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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by Meddy43 on August 7, 2011, at 11:16:11
Hi !
I was just wondering if anyone of you is bipolar, and have had Wellbutrin, and if it has caused mania ? Also, anyone there with a similar cocktail of Wellbutrin 450 mg, Zyprexa 10 mg, Lyrica 600 mg and Oxazepam 60 mg ?
I also have GAD and social phobia, and so far these meds seem to work, but I just wish they won't stop working.
Any input ?
Posted by floatingbridge on August 7, 2011, at 12:29:18
In reply to Bipolar-Wellbutrin-Zyprexa-Lyrica-Oxazepam ?, posted by Meddy43 on August 7, 2011, at 11:16:11
> Hi !
> I was just wondering if anyone of you is bipolar, and have had Wellbutrin, and if it has caused mania ? Also, anyone there with a similar cocktail of Wellbutrin 450 mg, Zyprexa 10 mg, Lyrica 600 mg and Oxazepam 60 mg ?
> I also have GAD and social phobia, and so far these meds seem to work, but I just wish they won't stop working.
> Any input ?Are you finding that the Lyrica is helping with the GAD?
Oxazepam is a benzo?
Sorry I don't know the answers, ESP about wellbutrin. You are tolerating it o,k,?
Posted by Phillipa on August 7, 2011, at 12:33:05
In reply to Re: Bipolar-Wellbutrin-Zyprexa-Lyrica-Oxazepam ? » Meddy43, posted by floatingbridge on August 7, 2011, at 12:29:18
If it's working seriously don't worry about it continue on and you are lucky you have a cocktail that works. Phillipa
Posted by Meddy43 on August 7, 2011, at 12:58:16
In reply to Re: Bipolar-Wellbutrin-Zyprexa-Lyrica-Oxazepam ? » Meddy43, posted by floatingbridge on August 7, 2011, at 12:29:18
Yes, I think Lyrica has helped with my anxieties. I have been able to cut down my benzos. Oxazepam is a benzo, similar to Ativan.
My psychiatrist doesn't like me taking Lyrica; she says I can't drive a car if I'm under the influence of Lyrica. She currently thinks I don't use it, but I got a prescription from another doctor. And yes, I am careful when driving.
I have told my psychiatrist, via e-mail, that I indeed now use Lyrica; she has been on a vacation for six weeks; I will see her next wednesday; I hope she isn't too mad at me...
But she is used to me trying to change meds by myself. this is a difficult issue, since I am an MD,PhD...
Posted by floatingbridge on August 7, 2011, at 13:21:49
In reply to Re: Bipolar-Wellbutrin-Zyprexa-Lyrica-Oxazepam ?, posted by Meddy43 on August 7, 2011, at 12:58:16
Umm. It Lyrica affected my ability to drive, too. :-/. Really, the only med to date that ever did. But I don't hear anyone else mentioning this. Nor did my doctor. I mean EVERY med comesvwith that don't operate mechanical equipment warning, but this was the only one I felt affected this ability.
> Yes, I think Lyrica has helped with my anxieties. I have been able to cut down my benzos. Oxazepam is a benzo, similar to Ativan.
> My psychiatrist doesn't like me taking Lyrica; she says I can't drive a car if I'm under the influence of Lyrica. She currently thinks I don't use it, but I got a prescription from another doctor. And yes, I am careful when driving.
> I have told my psychiatrist, via e-mail, that I indeed now use Lyrica; she has been on a vacation for six weeks; I will see her next wednesday; I hope she isn't too mad at me...
> But she is used to me trying to change meds by myself. this is a difficult issue, since I am an MD,PhD...
Posted by Meddy43 on August 7, 2011, at 13:44:06
In reply to Re: Bipolar-Wellbutrin-Zyprexa-Lyrica-Oxazepam ? » Meddy43, posted by floatingbridge on August 7, 2011, at 13:21:49
Yeah, I don't take Lyrica in the morning, when I have to drive, to decrease the possibility of a serious adverse event regarding driving.
I have found that benzos affect my driving, so I try to avoid them,too, at least when they are at a peak level.
I don't drive very much, either.
But when all is said and done, I think most all psychoactive drugs seem to affect driving in one way or another. Which presents us with a dilemma, manic, psychotically depressed, suicidal or severely anxious when driving, or driving carefully with the drugs prescribed to us.
