant randomised-controlled trials really. Open trials can be misleading. It's fantastic that it's working so well for you though.
>How is your anxiety disorder doing? Are you still using Paxil? What else? What does a benzo do to you? If you are on an antidepressant, there is something I’d like to mention.
I'm on citalopram but I'm tapering off it at the moment, I'm not sure I need it anymore. Benzos tend not to be very effective for me. Low doses don't work and high doses make me aggressive and depressive.
Take care
Posted by sdb on November 13, 2007, at 18:35:44
In reply to Re: Oh no!!!!!!! I am in big trouble!!!!Nardil Man! » Ron Hill, posted by kaleidoscope on November 12, 2007, at 15:34:36
> Hi Ron
>
> > Ed, so sorry to be so slow to answer. I've been swamped with projects for the past few days and, therefore, I have not been on PB. Again, sorry to leave ya hanging.
>
> No problem!
>
> > Keppra does an astonishing job in the tx of my bipolar rapid cycling. Actually, there is quite a bit of open trial results and case study reports.
>
> I've see some open trials. I meant randomised-controlled trials really. Open trials can be misleading. It's fantastic that it's working so well for you though.
>
> >How is your anxiety disorder doing? Are you still using Paxil? What else? What does a benzo do to you? If you are on an antidepressant, there is something I’d like to mention.
>
> I'm on citalopram but I'm tapering off it at the moment, I'm not sure I need it anymore. Benzos tend not to be very effective for me. Low doses don't work and high doses make me aggressive and depressive.
>
> Take care
>hi k!
Take care, good if it will probably work without drugs for you.
warm regards
sdb
Posted by Ron Hill on November 14, 2007, at 12:42:40
In reply to Re: Oh no!!!!!!! I am in big trouble!!!!Nardil Man! » Ron Hill, posted by kaleidoscope on November 9, 2007, at 12:09:45
> Hi Ron
> What benefit do you get from Keppra? I guess I'm suspicious because there's virtually no evidence to support its use in psychiatry, although it's clearly useful in epilepsy.
Keppra works great to tx my bipolar II ultra rapid cycling. I always go through one complete cycle every 15 days. Let me tell my background before discussing Keppra.My ultra rapid cycling was induced in 1996 by a p-doc who, without any testing, misdiagnosed me as ADHD, and started feeding me Ritalin. Initially, the Ritalin caused me to hyper-focus, with good energy, and motivation.
This was the first time that I ever visited a pdoc. Unfortunately, I knew nothing about p-dx's and nothing about p-meds. I went to see the p-doc because I was having trouble staying motivated to work hard at my job as an engineer.
Like you, Ed, I believe that a full day's pay deserves a full day's effort. Therefore, I was trying to find out why I lacked the motivation and energy that I had always had for my job prior to then.
Well, long story short, within a couple of weeks of taking 20 mg/day of IR Ritalin, I became VERY IRRITABLE with severe mood swings. I went in and told the pdoc that I needed to stop taking Ritalin because of the severe mood swings. His response was; "Stick with me, we can add Paxil to the Ritalin and it will take away the moodiness".
As a bipolar patient, the SSRI without any moodstabilizer on-board pushed me into a full blown mania. Further, I began to rapid cycle. I was not yet married, so I did not have anyone to tell the pdoc that I was all screwed up. The pdoc was apparently oblivious to my condition.
For example, while in mania one time I bought the pdoc a $350 fly fishing rod. He accepted it with a smile and a thank you, but no mention of mania. Hell-oh, pdoc; his lights were on, but apparently nobody was home.
My workplace put up with my completely inappropriate manic behavior for as long as they could, but eventually they had to show me the door. A couple of months later I fell into a debilitating atypical depression that I could not pull out of.
No job, no income, and so debilitated with depression that I could not even go out to apply for jobs. Further, Paxil caused me to gain so much weight that none of my business clothes fit.
As a result, Ed, I lost everything except my house, and I darn near lost it as well. I even cashed in my retirement account. All because a pdoc did not take time to give me a simply screening test.
A screening test plainly shows that I have bipolar disorder and NOT ADHD. Can you say malpractice? However, I was so bad off that I was not able to contact a malpractice attorney before the two-year Statute of Limitations ran out. In fact, I've only recently gotten well enough that I would be able to contact the proper attorneys and follow through with the malpractice process.
