Posted by bleauberry on February 11, 2010, at 18:28:07
In reply to What do I do about my mood?, posted by Phidippus on February 11, 2010, at 13:51:27
I'm very sorry you are in the dumps. Been there so many times I lost count. Hang on, it does get better.
Keep in mind, switching from any med to another, even when the old med was not helping at all, will often unbalance things and cause bad feelings. The brain is basically in a state of confusion not knowing what to do for a few days to a couple weeks.
Prozac and zyprexa combo is a good one and I am surprised it is not employed more often. It is well researched for your needs, including bipolor and treatment resistant depression.
SSRIs can sometimes be used as monotherapy for bipolar depression, with destabilization avoided by starting at very low doses and increasing very slowly. Zyprexa onboard helps a ton.
Since we are all so different, and I don't know your symptoms or history at all, my following comments are in generalized terms. These are macro-views based on clusters of observations, but not focusing on individual differences.
First, Lithium might be way too high. That kind of dose is likely to be very dulling and depressing. It would be a reasonable dose as monotherapy to control mania. But with depression, that's a different story. I would think a dose in the 300mg to 600mg range would feel better.
Keppra I do not know enough to comment on. I would just take a moment to reassess why you are taking it and ask yourself what it is doing. If it isn't doing you a lot of good, you kind of have to question why stay with it. Be suspicious of anything that is not providing significant benefits.
Memantine, my guess is it is probably hurting more than helping. It is anecdotally good for preventing stimulant tolerance, and is used for treating senile senior citizens. I don't see any use for it in most people. The ones that have tried it here got either neutral or negative reactions from it. Comments from it making people feel worse rather than better were fairly common. The couple good ones were taking it with stimulants. Again, you have to ask yourself, is this med doing a lot of good? If not, you have to wonder if it is instead contributing to making you feel worse than you would be without it. Gotta be suspicious.
Prozac 20mg is a good common dose. It can go much higher, but give it 3 months before doing that. Generally when prozac starts to change how you feel is within the 2 to 3 week range. Most people feel some stimulation from it almost immediately, but the lithium and memantine are likely blunting that completely.
Zyprexa 10mg I think is too high. I would have been more comfortable at 5mg.
I was on Prozac 20mg and Zyprexa 5mg for almost 8 years and it worked pretty well. It was probably about 3 weeks before it was doing something I could feel, and about 2 to 3 months where I realized I had come a long way and was doing pretty good.
You are in the middle of a transition, and that is always hard. During this time, you should be able to see how well the other meds are helping or not. I mean, to feel down in the dumps doesn't speak very well of lithium or memantine doing much good for you. If they were providing antidepressant oomph, they should have buffered the blow. But they didn't. Kind of makes me wonder.
Give the prozac and zyprexa some time. Scrutenize the other meds with a sense of suspicion to determine whether they are keepers or not, and to determine if doses need to be adjusted downward.
> I am in the dumps. I just switched from Geodon to Zyprexa and added Prozac. I am bipolar and want to know if Prozac will help me out of this depression. Are SSRIs efficacious in treating Bipolar depression?
>
> Here's my cocktail: Keppra 2000 mg, Lithium 1200 mg, Memantine 10 mg, Prozac 20 mg, Zyprexa 10 mg.
>
> IF any of you have suggestions I'd appreciate it.
poster:bleauberry
thread:936740
URL: http://www.dr-bob.org/babble/20100204/msgs/936756.html