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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by Katekite on April 9, 2002, at 20:40:18
Hi -- I am new to this forum and could use insight on puzzling side effects. The neat part is I think maybe my flushing effect is indicative of some little known drug mechanisms at work.....................My psychiatrist appears stumped. (This could get long.) I've taken a bunch of psychotropic meds (prescribed :) over the last 10 years (moody mildly anxious depression). Including (all by themselves): one dose buspar (felt like alien), 4 ssris with typical side effects of sedation, nausea, best was prozac which just didn't do much, trazodone one dose (hypotensive crisis), serzone (nothing until confusion at 300mg/day), xyprexa 3 smallest available doses (confusion and inability to stand up), one high dose remeron (24hrs sleep followed by hypnotic state for 2d), 4 days wellbutrin (suicidal agitation), valium (nice!), Ativan (mild anti-anxiety, mostly just sedating), Klonopin (helps moodiness, also sedating, cognitive effects, ? other side effects see below). Here's where it gets fun! Having started klonopin 1 mg/day last summer then also started neurontin 600mg/day and felt darn good, calm, focussed, goal oriented although more moody than usual for the first 5 weeks. Then ate salmon (don't laugh) and became hot. Hot flush. Flu-like symptoms, neck stiffness, headache, muscle fasciculations similar to nervous tics, mild vertigo, alternating hot and cold symptoms for several days. BP and temp normal but subjectively temp felt hot. Tapered neurontin, went away. Unfortunately did not associate tapering neurontin with resolution and reinstated neurontin, lower dose. While on neurontin and klonopin: tried depakote one dose (24 hrs vertigo and extreme sedation but still anxious), tried one dose lamictal (10 days of nausea), tried one dose gabatril (3 days vertigo). During following month continued to have occasional hot flushes, flu symptoms, etc, worsening with time until was sick and hot continuously. True temp was never high. Finally became pissed off and stopped neurontin and tapered klonopin to 0.5 mg/day. 2 days later completely normal. Still on klonopin: Restarted neurontin several weeks later, became hot/flushed, discontinued. Still on klonopin: Tried moclobemide 5 days, amotivation after 3rd day, hot on 5th day. Retried at lower dose, 5th day amotivation no flushing. Have eaten salmon twice, have become hot after each time but resolves in 24hrs. Decided buspar had not given buspar a fair chance, retried one dose, became hot at 60 minutes lasting 12hrs. Decided Wellbutrin not a fair trial 5 years back, did another 5 days, again extreme agitation but NOT flushed. Ativan and valium do not cause flushing at least in one time doses. Flush responds a bit to high doses of antihistamines, I think, but can't be positive on that..................................... Every flushing episode resolves within 24 hrs of stopping the new drug. Flushing is always accompanied by mild neck stiffness, sense of malaise, and increased anxiety or mild agitation. I may 'feel' flushed, but do not always 'look' flushed, although usually there is at least a transient objective whole body flush when it starts........... sorry this is so long...... the question is what is the mechanism of this...... I'm concerned about a serotonergic mechanism given flush on all but wellbutrin and other benzos, found one reference to a klonopin maoi interaction causing flushing, on medline, but otherwise can not find that klonopin should cause increased tendency to flush. Is this just benign flushing, or is it some sort of mild serotonin syndrome? Is it dangerous? ......................I have now been diagnosed with ADD (only the previous shrink thought I was BP II, no one else, ADD makes sense to me) and will start ritalin in a couple days.... is this wise? Why is my psychiatrist not more concerned about this? He simply shrugs and tries something else, I get hot every time unless they are single dose meds (with the exception of buspar which does it with a single dose). He really would like to try effexor next but given the recent hx I'm pretty sure it would simply make me hot, then I would face withdrawal. Since buspar has such a distinct mechanism and it does it in a single dose of 3.75 mg I have come up with a serotonin hypothesis, but truly don't understand it and would appreciate all comments. How can salmon be involved........salmon is known for histamine problems but not serotonin that I am aware of. What about switching to a less serotonergic benzo? What is the least serotonergic benzo that still has anti-anxiety effects (ie not a pure sleep aid)?...... Is it worth asking to get serotonin metabolites measured or will they laugh? Thankyou in advance for any similar experiences or interpretation of this weird reaction..................... In conclusion, if it is serotonin then neurontin has to have a serotonin modulating effect which I haven't seen reported yet. Interesting, eh? -- Apologies for length of first post, does not bode well for future posts, LOL. -- kate
Posted by amber_spirit on April 10, 2002, at 6:57:09
In reply to help -- flush on new meds, mechanism?, serotonin?, posted by Katekite on April 9, 2002, at 20:40:18
I figured it was just me. I've had similar experiences
but more limited. I've been on 150mg Effexor XR for
2 years and get terrible hot flashes and flushed feeling.