Geeze, my long-story-short turned out to be more long than short. Sorry. But, I gave all this history to say this: Before starting Keppra, my cycle consisted of ten days of deep debilitating depression, one day of dysphoric mixed state, and four days of normal mood. The process repeated over and over and over and ... over ..., never ending. I can set my watch by my cycling frequency. The timing is that predictable.
The most useful thing I've ever began, was to start tracking my mood states daily using a scale of 0 to 5 in an Excel spreadsheet format. Excel then presents these data graphically. The depression verses time graph is absolutely eye opening, because it so clearly shows the ultra rapid cycling frequency, severity, and pattern.
Each day I enter numerical values (0 = no symptoms, to 5 = dead from ..., well you know). I track the severity of the following mood states; 1) Depression, 2) Hypomania, 3) Irritability, and 4) Obsessive Compulsive Personality Disorder symptoms. Each of these four major categories is displayed on four respective graphs.
My OCPD symptoms are usually very mild. In fact, with the addition of Deplin, I no longer have OCPD symptoms, nor do I become irritable.
I suspect that my OCPD symptoms may be what you deal with, although you have it much worse than I do. Keep it in the back of your mind that Deplin took away all of my OCPD symptoms via what feels to me like a serotoninergic action, but without the SSRI-induced apathy thingy. But, of course, Nardil is playing into all this as well in a very beneficial manner.
My irritability and OCPD symptoms are always zero since I added 15 mg/day of Deplin. My wife says the Deplin has changed me from "growly-boy", to "lovey-dovey boy". And my mood tracking data support her observation.Getting back to your question, Keppra greatly reduces the severity of my rapid cycling. I still complete one full cycle every 15 days, but since the addition of Keppra, my cycle consists of two or three days of depression, and twelve or thirteen days of a normal mood state.
Paradoxically, if I take any more than 1000 mg/day, Keppra makes me depressed. The PB archives show that this happens to a lot of pts taking Keppra.
My med cocktail is currently working very well. The addition of Deplin has brought back my belly laughter, enjoyment of a sunset, the smell of a fresh rain, etc. As I previously mentioned, Deplin has completely taken away my irritability and my OCPD symptoms. However, I have only been taking it for a little more than three weeks. Time will tell with regard to long-term efficacy.
However, despite the fact that the severity and duration of my depressive phases have been lessened tremendously, I still cycle into an atypical mini-depressive phase (i.e.; low energy, lack of motivation, sleepy-tired, etc), for two or three days out of every 15 day cycle. But, with one very recent exception.
During my most recent depressive phase a few days ago, I got to thinking that perhaps my 15 day cycling is somewhat akin to other types of cycling that are hormonal in their cause. So, as I was entering depression this time, for one day on a PRN basis, I applied four pumps of Androgel, exogenous testosterone applied dermal. And, by golly, I instantly snapped out of the depressive and I did not return to depression after the one day of testosterone tx. Way too early to tell if it will continue to work, but it worked this time. As always, time will tell.
Ed, read my post regarding Deplin that I posted earlier today:
http://www.dr-bob.org/babble/20071104/msgs/795014.html
Also, here are some links to abstracts of a few small open studies and case histories. And, your are right, I've not seen a good double blind study on Keppra tx of bipolar disorder or bipolar rapid cycling. None the less, many researchers and pdocs are very intrigued by a tx that might reduce the hard to treat rapid cycling:
http://jop.sagepub.com/cgi/content/abstract/17/2/239
The follow are for the tx of p-disorder other than bipolar disorder:
-- Rondx: Bipolar II, with ultra rapid cycling (15 days for one complete cycle), and mild Obsessive Compulsive Personality Disorder (OCPD)
600 mg/day Trileptal
200 mg/day Lamictal
875 mg/day Keppra
90 mg/day Nardil
15 mg/day Deplin
4 pumps of Androgel on a prn basis.
Posted by Jeroen on November 18, 2007, at 5:09:31
In reply to Oh no!!!!!!! I am in big trouble!!!!Nardil Man!, posted by ace on November 3, 2007, at 0:19:58
HI, i am currently taking anti biotic for the infection on my wisdom teeth
I also take Zyprexa, and Temesta
what i am reading here, is this dangerous???
