loufrank
09-18-2007, 07:04 PM
I know different things work for different people. I was just curious as to which meds have worked well for others? I am doing better with my depression but still have a ways to go. I have been trying for over a year to find the right combo and was just wondering what meds others have found useful for bipolar. Thanks.
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Jenn4508
09-18-2007, 07:54 PM
Hello and Welcome. I have been trying for years to get the right combo. I know that I did just find out the other day after having blood work that I had an appt with the shrink and I told him I just cannot continue to take these meds as there has been no improvment in a year. I think this time he actually looked at the blood work. My shrink had me on 1000 mg of depakote, 100 mg of seroquel, .5 mg of xanax 3x per day and 40 mg of ritalin per day along with sleeping meds. He tried 8 different sleeping meds none of them worked. Getting back to the appt., He said that for Depakote to be at a working level to be able to reach the part of the brain that it needs to get to the blood level needs to be 50, mine was 43, so it was like all this time I was taking nothing. He increased my depakote to 1500 mg, my seroquel to 200 mg, and kept the others the same. However, I also take topamax for migraines and I also suffer from fibromyalgia. For the fibro I take 6 pain pills per day, 4 muscle relaxers, 1 anti-inflammatory and get trigger point injections on a regular basis. So I take a total of 26 pills per day.
What meds are you currently on and how much? How long have you been taking them.
keep posting, because I care.
What meds are you currently on and how much? How long have you been taking them.
keep posting, because I care.
Paige1989
09-18-2007, 08:13 PM
Wow...twenty-six pills? I doubt I could juggle that many with times and dosages and all. :S
I'm on 400mg. Lamictal, 150mg. Seroquel, 1mg. Klonopin, and 1-2mg. Ativan PRN. I generally take the Ativan twice per day, adding up to two mg. because if I don't, I end up getting anxious over something stupid so I take it in the morning and midday. The Lamictal is split into two 200mg. doses - one when I wake up and one at night. The Seroquel, I take two hours before bed (though sometimes I'll go to bed earlier or a little later, depending on the night) and it helps me sleep plus it helps with my mood. Klonopin, I take at night for anxiety as well. It took two years, a hospital stay, and a gazillion different combinations to get to this one...I've been on Geodon, Abilify, Ambien CR for sleep (instead it made me manic :S )...and that's just the tip of the ice burg...I can't even remember half the meds I've been on...I know I started out on Zoloft because it was thought that I was depressed, but it made me manic, thus the new dx....
Good luck. :)
~~Paige
I'm on 400mg. Lamictal, 150mg. Seroquel, 1mg. Klonopin, and 1-2mg. Ativan PRN. I generally take the Ativan twice per day, adding up to two mg. because if I don't, I end up getting anxious over something stupid so I take it in the morning and midday. The Lamictal is split into two 200mg. doses - one when I wake up and one at night. The Seroquel, I take two hours before bed (though sometimes I'll go to bed earlier or a little later, depending on the night) and it helps me sleep plus it helps with my mood. Klonopin, I take at night for anxiety as well. It took two years, a hospital stay, and a gazillion different combinations to get to this one...I've been on Geodon, Abilify, Ambien CR for sleep (instead it made me manic :S )...and that's just the tip of the ice burg...I can't even remember half the meds I've been on...I know I started out on Zoloft because it was thought that I was depressed, but it made me manic, thus the new dx....
Good luck. :)
~~Paige
loufrank
09-18-2007, 09:35 PM
Hi Jen. Thanks for responding, wow, 26 pills. I feel foolish now as my amount seems minimal next to yours. It's not that I fear medication, but I am VERY sensitive to medicine and tend to pick up the side effects easily. Part of the problem is also that my diagnosis is still a little confusing to me. I have had a few depressive episodes, anxiety, panic attacks, off and on since 21. Mostly triggered by stress. 2 years ago, after my daughter was born, my thyroid crashed. It's now been regulated by synthriod, but the depression spiraled. My pdoc diagnosed me with Soft Bipolar...basically more lows then high, anger, irritablity, etc. He does not believe that I would have a high manic episode, although there have been some things I have done in the past that makes me doubt that...Anyway, I have been trying different meds. Right now I am on synthroid, Lamictal 200mg, provigil 200mg, xanax as needed. I tried a few AD and hated them due to side effects. I work 25 hours a week, have a 2 year old, and lead an active life, so I am cautious with what I take. I also have some issues with food, so the weight gain factor scares me. Anyway, I feel "ok" for the most part with what I am on, but still am having some pretty bad ups and downs. I guess I need to be open minded and learn by trial and error what works for me. Thanks again for the responses. I see my pdoc this week, so I'll see what he suggests.