However, the do go away within a short period of time
(hours). However, the neurontin (at 300 mg am&pm) made
me terrible flushed, headaches, neck pain, flu-like
symptoms. Could only handle it 4 days and went back
to 300 mg pm. Feel amazingly better now, but only bc
I take it with ambien at night so I'm knocked out before
any of the side effects kick in. If I take it early (w/o
ambien) I get the same effects on this 300mg dose.Don't know what it is, but glad to hear I'm not crazy
(which is what my husband insists!). I'd be interested
in anyone's thoughts as this worries me.Thanks!
AS
Posted by katekite on April 10, 2002, at 9:25:51
In reply to sounds famililar - no answer :(, posted by amber_spirit on April 10, 2002, at 6:57:09
Thanks for at least letting me know someone else has had this. When I had the one on neurontin + klonopin that lasted on and off for 6 weeks, I went to several doctors, they all heard the history, raised their eyebrows when I said BP II and told me it would probably go away. When I went back they did tests: Bloodwork was normal. They did ESR and mono test, a chest xray, one guy thought I had pancreatitis if you can believe that, upper abdominal ultrasound. HAH.
All I know is feeling hot is a subjective feeling which you can't show anyone, and no one takes it seriously despite it feeling awfully serious at the time. I'm so reluctant to try anything else that could do this to me.
If you are like me then if you stay on effexor and try to add any other drug it will happen again.
Ambien might do more than knock you out so you can't tell.... when I take Sonata I get a chill as it sets in. Do you get pleasantly chilled on Ambien or benzodiazepines?
Kate
Posted by amber_spirit on April 10, 2002, at 10:03:47
In reply to Re: sounds famililar - no answer :( » amber_spirit, posted by katekite on April 10, 2002, at 9:25:51
Well, I'm usually out pretty quick on the ambien so I can't say
I feel a chill. Actually, I'm usually pretty hot as I'm trying
to fall asleep. But, I do know its very tied to mood. If I'm
getting ready to cry, been crying, or just upset I get VERY hot!
I wondered when you mentioned BPII also. The pdocs
haven't actually decided if I'm just depressive or BPII also.
Some experience with AD induced hypomania a some independent
epsidoes which are "questionable" hypomania. One pdoc says
yes, another says no. I figure it doesn't matter as long as I
get the right meds. (Sister is diagnosed BPII so it could be.)All I know is I'm so tired of this med game. After months of
playing the first time (Celexa, Wellbutrin, Buspar, Paxil,
Topamax) Effexor XR and klonopin seemed to work for about 18 months.
Then started not sleeping and got more anxious and depressed.
Went off klonopin, tried trazodone (made me agitated), then the
neurontin which has made me VERY sick at the current dosages. I'm
just running out of patience. I don't see pdoc for 2 weeks
and see myself getting more depressed again now that I dropped the
300 mg am neurontin. It's a capsule so I can't reduce/adjust the
dosing schedule either.Sorry to rant, just losing patience...