Posted by Jeroen on November 18, 2007, at 5:20:08
In reply to URGENT REPLY NEEDED!!!, posted by Jeroen on November 18, 2007, at 5:11:17
they need to be removed
Posted by yxibow on November 18, 2007, at 9:51:12
In reply to URGENT REPLY NEEDED!!!, posted by Jeroen on November 18, 2007, at 5:11:17
> HI, i am currently taking anti biotic for the infection on my wisdom teeth
>
> I also take Zyprexa, and Temesta
>
>
> what i am reading here, is this dangerous???
>Neither Zyprexa nor Temesta (Ativan) would have any effect on your wisdom teeth. I have no idea what antibiotic you are taking since you didn't mention it. A few can cause psychiatric problems such as Biaxin but there are plenty of choices out there. Also plenty of choices for 100% successful anaesthesia if you choose general instead of local for removal.
Posted by Phillipa on November 18, 2007, at 10:24:39
In reply to Re: URGENT REPLY NEEDED!!! » Jeroen, posted by yxibow on November 18, 2007, at 9:51:12
Biaxin????Was on it for three years three months at a time for lyme's disease you said psychiatric what type? Jeroen I don't think you will have a problem with your teeth when they are out and the infection gone I'm sure you will feel better and what is your antibiotic? Phillipa
Posted by gardenergirl on November 18, 2007, at 11:22:16
In reply to Re: URGENT REPLY NEEDED!!! » yxibow, posted by Phillipa on November 18, 2007, at 10:24:39
Biaxin XR (XL?) made me hypomanic when I took it for a week for a bad sinus infection.
gg
Posted by yxibow on November 18, 2007, at 12:38:33
In reply to Re: URGENT REPLY NEEDED!!! » yxibow, posted by Phillipa on November 18, 2007, at 10:24:39
> Biaxin????Was on it for three years three months at a time for lyme's disease you said psychiatric what type? Jeroen I don't think you will have a problem with your teeth when they are out and the infection gone I'm sure you will feel better and what is your antibiotic? Phillipa
No, it was for some random short term infection, we switched it to something else, for a lack of a better scientific term, I really can't remember the feeling it was quite a while ago.. mm.. "nuts" (no offense to our mental illnesses)? No hallucinations or anything like that, just off kilter.
Posted by kaleidoscope on November 18, 2007, at 16:57:28
In reply to Keppra » kaleidoscope, posted by Ron Hill on November 14, 2007, at 12:42:40
Hi Ron
What a fascinating story. Thank you for telling me. Have you just started the Androgel? I don't remember you mentioning it before.
Ed
Posted by tecknohed on November 18, 2007, at 17:48:22
In reply to Keppra » kaleidoscope, posted by Ron Hill on November 14, 2007, at 12:42:40
Thanks for posting your story Ron. Sounds like you've been to hell & back - & IMO that WAS DEFINITELY malpractice! I mean if I gave my pdoc a fly rod he'd definitely suss something was up!
Anyway, I'm interested in this Keppra. My pdoc beleives I would benefit from a mood stabiliser. I do get mood swings & irritability but I've never considered myself bipolar (though I may be for all I know). I've tried lamotrigine twice but find it too sedating. I wouldn't want to try lithium...yet. Questions: does Keppra just stabilize you mood or does it have any other benificial effects? Does it enhance your other meds (esp. Nardil) or have any mood elivating effects of it's own? Any side effects?
Also, whether you get side effects or not, do you take B6 with it? I found these: http://www.aesnet.org/Visitors/AnnualMeeting/Abstracts/dsp_Abstract.cfm?id=3367 & http://www.blackwell-synergy.com/doi/abs/10.1111/j.1528-1167.2005.460801_16.x (abstract 2.163).
And do you know if Deplin is available on prescription in the UK?
Glad you're doing well! Nice to see ANY success on this board which is (unfortunitely) a pretty rare occurance!
Thanx in advance for any answers you (or anyone else) provide.
teck
Posted by Phillipa on November 18, 2007, at 19:19:24
In reply to Re: URGENT REPLY NEEDED!!! » Phillipa, posted by gardenergirl on November 18, 2007, at 11:22:16
GG strange as I distinctly remember sitting on a beach the day after stopping the med and boom felt like I'd been hit in the heas as it made me feel good but wasn't hypomanic. But did lose sense of taste and smell right after wonder if it caused it? Phillipa
Posted by Ron Hill on November 18, 2007, at 20:40:37
In reply to Re: Keppra » Ron Hill, posted by kaleidoscope on November 18, 2007, at 16:57:28
> Have you just started the Androgel? I don't remember you mentioning it before.
