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Old 12-30-2008, 02:21 PM   #1
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Treatment Resistant BP

Has anyone ever heard of treatment resistent bipolar disorder? Or maybe suffers from what might be considered treatment resistent? (i.e. you have a hard time finding medications that work, etc.) I would be interested to hear from you......

 
Old 12-30-2008, 02:35 PM   #2
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Re: Treatment Resistant BP

which treatment are you taking now?

 
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Old 12-30-2008, 04:33 PM   #3
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Re: Treatment Resistant BP

I've never heard of treatment resistant BP, but I do know that certain types of bipolar (like rapid cycling) are more difficult to treat than others. I have atypical bipolar I with ultradian or ultra-ultra rapid cycling where I experience severe mood swings on an hourly basis. I've just now started to see a new pdoc after not getting good treatment from my previous pdoc for the last year and a half. My new pdoc thinks that although I will still continue to experience rapid cycling even when on meds, together we can try to reach a point where I'm not rapid cycling as much as I do now and am as close to feeling "normal" as possible. I've just started on a 20mg dose of Fluoxetine which (according to my tdoc) should take another 6-8 weeks to start working. If I still don't notice any improvement, the next step is to add a small dose of Lithium and increase my Depakote as well if needed.
__________________
Atypical Bipolar I Disorder with Rapid Cycling
Meds:
Depakote 1500mg
Prozac 40mg
Risperdal 1mg titrating to 6mg/day
Klonopin .5mg (2x/day)
Trazodone 100mg or 200mg PRN

 
Old 12-30-2008, 05:37 PM   #4
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Re: Treatment Resistant BP

tigger,

Welcome back. How are you doing?

k

 
Old 12-30-2008, 05:51 PM   #5
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Re: Treatment Resistant BP

currently I am taking cymbalta, lithium, epilim, valium (& anther drug that I can't recall the name of).

The reason I'm asking the question is that I seem to find a good combination of drugs, but they will only "work" for about 6 months if I'm lucky and then I'm back to square 1. I just wondered if others found this to be an issue.

 
Old 12-30-2008, 08:03 PM   #6
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Smile Re: Treatment Resistant BP

Hi Tigger

I too have been told that I have treatment resistant bipolar disorder. I have had similar experiences in that I would be treated and get a little relief or none and we always end up back to the drawing board

Right now I'm still finding my proper dose for Divalproex Sodium. I'm currently taking 1250 mg/day and after my blood levels are checked I'll know if I need to continue the increase for the correct amount. I'm also taking 60 mg/day Cymbalta, 0.5mg/day Risperidone which I'm just starting...so it could increase, 15mg/night Imovane and Lorazepam as required.... Nothings under control yet. I'm a rapid cycler too....so the shifting is still happening and I'm getting more than frustrated as I wait for the impatient program that I'm signed up for to have a bed come open.

In the past I have taken Topimax, Lamotrigen and Seroquil however I don't believe that I was ever properly dosed. I never thought that I'd be so eager to get into and IP but when life feels like a roller coaster and like I'm in limbo I feel like it may be my only solution right now. I have a 4 year old daughter and every day I feel like I continue to warp her in some way because of my thinking etc. I'm so depressed and suicidal at times and then before I know it the manic side is back with me not sleeping, being so agitated and irritable. I can't seem to sit and watch tv with my hubby while he snacks on chips because the sound of the crunching makes me want to choke him! lol I know it's not funny but at this point I have to laugh about something. I know everyone on here mostly understands all of the symptoms etc. But I guess today is just a bad day.....

After all of that... I hope that you know I too am struggling with the difficulties of finding the right treatment too. Hang in there Tigger.

 
Old 12-30-2008, 09:19 PM   #7
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Re: Treatment Resistant BP

Well, it feels good to hear someone else is going through similar experiences. I understand what you mean about IP. About 3 months ago I couldn't wait until I got there and got my treatment options which just so happened to end up being ECT. Of course when all was over I was overjoyed as I felt the best I had felt in years. Unfortunately it didn't last long, only this time I was all ready to go back and repeat the treatment - only this time it didn't work and I was worse off than when we started (which is when my Pdoc said it looked like I might have treatment resistant BP)... so now I'm back struggling. Luckily for me I'm at least not a rapid cycler - in fact recently my mania doesn't appear much at all- but I have had major issues with depression and suicide ideation.

I keep waiting for someone to invent a magic want to make this disorder just go away

 
Old 12-30-2008, 09:24 PM   #8
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Re: Treatment Resistant BP

Hi Katlin,

Ah well I'm struggling. I didn't respond to this round of ECT like my first round and ended up worse off than before the treatment. I feel like I'm just finally climbing out of the hole and it's been 3 weeks. On top of that we have had to do another medication change so I"m in the usual "holding pattern" of waiting for the drugs to kick in while I struggle with my depression. I would give anything for just a small bit of mania at the moment! LOL

 
Old 12-30-2008, 09:26 PM   #9
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Re: Treatment Resistant BP

I'm beginning to think that in most cases BP is difficult to treat. I cannot imagine cycling on hourly basis....I sure hope you get some success with the new Pdoc.

