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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Mikey_C on February 6, 2003, at 15:27:31
Hey all, I'm trying to find out what information there is on the type of anti-depressants that are available for Bi-Polars that are not in the SSRI spectrum. Out of the SSRIs, I've tried Paxil, Celexa, and Effexor, all of which I could not function properly on. I am no longer even interested in trying anything that is classified as an SSRI.At the moment I'm taking 500mg of Depakote per day, 1mg of Clonazepam per day (to help me sleep... otherwise I just toss and turn all night, eventually leading to a panic attack), and 50mg of Trazadone (I've been using this as an anti-depressant for the time being since my Doctor is on vacation). Out of the current medications, Depakote has started to give me the runs pretty badly (not pleasant at all), while the Clonazepam and Trazadone taken together make me really lethargic the next day.
If I try to stop taking the Clonazepam and only take the Trazadone (100mg), in about a week my panic attacks start returning. If I don't take the Trazadone (which is only barely keeping my depression at bay) within a day my depression hits me.
I've still got 12 days to go before I see my Doctor, but I'd like to hear if anybody else has gone through this problem and found anything that actually worked. Maybe as a non-SSRI add-on to my Mood Stabilizer or even a change in Mood Stabilizers.
Thanks,
Posted by Ritch on February 6, 2003, at 22:51:20
In reply to Anti-Depressants for Bi-Polars????, posted by Mikey_C on February 6, 2003, at 15:27:31
>
> Hey all, I'm trying to find out what information there is on the type of anti-depressants that are available for Bi-Polars that are not in the SSRI spectrum. Out of the SSRIs, I've tried Paxil, Celexa, and Effexor, all of which I could not function properly on. I am no longer even interested in trying anything that is classified as an SSRI.
>
> At the moment I'm taking 500mg of Depakote per day, 1mg of Clonazepam per day (to help me sleep... otherwise I just toss and turn all night, eventually leading to a panic attack), and 50mg of Trazadone (I've been using this as an anti-depressant for the time being since my Doctor is on vacation). Out of the current medications, Depakote has started to give me the runs pretty badly (not pleasant at all), while the Clonazepam and Trazadone taken together make me really lethargic the next day.
>
> If I try to stop taking the Clonazepam and only take the Trazadone (100mg), in about a week my panic attacks start returning. If I don't take the Trazadone (which is only barely keeping my depression at bay) within a day my depression hits me.
>
> I've still got 12 days to go before I see my Doctor, but I'd like to hear if anybody else has gone through this problem and found anything that actually worked. Maybe as a non-SSRI add-on to my Mood Stabilizer or even a change in Mood Stabilizers.
>
> Thanks,
>
>
If your hypomania/mania probs are under control and you are looking at anxiety/depression/panic stuff, I would try a Neurontin add-on first and see how that goes. Given you are at 500mg of Depakote, perhaps try 300mg 2x daily of Neurontin. You might see less Depakote induced diarrhea.
Posted by Mikey_C on February 7, 2003, at 10:12:58
In reply to Re: Anti-Depressants for Bi-Polars???? » Mikey_C, posted by Ritch on February 6, 2003, at 22:51:20
Neurotonin will work that well for depression and panic attacks? Depakote has worked amazingly well for me in getting my anxiety/mania symptoms under control, but the only problem is that if I forget to take it at the exact minute that I should (for example, if I take it at 9:00AM and PM for a few days, then forget and take it at 9:30AM or PM, I'll almost always get the runs). So Neurotonin will also work well for stopping that?Depakote, as I've said, worked amazing in getting my anxiety/mania under control, but it hasn't done anything for my panic attacks. Without Clonazepam I still get them frequently. I also find it nearly impossible to sleep at night without Clonazepam. I was thinking about sticking with that one for the long term since you shouldn't fix what's not broken...
But Neurotonin definitely sounds like an option... I know it's a Mood Stabilizer and anything that can help fight off depression that is not from the SSRI family is good news to me.
SSRIs = EVIL
Posted by Ritch on February 7, 2003, at 21:42:39
In reply to Re: Anti-Depressants for Bi-Polars???? » Ritch, posted by Mikey_C on February 7, 2003, at 10:12:58
>
> Neurotonin will work that well for depression and panic attacks? Depakote has worked amazingly well for me in getting my anxiety/mania symptoms under control, but the only problem is that if I forget to take it at the exact minute that I should (for example, if I take it at 9:00AM and PM for a few days, then forget and take it at 9:30AM or PM, I'll almost always get the runs). So Neurotonin will also work well for stopping that?
>
> Depakote, as I've said, worked amazing in getting my anxiety/mania under control, but it hasn't done anything for my panic attacks. Without Clonazepam I still get them frequently. I also find it nearly impossible to sleep at night without Clonazepam. I was thinking about sticking with that one for the long term since you shouldn't fix what's not broken...
>
> But Neurotonin definitely sounds like an option... I know it's a Mood Stabilizer and anything that can help fight off depression that is not from the SSRI family is good news to me.
>
> SSRIs = EVIL
LoL! I love that equation. Sounds like a great tee-shirt silkscreen. It is interesting that you mention not taking your Depakote at *the exact* time causing trouble. It really shouldn't make a lot of difference. In fact, I've noticed the antimanic effect of Depakote has a *delayed* effect of several hours after I take it. IOW, the intended effects seem to occur several hours *later* than the peak serum level of the drug. I was reading about Neurontin and epilepsy today and noticed that the anticonvulsant effects (the seizure reduction timeframe) was delayed several hours after the peak blood levels of the drug in question as well. All this implies a "cascade of events" beyond the simple presence of the drug in queston (its peak blood level, post-dosing). I don't know how to explain the 30 minute difference in dosing and your symptoms....
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