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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by john anderton on November 5, 2006, at 19:44:27
Guys:
Im about to put my fist threw a wall!!! I have been on a med wheel of SSRI's for the past ten years. Tried them all except prozac and luvox. They seemed to be somewhat effective but I would have continuous breakthrough
depression/anxiety/agitation about every 2-4 months while on them. Once I got well again I would go from 6-12 months of feeling well before slipping back into depression. This past spring I went onto Effexor monotherapy. It blasted me out of my depression. I honestly thought I had found a miracle cure! Then after two months I am back into a very agitated and depressed state. So I quit the Effexor cold turkey, which made me suicidally depressed and manic. After further investigating this with my pdoc, I was diagnosed with Bipolar. I am not sure if this is correct as my switching seems to only occur when I am on AD's. My depressions do come back when I go off of AD's but not with the associated mixed states. Now I am on 200 mg's of Lamictal. I have been on it for three months and have been at the full dose for almost a month. It has helped somewhat, but certainly not amazing. I have attemtped to add zyprexa and seroquel. Both zombified me. Now I have just added Abilify 2mg's. It makes me feel kinda dead inside, nausea, ahches, kind of fluish etc. Also, when I take my lamictal a little bit after the Abilify, I go into a an extreme agitated state. Not a whole lot of fun!!! Right now I am looking for suggestions about what I can do or bring up with my doc!! Please help!
Posted by Phillipa on November 5, 2006, at 20:12:15
In reply to I need help immediately!!!!, posted by john anderton on November 5, 2006, at 19:44:27
Bring up the whole thing. Maybe taking ambilify and lamictal at different times would help? Love Phillipa
Posted by Jost on November 5, 2006, at 20:56:15
In reply to Re: I need help immediately!!!! » john anderton, posted by Phillipa on November 5, 2006, at 20:12:15
Or, frankly, maybe going back to ssri's and, when the depressions returns, trying to boost them with lithium or lamictal --or using some other combination with them -- would be better than this new track.
Seems you were doing better, and maybe needed some serious support of the effect, rather than a wholesale new dx and set of meds.
Jost
Posted by Racer on November 5, 2006, at 21:14:56
In reply to Re: I need help immediately!!!!, posted by Jost on November 5, 2006, at 20:56:15
I agree with Jost. I think I'd probably suggest trying Effexor and Lamictal, but an SSRI and Lamictal should be fine, too.
It used to be thought that one should respond to a single antidepressant. Period. If one drug didn't work, you stopped it and tried another. These days, though, augmenting strategies are the better choice, and most doctors know that. Lamictal alone isn't necessarily great for depression, but it is supposed to be very good as an augmenting agent with an antidepressant.
I hope that's helpful. Good luck.
Posted by john anderton on November 5, 2006, at 22:56:13
In reply to I need help immediately!!!!, posted by john anderton on November 5, 2006, at 19:44:27
My problem is that AD's cause me to cycle. But the are the only thing that truley releives my dpression. Is Lamictal a strong enough stabilizer to prevent further cycling of the AD's? Im on 200 now but I hear that in order to get mood stablizing effects, you need to go to 300-400 thoughts?
Posted by ronaldo on November 6, 2006, at 10:40:51
In reply to I need help immediately!!!!, posted by john anderton on November 5, 2006, at 19:44:27
Hello John,
The usual final dose of Lamictal is 100 to 200 mg but some patients need as much as 600 mg.
http://www.psycom.net/depression.central.lamotrigine.html
Good luck
.....Alan
Posted by polarbear206 on November 6, 2006, at 10:59:11
In reply to I need help immediately!!!!, posted by john anderton on November 5, 2006, at 19:44:27
John,
It appears to me your doctor is on the right track with a diagnosis of bipolar. You should be able to introduce back and AD now that your on a mood stabilizer. Start low and slow. With bipolar, if an AD is required, you shouold get a good response now that your on a mood stabilizer. It can be frustrating to find the right combination of drugs to work for you. Many of us have "been there and done that." Hang in there!!
Polarbear
Lamictal 200mg (my miricle drug)
Effexor 300mgGo to psycheducation.org for bipolar II diagnosis and treatment info.
> Guys:
>
> Im about to put my fist threw a wall!!! I have been on a med wheel of SSRI's for the past ten years. Tried them all except prozac and luvox. They seemed to be somewhat effective but I would have continuous breakthrough
> depression/anxiety/agitation about every 2-4 months while on them. Once I got well again I would go from 6-12 months of feeling well before slipping back into depression. This past spring I went onto Effexor monotherapy. It blasted me out of my depression. I honestly thought I had found a miracle cure! Then after two months I am back into a very agitated and depressed state. So I quit the Effexor cold turkey, which made me suicidally depressed and manic. After further investigating this with my pdoc, I was diagnosed with Bipolar. I am not sure if this is correct as my switching seems to only occur when I am on AD's. My depressions do come back when I go off of AD's but not with the associated mixed states. Now I am on 200 mg's of Lamictal. I have been on it for three months and have been at the full dose for almost a month. It has helped somewhat, but certainly not amazing. I have attemtped to add zyprexa and seroquel. Both zombified me. Now I have just added Abilify 2mg's. It makes me feel kinda dead inside, nausea, ahches, kind of fluish etc. Also, when I take my lamictal a little bit after the Abilify, I go into a an extreme agitated state. Not a whole lot of fun!!! Right now I am looking for suggestions about what I can do or bring up with my doc!! Please help!
Posted by john anderton on November 7, 2006, at 10:56:55
In reply to Re: I need help immediately!!!!, posted by polarbear206 on November 6, 2006, at 10:59:11
Polarbear,
That is good advice. If I stay on the Bilify and the Lamictal which is 2mg's of ABL and 100mgs of Lam is it safe to add a low dose AD?
Posted by blueberry on November 8, 2006, at 21:24:43
In reply to I need help immediately!!!!, posted by john anderton on November 5, 2006, at 19:44:27
I know something that will help. It goes extremely well with the pattern you are experiencing. The first thing to do is to minimize the meds by weeding out all except the most helpful. The educated guessing game is tough. You, me, and a handful of psychiatrists would probably all have different opinions. Mine is to keep the lamictal solo.
Then...begin ECT. I've been through it. I can speak from experience. My pattern of depression was eerily like the way you describe. ECT blasted it into total nonexistence. People describe me as being more alive, more engaging, more happy, more confident, and more stable than they've ever seen me. Here's how it goes...
You go into the hospital Monday, Wednesday, and Friday mornings. They hook anesthesia into your arm and you're out. They give you controlled electrical stimulus to the head. How it works I have no idea. It actually begins working right away, but really kicks in after a few treatments. The primary side effect is amnesia. You will forget some things and other things will be kind of foggy. The trade-off though is worth it. The amnesia only affects things right around the treatment, not everything, and not other times.
I have written a followup thread to my ECT treatment further down this page. In it I give strategies to minimize side effects, minimize the cost, and get full benefit.
I have no experience with MAOI antidepressants, but that may be something to consider if not ECT.
Posted by Phillipa on November 8, 2006, at 23:26:45
In reply to Re: I need help immediately!!!!, posted by blueberry on November 8, 2006, at 21:24:43
Blueberry you sound wonderful. Memory back? I guess so. I'm so happy to see you happy this gives me hope too. Love Phillipa
This is the end of the thread.
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