Thanks,
AS
Posted by katekite on April 10, 2002, at 17:19:59
In reply to Re: sounds famililar katekite, posted by amber_spirit on April 10, 2002, at 10:03:47
Hi Amberspirit,
Its interesting the similar reactions you've had to mine. I had such a strange reaction to trazodone too.... it was not sedating at all as it is supposed to be, I took it in the evening and was awake until 6am, having similar signs to an anxiety attack except no anxiety, just what would be normal concern over severe chest pain.
Effexor is really the only one I haven't tried, they all want me to, but I feel it would probably work OK, but I want better than OK, so want to hold out for a better combo, does that make sense? As withdrawal from Effexor would be bad if I wanted to switch.
Tell me, amongst the yucky side effects you had to neurontin, did you feel sedated at all? The reason I got the BP II designation to begin with was that while on klonopin I started neurontin and promptly stayed awake for a whole night, then had more trouble sleeping but didn't mind so much, had increased energy, stick-to-it-ness, focus, etc. Other people start out tired, supposedly. Never talked fast or seemed abnormal to my hubby, just seemed to him like my depression had finally miraculously lifted. My subjective feeling was just wow, thank god something worked after all this bs, now I'll get on with my life. I didn't do any weird shopping or talking etc. Then sadly after 5 weeks of doing finally fine, I became increasingly sick (all the side effects I said before) until I stopped it. I would say that I am moody, maybe BP 24 or something, but not BP II. But my pdoc labelled that a hypomanic episode and called me BPII. The one thing that was good turned out to be extra therapy visits that are now covered by insurance because BPII is a 'biological illness" in their manual, LOL. Although my current pdoc doesn't even believe I had med induced hypomania. But of course he didn't personally see it.
So you are currently on effexor only? (that is if you have stopped the neurontin?). And Ambien to sleep? Are you still having trouble sleeping? Do you wake too early or late? Do you think think think until falling asleep? Does it take a long time to fall asleep? Do wake at night? Just curious how similar we are in symptoms.
Because I too wish I could find an excellent combination. I will not be satisfied with feeling OK mood wise, but a bit dumb on klonopin alone. I am trying ritalin tomorrow, we shall see what that does.
kate
Posted by amber_spirit on April 11, 2002, at 13:36:57
In reply to agitated on trazodone, other weird reactions » amber_spirit, posted by katekite on April 10, 2002, at 17:19:59
Thanks so much!
I've been starting to think I'm crazy. I seem to
react the opposite to all of the meds they give me.
Trazodone was supposed to sedate me and just made
me "hypo". I do have the "pressured" speech though.
I actually will find myself talking WAY too loud
or about something I don't want to and in the back
of my mind I'll be thinking "Why don't I just shut
up?". I don't need as much sleep, I get really busy,
and start vounteering and starting additional things
when I can't even handle my current schedule. It's
kind of nice until it gets to the point that I can't
type fast enough to keep up with my thoughts and I'm
constantly agitated and shakey. Oh well, it was a
nice change for a while.In answer to some of your questions:
Neurontin made me so "drunk" feeling it was hard
to tell if its sedating or not. It can't be helping
too much since I'm on 20mg of ambien to sleep.Currently on 150mg Effexor am and 15-20mg ambien to
sleep. I finally cut out the evening neurontin also.
(It seems like its mood stabilizing effects have
totally wiped out my feelings - I'm numb. Can't
laugh, cry, anything. Couldn't understand what my
sister was talking about when she would describe
this feeling. Now I know and it SUCKS!)The ambien has been great. It doesn't take long at
all to fall asleep and I actually sleep 8 hours.
(This doesn't necessarily apply to everyone. I've
seen posts from others for whom it doesn't work
nearly as well.)I'm sorry this is rambling and disorganized and
long but the back ground seems necessary. I was
on Effexor with Klonopin for sleep for last 18 mo.
It was working great. Then less so. Then finally
realized I wasn't getting more than a few hours
each nite. This time around I couldn't fall asleep
till early morning (2-3 am and I get up at 5am).
