![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by colin wallace on July 23, 2002, at 14:10:22
I've just returned from a long awaited, marginally disappointing consultation with a psychiatrist.Disappointing because, although he seemed a decent enough guy, English was not his first spoken language, and in an interview where nuances can be so important(in my lowly opinion)-I feel much may have been missed, as striking a rapport in these circumstances is more difficult.
However, my diagnosis for today is double depression, and due to my adverse, erratic and angry reactions to AD's, he's going to give Depakote a shot- at 200mg to start.
He didn't agree with (though in fairness, wouldn't dismiss)my bipolar type 11 theory, but declined my request for lithium because he felt that the small dose I wanted (300/600mg) would be unlikely to be beneficial.Most of his patients are on +1000mg .
Valproate, I understand, does not exert any standalone antidepressant or prophalactic effects, as does lithium ? And seeing as I'm still depressed as hell and will only ever take another standard AD if my mouth is held open with forceps and a medieval catapult is used to force feed me, what's the point of a mood stabilizer alone?
Also, would I be wrong in thinking that lithium (in a low dose range)has a more benign side effect profile than valproate? I find the liver thing worrisome to say the least.
Still, its my call, and now I'm edging towards refusing the stuff, and obtaining my own lithium if needs be-
then I'll just present myself and say, 'monitor my blood levels for lithium please- or don't 'cos I don't really care.Col.
Incidentally, I've now stopped ALL meds, with the exception of 2mg diazepam-the angry mood
swings are lessening now too.And my mood is SO much more manageable than when I was on AD's.
Posted by velaguff on July 23, 2002, at 15:59:06
In reply to Depakote tantrums..., posted by colin wallace on July 23, 2002, at 14:10:22
I'm certainly symapthetic with your desire to control your own meds. Wish this were REALLY a free country! You might want to try this: go to www.findserenitynow.com I have tried this product. It doesn't do much for my unipolar major depression, but it's quite sedating. The "organic lithium orotate" in it certainly has an effect. 2 of them turns me into a zombie. They're great as a sleep aid. 2 at bedtime, restful sleep, extremely vivid, interesting (not always pleasant, but never boring) dreams. Best wishes, Velaguff.
Posted by Ron Hill on July 23, 2002, at 16:27:07
In reply to Depakote tantrums..., posted by colin wallace on July 23, 2002, at 14:10:22
Hi Colin,
Sorry to hear about your mood swing problems. Let me briefly comment on two topics. First, lithium vs Depakote and, second, SAM-e induced irritability.
> Also, would I be wrong in thinking that lithium (in a low dose range)has a more benign side effect profile than valproate? I find the liver thing worrisome to say the least.
I took Depakote for a year or so. On the plus side, I slept like a baby with very vivid dreams. On the other hand, however, it caused weight gain and it seemed to make my depression worse. YMMV. I didn't concern myself regarding liver issues. Ignorance is bliss. However, my pdoc ordered periodic blood level tests.
In contrast, although 600 mg/day of Lithobid does not seem to provide much (if any) antidepressant effect for me, at least it does not seem to make my depression worse than baseline. Lithobid causes a slight weight gain above my no-medication baseline weight.
> Incidentally, I've now stopped ALL meds, with the exception of 2mg diazepam-the angry mood
> swings are lessening now too.And my mood is SO much more manageable than when I was on AD's.Did you also discontinue your SAM-e? I had to quit SAM-e because of irritability. I feel really sheepish about having posted frequently regarding the wonderful benefits I was experiencing with SAM-e, and now it turns out to be extremely detrimental to my mood in the long term. My hope is that any and all people that read my earlier posts would stumble across this post to get the rest of the story.
Let me block and copy three paragraphs from a post that I wrote to you prior to you going on holiday. I'll paste the three summary paragraphs immediately below and continue from there:
Colin, recall that I had roughly five months of excellent results with 200 mg of SAM-e. Then I began to experience extreme irritability/flash rage problems and I did not know why. As a last dig effort to identify the culprit causing the foul mood, I discontinued all vitamins and supplements (including SAM-e) but continued taking my Lithobid. The irritability continued.
I slowly began to re-add vitamins supplements to my daily intake and when I added 400mg/day of chelated magnesium, the crises state of my irritability subsided. I still have ongoing bouts of irritability (I think all bipolars do) but nothing like what it was without the magnesium.
I then resumed my 200 mg/day SAM-e intake, but it did not provide the same beneficial effect that it had during the first five months of use, so I increased to 400 mg/day. At 400 mg/day, SAM-e currently provides some benefit and I deem it worthwhile, but it has lost a lot of its effectiveness compared to what it once did for me. I do not know whether or not SAM-e was at least partially to blame for the initiation of the extreme irritability, but the current 400 mg/day does not cause irritability.