Ed,
My testosterone levels are on the low end of the normal range. In May 2006, I began to wonder if low T was causing my depression. So I asked my endo if he would allow me to conduct a trial of Testosterone Replacement Therapy (TRT). Somewhat reluctantly, he approved my request.
At first, the TRT made a profound improvement and it completely resolved by depression. However, as time progressed, it stopped working as an antidepressant and it began to cause severe irritability. So, I discontinued the TRT. I have a little bit of Androgel left over from my previous trial.
These days, due primarily to the addition of Nardil (1.5 years ago) and Keppra (one year ago), my depressive phases of my bipolar ultra rapid cycling are relatively mild, and they last for only two or three days out of each 15 day cycle.
This is heaven compared to the horrendous debilitating depression 10 days out of every 15 days that I used to experience on an ongoing, ever repeating basis. But, none-the-less, I am continually looking for something that will take away my current residual ultra rapid cycling depressive phases.
So, my current trial is to use one day of Androgel tx at the onset of my depressive phase. I tried it for the first time during my most recent depressive phase (11/08/07) and it worked like a charm. I am scheduled to go into depression on 11/23/07, so I'll see if the one-day prn tx of Androgel will eliminate the depressive phase.
I have a tendency to conclude too quickly that just because something works once; it will continue to work forever. And I often proclaim full remission in my PB posts too soon.
As an aside, I began taking Deplin a month ago and I am continuing to get good results from it. Most notability, Deplin takes away my dysphoric mood states.
Posted by Ron Hill on November 18, 2007, at 22:55:23
In reply to Re: Keppra » Ron Hill, posted by tecknohed on November 18, 2007, at 17:48:22
Teck,
> Anyway, I'm interested in this Keppra. My pdoc believes I would benefit from a mood stabilizer. I do get mood swings & irritability but I've never considered myself bipolar (though I may be for all I know).
What makes your pdoc think that you need a moodstablizer?
Which moodstabilizer does your pdoc recommend that you try?
What is your diagnosis?
Keppra is typically used as an add-on moodstabilizer and it is rarely used as a first-line moodstablizer. Although there are exceptions:
What caused you to be interested in Keppra?
> Questions: does Keppra just stabilize you mood or does it have any other beneficial effects?
I added Keppra solely because there are some studies that show Keppra treats bipolar rapid cycling. I already had plenty of moodstablizers on board; First and foremost, 600 mg/day of Trileptal, and secondarily, 200 mg/day of Lamictal. As it turns out, Keppra does indeed greatly reduce the severity of my rapid cycling.
> Does it enhance your other meds (esp. Nardil) or have any mood elivating effects of it's own?
Not that I've noticed.
> Any side effects?
If I take more than 1000 mg/day, Keppra causes depression for me. But, everyone is different. Further, some people experience other side effects. In fact, most people in the PB archives ended up quitting Keppra for one reason or another.
What I did when I was considering Keppra was to search for as may research studies as I could find, and read them. Then I searched the PB archives to obtain some anecdotal responses. For example, here are the detailed posts of SusanC with regard to her Keppra trial. Read the entire thread:
http://www.dr-bob.org/babble/20010725/msgs/72416.html
Let me know if you want similar posts for other posters. You could search the archives yourself, if you want, but I already have done this as of 11/2/06. And, I grouped all of the posts scattered throughout the archives for each person that tried Keppra. So it makes it much easier to read the progression of the individual poster's Keppra trial. Let me know if you want the links.
> Also, whether you get side effects or not, do you take B6 with it? I found these: http://www.aesnet.org/Visitors/AnnualMeeting/Abstracts/dsp_Abstract.cfm?id=3367 & http://www.blackwell-synergy.com/doi/abs/10.1111/j.1528-1167.2005.460801_16.x (abstract 2.163).Very interesting! Thanks for the links, Teck. I do take P-5-P, the coenzymatic form of B-6 which is the highly bioavailable form of B-6. I take it because it is used in a plethora of neurofunctions. However, I was not aware of the Keppra/B-6 link.