Jenn4508
09-18-2007, 10:23 PM
Please don't ever feel foolish. There are many who have been through so many diagnoses and doc and different meds that there are no foolish questions. I started off diagnosed as depression, then severe depression, then generalized anxiety disorder and that was the last 25 years. They didn't figure out until a little over a year ago I was BP 1. Once I started reading and doing a lot of researching on my own it made a lot of sense. I will tell you that you can have high anger and irritability on the manic episode. So don't think that that is only on the depressive side. It can go either way. You can do some research and find that out in just about anything you read. That comes on either side of the pole.
Hang in there and keep posting. It does help. I have to keep the faith that one day the combo will work.
God Bless and Big Hugs to the both of you.
Hang in there and keep posting. It does help. I have to keep the faith that one day the combo will work.
God Bless and Big Hugs to the both of you.
tsohl
09-19-2007, 01:02 AM
Hello,
It is unfortunate that there isn't a more efficient way to determine which meds will work best for you with the fewest side effects. It is all trial and error and some pdocs are much better at combining meds than others.
My 25-year old son changed pdocs 4 times before finding one who had more experience with psychotropic drugs. A surprising number of pdocs really don't know much, other than "book learning" about BP. His current pdoc eliminated all other types of meds and had my son take two mood stabilizers, lithium (lithobid) and tegretol. This made him feel about 95% more like his "old" self, but not 100%. So then the pdoc added on Lamictal and this really did the trick. Each mood stabilizer works slightly differently and on slightly different areas of the brain. My son is stable and well on this combination and has no need for other meds as he no longer has episodes of either mania or depression.
Many people do not understand mania. We first tend to think of it as euphoria, feeling really over-the-top. But many people never experience a true manic episode. Hypomania is much more common and can include feelings of rage, intense anger, irritability, sleep problems, etc. And of course, it is possible to feel some of these things while also being depressed.
I don't recall what med/meds you are currently taking. You might want to look into Lamictal. It is one of the newer drugs that is used as a mood stabilizer. It works especially well for those whose main symptoms are on the depressive side and it is weight neutral for most. Its main disadvantage is that it takes a long time to titrate up to a therapeutic level. For this reason it cannot be given if the patient is in "crisis."
It is unfortunate that there isn't a more efficient way to determine which meds will work best for you with the fewest side effects. It is all trial and error and some pdocs are much better at combining meds than others.
My 25-year old son changed pdocs 4 times before finding one who had more experience with psychotropic drugs. A surprising number of pdocs really don't know much, other than "book learning" about BP. His current pdoc eliminated all other types of meds and had my son take two mood stabilizers, lithium (lithobid) and tegretol. This made him feel about 95% more like his "old" self, but not 100%. So then the pdoc added on Lamictal and this really did the trick. Each mood stabilizer works slightly differently and on slightly different areas of the brain. My son is stable and well on this combination and has no need for other meds as he no longer has episodes of either mania or depression.
Many people do not understand mania. We first tend to think of it as euphoria, feeling really over-the-top. But many people never experience a true manic episode. Hypomania is much more common and can include feelings of rage, intense anger, irritability, sleep problems, etc. And of course, it is possible to feel some of these things while also being depressed.
