Posted by Ritch on March 9, 2003, at 16:10:33
In reply to Re: Another horrible 'episode'-so sick and tired of it » Ritch, posted by Peter on March 9, 2003, at 13:50:47
> >The interesting thing is that I've always had profoundly beneficial responses to SSRI's for at least a month or 2. More specifically, they 've helped me a lot with sepression, social anxiety, agoraphobia, public performancec (musician), etc.
But the 'hypomania' wouldn't occur for a few months-and when it does, I don't know if it's hypomania.Wow, that's where we differ for sure. I could go and get a "typical" dose of ANY SSRI/Effexor right *now* and within a few hours to a day be hypomanic (except if I am dead in the middle of a major depressive episode). That's interesting that you say you don't know whether it is hypomania or not.
> > Wow, 2.5mg seems tiny. The only 2 SSRI's on which I've been up to a fairly hefty amount are Paxil and Zoloft. But my doc said he wants to stay on a 'small' Prozac dose (5mg). I was prescribed Paxil for the first time by my internist doctor back in '94 because I had like a week long panic episode in response to someone in my dorm getting meningitis. I didn't know anything about meds, so I kept taking it for about 2 years-even through all my hard drug use. Who knows if it made my drug-seeking worse than it already was? that's the qiestion.Yes, 2.5mg isn't much! But, much more than that for very long and I get all sorts of weirdo symptoms (not just "typical" hypomanic symptoms). The visual/auditory illusions with Prozac were very weird (mostly intrusive music). Prozac and Celexa at higher doses make it hard for me to breathe for some reason, too.
...What is his rationale behind giving you stims, then? Evidently he didn't have any qualms with you trying stimulants. TCA's can work rather well for agoraphobic symptoms and GAD.
> > That's what I thought, too. But he said that stimulants have much less of a tendency to push someone into hypomania than antidepressants, especially TCA's. He said he treats a lot of bipolar patients with a mood stabilizer and a stimulant instead of an antidepreesant. If their depression doesn't respond adequately, that's when he considers an AD add-on.
I shouldn't be too surprised to hear that actually. I never had the "instant" hypomania from stimulants that I get from SSRI's. In fact, I don't experience much mood-elevation at all from stims (Ritalin had zero mood effects). However, every time I try classical stims I start to get this anxiety thing churning (sleep fine though) and it just worsens and I wind up off the stims again.
> > Do you think the Lamictal has helped you in any way?> > Honestly, it's been such a long bout with the lamictal that I can't really tell. I'd go through a few days of felling more balanced and hopeful about the med, but then I'd go through all the bad stuff again. Either way, it certainly hasn't helped to any noticeable degree, anywhere near how my doc said it 'could' help-as an 'all-in-one' solution. There has been no real improvement in my anxiety and my depressive episodes, when they hit me, are just as bad, if not worse. I did for a bit think the med was working and was superior to the other MS's Itried, but I think my periods of feeling hopeful were largely influenced by my doctor's positive feelings about the med for atypical depression and mixed/rapid cycling BP, and even anxiety. But 6 months is enough of a trial. If it hasn't worked as he said by now, it doesn't seem like the right choice.
> >BTW, It amazes me how attentive you are to people's problems and how helpful you are. I really admire that. Thanks again Mitch,
> Peter
> >Thanks! Your problems are just SO similar to mine. I just feel all puzzled by it. When I was taking Neurontin (300mg/day) and a little Klonopin (.5mg) and a *little* Celexa (1.5mg/day) for nearly a year I didn't have any unusual hypomanic spells. Since Neurontin doesn't "work" for mania-then what was it "working" on?? I really wonder if it isn't BPII at times, just anxiety and ADHD. I added a little Wellbutrin in the last several days because I was getting so unfocused I couldn't complete ANYTHING. It helped somewhat right away. If it was bipolar shouldn't it have gotten WORSE (the distractability, inattentiveness)? I get hypomanias but usually only SSRI related........Mitch
P.S.-Got a question for you. When you were diagnosed with ADHD, were you tested? The reason I ask is that when I take stims and esp. WB (for some reason), the sense of time passing slows almost to a stop. Is that a symptom of ADHD (sense of time passing very rapidly)?
poster:Ritch
thread:207296
URL: http://www.dr-bob.org/babble/20030306/msgs/207491.html