> And do you know if Deplin is available on prescription in the UK?I do not know.
> Glad you're doing well! Nice to see ANY success on this board which is (unfortunately) a pretty rare occurance!
Thanks. However, I often find myself proclaiming full remission only to find out latter that something goes a rye. I should learn not to be too quick to speak.
> Thanx in advance for any answers you (or anyone else) provide.
Bottom line, I'd need to know what you and your pdoc are trying to treat before I would even have a clue if Keppra might help. And even then, as you know, finding the right p-med comes down to trial-and-error crap shoots.
Here is the Keppra prescribing information document:
http://www.keppra.com/pc/global/Keppra_Full_PI.pdf
-- Ron
Posted by tecknohed on November 19, 2007, at 5:36:03
In reply to Re: Keppra » tecknohed, posted by Ron Hill on November 18, 2007, at 22:55:23
> What makes your pdoc think that you need a moodstablizer?
>
> Which moodstabilizer does your pdoc recommend that you try?I've been put on lamotrigine twice. First time was an attempt to enhance Nardil but all I got was more tiredness, worsened hypersomnia & apathy. Second time was with another pdoc (my current one) . Again it was to help enhance Nardil (I assumed) but he did say in his own words, "it will stabilize your moods". He was already aware of my mood swings & irritability.
> What is your diagnosis?Social Phobia (or more likely Avoidant Personality Disorder), Depression (not always associated with the anxiety - I can often feel one & not the other), lifelong Hypersomnia, some OCD symptoms, Irritability & a temper (since I was teenager - I'm now 28). I have other symptoms that come & go. My mood never seems to level out, ie even when an AD is working well for me I'm never the same from one day to the next. I might appear to relapse for 3 days then the AD will just seem to spring into action again. Wierd.
> What caused you to be interested in Keppra?
Just looking for an alternative stabilizer (to lamotrigine) for future consideration. Something I can tolerate. I'm currently doing pretty well on Marplan, Klonopin, Idebenone & Vinpocetine. But after my 'sort of' Nardil poop-out I dont think I'll ever feel confident of a LOOOOONG lasting response to any drug again. But I'm thinking a mood stabilizer might help with this(?).
Nardil was very cruel to me - it totally changed my personality when it first worked, the first 8 months were the best 8 months of my life. Then it went pear shaped. Often makes me wonder if my initial responce to it was really hypomania. I mean, I went from being a TOTAL recluse to suddenly starting work for the first time, getting my own place, getting my first proper girlfriend (& losing my virginity), making new friends & contacting old ones, making up with my parents. I also overspent on credit & store cards & became £5,000 in debt (NEVER done that before).
But then after about 8 months Nardil started to lose it's efficacy. No addons helped in the long run & after nearly 4 years it became more trouble than it was worth.At the end of the day I have a hunch that I would benifit from a mood stabilizer. It just needs to be one which I can tolerate otherwise I simply wont comply.
Anyway, thanks for your reply & all the links - lots for me to read.
teck
Posted by Ron Hill on November 19, 2007, at 16:42:04
In reply to Re: Keppra » Ron Hill, posted by tecknohed on November 19, 2007, at 5:36:03
Teck,
You have a difficult case, don't you?
Have you considered gabapentin (Neurontin)?
http://www.priory.com/focus8.htm#Gabapentin%20for%20Mood%20Disorders
Also, as a tx for your irritability/temper, I'd like to see you conduct a trial of Deplin. I've been taking Deplin for a month and right from the beginning it completely took away my dysphoric mood states.
Depakote is a first line moodstablizer and it is supposedly a good tx for irritability. However, I hated Depakote. It caused me to pack on 30 pounds and it made me depressed. But, everyone is different.
Teck, my gut feeling is that Keppra is not a good med for you. I can't seem to put my finger on it, but it feels like Keppra might worsen your irritability. And, it is often the case that if the patient takes more than 1000 mg/day, depression occurs. This low dosage level limits the amount of moodstablization that Keppra can provide.
Teck, take all of this with a grain of salt. I'm just a patient like you.
But if I were in your position, I'd conduct a trial of Deplin. If it doesn't help, I'd dump it. If it helped, I'd keep it on-board. Next, I'd give Neurontin a trial to see if it will reduce the anxiety and provide some moodstabilization. However, it should be noted that Neurontin is a rather weak moodstablizer.