Last episode was early wakening. Then I get this
wierd symptom where each time I start to doze, my
whole body jerks and wakes me up. Not a problem now
with the ambien.I feel the same as you. I have a strong family
history of depression and don't want to spend my
life feeling "ok" or having something work for a
while then stop and have to spend 6 months finding
something else to work. My uncle and sister have
just started on Adderall and its seems to be having
amazing effects. I'm thinking of asking to try it.
Please, let me know how you do on the ritalin. I'd
be curious how someone "similar" does on a stimulant.Again, apologies for the long post. No one to talk
to that understands...AS
Posted by katekite on April 11, 2002, at 16:08:49
In reply to Wow, sounds very similar katekite, posted by amber_spirit on April 11, 2002, at 13:36:57
Hi,
Well I'm just in the middle of my first pill of ritalin, 5 mg.
It feels like I took valium. I can't believe this is an upper for some people.
Here is how it makes me feel: my head feels calm, the world of tweeting birds and talking people and cars and everyone else's feelings and needs feels as if it is now at arms reach, that I have a boundary around me, where before this all felt 'in my face'..... but I can only say that in retrospect. In fact the world sounds a bit muffled. I've never felt like this in my memory, the closest thing would be to be fully awake but have the anti-anxiety effect of a lot of valium or a few drinks.
It feels like a subtle effect to me. However, I just got home from seeing my therapist and he commented that I'd managed to have a coherent 'deep' conversation for an entire hour with him, out in the park (its a nice day, we went out). Had I just 'been me' I would have jumped around subjects and made jokes, or talked about something easy just because of feeling a bit weird about having therapy outdoors, or feeling self concious that passing people would overhear us or something. But I just got down to business instead. Less reactive to my environment.
I also feel a bit flat emotionally, I guess. That things that would normally irritate me aren't. Frustration tolerance much higher. Mostly tolerance for myself, for example if I miss a freeway exit I didn't beat myself up over it, I just turned around. I don't mind the flatness, I think if I decrease my klonopin I'll get some energy back.
Life feels like is simpler than I thought.
Stimulants or uppers are the one drug I always thought I would never try as I certainly did not need "more" of how I feel/felt. I always was more interested in pot or alcohol that would just give me a little relaxation.
So that's all good, I guess. I don't feel euphoric or anything, more like I had a relaxing day, which if I think about it I didn't at all.
I hope this effect doesn't wear off. I've heard a few reports of people having to up their dose, or it stops working.
I still am having trouble believing the ADD diagnosis, though I would have to be in denial at this point. For example, I'm not late all the time, I got great grades in college, I don't feel like I 'space out', I never lost pens or homework. But I think maybe I would be all that if I hadn't practiced for 30 years feeling frantic over those things. Like at the end of a school day I would feel like crying for no understandable reason, just wound up and tired, probably from hurriedly copying down every spec of available information so I didn't miss anything. Like life was harder than it needed to be, other people seemed more relaxed and having fun. Right now I feel relaxed, normally I would be thinking to myself I should get off the computer, etc.
I went and ran errands on the way home and was not socially anxious compared to usual. I was just going about my business and mostly ignoring others.
Ok well that's the report. I just have my fingers crossed I'll stay this way.
My shrink today also said he agrees he thinks the hot thing is serotonin mediated, mild serotonin syndrome. So don't up your effexor dose suddenly as you said you feel warmer on effexor.
kate
Posted by medlib on April 12, 2002, at 2:58:29
In reply to help -- flush on new meds, mechanism?, serotonin?, posted by Katekite on April 9, 2002, at 20:40:18
Hi Kate--
Welcome to the board! Glad to hear that you had a positive response to Ritalin. Its primary drawback is a short half-life; for most people, the therapeutic effect lasts only 3-4 hours. This usually requires multiple doses/day, often producing a "rollercoaster effect." If this proves a problem for you, you might want to ask your pdoc to try Concerta, a timed-release formulation of methylphenidate. Btw, it is my impression that most people who experience stimulant "poop out" are taking them as antidepressant augmenters; I believe that ADDers seldom have that problem.