Posted by morgan miller on August 7, 2011, at 15:51:07
In reply to Bipolar-Wellbutrin-Zyprexa-Lyrica-Oxazepam ?, posted by Meddy43 on August 7, 2011, at 11:16:11
I'm sorry, but that's just too many medications IMO. I bet you could have eventually healed and improved with less medications and a more integrative approach. Sometimes looking for a quicker overall fix in the short run puts us in a place where it is harder to heal and keep things simple in the long run. F*ck*ng psychiatry *Sigh*
I'm glad you are doing better, really I am. But, I wonder about what the future holds for your overally health, including mental health, with such a cocktail of mind altering drugs.
The goal should be to get 70 percent better, then do the work we should all be doing to reach 100 percent half the time. Why do I say half the time? Because, it's not realistic to think we should feel great all the time. Even the most psychologically sound people deal with anxiety and depression and do not feel all that great most of the time. I'm not saying you feel great all the time because of the cocktail you are on, I'm sure you do not. I'm just saying we should not expect medication to be a quick fix to all of the things that ail us. Unfortunately, I get the sense that many people feel this way about medication.
Morgan
Posted by morgan miller on August 7, 2011, at 15:57:28
In reply to Re: Bipolar-Wellbutrin-Zyprexa-Lyrica-Oxazepam ?, posted by Meddy43 on August 7, 2011, at 12:58:16
Do you think being an M.D. might make it too easy for you to believe in the common traditional ways of using medication?
Your doctor is right, Lyrica is not something you want to be on. I will come back later with an explanation if you want.
I hate to say this, but sometimes we need to tough things out, build up a bit of a tolerance for pain, and start dealing with certain realities in life. Medication is certainly helpful, but it is not the ultimate answer.
You might want to consider a primal or paleo diet. Some good websites are Mark's Daily Apple and Weston A Price Foundation.
Are you taking fish oil?
Are you exercising? The best cardiovascular exercise, at least 2 or 3 times a week, is brief and intense, maybe lasting up to 20 minutes, but no more. Exercise should always be followed up by a meditative stretch to increase GABA levels and further improve the state and function of your brain.
Posted by Meddy43 on August 8, 2011, at 0:07:09
In reply to Re: Bipolar-Wellbutrin-Zyprexa-Lyrica-Oxazepam ?, posted by morgan miller on August 7, 2011, at 15:57:28
Hello !
Thank you for your input !
Let me explain things a bit.
I do excercise at least 3 times a week, and I have a personal trainer to keep me in line ;-)
I don't take fish oils since I am a vegetarian. I do take a vitamin supplement and extra vitamin B's. And I use eggs that have a high omega-content.
As for my medication. I have had a few severe bouts of psychotic depression, and a few not so fun mixed episodes; and a few manic episodes; but the manic episodes have been easy to treat.
The problem has been with the psychotic depressions I have had. A year ago I tried to kill myself with lithium, and got a nice level of 3,75 lithium concentration. But for some odd reason I called my psychiatrist, and I survived the episode with ICU therapy. I also have 2 other suicide attempts, one 25 years ago with ACE inhibitors, calcium antagonists and beta blockers, but I was found wandering in the hospital personnel area, and brought to the ICU. My heart stopped, but I was resuscitated. One other incident of suicide was two years ago, with several drugs, treated with ICU, too.
I havent been in the locked ward for more than 2 weeks after each episode, as I don't think they help me, and threatening to sue the doctors with malpractice have gotten me out of the hospital.
But I do have a wonderful, senior psychiatrist whom I have been seeing once a week for more than five years now. She really is quite amazing.
As for my drugs; for the psychotic problems, zyprexa really is the only one that really works. I have tried quetiapine, abilify and others but they just havent done it for me. Also my doctor won't prescribe lithium for me anymore, and hence we tried different mood stabilizers, and our experience brought us into the conclusion, that zyprexa was the best stabilizor for me. Occasionally it has been brought up to 40 mg/day, but at the moment 10 mg does the trick, and we are looking to reducing back to 5 mg, as this is the level that has helped me in the past in my well periods (I have been mostly symptom free for a year now).
As for the social phobia, GAD and a hint of OCD, benzodiazepines have been in my life for more than 30 years. I'm sure they haven't been great for my brain, but neither would have social isolation have been. I have used different benzos, and after my last suicide attempt I was at Ativan 10 mg a day (Sic!). Now I'm fine with oxazepam 15 mg x 4. I don't even wish to wean off this, I think it's the safe dose to keep my severe anxieties at bay.
The use for Lyrica has gone from trial to, well routine, and I am looking to wean myself off of it. I will discuss this with my psychiatrist on wednesday. I do fear uncontrollable anxiety, as they tend to be psychotic at times. Hence the safeguard for anxiety attacs.