Teck, your dx is much different than mine. If you had bipolar disorder, I could be more help. But, I know very very little about social phobia.
Click through Ritch's posts regarding his trials of Keppra:
http://www.dr-bob.org/babble/20041002/msgs/398228.html
http://www.dr-bob.org/babble/20050418/msgs/487754.html
http://www.dr-bob.org/babble/20050428/msgs/492291.html
http://www.dr-bob.org/babble/20050428/msgs/493398.html
http://www.dr-bob.org/babble/20050504/msgs/494314.html
http://www.dr-bob.org/babble/20050504/msgs/494475.html
-- Ron
------------------------------------------
> > What makes your pdoc think that you need a moodstablizer?
> >
> > Which moodstabilizer does your pdoc recommend that you try?
>
> I've been put on lamotrigine twice. First time was an attempt to enhance Nardil but all I got was more tiredness, worsened hypersomnia & apathy. Second time was with another pdoc (my current one) . Again it was to help enhance Nardil (I assumed) but he did say in his own words, "it will stabilize your moods". He was already aware of my mood swings & irritability.
>
> > What is your diagnosis?
>
> Social Phobia (or more likely Avoidant Personality Disorder), Depression (not always associated with the anxiety - I can often feel one & not the other), lifelong Hypersomnia, some OCD symptoms, Irritability & a temper (since I was teenager - I'm now 28). I have other symptoms that come & go. My mood never seems to level out, ie even when an AD is working well for me I'm never the same from one day to the next. I might appear to relapse for 3 days then the AD will just seem to spring into action again. Wierd.
>
> > What caused you to be interested in Keppra?
>
> Just looking for an alternative stabilizer (to lamotrigine) for future consideration. Something I can tolerate. I'm currently doing pretty well on Marplan, Klonopin, Idebenone & Vinpocetine. But after my 'sort of' Nardil poop-out I dont think I'll ever feel confident of a LOOOOONG lasting response to any drug again. But I'm thinking a mood stabilizer might help with this(?).
> Nardil was very cruel to me - it totally changed my personality when it first worked, the first 8 months were the best 8 months of my life. Then it went pear shaped. Often makes me wonder if my initial responce to it was really hypomania. I mean, I went from being a TOTAL recluse to suddenly starting work for the first time, getting my own place, getting my first proper girlfriend (& losing my virginity), making new friends & contacting old ones, making up with my parents. I also overspent on credit & store cards & became £5,000 in debt (NEVER done that before).
> But then after about 8 months Nardil started to lose it's efficacy. No addons helped in the long run & after nearly 4 years it became more trouble than it was worth.
>
> At the end of the day I have a hunch that I would benifit from a mood stabilizer. It just needs to be one which I can tolerate otherwise I simply wont comply.
>
> Anyway, thanks for your reply & all the links - lots for me to read.
>
> teck
>
Posted by tecknohed on November 19, 2007, at 19:22:25
In reply to Re: Keppra » tecknohed, posted by Ron Hill on November 19, 2007, at 16:42:04
Thanks Ron!
I have tried gabapentin in the past, on its own, & hated it. Felt just like an SSRI - completely brain-numbing. But who knows, now I'm on different meds I may get a completely different reaction. I have actually considered it in an attempt to lower my Klonopin dosage.
On the other hand my mood seems pretty good & even at the mo, apart from the odd mild irritable attack. I actually think the idebenone is doing some good - in fact I'm sure of it. By what mechanism I dont know. Vinpocetine seems to be clearing my brain fog too & no doubt there is some synergy with the idebenone - they're both nootropics.
Even though I'm doing ok at present, I always try & stay one step ahead - having ideas to try if something goes wrong. Its hard to come up with ideas when things have already gone pear shaped!
And I've actually been thinking about lithium today. If the time does indeed come when I might benefit from a mood stabilizer I may just go strait for the lithium, especially as its one of the few stabilizers that can actually improve mood/enhance an AD.Thanx again mate!
teck
Posted by Phillipa on November 19, 2007, at 20:00:00
In reply to Re: Keppra » Ron Hill, posted by tecknohed on November 19, 2007, at 19:22:25
Up late like I always am. Love Phillipa
Posted by Zyprexa on November 19, 2007, at 21:51:30
In reply to Re: URGENT REPLY NEEDED!!! » gardenergirl, posted by Phillipa on November 18, 2007, at 19:19:24
I had a wisdom tooth removed while taking zyprexa, no problems. They knocked me out compleatly.
