![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 2 of 2. This is the beginning of the thread.
Posted by Peter on April 1, 2002, at 2:08:27
Hi all:
To summarize, I've been on many cocktails working with the same pdoc for 7 years; I wanted a second opinion so I went to a consultation with someone else who stated his opinion that I simplify and try monotherapy with Lithium. I've been diagnosed with mild BPII/SP/panic/possible ADD. For years I was on depakote and klonopin, which stabilized me but left me a bit depressed/socially withdrawn. So my pdoc would prescribe me SSRI's for short-term therapy, but they usually, by increasing seratonin, created a dopamine-deficiency in me which caused me to crave alcohol/illicit drugs, and I'd have to taper off them. So, my pdoc started prescribing me adderall with the depakote and klonopin. It worked for awhile, but caused some instability&anxiety. So he replaced depakote with Neurontin, but it's not helping. That's when I decided to go get this second opinion, which was that I start Lithium. Well, it turned out that I was so terrified of taking lithium, with all it's precautions and blood monitering, especially without sufficient proof of my BP, that I decided, since my pdoc insisted I stay on a mood-stabilizer, that I was much more comfortable going back on depakote. What I'd like anyone's opinion on is the following plan I've proposed to my pdoc: 1) Go back to depakote as my stabilizer
2) stay on klonopin to ward off panic
3) Start an SSRI: I find I've always been able to function most on SSRI's over any other drug. They take away all my many phobias and anxieties and help me with my depressive dips.
4) Here's the added twist: stay on a stimulant, probably switching from adderall to dexedrine. The point of my wanting to stay on a stimulant is because, if in fact it's true that I always had to stop SSRI's because they induced emotional numbness and dopamine deficiency, the stimulant would surely make up for the deficiency. In turn, the SSRI could buffer any anxiety/agitation caused by the stimulant. This plan could thus possibly prolong SSRI treatment, and, essentially, help me with all the elements of my illness without my having to touch lithium, about which I'm apprehensive and really don't think is a drug for me.
Sorry for such a long post, but I'd really like to know people's opinions. Thanks.
Peter
Posted by Zo on April 2, 2002, at 23:54:11
In reply to Goodbye lithium, back to more familiar meds, posted by Peter on April 1, 2002, at 2:08:27
Hi Peter!
Myexperience is that lithium is blunting and unhelpful, hard on the body--and I think of Lamictal as a much more versatile replacement. Think about kindling, and the ways in which conditions overlap, I would suggest, not getting ultra-specific on individual meds which simply do not bear that much scientific scrutiny. As a woman--and as someone *extremely* right-brain dominant, who cannot add two and two (five?) --I 've relied on intution--about meds, about doses, and for an overall sense of what these interrelated conditons mean.
My pdoc gives me a gentle shove, and then we both defer to that felt sense, for that kind of knowledge is the broadest of all. Drawing, as it does, upon a far larger body of knowledge than we are aware of.I think about Lamictal, for example, as having much broader application than strict mood stabilizing. In fact, for many years, lacking solid diagnosis, I medicated backwards, using the smartest things we could come up with to address my symptoms. It has only been in the past four years that my ADD "settled out," then TLE, and finally, umistakably, Bipolar ii. It's one thing to have suspicions, quite anotther to *know.* In this seemingly backwards way, once the pieces fell into place, it's been a fairly rapid resolve.
I hope you find any of this useful; it's about all I can some up with tonight. Just shifting the light around--see what catches your eye.
Warmly,
Zo
This is the end of the 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.