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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 Sheilac on August 16, 2012, at 8:20:50
Since my old doc retired I finally got in to see a new doc. He is quite a ways from where I live, but I was very impressed. He interviewed me for a long time and asked questions that no other doc has. He seems to be very knowledgeable.
He said I was BPII (which is what my first doc in another state told me).
He felt that I was not severe enough to be on lithium and with my already bad thyroid and the constant diarrhea and hair loss, he said it just wasn't worth it.
He also wasn't crazy about me relying on klonopin everyday. He said it could be a depressant (which it is, but it does work for really stressful situations and such).
He had me drop lithium down to 300mg a day and klonopin down to 2mg a day. He eventually wants to wean me off of both meds. Maybe he will give me an RX for Klonopin or xanax for as needed basis.
In the meantime, he added a baby dose of Lamictal (even though I told him I failed it in the past, he said maybe after all these years we could try a child's dose again and see).
So I am halfing a 25mg tablet of Lamictal for a week and going up to 25mg after that until I see him again in 3 weeks.
He also wanted me to stop all caffeine. I told him no way, I needed my morning coffee. He said fine to 1 cup of morning coffee.
He also wanted me to drop the Adderall. He's not sure I'm ADD or if I was using it for depression or what. I wasn't crazy about that either considering I can get by on 5mg.
Since I have stopped the Adderall I feel like crap. I am so tired all day and unmotivated. I stopped the hobby that I was so in to and pretty much have been a bump on a log.
I get that he wants me to get down to 1 or 2 meds. That's great. If Lamictal ends up working fantastic and I can drop the Lithium and only use a benzo when things get bad - great. That's the plan for now. But I really need my Adderall.
I actually feel depressed without the low dose Adderall.
Ugh.
I'm supposed to start taking a class this semester and I don't know how I will get through it without the Adderall.
Not sure what to do. I like his way of thinking and would love to be on one med, but I want my Adderall back.
I guess I will be taking a lot of naps.
Posted by Phillipa on August 16, 2012, at 9:57:29
In reply to New doc/new diagnosis..., posted by Sheilac on August 16, 2012, at 8:20:50
Sheila he's right about the klonopin but maybe switch to a less depressing benzo and still take it as you have been. I didn't know you had thyroi issues or if did forgot. But lithium isn't usually used with thyroid as can cause worsening of conditon. That explains the hair loss. As hypothyroidism also causes it. Also the thyroid can cause depresssion/anxiety. And as thyroid levels fluctuate the ups and down you feel. Also notorious for feeling tired. Are you taking a thyroid med? I think this doc sounds like he's also covering the medical end. Phillipa
Posted by sheilac on August 16, 2012, at 15:26:28
In reply to Re: New doc/new diagnosis... » Sheilac, posted by Phillipa on August 16, 2012, at 9:57:29
Yes, I've been taking synthroid for several years. I've had my thyroid levels checked and they are great.
I would love to get down to being able to take just one med. And if Lamictal works by me trying a baby dose and working up - great. But for now, I think the Lamictal and Lithium and no Adderall are making me dog tired.
I know I need to wait until I get higher on the Lamictal before I go back to Adderall, but it is so hard. I have lost my creativity and motivation.
But, hopefully in a month or two I'll be off the Lithium and at a higher dose of Lamictal. I'm just not sure I can wait that long to be without Adderall.
The bad part about being off Adderall is I find myself drinking more and more caffeine without any effect. Which, I am supposed to stay off caffeine except for my morning cup of coffee.
Posted by brynb on August 16, 2012, at 19:44:35
In reply to New doc/new diagnosis..., posted by Sheilac on August 16, 2012, at 8:20:50
Hi Sheila,
It sounds like you've got a good new doc :). Give it some time (off Adderall) to see how you feel. Even at low doses, sometimes it takes awhile off of it to bounce back. While it didn't really do much for mood, I've taken Provigil in the past to combat fatigue and it worked great (and unlike Adderall, I didn't experience mood fluctuations or irritability from it).
I agree with Phillipa that switching your benzo is a good option. Valium is a good choice to switch to from Klonopin, especially if you're planning on weaning down. Xanax is good as a prn.
Good luck...
b
Posted by Sheilac on August 16, 2012, at 20:17:34
In reply to Re: New doc/new diagnosis... » Sheilac, posted by brynb on August 16, 2012, at 19:44:35
I was miserable being off Adderall today. I know it's a small dose, but I'm not sure I can be without it.
Will the Lamictal eventually help? And maybe I won't feel so sleepy and sluggish.
The difference in my personality is remarkable when I take just 5mg of Adderall. Not even caffeine compares.
This sucks
Posted by phidippus on August 16, 2012, at 22:03:35
In reply to New doc/new diagnosis..., posted by Sheilac on August 16, 2012, at 8:20:50
Sorry to hear about the Adderall. Lamictal at the right dose should have antidepressant qualities which may negate your need for Adderall.
Why do you take the Klonopin?
Eric
Posted by Christ_empowered on August 16, 2012, at 22:10:59
In reply to Not sure I can, posted by Sheilac on August 16, 2012, at 20:17:34
low-dose speed can be great..or it can make you crazy. It really depends. I think you should just taper off, tough it out, and see if the lamictal+ a prn benzo works. That's pretty simple.
After that, if your concentration is problematic and/or you get the kind of sadness that responds to Rx speed, see about getting that adderall back in the line up. I think part of his game plan is to see where you are on a very minimum of meds. Probably a good idea...definitely a better use of time, money, and other resources than loading up on meds and switching out pills all the time. Only problem is...sucks for a while, that's all.
Posted by Raisinb on August 17, 2012, at 1:24:17
In reply to New doc/new diagnosis..., posted by Sheilac on August 16, 2012, at 8:20:50
I am kind of dealing with the same possible diagnoses. I was diagnosed with BPII last year, but didn't respond fully to any of the meds. Lithium was horrible for me.
My new pdoc, and my therapist, think adult ADHD is a legitimate possibility. My therapist says there is often a link between ADHD and bipolar depression, and the pdoc says that often, if you don't respond fully to bipolar meds, it's because there's a comorbid ADHD condition. Have you discussed this possibility with your doctors?
My point is that you might need both the bipolar meds and the Adderall, if your presenting symptoms are both depression and disorganization/ lack of focus.
I had never heard that there was a link between the two, but my first day on Adderall has been pretty fun. Those amphetamines really put a dent in your depression.
If you feel you need the Adderall that badly, you might consider bringing up recent research on the link between bipolar and the add with your doc.
Posted by Phillipa on August 17, 2012, at 18:31:39
In reply to Re: New doc/new diagnosis... » Sheilac, posted by Raisinb on August 17, 2012, at 1:24:17
I had no idea there was a link between bipolar and add. But then don't they say that children with add often get bipolar when older? Phillipa
Posted by phidippus on August 17, 2012, at 18:44:21
In reply to Re: New doc/new diagnosis... » Raisinb, posted by Phillipa on August 17, 2012, at 18:31:39
There's not really a link, just an overlapp in symptoms.
Eric
This is the end of the thread.
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