Posted by blueboy on November 20, 2007, at 16:46:45
In reply to Oh no!!!!!!! I am in big trouble!!!!Nardil Man!, posted by ace on November 3, 2007, at 0:19:58
> Girls and guys!
>
> first of all i am really sorry if i missed any messages someone posted at me last time...I think sorry to Ron is in order...I just have so much workload, but I don't want to ignotre anyone. Unlike on myspace where it is common practice!
>
>
> Now, I am in a tad of a jam.....!!:)
>
> I have to get wisdom teeth out, and YES- i have to stop Nardil, due to absolute contraindications...Otherwise Ace will be digging up daisy'....(I am too young and handsome to die now:))
>
> One good thing is it my 'refresh' my biochemistry, but nardil has been working great as of late.....at times really brilliant.
>
> HELP!!!!!!!!!!!!!!!!!
>
> Ace:)
>
>The solution is easy. Do it with a local.
I had impacted wisdom teeth taken out while in Vietnam (long time ago), and let me tell you, I was lucky to get novocaine. I asked the dentist for "something for the pain" and he gave me some aspirin. My unit gave me the rest of the morning off, but I was back at work after lunch (spitting blood, LOL. Well, okay, bloody pieces of gauze).
It throbbed but I survived.
AFAIK there are ample locals you can take with Nardil. People over-anesthetize, but most of the problem is anxiety, not pain. Take some benzo's, or better yet, see if your dentist/oral surgeon will give you nitrous oxide.
You can get fully, or 97%, anesthetized during the procedure with a local. You'll have something like a very bad headache for maybe 8 hours, when the local wears off. Like I said, I was functional when I did it.
Posted by yxibow on November 21, 2007, at 22:08:40
In reply to Re: Oh no!!!!!!! I am in big trouble!!!!Nardil Ma, posted by blueboy on November 20, 2007, at 16:46:45
> > Girls and guys!
> >
> > first of all i am really sorry if i missed any messages someone posted at me last time...I think sorry to Ron is in order...I just have so much workload, but I don't want to ignotre anyone. Unlike on myspace where it is common practice!
> >
> >
> > Now, I am in a tad of a jam.....!!:)
> >
> > I have to get wisdom teeth out, and YES- i have to stop Nardil, due to absolute contraindications...Otherwise Ace will be digging up daisy'....(I am too young and handsome to die now:))
> >
> > One good thing is it my 'refresh' my biochemistry, but nardil has been working great as of late.....at times really brilliant.
> >
> > HELP!!!!!!!!!!!!!!!!!
> >
> > Ace:)
> >
> >
>
> The solution is easy. Do it with a local.
>
> I had impacted wisdom teeth taken out while in Vietnam (long time ago), and let me tell you, I was lucky to get novocaine. I asked the dentist for "something for the pain" and he gave me some aspirin. My unit gave me the rest of the morning off, but I was back at work after lunch (spitting blood, LOL. Well, okay, bloody pieces of gauze).
>
> It throbbed but I survived.
>
> AFAIK there are ample locals you can take with Nardil. People over-anesthetize, but most of the problem is anxiety, not pain. Take some benzo's, or better yet, see if your dentist/oral surgeon will give you nitrous oxide.
>
> You can get fully, or 97%, anesthetized during the procedure with a local. You'll have something like a very bad headache for maybe 8 hours, when the local wears off. Like I said, I was functional when I did it.
Nitrous has fallen out of favour in some places because it can cause unconsciousness problems (like teenagers doing whippet canisters). Full anaesthesia is known to produce less post operative difficulties.I'm afraid of general anaesthesia although modern practices are very safe in western countries and you needn't be. Its my fear of death and unrealistic ideas of control, I had them done under local and I nearly fainted because I didn't eat anything that morning. Should have some orange juice or something.
Either way, it takes around 45 minutes for all 4 impacted with a good dental surgeon. And you get to have percocet or something like that if you have a nice doctor and laugh at movies or something for a few days.
You can check a lot of agents together athttp://www.drugdigest.org/DD/Interaction/ChooseDrugs/1,4109,,00.html
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.