Posted by Ritch on January 31, 2002, at 10:17:09
In reply to Re: Bipolar II and ADHD Differences?, posted by Peter on January 31, 2002, at 2:18:24
> This is certainly an interesting post that relates significantly to that with which I myself have been grappling. At the onset of my pdoc sessions about 5 years ago, I was diagnosed with hypomania, possible ADD, and varying degrees of anxiety (generalized, social, etc.). My doctor prescribed me numerous drug combos over about 5 years, covering the spectrum of SSRI's, mood stabilizers, benzos, dopamine agonists, stimulants, and beta-blockers. My last cocktail consisted of adderal, depakote, klonopin, and Atenolol. The adderal helped me with attention/focus difficulties, impulsivity, and lack of drive and motivation, and the depakote was helping to curtail manic episodes. The klonopin decreased anxiety, and the atenolol kept my heart rate low and steady. But, as often occurs during med trials, what started off seemingly flawless became a mess; evidently, the adderall, as it accumulated in my system over a few weeks, caused increasing, unmanageable amounts of anxiety. So, I decided, along with my pdoc, to reduce everything and start with a clean slate. I came off the adderall, the atenolol, & reduced the depakote to almost nothing (but I kept the klonopin at a fairly steady low dose). Things seemed to be going well, and I even thought for awhile that I'd be able to deal with myself and my life without meds, when I began to experience terrible episodes of a whole jumble of symptoms that seemed to overlap into areas of ADD, hypomania, and anxiety. So now my doctor has prescribed me Neurontin (to add to my klonopin) with the intent that it could possibly deal with my wide spectrum of symptoms better than depakote, especially, those of anxiety and episodic depression. Who knows? Maybe it was my hypomania, not ADD, that rendered me unable to concentrate and relax. Later down the line, depending on how the neurontin helps me, I might have a small amount of pstim and/or SSRI added. Sorry for the length of this thread, but I thought I'd give a personal testimony reflecting the frequent difficulties of distinguishing between bipolar II and ADD, and the problems that can arise treating a comorbid case conventionally, especially when there's anxiety involved that a stimulant or SSRI can exacerbate. So much of it is trial and error. BTW, does anyone with similar diagnoses have positive experience with neurontin as an aid to episodic hypomania, anxiety, and underlying ADD? if the addition of a stimulant becomes necessary due to difficult ADD symptoms, is neurontin a better mood stabilizer to combine with a stimulant than depakote for those with anxiety? Thanks.
Peter,Wow, your story is almost exactamente to my own. Yes, hypomania can be distracting enough to create focus troubles, too-I believe that. The trouble I have is I go into these seasonal depressions and the most prominent feature is daytime fatigue, hypersomnia, severe attentional problems with total lack of interest in everything (everything is BORING). *Nothing* has worked with *complete* success for these particular symptoms than a stimulant. In other words, during my depressive episodes IF I can focus (due to a pstim, i.e.) and not feel sleepy all day I am *not* depressed. I have never had such a striking remission from a depressive state. But, the anxiety does start "creeping up" and after a few weeks on 5mg of Adderall I got panicky and had to stop it. BTW, I am still taking Neurontin and Neurontin was the only med I was taking with the Adderall at the time and I still panicked. I seem to need a little bit of SSRI and clonazepam to prevent panic from recurring. I am not sure how it would go if I had those thrown in the mix (would I still have to stop the Adderall again?). Neurontin *does* seem to help with all three things you mentioned-anxiety, hypomania, and ADD. It just doesn't seem to work well by itself for everybody. Also, at higher doses you can get cognitive blunting from it (I did above 900mg/day).
Mitch
poster:Ritch
thread:92098
URL: http://www.dr-bob.org/babble/20020131/msgs/92358.html