If you are sensitive to increases in serotonin availability, it's not surprising that salmon causes you problems. It's high in the amino acid tryptophan, which is a precursor of serotonin. Some have suggested that the Omega 3 fatty acids prevalent in salmon may play a role in serotonin synthesis, as well; if that's so, salmon may deliver sort of a serotonin "double whammy." Turkey and milk are among the many foods high in tryptophan.
Well wishes---medlib
Posted by amber_spirit on April 12, 2002, at 6:59:37
In reply to Gosh I guess I do have ADD, ritalin works » amber_spirit, posted by katekite on April 11, 2002, at 16:08:49
Kate
So glad to hear it. Although in someways makes my decision harder.
I know pdoc will look at me like I'm nuts if I suggest Adderall or
any other stim for that matter. It was helping my sister immensely
but insurance won't pay bc it doesn't match her bipolar DX. I've
never had any sign either, but sound very similar to you. I'm
VERY organized about my life. Have always had to keep control of
everything. Maybe our way of coping with a tendency to ADD? Besides
I'm starting to think that any number of imbalances can cause all
kinds of symptoms and the current DSM only matches the most common
and obvious ones.I'll keep you up to date. Right now I'm just on Effexor and ambien
and feeling ok. But have a strange feeling that things aren't stable.
We'll see what happens.Take care,
AS
Posted by katekite on April 12, 2002, at 9:19:41
In reply to Re: help -- serotonin-mediated flush?, posted by medlib on April 12, 2002, at 2:58:29
Hi,
Thanks for the information. I had read a list of tryptophan containing foods, and salmon was among them, but so were so many other things that I don't flush to, that I felt it would be wrong to assume it was due to tryptophan. Perhaps the combo of the fatty acids with tryptophan and my serotonergic benzodiazepine (klonopin). Or perhaps it is much higher in tryptophan than some of the other tryptophan containing foods.
One would think with all this serotonin available I would be euphoric. If only I could direct the flush more centrally. LOL.
I saw my psychiatrist yesterday (first time after buspar trial) and presented my serotonin theory and he reservedly agreed that it was likely, given my list of medication responses.
I find it extremely interesting that neurontin caused these side effects and wonder if it is a serotonergic drug. There have been sporadic reports of it having an antidepressant action and more pertinently perhaps a fairly common anti-anxiety effect and since these effects often indicate a serotonergic mechanism it makes me very curious. However, I simply have not seen this reported. What do you think, are you aware of any reports of serotonin involvement in the mechanism of neurontin action?
As far as ritalin goes, I took it last night around midnight when not able to go to sleep, and soon dropped off. I am more relaxed than I recall, and now need to taper down on klonopin a bit. I find it bizarre that I got to be 30, through grad school, without finding out this rather important information about myself.
The thinking with the short acting version is that since I'm so sensitive to all psychoactive drugs its worth seeing what length of effect I find for regular ritalin. It should also be quicker to find the effective dose, then I can translate that to a longer acting one. I'm considering asking to try dex etc as well, to see which fits me best. So far it seems to last 4-5 hrs, but I'm not at an optimal dose.
Anyhow, thanks for your comment and I'm curious what you have heard about neurontin and serotonin.
kate
Posted by katekite on April 12, 2002, at 9:37:21
In reply to So glad its helping!!! » katekite, posted by amber_spirit on April 12, 2002, at 6:59:37
Hi Amber,
You might try the website www.mindfixers.com or maybe its brainfixers. There is a very long on line quiz there that makes an attempt to screen for ADD. If you come out as possible or probable then definitely I would say get an evaluation done. In the quiz, on things like "do you interupt a lot" its best to actually ask a close friend or family member rather than try to answer yourself, because at least for me I was not aware of quite how much I interrupt, etc. And the same quiz, if you aren't ADD, also tries to provide some idea of what neurotransmitters would be the best to try to target with drugs: norepinephrine vs serotonin vs dopamine.