I don't recall what med/meds you are currently taking. You might want to look into Lamictal. It is one of the newer drugs that is used as a mood stabilizer. It works especially well for those whose main symptoms are on the depressive side and it is weight neutral for most. Its main disadvantage is that it takes a long time to titrate up to a therapeutic level. For this reason it cannot be given if the patient is in "crisis."
happydays:)
09-19-2007, 01:17 AM
lamictal and seroquel have been working well with me. and to fight off the depression, adding some exercise and more time outside has helped me out too.
loufrank
09-19-2007, 09:27 AM
The excersice factor is what I think triggered my latest round of depression. I was home with my daughter for about 2 years. At that time I went to the gym 5 days a week and worked out for an hr and a half (they had a daycare for my daughter). I met a group of women who I became friendly with and looked forward to seeing everyday. Anyway, about 2 months ago, I returned to work 3 days a week. I do like my job and think it's a good thing for me. It does make me happy in many ways and the 3 days a week is a great balance with a 2 year old. However, I am so busy that the most I excersice is 1-2 days a week. I think that is having a HUGE effect on my mood. Once I get used to my routine, I need to fit excersice in more. Right now, I am just so tired. When I am not working, I want to be with my daughter. I do take Lamictal, which balances me out a bit, but it may be time to add a AD to help with my depression and fatigue. On a positive note, now that I am used to my job and my daughter has adjusted well to daycare, my anxiety has went away. I am happy for that. Now time to work on the depression. Thanks for all the advice! It's nice to have people to talk to about this.
Jenn4508
09-19-2007, 04:10 PM
I am glad to see that things seem to be working out for you. You just need to take it one step at a time. Alot of the time it is trial and error until they get the right mix. I do believe that I am on my way to getting to where I need to be on some of my meds for the BP. Its not perfect however, it is better than it has been in a long time.
Talk to your PDoc and let him know all that you are doing and that you need some help with the depression. Then go from there. He may not get it right the first time but eventually I think you will get where you need to be.
Good Luck and God Bless :angel:
Talk to your PDoc and let him know all that you are doing and that you need some help with the depression. Then go from there. He may not get it right the first time but eventually I think you will get where you need to be.
Good Luck and God Bless :angel:
loufrank
09-19-2007, 08:07 PM
Thanks everybody. With all the changes in my life, I need to adjust the meds. The depression is getting worse. I cried a lot of the day todayand didn't feel up to talk to anybody..luckily I was off of work. I am going to talk to my doctor tommorrow.
Jenn4508
09-20-2007, 02:54 AM
I am sorry that you had such a bad day. Please let us know what the doc said. I know how bad things can get but you just have to keep trying for that little girl of yours.
You may want to download a mood chart and start keeping track of your moods on that and also journaling is good for some people also. Journaling saved my life at times and the mood chart has really helped my Pdoc understand what is going on in between visits and not just on that particular day. Just some things that might help you.
Please hang in there.
Sending you ((((((((((((((((Big Hugs))))))))))))))))))) and Lots Of Sunshine :cool: :cool: :cool: :cool: :cool:
Cheryl
You may want to download a mood chart and start keeping track of your moods on that and also journaling is good for some people also. Journaling saved my life at times and the mood chart has really helped my Pdoc understand what is going on in between visits and not just on that particular day. Just some things that might help you.
Please hang in there.
Sending you ((((((((((((((((Big Hugs))))))))))))))))))) and Lots Of Sunshine :cool: :cool: :cool: :cool: :cool:
Cheryl
loufrank
09-20-2007, 12:37 PM
Just got back from the doctor. He raised my dose of Lamictal from 200mg to 300mg since it is working a little without side effects...he also perscribed vyvanse (dexedrine) for fatigue and lack of focus , and a natural vitamin with folic acid and L carityne (which is suppossed to boost the mood). Anyway, I am hopeful. I will keep you posted! Thanks again for the support and advice.
tsohl
09-20-2007, 12:46 PM
Hello Loufrank,
Glad your pdoc was responsive to your feelings. That sounds like an interesting way of dealing with your complaints and sounds like it should work well. I'll keep my fingers crossed.
One thing I'd like to mention, especially if you are relatively new to this bipolar thing, is that some people have to take what seems like LOTS of meds to achieve stability. :eek: I remember when my son started having things prescribed in multiples. I thought it was crazy! But in order for him to be free of episodes, to feel well and stable, he takes 3 mood stabilizers and provigil (1200 mg lithium, 400 mg Lamictal and 600 mg tegretol). It seems like so much, but he's a big guy and this is what it takes to keep him stable. I mention this just so you don't worry that you are taking too much medicine!
