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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Maximus on November 2, 2002, at 14:19:48
Hello guys,
My dx: bipolar II.
I was "virtually" cured. I thought i was. I had been in an euthymic (normal), pleasant and peaceful state for 8 months. My sanity was back and my problems were gone.
10 days ago, the hell came back. 4 days of hypomania followed by 1 day of mixed state, then the dreaded depression hit me again with vengeance.
My medication was:
- Lamictal 200 mg a day
- Lithium 0.65 to 0.85 mmol/L
- Rivotril (clonazepam) 1 mg a daySince 2 days my medication is:
- Lamictal 200 mg a day (sadly, i can not take more)
- Lithium re-targeted for 0.8 to 0.9 mmol/L
- Neurontin 300 mg x 3 (for anxiety) as Rivotril's replacement.
- Effexor XR 75 mg a day.So much meds, isn't it? Sigh...
I'm tired, anxious, vulnerable. I know for sure that things will get better with time, one more time. But life is such a mess sometimes.
P.S. I've tried all the meds known to the mankind and available on earth, (except Topimarate and all anti-psychotics drugs). I even tried the dreaded ECT. Bi-lateral treatments. A mess, waist of time (for me anyway). Memory loss and worsening state were at the rendez-vous.
So i keep my finger crossed.
Thanks to read or share.
n.b. as a native french-canadian, be indulgent with my english ;-) Bye.
Max
Posted by judy1 on November 2, 2002, at 15:26:38
In reply to Lamictal + Lithium, honeymoon is OVER!!!, posted by Maximus on November 2, 2002, at 14:19:48
First, I'm sorry you are feeling so bad. Why stop the klonopin?- it is a much better med for anxiety than neurontin, and that sounds like your primary symptom right now. It also helps as an adjunctive mood stabilizer, and neurontin has proved to be no better than a placebo in several studies. Unfortunately on the bipolar spectrum, you can be stable for months or years and then fall into an episode. It sounds like this has happened and as you know from the past will stop. I hope you achieve a healthy and normal state soon. take care, judy
Posted by Maximus on November 2, 2002, at 18:12:57
In reply to Re: Lamictal + Lithium, honeymoon is OVER!!! » Maximus, posted by judy1 on November 2, 2002, at 15:26:38
> First, I'm sorry you are feeling so bad. Why stop the klonopin?- it is a much better med for anxiety than neurontin, and that sounds like your primary symptom right now. It also helps as an adjunctive mood stabilizer, and neurontin has proved to be no better than a placebo in several studies.
Hi Judy1,
First of all, thank you so much for your kind and warm words. It is very appreciated.
To answer your questions, yes Klonopin is a great anti-anxiety/panic drug. I've been taken Klonopin for 10 years. But according to my pdoc, clonazepam is a CNS depressant (with a mild interaction with Lamictal), althought it is a very very good anti-anxiety med. I should add that my pdoc is not at all "benzophobic".
I've been taken Neurontin in the past. Yes it is true that Neurontin has absolutely NO mood stability effect. In that deparment (mood stabilizer), Neurontin is the most expensive sugar pill ever. BUT, but she prescribed it to me as an anti-anxiety med only. And i prefer myself Neurontin to Klonopin because it tends to relax my muscles. A bonus for me.
Best regards,
Max
Posted by BarbaraCat on November 7, 2002, at 1:53:04
In reply to Re: Lamictal + Lithium » judy1, posted by Maximus on November 2, 2002, at 18:12:57
Dear Max,
I sincerely hope you get to feeling better soon. Bipolar mixed states is the closest to hell on earth anyone can imagine. I know it well. You might be able to get tryptophan in Canada. It's an amino acid precursor to serotonin and acts differently than SSRI's (which I cannot take). It's helped very much with my insomnia, cured my fibromyalgia muscle pains, and is a good relaxer. It doesn't replace benzos for anxiety problems, unfortunately, but it does seem to be improving my life none the less. Just a suggestion, and a prayer that you'll emerge stonger and happier.
Posted by Maximus on November 7, 2002, at 11:50:15
In reply to Re: Lamictal + Lithium » Maximus, posted by BarbaraCat on November 7, 2002, at 1:53:04
Posted by McPac on November 9, 2002, at 1:15:53
In reply to Re: Lamictal + Lithium » Maximus, posted by BarbaraCat on November 7, 2002, at 1:53:04
Barb, have you ever taken 5-HTP? If so, did you find its effects similar to tryptophan?
Thanks!