I took a printout of the quiz to my psychiatrist, he didn't believe me, but at least referred me to a ADD specialist, who is the person who finally evaluated me. My insurance, which almost never pays for ADD testing, actually paid, because I think their docs had reviewed my expensive case and decided something was a bit off about my diagnosis.
Even if one does have ADD it doesn't mean one doesn't have bipolar. Similarly, if one has ADD maybe one doesn't have bipolar, given ADD is way more common a problem. A family history of bipolar would suggest bipolar, but relatives responding to stimulants certainly suggests ADD. Bipolar, OCD and some other problems I can't recall occur with ADD more than would be expected by chance alone. So its certainly worth looking into. For example, some obsessive traits could mask some ADD traits. I will try to find this comparison chart I once saw for ADD and bipolar symptoms and post it here. Probably under a new thread.
Hope things work out for you. I really like this board, much more than others I was aware of. Just many more visitors I think so lots of diversity of opinion. Thanks so much for your support and comments, it was immediately helpful to me to find that someone else had gotten hot on a drug. There are so many times I had thought in retrospect maybe it was some bizarre delusion.
Kate
Posted by amber_spirit on April 12, 2002, at 10:59:07
In reply to Re: So glad its helping!!!, posted by katekite on April 12, 2002, at 9:37:21
That is a great website. It seems to fit my medication
history perfectly. I noticed (before the survey) that
Effexor is the only med I'd tried with norepinepherine
effects and its the only one that helped. Also, meds
without seratonin didn't. The survey suggested that
I probably have deficiencies of S & NE as well. Even
suggested Adderrall or other stimulant for "Limbic
ADD". This would fit many of my symptoms.Thanks again for the pointer and take care.
ASP.S. Glad to hear you got through grad school. I'm
ABD and every time I get close I seem to fall apart.
Hopefully if I can find a good med combo I can finish!
Posted by jane d on April 12, 2002, at 12:17:00
In reply to agitated on trazodone, other weird reactions » amber_spirit, posted by katekite on April 10, 2002, at 17:19:59
> But my pdoc labelled that a hypomanic episode and called me BPII. The one thing that was good turned out to be extra therapy visits that are now covered by insurance because BPII is a 'biological illness" in their manual, LOL.
Kate,
I'm curious about this statement. Do you mean that your insurer will pay for more visits for bipolar 2 than for depression? I wonder if this is common. If it is maybe it is one of the reasons for the sudden popularity of the bipolar 2 diagnosis.Jane, always fascinated by the quirks of insurance companies.
Posted by medlib on April 12, 2002, at 12:49:35
In reply to Re: help -- serotonin-mediated flush? » medlib, posted by katekite on April 12, 2002, at 9:19:41
Hi Katie--
It sounds like you've really done your homework and it's paid off in a beneficial med change; many Babblers wish they could say the same. A number of PB members who have no medical background have taught themselves psychopharmacology and neurobiology in self-defense; they weren't getting the help they needed from their pdoc "experts." I'm very grateful to quite a number of these PB experts; I've taken their posts to my pdoc to bolster my case for med changes on many occasions over the last 2 1/2 years.
Re 2 meds you mentioned: Neurontin and Wellbutrin have at least one thing in common other than their reputed antidepressant effect--no one knows (or will admit to knowing) exactly how either of them works. More is "known" about how each of them *doesn't* work than how it does. Wellbutrin is the only drug classed as an AD which is thought to have no direct effect on serotonin. (Serotonin, btw, is considered to be a calming, not an activating, NT-- at least for most people.)
Articles on Neurontin cite tests which appear to rule out direct action on *any* of the major brain NTs. I did find 1 citation on Medline, a review article in the Journal of Epilepsy Research, whose abstract itemized 6 possible hypotheses about Neurontin's mechanism(s) of action. 1 of the 6 concerned serotonin. Unfortunately, this journal is not online, so full text of the article is available only at selected medical school libraries or from the NLM. On a different note, Neurontin is not metabolized in the body (it's excreted in the urine unchanged); so it has no metabolites which could account for its action.