 
Old 12-30-2008, 10:22 PM   #10
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Re: Treatment Resistant BP

Tigger -

One woman in my bp group has treatment-resistant bipolar I. Her medication is constantly changes, and nothing really works for her. She is better, let me emphasize, but they just cannot get her stable.

Working very closely with her therapist and having a Crisis Plan has helped her. She is also considering ECT, which has worked for her very well in the past (though, obviously, temporarily).

She also works hard at maintaining a regular schedule of good nutrition and sleep. Even when she cannot sleep, she goes to bed and gets up at the same time. She also (sometimes, when not depressed) exercises regularly.

I do hope you find some answers out there.

Seaturtle

 
Old 12-30-2008, 11:49 PM   #11
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Re: Treatment Resistant BP

Hi Tigger,

Welcome back! I feel the same way you do about the frustration of taking so many meds, but nothing working.

As you know, I'm a rapid cycler and I'm currently taking 4 different meds for my bipolar.

According to my new pdoc, part of the reason why my meds aren't working is because rapid cycling is so difficult to treat and because my previous pdoc never did anything to address my cycling. Whenever I said I was manic, he simply told me to come back and see him in 3 months.

My new pdoc is wonderful. After I told him how difficult this time of year is for me, he added Fluoxetine in the hopes it will help relieve my depression. If that doesn't prove effective, he plans to add a small dose of Lithium and increase my Depakote if needed.

Over the past year and a half I've been so discouraged about my rapid cycling.

However, my new pdoc has given me hope and told me that he's going to do everything he can to give me the help I need. In his words, he wants to get me to as "normal" a mood as possible.

We'll see how things work out. I'll keep you posted.

Again, welcome back.
__________________
Atypical Bipolar I Disorder with Rapid Cycling
Meds:
Depakote 1500mg
Prozac 40mg
Risperdal 1mg titrating to 6mg/day
Klonopin .5mg (2x/day)
Trazodone 100mg or 200mg PRN

 
Old 12-31-2008, 09:41 AM   #12
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Re: Treatment Resistant BP

Tigger,

I am so sorry that you are having such a rough time. I know that before you went IP you were so hoping the ECT would help. I've been on the Cymbalta for about a month now, and unfortunately it hasn't been as easy as I hoped. there's been alot of rapid cycling, which has never been my problem, like you I'm BP with severe suicidal depression. And now we've added back the seroquel to try and balance the Cymbalta. So for now I'm a bit stable but at the more "depressed" level and am having trouble with Trauma induced nightmares. So now the med list is Lamictal, Seroquel, Cymbalta, Topomax and 3 various vitamins/minerals.

At my pdoc appt. last week I also asked him to wave a magic wand and make it all go away, he just kind of shook his head sadly and said, "If I could I promise you I would, but I can't, and unfortunately you aren't alone in that wish." At least he was compassionate about it, and didn't treat it like a joke.

I'm beginning to think that we're all just destined to be on the hard road forever, or if not and someone has proof of that, I'd like to see it.

 
Old 12-31-2008, 02:00 PM   #13
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Re: Treatment Resistant BP

Quote:
Originally Posted by tigger5150 View Post
I'm beginning to think that in most cases BP is difficult to treat. I cannot imagine cycling on hourly basis....I sure hope you get some success with the new Pdoc.
Thanks, Tigger. I do too. My new pdoc told me I've suffered way too long with my rapid cycling thanks to my old pdoc and it's about time that we start finding ways to get it under control. Needless to say, I'm exhausted and am more than ready to experience some relief. I was so discouraged the other day that I seriously considered going IP again because of my severe depression and suicidal thoughts. It's frustrating!!!

I hope you're able to find effective treatment as well. ((((((tigger))))))
__________________
Atypical Bipolar I Disorder with Rapid Cycling
Meds:
Depakote 1500mg
Prozac 40mg
Risperdal 1mg titrating to 6mg/day
Klonopin .5mg (2x/day)
Trazodone 100mg or 200mg PRN

 
Old 01-01-2009, 05:08 PM   #14
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Re: Treatment Resistant BP

I think we'll need cases of those wands! LOL

Hmmm interesting to hear about your experience with ECT. I have read about it and know that it's one of my options but have been really nervous. Did you have the memory loss that they say comes along with that treatment?

Hang in there! I'll be thinking of you

 
Old 01-01-2009, 05:58 PM   #15
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Re: Treatment Resistant BP

TM - I have to say I had very good success the first time I had the treatment. I did have the memory loss, but it progressively got better after the treatment finished and returned to normal, there were a few things that I couldn't remember but nothing major.

I wish I knew what was different with the second round of treatment and why I didn't get the benefit and had such a strange reaction. My doctor things it has to do with the same reason meds don't work for a long period of time with me which he doesn't have an answer for..... when you find those wands let me know as I would happily have one waved over m! LOL

 
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