Wellbutrin I started just two weeks ago, and it has changed me from a zombilike couch potato, which I feel I have been for a couple of years, into a normal, active (not manic) person enjoying life !!! I paint my toenails, I do the dishes and vacuum; all things that would have been impossible or very hard previously with the other antidepressants. And I think I have tried them all. MAO inhibitors aren't available here, but I have tried most everything else, and they haven't worked, hence the wish to die previously. Now I am free of suicidal ideation, which is such a relief. Now I can enjoy my kids when they come over from my ex husband's care. I cook, I clean, I converse with my kids and such, and it's magnificent.
I'm not looking for a miracle drug that would make life a 100 % fine, but staying alive would be nice.
I think I will now delete the Lyrica from my repertoire, decrease my Zyprexa to 5 mg/night, if my psychiatrist allows it, and continue with the oxazepam 60 mg/day. How do you feel about this combo ?
With kind regards, Meddy43
Posted by Meddy43 on August 8, 2011, at 3:14:54
In reply to Re: Bipolar-Wellbutrin-Zyprexa-Lyrica-Oxazepam ?, posted by morgan miller on August 7, 2011, at 15:57:28
I don't think being an MD helps, maybe even hinders trying to believe the help I am getting (from my psychiatrist, for example).
Yes, I would like to know why you think Lyrica is not something I should be on.
I have tried to toughen up, and having been at work for 15 years as a doc certainly has toughened me up. And yes, I try not to use self pity so much, but I do think I need medication.
I try to deal with the cards that life has dealt me, but sometimes, being human, I crumble. Today is one of those days. I cannot leave the house because of severe anxiety. But I invited my mom over, I texted some of my good friends, and after my mom has been here I will toughen up, bite the bullet, and go to the store, just to get out of the house.
Maybe I haven't expressed clearly enough the amount of anxiety I have sometimes endured. It has incapacitated me, and it was one of the reasons I got out of the work force for now. I am trying to discuss my anxieties with my psychiatrist, but I don't know if anyone who hasn't dealt with severe anxiety themselves can even begin to understand how much it can cripple you.
I have a bottle of Valium in my cupboard which I could have used to day, but I chose not to. So I am trying to toughen up.
With kind regards; Meddy43
Posted by floatingbridge on August 8, 2011, at 9:08:17
In reply to Re: Bipolar-Wellbutrin-Zyprexa-Lyrica-Oxazepam ?, posted by Meddy43 on August 8, 2011, at 3:14:54
Meddy, it is true what you say about anxiety and psychic/mental pain. Unless someone has experienced it, very few others understand. Even loved ones who have witnessed the effects and behaviors of extreme emotion or experience in the afflicted can forget how pervasive and persistent this anguish can be. There are a few people in my life that I have met, notably a psychiatrist or rare therapist or nurse here and there who somehow can understand and see this sort of pain while they themselves remain immune to the extremes. I really don't know how they do it.
I would imagine being an MD would complicate your situation in many ways.
So you will withdraw the Lyrica? I am curiuos why it is so toxic myself, having had my own experiences on it. I was
prescribed it for pain and hoping it could also replace my AD. A kind of double duty. It failed completely to affect pain, but was an odd med. If it hadn't wrecked cognitive functions for me, I might have stayed on it. The effects of diminishing anxiety were extraordinary. I did, though have about two rage
episodes which scared me so badly that I called my doctor and insisted on being withdrawn. I remember yelling about the amount of chocolate cake my son was being given less than an hour before bed. I mean going on and on. While
rationally, I know I would have always thought giving him that much sugar+chocolate then expecting to hop into bed and sleep was wrong, my response was unlike any normal protestation. I witnessed myself go on and on, but could not stop. Horrible. I really don't know what that medication was doing....I appreciate the fuller elucidation of your story and symptomology, and I hope you do not feel a need to justify yourself. You're welcome here.
fb
Posted by Meddy43 on August 8, 2011, at 10:31:27
In reply to Re: Bipolar-Wellbutrin-Zyprexa-Lyrica-Oxazepam ? » Meddy43, posted by floatingbridge on August 8, 2011, at 9:08:17
Thank you fb for your kind words. They were heart warming. I was starting to think that I was a complete moron who just popped pills randomly and for fun...:-(
Lyrica has helped my anxiety tremendously, but it has had cognitive side effects. But I reasoned that perchance the negative effects would be less than those caused by an amount of benzodiazepines that would abolish my anxiety to that degree.