Posted by SLS on November 11, 2002, at 22:35:17
In reply to Lamictal + Lithium, honeymoon is OVER!!!, posted by Maximus on November 2, 2002, at 14:19:48
Hi Max.
> - Lamictal 200 mg a day (sadly, i can not take more)
What prevents you from taking more Lamictal? At 300mg, it affects my memory.Thanks.
- Scott
Posted by Maximus on November 12, 2002, at 9:38:12
In reply to Re: Lamictal + Lithium, honeymoon is OVER!!! » Maximus, posted by SLS on November 11, 2002, at 22:35:17
> Hi Max.
>
> > - Lamictal 200 mg a day (sadly, i can not take more)
>
>
> What prevents you from taking more Lamictal? At 300mg, it affects my memory.
>
> Thanks.
>
>
> - ScottHi Scott,
Essentially i can't take a higher dose of Lamictal because i would become hypomanic with mixed states. I experienced it. It's quite ugly.
Max
Posted by BarbaraCat on November 12, 2002, at 23:05:50
In reply to Barbcat Re: Lamictal + Lithium, posted by McPac on November 9, 2002, at 1:15:53
Hi Mike,
Yes I have taken 5-HTP. It's supposed to work the same and be 'one step closer' to serotonin synthesis, but it didn't work very well for me. It made me feel more depressed like I get taking an SSRI. I'm not sure why, maybe it's that first step that tryptophan hits and 5-HTP misses that are important to my body. I read somewhere that tryptophan goes to the body first and then the brain, whereas 5-HTP bypasses the body on it's little highway to the brain. Tryptophan also converts to Niacin which is probably no bit deal, but also another thing called kyalauronic acid, or something like that, in this first step. No one seems to know what it does, but it's probably important. I've seen some studies whereby 5-HTP helped fibromyalgia pain alot, but it didn't for me and tryptophan does. I think I'm getting used to it, though, cause unfortunately I'm not getting the bedtime sleepy effect like I used to.> Barb, have you ever taken 5-HTP? If so, did you find its effects similar to tryptophan?
> Thanks!
Posted by SLS on November 13, 2002, at 23:08:42
In reply to Re: Lamictal + Lithium » SLS, posted by Maximus on November 12, 2002, at 9:38:12
> > What prevents you from taking more Lamictal?
>
> Hi Scott,
>
> Essentially i can't take a higher dose of Lamictal because i would become hypomanic with mixed states. I experienced it. It's quite ugly.
Hi Max.
If Lamictal causes you to become hypomanic at 300mg, the remedy for this situation might be simply to treat the hypomania when it appears. Hypomania can often be treated quite easily using either Depakote (valproate) or one of the atypical neuroleptic antipsychotics. My personal preference is Zyprexa (olanzapine). There are other alternatives among mood stabilizers. Perhaps Neurontin (gabapentin) would help. I have read of its use in combination with Neurontin. However, I should think that this would help with the depressive component of your mixed state. Again, I think Zyprexa would be a better choice.
If you choose use Depakote to augment Lamictal, it is critically important to reduce the dosage of Lamictal by half (50%). Depakote reduces the rate at which the body metabolizes Lamictal.
Let me know what you decide.
- Scott
Posted by Maximus on November 14, 2002, at 0:13:34
In reply to Re: Lamictal + Lithium » Maximus, posted by SLS on November 13, 2002, at 23:08:42
> If Lamictal causes you to become hypomanic at 300mg, the remedy for this situation might be simply to treat the hypomania when it appears. Hypomania can often be treated quite easily using either Depakote (valproate) or one of the atypical neuroleptic antipsychotics. My personal preference is Zyprexa (olanzapine). There are other alternatives among mood stabilizers. Perhaps Neurontin (gabapentin) would help. I have read of its use in combination with Neurontin. However, I should think that this would help with the depressive component of your mixed state. Again, I think Zyprexa would be a better choice.
>
> If you choose use Depakote to augment Lamictal, it is critically important to reduce the dosage of Lamictal by half (50%). Depakote reduces the rate at which the body metabolizes Lamictal.
>
> Let me know what you decide.Hi Scott,
Thank you for your concern. But now everything has been ok for one week. The train is back on track.
My pdoc has slightly increased the dose of my lithium and it is doing the job fairly well.
God bless me, i never took APs drugs and i hope i never will.
I LOVE Lamictal. But over 250 mg, lamotrigine is simply too much activating (for me anyway).
For my condition (bipolar disorder), my pdoc and i swear only by the combo Lamictal + Lithium. No interaction and effective. A good balance between stimulation and stabilization does the trick.
Hoping you're doing well too,
Regards,
Max
This is the end of the thread.
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