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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 med_empowered on November 17, 2005, at 5:55:45
hey Phillipa! Sorry you're still having medication troubles :-(
So..how much Trileptal are you prescribed? It takes about 4-6 weeks to help (in my experience), so keep that in mind..its kind of like an antidepressant, only the effects are more subtle. Dosing is tricky; for bipolar, you need to get the dose high enough to control the mood swings, but not so high that you're left "flat" or with cognitive problems.
Have you tried Surmontil? Its a TCA, so it has all the usual TCA problems. But..its apparently a pretty unique antidepressant; its close in structure to clozapine, but it helps reduce anxiety and depression...I guess its more of a "mellow" antidepressant, instead of an "energizing" one like, say, Prozac. Might be worth a shot.
If I were you, I'd avoid high-dose mood stabilizers, high dose antidepressants, and *all* atypical antipsychotics. I think we have a lot of the same problems (mine used to be more severe, like when I had psychotic depression). Based on that, I'd say focus on reducing mood swings (therapy, maybe low-dose mood stabilizers) and bringing down your anxiety...also, as needed sleep medicine could be helpful; personally, I think Restoril is good stuff, but Vistaril is OK too (it gave me crazy dreams, but some people like it). Plus, there are all the new ones out now--those might be worth a shot. In my experience, the #1 mistake shrinks make is RXing sleeping pills for nightly use...even if the sleeping pills work for that long, you still kind of lose the ability to try to get your body into a natural rhythm, which helps alot with mood and anxiety. Plus, long-term sleeping pill use can make mood and anxiety issues worse, so thats something to consider.
I dont know if you've tried it yet, but BuSpar could help. Usually, it seems that docs want to RX BuSpar OR a benzo; not both. I've tried the combo (BuSpar plus Klonopin), and it rocks...the doses of both can be reduced, and the side effects are minimal; the overall effect is significantly reduced anxiety, almost zero panic attacks, and little if any cognitive impairment or sedation. I don't understand why more docs don't try this combination.
Posted by Phillipa on November 17, 2005, at 22:20:38
In reply to Phillipa, posted by med_empowered on November 17, 2005, at 5:55:45
Hi med a Thread just to me? Wow I feel special. I see this new pdoc on Dec 22. And since my move to Charlotte the medical care is superb. I'm planning on E-mailing you. As far as trileptal is concerned I was taking a very low dose l50mg and found it was keeping me from sleeping. So I stopped it. Found the cost with insurance was $l28 and $l78 for the namebrand valium. So I'm calling CVS in am and asking for the generic valium and hold the trileptal for now. Want new pdoc to be better able to evaluate me. I promise to write you Saturday at the latest. Tomorrow I have to see internist for follow-up. And other moving stuff still going on. And maybe I am bipolar. I'm having so much fun buying all new furniture and decorating this house. I need to feel well enough to go back to nursing I need the money. Love your new friend Jan/Phillipa
This is the end of the thread.
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