Please keep posting so we know how you're feeling. Remember, it may take awhile for these new things to kick in and make a difference.
xxTsohl :wave:
Glad your pdoc was responsive to your feelings. That sounds like an interesting way of dealing with your complaints and sounds like it should work well. I'll keep my fingers crossed.
One thing I'd like to mention, especially if you are relatively new to this bipolar thing, is that some people have to take what seems like LOTS of meds to achieve stability. :eek: I remember when my son started having things prescribed in multiples. I thought it was crazy! But in order for him to be free of episodes, to feel well and stable, he takes 3 mood stabilizers and provigil (1200 mg lithium, 400 mg Lamictal and 600 mg tegretol). It seems like so much, but he's a big guy and this is what it takes to keep him stable. I mention this just so you don't worry that you are taking too much medicine!
Please keep posting so we know how you're feeling. Remember, it may take awhile for these new things to kick in and make a difference.
xxTsohl :wave:
goody2shuz
09-20-2007, 01:52 PM
Hi. Loufrank ~ I just read in the paper today that a study ran at Duke University showed that "regular exercise could help lift majr depression as effectively as an antidepressant." In this study a group of people who had a diagnosis of Major Depression were split up....one group were given daily exercise and the other treated with Zoloft. Tje studu found that after 16 weeks that 45% of those who exercised improved and 47% of those treated with Zoloft did.
I am not by any means suggesting that anybody stop taking an antidepressant :nono: but this isn't the first time that I have read about exercise helping out with depression. You might want to incorporate a 20 minute walk into your daily routine.
(((HUGS))) ~ Goody:angel: :wave:
I am not by any means suggesting that anybody stop taking an antidepressant :nono: but this isn't the first time that I have read about exercise helping out with depression. You might want to incorporate a 20 minute walk into your daily routine.
(((HUGS))) ~ Goody:angel: :wave:
loufrank
09-22-2007, 12:29 PM
I don't want to hinjx myself but I am starting to feel calmer on the upped dose of lamictal and the dexedrine. I am able to sit still for the first time in a while and am not as sad and irritable. I am thinking thay maybe I had some mild form of ADD that was never diagnosed?
goody2shuz
09-22-2007, 12:55 PM
Loufrank ~ Many people who have BP also have a comorbid diagnosis of ADD as both my daughters do. You should wait until you are on the right doses of the meds for BP and see how severe the symptoms of ADD are....many decide it isn't worth medicating for the ADD because by doing so you can offset the stabilizataion of the BP since most of the meds for ADD are stimulants. In any case I have heard that once the BP is properly medicated that most of the ADD symtoms are taked care of too.
So give it some time....I am glad to hear that the meds are finally kicking in for you.
Keep us posted ~ Goody:angel: :wave:
So give it some time....I am glad to hear that the meds are finally kicking in for you.
Keep us posted ~ Goody:angel: :wave:
kwj001
09-23-2007, 10:27 AM
I too have more downs than ups...my pdoc recently added Vyvanse to my meds as well. And so far so good, although after about 3 weeks on the lowest Vyvance dose (30mg I think) I crashed. She upped it to 70mg last week and within 4 hours, the darkness lifted and I could see sunshine. I also take 200mg Lamictal (in the AM) along with my Synthroid and then 1mg Klonopin around 4pm. After a week, I don't feel as great as I did on the first day or so of Vyvanse, but still - better than at a low. I'm going back this week for a quick recheck. My pdoc has been very hesitatant to put me back on an anti-depressant because she feels like many of them negate themselves in BP2'ers...at least I think that's what she said months ago.
