Posted by JohnX2 on March 9, 2002, at 20:57:20
In reply to Re: Nardil » Elizabeth, posted by JonW on March 9, 2002, at 16:38:16
Hi JonW,
What mood stabilizers have you tried besides Depakote?Have you been able to get onto an anti-depressant without
getting such a wild manic response?Has your pdoc talked about taking more
mood stabilizers like lithium, lamictal, more depakote?My pdoc's opinion is that most bipolars should be treated
with more mood stabilizers and as few ads as possible.Has your physician ever started you solely on a mood stabilizer,
before adding on ADs?I'm just wondering what the strategy is to avoid the pattern of
cycling. I had the same snag, and Lamictal was the only medicine
that helped me without causing a big cycle (Lamictal of the
mood stabilizers has a good anti-depressant action). Lithium
is good at snaggig the bad mania.Even now that I have good Lamictal and Topamax
some Serzone dosing makes me hypomanic. I might add
some Lithium soon.sorry for all the questions.
best wishes,
-John
> Hi Elizabeth,
>
> Thanks for the informative post! I've read other post of yours and have found them useful as well.
>
> As for my symptoms... Well, I suppose I'm a mut when it comes to that but I'll try to paint a picture. I have very bad social phobia -- I used to be afraid of just going out to my mailbox. I also have this general physiological anxiety that never goes away -- neurontin helps somewhat. If I had to pick out the depression it might be considered double depression by some but its far worse than dysthymia most of the time. My mood cycles every couple of days, but sometimes within the same day. I can be cheered up by driving in my car or watching a sitcom. I definitely crave sweets,etc. I feel better at night and horrible in the morning, have difficult time getting out of bed in the morning.
>
> What makes my doctor think I am bipolar? Nearly every AD made me "high" the first couple of days and then irritable agitated depressed. When "high" I could just lay on my back and smell the air as it never smelled so good and the sights never looked so good. I would drive 90mph and yell at the top of my lungs! I cycle more frequently when on ADs -- although life is subjectively better. Parnate (I only took it for 2 days) in particular made me sooo high and overconfident I aced a job interview (plus) but I verbally assaulted others (big minus) because I was very agitated. I'm very impulsive at times. As a child I reacted with violent temper tantrums to being told "no". I absolutely love pissing off authority -- I may do it under the guise of some principal, of course. I had suicidal thoughts as early as age 9. I've been hospitalized twice -- both in the last 6 months.
>
> Sorry for this being so long... Well, if you or anyone else has any ideas or avenues I might want to pursue please let me know.
>
> Thanks,
> Jon
>
>
>
> > Nardil is a great anti-anxiety drug. I've seen it do wonders for people with social phobia and other kinds of interpersonal sensitivity. MAOIs are also known to be effective for atypical depression -- more so than SSRIs like Zoloft.
> >
> > Atypical depression isn't the same as bipolar II disorder, but depression in bipolar disorders can have "atypical" features: excessive eating and sleeping, feelings of heaviness, interpersonal sensitivity (esp. rejection sensitivity), ability to be cheered up temporarily. The more of these characteristics apply to your depression, the more likely it is that the diagnosis of atypical depression is accurate. Nardil is good at relieving the hpersensitivity that is seen in atypical depression and social phobia.
> >
> > I also think that MAOIs are the antidepressants that are most helpful in ADHD, although doctors shy away from giving them to children. Parnate may be better than Nardil for ADD since Parnate seems to share more characteristics of the stimulants. On the other hand, as John says, Nardil seems to be better for anxiety symptoms. MAOIs often relieve lethargy, whereas SSRIs can make it worse; Parnate may be the better choice for this symptom.
> >
> > MAOIs can be used in combination with stimulants, but you have to be cautious. Some people (like me) can't get away with it because they have hypertensive reactions even on low doses of stimulants, but many people can do it safely. You need to be able to monitor your blood pressure if you're going to try it. As I said, I think that if you try an MAOI, you may find that it helps with the ADD by itself.
> >
> > MAOIs can trigger cycling in bipolar disorder, so if that diagnosis is correct, you should be cautious (this is true of any antidepressant, including Zoloft). Can I ask what symptoms led to the diagnosis of bipolar II? IMO, this has become a bit of a "wastebasket" diagnosis, used for all kinds of unidentified conditions that probably are not all the same thing. I agree with John that doctors may be inclined to misinterpret ADD symptoms (especially in adults) as hypomania.
> >
> > Just some opinions, for whatever they're worth.
> >
> > -elizabeth
poster:JohnX2
thread:97093
URL: http://www.dr-bob.org/babble/20020307/msgs/97261.html