Posted by Ritch on February 28, 2002, at 11:49:11
In reply to Re: Having the rug pulled out from under you » Ritch, posted by BarbaraCat on February 28, 2002, at 10:33:20
> Ritch and Misty,
> I relate to your post re mixed states, ADHD etc. Some questions: 1. How does lamictal differ from lithium, i.e., why choose one over the other? 2. where does ADD leave off and bipolar begin and vice versa? How do we know these are different states and not just different points on the continuum of one state?
I haven't had any experience with Lamictal, but it is an anticonvulsant whereas Lithium lacks anticonvulsant activity. I think many would think that Lithium would be the stabilizer of choice if there was some psychosis, it is a more powerful antimanic agent than Lamictal, generally. If depression tends to predominate and there is rapid-cycling, probably Lamictal would be a better choice. I haven't heard of many bipolars on Lamictal monotherapy, usually it is combined with something else-Lithium, Topamax, Neurontin, etc. There are several on the board on Lamictal who could answer Lamictal questions more thoroughly.I really don't think bipolarII and ADHD are in a "sequence" of any kind. I think there are folks that are BP and have very prominent ADHD symptoms (primarily inattentiveness). I really think it is a comorbid condition. I have had ADHD probs since I started grade school. If you want to look at med responsiveness-I tried Adderall once (small dose) during a bipolar depressive episode and it *vanished* completely (and that was without any antidepressants). My rapid-cycling patterns also became very tough to pick out, my sleep quality and architecture improved greatly. That makes me wonder a lot whether I just have a quirky form of ADHD that is characterised by seasonal patterns, mood reactivity, lability, and GAD/OCD/SP/panic stuff. Or it is just a quirky form of bipolar that is ADHD predominant. My cycle lengths haven't changed for over 25 years. Nothing seems to be getting *worse* really. It is just a chronic, relatively predictable, that adversely impacts my ability to learn new things, listen to people, etc. It would be nice to just feel half-ass normal for a solid month-wow.
>
> In my wild and crazy days, methamphetamine was my self medicating drug of choice and in large quantities would calm me down. However, any speedy substance now in normal quantities makes me feel restless and can tip me into a weepy anxiety state. When I'm in the throes of a panic episode, nothing helps except time. I wonder if those selfmedicating days overamped me and burned something out.
>Hey, anything is possible. I do know there is NO way I can take a stimulant by itself (like people with plain ADHD can). It looks like polypharmacy for some time until something innovative comes along. I am not taking a pstim now (am on a pinch of Wellbutrin, though).
good luck,
Mitch
poster:Ritch
thread:95687
URL: http://www.dr-bob.org/babble/20020222/msgs/95827.html