I'm sorry to hear about your episodes with Lyrica; how do you cope with anxiety now ?
Yes, being a doc isn't all that much fun, especially when you are a resident psychiatrist, when you fall ill, especially with mental problems. Until five years ago I managed to self prescribe/deal with my problems, but after that I thought I should seek help from someone else. I don't know if it was a wise thing to do. The repercussions have been great. I have lost my licence to practice medicine, at least for the time being. And I don't think they'll be reinstituted.
Also, when I have seeked help, I have been met by either very hostile comments and behaviour (I don't know why, as I am not an overtly hostile person in my own opinion, not even when manic or psychotic). Or I have been treated as someone superior, being asked what drugs I would like to be prescribed, and weather I would like to be admitted to a hospital or not, and would I think an MRI would be in order etc.
One group of doctors have seemed to prescribe me a medicine, and not tell me about side effects etc, saying "well, you know all that", not letting me be a patient.
I have finally met my match, in a very kind yet assertive, when needed, doctor, who lets me be a patient, isn't intimidated by my MD.PhD, talks with me about various medications, but in the end tells me which ones she will prescribe, and what to expect. She has admitted me into a closed ward on suicide watch against my will, but has afterwards discussed with me how traumatizing an involuntary hospitalization is. She has dried my tears when I have wept, she has hugged me when I have been a total wreck and she has fought for the right to be able to treat me once a week for an hour. She is a senior doctor, has held/holds many prestigious posts within psychiatry here, and she genuinely seems to think of my best interest. I will be eternally grateful for all she has done for me, and continues to do so. Without a fee.
She has put me on disability for now (I have been at home for two years), but does not completely rule out future employment, but thinks I still need a year or two to heal from my difficult to treat psychotic bipolar I, GAD and social phobia.
As may have been obvious from my posts, I still have the tendency to self medicate, or adjust doses or medicines without her consent. I might be a tad stubborn ;-)
Thank you for listening to me.
Kindly, Meddy43
Posted by morgan miller on August 8, 2011, at 10:36:56
In reply to Re: Bipolar-Wellbutrin-Zyprexa-Lyrica-Oxazepam ?, posted by Meddy43 on August 8, 2011, at 3:14:54
Hey Meddy, I get a little fiesty at times, sorry for coming down hard on you, if you percieved it this way. So, I'm guessing you have something like bipolar I with psychotic features??? It makes sense that with the deterioration of your illness you would need such a cocktail, at leas untill you really got back to being more healthy.
Have you ever spent a long time in therapy doing some hard work? I'm speaking of doing the emotional work outside of therapy, not just during the one session a week.
I'm going to have to get back to you on why Lyrica might not be such a good idea long term. I have to go back and research what I read before. I believe one thing is the potential for tolerance build up. But, there are other health issues I believe that can potentially develop.
Did SSRIs help you back when you started using benzos? I know your options may have been limited to just Prozac at the time.
Would you ever consider eating meat again to see if it benefitted your mental health. Even if you didn't, I think going for a more paleo type diet could be beneficial. I'm not sure your getting enough omega 3s from eggs to really benefit. You need to experiment with higher doses of EPA to see if it helps some of your psychotic symptoms. If anything, getting anywhere from 600 to 1000 mg of combined EPA and DHA would be a good idea. It's really worth considering going back to eating some meat, especially fish, for the sake of maintaining better mental health. Why would eating eggs be any better than eating fish? Sorry, not trying to give you a hard time.
I think reducing medications is a good idea if you transition into continuing sound health.
I'm sorry you've had to deal with such a horrible illness in such a way.
Morgan
Posted by morgan miller on August 8, 2011, at 11:06:18
In reply to Re: Bipolar-Wellbutrin-Zyprexa-Lyrica-Oxazepam ?, posted by Meddy43 on August 8, 2011, at 10:31:27
Meddy, how old are you if you don't mind my asking? I'm guessing late 20s to low 30s.
I hope you and everyone else knows that we can heal from the damage done in the past. I also hope we all realize that if we take all the right measures we can prevent future damaging episodes, and I'm not just talking about medication. One reason for knowing that prevention can be accomplished, as you likely already know, is so we can not only prevent the disruption in our lives with each episode, but just as important prevent the damage that episodes inflict on our brains, making our condition worse and more difficult to heal from and recover from.
What most of us do not want to face is the reality that if we had the unconditional love, nurture, and structure we needed as children, our genetic predispositions likely would not have developed into such a life altering and nightmare of an illness. Basically, things would have been far more manageable.