This disease is so extreme - LOL...we are either happy or sad and I know that the mood stabilizers like Lamictal are supposed to help and they do, but apparently, there is so much more at play. In my case and maybe others - there are family dynamics that would make a "non-BP person" miserable, or stressful jobs...so if you add those kinds of things to what we deal with internally - it's no wonder many of us feel great or awful or even have a difficult time finding that safe middle ground. These outside dynamics are what gives me the fight or flight symptoms. I either react angrily to whatever is causing me stress, or I want to run away. Unfortunately, most of us just can't up and run - or maybe fortunately because that doesn't solve the problem - so we stand and fight - for our lives. We are strong - if we weren't, we would be here now.:)
This disease is so extreme - LOL...we are either happy or sad and I know that the mood stabilizers like Lamictal are supposed to help and they do, but apparently, there is so much more at play. In my case and maybe others - there are family dynamics that would make a "non-BP person" miserable, or stressful jobs...so if you add those kinds of things to what we deal with internally - it's no wonder many of us feel great or awful or even have a difficult time finding that safe middle ground. These outside dynamics are what gives me the fight or flight symptoms. I either react angrily to whatever is causing me stress, or I want to run away. Unfortunately, most of us just can't up and run - or maybe fortunately because that doesn't solve the problem - so we stand and fight - for our lives. We are strong - if we weren't, we would be here now.:)
Jenn4508
09-24-2007, 07:35 PM
kwj001 What a wonderful post. I can completely understand where you are coming from. When I went to the PDoc 2 weeks ago I told him, look doc, we are going no where. I have been with him over a year and tried so many combos. I know there is a lot of trial and error. I am BP1. I even took the mood chart that I started. I also have fibro and know that it plays a role but, I told him I never get to that middle ground. I have so many more downs than ups and never the middle. I want to get to the middle. I had just had blood work done earlier that week and my depakote level was at 43. He said that for the depakote to be at a level to reach the part of the brain where it needed to get the depakote level needed to be at 50, so it was like all that depakote I had been taken was pretty much for nothing. I thought to myself, had he not looked at the other blood test. So he uped the depakote from 1000mg to 1500 and the seroquel from 100mg to 200 mg along with all the other many cocktails I take and I started to feel much better for about a week. I could see the sunshine everyday and the rainbow at the end of the tunnel. Now it doesn't seem to be working as well but I am not as down as I was either. I am going back to him on Friday which is exactly two weeks from when he uped the meds so I will see what happens. We do just have to keep fighting to get to that middle ground. That's all I am asking for. I want to see the sunshine and the rainbow at the end of the tunnel everyday. You had a beautiful post and thank you for lifting me up.
Cheryl :)
Cheryl :)
loufrank
10-17-2007, 01:16 PM
Hi everbody-
Thank you for all your support. My doctor prescribed me ritalin (aside from the bipolar, just found out I am ADHD). I feel pretty good. Better then I have in a long time. I hope it lasts (fingers crossed). I have made some changes with my job, so I'm going to workjust weekends, and won't have to put my daughter in daycare, and I also applyed to graduate school for an MFA. I would only take one class at a time if accepted. I did have a bad breakdown, but it slowly passed within a week. I know this goes in cycles, and I will have more, but I feel like it is easier to cope with. I now know the signs of upcoming depression and will try to be more pro-active. Thanks again everybody for helping me through a difficult time.
Thank you for all your support. My doctor prescribed me ritalin (aside from the bipolar, just found out I am ADHD). I feel pretty good. Better then I have in a long time. I hope it lasts (fingers crossed). I have made some changes with my job, so I'm going to workjust weekends, and won't have to put my daughter in daycare, and I also applyed to graduate school for an MFA. I would only take one class at a time if accepted. I did have a bad breakdown, but it slowly passed within a week. I know this goes in cycles, and I will have more, but I feel like it is easier to cope with. I now know the signs of upcoming depression and will try to be more pro-active. Thanks again everybody for helping me through a difficult time.
Jenn4508
10-17-2007, 04:24 PM
loufrank - I did not have ADHD or anything however my pdoc did prescribe me the ritalin for energy which helps me quit a bit. I am not saying I can go all day as I also have fibro and sometimes hurt so much I have to rest but I don't go to sleep. I do like the energy.
I think you will be happy that your doc added this to your meds.
Good Luck to you. Cheryl
I think you will be happy that your doc added this to your meds.
Good Luck to you. Cheryl
loufrank
10-18-2007, 02:48 PM
Thanks Jenn-
I am just curious. Does the ritalin cause decreased appetite or weight loss?
I am just curious. Does the ritalin cause decreased appetite or weight loss?
Jenn4508
10-20-2007, 01:12 AM
Normally weight loss. Hope that helps.