I do have an idea of how you feel about an ADD diagnosis, though. Not everyone presents with the typical symptom pattern for a disorder or disease. I never had academic difficulties and my attention span is the opposite of most ADDers. I shift gears mentally only with the greatest of difficulty, and multi-tasking isn't a realistic option for me. Also, I find methylphenidate typically stimulating (have been on it for 2+ years w/out "poop out"). But....dexadrine puts me to sleep! And one ADD expert on PB mentioned that both extremes of the attentional spectrum are considered ADD symptoms. So, I don't know. I haven't researched it, and probably won't; it's peripheral to my primary dx, double depression; and other priorities seem more pressing right now. Interesting, tho.
Hope you continue to improve on Ritalin. But, if you do have a problem, there are several other stimulants which may work as well, perhaps even better!
Well wishes--medlib
Posted by katekite on April 12, 2002, at 17:05:54
In reply to Re: agitated on trazodone, other weird reactions, posted by jane d on April 12, 2002, at 12:17:00
Yes.
My insurance will pay for more therapy visits per year if I have what they term "a biologically based mental illness". (total crap of course, as if to say that some mental illnesses are not biological?) Basically for them "biological" is just a list that includes: bipolar, major depression (with strict DSM IV guidelines) and schizophrenia, other very serious problems where the person might off themselves at any moment. I think they pretty much exclude other stuff such as dysthymia, all anxiety problems, and ADD. They don't even consider ADD a mental problem, I think its in their learning disorder section, where any remote hope of reimbursement most likely stops as soon as you get out of school.
If I was classified as "only" having an anxiety problem, I would be allowed 30 visits per year, maximum (and they can argue for less). If its a "biologically based" problem the number is "unlimited". Now that doesn't mean I can go every day because they would notice and start really arguing, but I can go once a week all year and occasionally twice a week. It all depends what they've given to other people in the past and how smart my therapist can be with his plan and description of me. Basically the shrinks are on my side and will continue to write down that I'm bipolar II and completely unresponsive to medication but that therapy seems to help my moods. I can just be co-morbidly ADD. I am at least morbid.
Kate
Posted by wendy b. on April 12, 2002, at 19:03:26
In reply to Re: agitated on trazodone, other weird reactions, posted by jane d on April 12, 2002, at 12:17:00
Hi Jane,
I was just about to cut and paste the very same sentences out of Kate's message. I am currently in a thing over my BPII dx, and the insurance paying *nothing*, but was glad to read just yesterday about a federal case regarding this issue, and they sided with the patient. This is from the NAMI (National Alliance for the Mentally Ill) web site:
"Federal Court Strikes Down Boundary Between Physical And Mental Illness: Precedent Has Implications For Both Health and Long-Term Disability Insurance." See the following, it's interesting, and hope it might help you.
http://www.nami.org/pressroom/20020228.html
Seems Kate's insurance company is ahead of the curve, and good for them... AND for her!Wendy
ps: Hi Kate...
> > But my pdoc labelled that a hypomanic episode and called me BPII. The one thing that was good turned out to be extra therapy visits that are now covered by insurance because BPII is a 'biological illness" in their manual, LOL.
>
> Kate,
> I'm curious about this statement. Do you mean that your insurer will pay for more visits for bipolar 2 than for depression? I wonder if this is common. If it is maybe it is one of the reasons for the sudden popularity of the bipolar 2 diagnosis.
>
> Jane, always fascinated by the quirks of insurance companies.
Posted by amber_spirit on April 15, 2002, at 13:15:00
In reply to re: insurance, posted by katekite on April 12, 2002, at 17:05:54
Kate,
Just wanted to see how you were continuing to do on
the stimulant and a few questions...Did any of the doctors mention taking medication
vacations or that stimulants might lose effectiveness?
Just wondering bc I've seen posts and wonder if it
applies to few, many, most, etc. Also, what types
of side effects (if any) have you had? Basically I
guess I just want some encouraging news - getting
very tired of not feeling good and wondering what
medication will be next.Thanks,
AS
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