Posted by Meddy43 on August 8, 2011, at 11:51:57
In reply to Re: Bipolar-Wellbutrin-Zyprexa-Lyrica-Oxazepam ?, posted by morgan miller on August 8, 2011, at 10:36:56
Dear Morgan, thank you for your kindness.
As for my diagnosis, I think my ilness developed in my late teens, with an initial depressive episode. As time passed by, I had well periods, untill, when in Med School, I got Manic (but hey, I got my MD AND PhD simultaneously ;-), but my mania was considered "normal", being a lab rat and all that...
I continued to have major depressions, some psychotic, but nothing was done at that time. I did see a psychiatrist, but he abused me sexually, so I went off trying to trust anyone for a while.
I self prescribed with the help of one of my reseach fellows antidepressants for myself, mostly SSRI's, and Citalopram seemed to help the depressions, but I did have what I now think were mixed episodes after a while, and stopped taking the meds. Well, I was the first to graduate from my Med School, and went on to marry a nice man, and have six kids. One was stillborn, and especially at that time I spiralled down into deep depression. I was always very anxious and depressed while pregnant, but got manic after their births. When the twins were born I compiled my final thesis for my PhD, while they were still in their incubators (they were 5 weeks premature). But the manic episodes developed rapidly into what I now think of as mixed episodes, where I was so agitated that I tried to bleed myself to death, hang myself with a tourniquet, wander in the dark of night in the city etc. but there were well episodes in between, and I was in the work force for 15 years, mostly within psychiatry (go figure ;-), with only short leaves of absence in between.
At the time when three of our babies were born, all under the ages of three, I did stumble into a nice psychiatrist. He worked at a community mental health clinic, and agreed to take me on as his patient even when he relocated into a hospital, and treated me for three years, three times a year (I don't know if the fact that I painted the community toilet wall with blood, saying "don't leave me" had anything to do with why he took on my case...). The therapy helped me stop self-injury, and go thru a lot of stuff, but my mood swing did not stop. Our therapy ended as we moved to another country due to employment issues.
I do know that I may have traits of a borderline kind, but now that I am in my forties, they seem to play a very minor role in my daily life.
I did try quite a few SSRI's but since they were not combined by a stabilizer or an antipsychotic, ended doing more harm than good. And even now, when I am finally treated for a correct diagnose; SSRI's really don't help much with my depressions, neither do moclobemide, mirtazapine, venlafaxine; and reboxetine sent me to a mixed episode.
I have used different benzodiazepines since the age of 15, so I guess the damage is done, so to say as for cognitive impairment and such, but I do feel that a small dose of a benzo, such as oxazepam 15 mg x 4, is needed for me to function at all. Olanzapine has also helped some.
I have now been almost symptom free for a year and a half, which is a great, as I tried to kill myself (seriously) a year and a half ago.
Sadly, my 15 year marriage ended in divorce 3 years ago. My husband has the kids for the majority of the time, but my psychiatrist thinks it may be time that I could have them half the time, which I would love. Hence I don't want to rock the boat with too many drug alterations, but life was so very sedentary, and lacking of energy, that I decided to add Wellbutrin/Voxra/bupropion into my drugs a couple of weeks ago, and I have been very pleased with the results. No mania, no mixed episode, no psychosis, just a bit more joy in my life. I will ofcourse discuss this line of medication with my psychiatrist, and I so very much hope she agrees on keeping me on it.
Sorry, I've been a vegetarian for thirty years now, and don't eat anything with neurons ;-)
Thank you for listening to me and helping me. With kind regards, Meddy43
Posted by Meddy43 on August 8, 2011, at 12:06:28
In reply to Re: Bipolar-Wellbutrin-Zyprexa-Lyrica-Oxazepam ?, posted by morgan miller on August 8, 2011, at 11:06:18
Dear Morgan; I'm 43 years old.
English is my third language and hence I may write a little "childishly", or was it something else that made you think I was so much younger ?I do agree that therapy is important, and that medication is not the only, or maybe even the most important, factor influencing our mental health. But it is important, in my opinion.
I talk to my friends, my mom, my brother, and my psychiatrist. She really is one of a kind. After all, she has put up with me for more than five years ;-). I can even occasionally email her about things that I may be hesitant in telling to her in person, altho there aren't many things that I would feel uncomfortable talking and sharing with her. But as I am impulsive at times, I am really a very shy person by nature.
I will reread your post a few more times; maybe I'll come up with something smarter than this...
Kindly, Meddy43
This is the end of the thread.
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