Okay, back to real-time. Within about a week or two after restarting SAM-e, I became VERY IRRITABLE and began to re-experience what I call flash rage. Four days ago I quit SAM-e and the irritability slowly subsided. But my brain chemistry got all screwed up; low motivation, difficulty concentrating, etc. My wife and I just closed on a new house so I need to have my brain in working order to get us moved. Therefore, in desperation I took 200 mg of SAM-e yesterday and sure enough my thoughts briefly became more focused and some motivation returned. But, within an hour of taking the SAM-e the irritability began to return. Even today I feel more irritable than I would have otherwise if I had not taken the small dose of SAM-e. I can no longer take SAM-e. Also, the perceived benefit of magnesium that I spoke of earlier may have just been coincidental. Maybe the SAM-e was just getting out of my system.
Sorry to ramble.
-- Ron
Posted by judy1 on July 23, 2002, at 17:43:54
In reply to Depakote tantrums..., posted by colin wallace on July 23, 2002, at 14:10:22
I'm really glad you stopped the ADs and the mood swings- they have the same effect on me. As far as depakote- while it is a wonderful anti-manic med, it is in fact quite depressing. I certainly would not take it if depression was my main symptom. If you just want to stay on benzos, xanax may be a little more uplifting than valium- it was for me. Take care, judy
Posted by Ritch on July 23, 2002, at 21:00:07
In reply to Depakote tantrums..., posted by colin wallace on July 23, 2002, at 14:10:22
> I've just returned from a long awaited, marginally disappointing consultation with a psychiatrist.Disappointing because, although he seemed a decent enough guy, English was not his first spoken language, and in an interview where nuances can be so important(in my lowly opinion)-I feel much may have been missed, as striking a rapport in these circumstances is more difficult.
> However, my diagnosis for today is double depression, and due to my adverse, erratic and angry reactions to AD's, he's going to give Depakote a shot- at 200mg to start.
> He didn't agree with (though in fairness, wouldn't dismiss)my bipolar type 11 theory, but declined my request for lithium because he felt that the small dose I wanted (300/600mg) would be unlikely to be beneficial.Most of his patients are on +1000mg .
> Valproate, I understand, does not exert any standalone antidepressant or prophalactic effects, as does lithium ? And seeing as I'm still depressed as hell and will only ever take another standard AD if my mouth is held open with forceps and a medieval catapult is used to force feed me, what's the point of a mood stabilizer alone?
> Also, would I be wrong in thinking that lithium (in a low dose range)has a more benign side effect profile than valproate? I find the liver thing worrisome to say the least.
> Still, its my call, and now I'm edging towards refusing the stuff, and obtaining my own lithium if needs be-
> then I'll just present myself and say, 'monitor my blood levels for lithium please- or don't 'cos I don't really care.
>
> Col.
>
> Incidentally, I've now stopped ALL meds, with the exception of 2mg diazepam-the angry mood
> swings are lessening now too.And my mood is SO much more manageable than when I was on AD's.
Colin,If I had a choice of ONE drug to take for bipolar-II it would be lithium. Depakote by itself just wouldn't cut it. I have been on lithium monotherapy in the past and it worked reasonably well. I pulled myself out a major depression with lithium once (by itself) at just 600mg/day after a couple of weeks. Just because you "only" take 600mg/day, doesn't mean it would not work-that's baloney!
Mitch
Posted by colin wallace on July 24, 2002, at 6:32:13
In reply to Re: Depakote tantrums..., posted by velaguff on July 23, 2002, at 15:59:06
Hi Velaguff,
Thanks, I really appreciate the info. on lithium orotate- I have definitely decided against taking valproate. Lithium is the only (prescription) med I am now prepared to try , so it may well make sense to give the orotate a whirl before I take the plunge with the lithobid/ carbonate etc.(if I can get it!)
Col.
Posted by colin wallace on July 24, 2002, at 6:55:04
In reply to Re: SAM-e Rage » colin wallace , posted by Ron Hill on July 23, 2002, at 16:27:07
Ron,
It's a pity that you and I both seem to be back at square one again with the medication roulette-
strange that sam-e should work so well for a while, and then trigger anger and rage symptoms.
This same effect has appeared with me with most of the ssri's- a latent, simmering anger, that only really breaks out when I've been taking the damn things for a month or so (the amount of time the AD effect is supposed to become apparent!!)
My verdict on sam-e is still ambivalent.I still view it as an excellent, unique med., that pulled me out of a nasty depression, and quickly.
Taken alone for a few months, with a benzo, I had few, if any, anger symptoms.I added a small dose of zoloft, as you know, and still things improved.
Then, due to a terminal illness of a close relative, I relapsed badly, and about this time the anger symptoms re-emerged.This is complicated to disentangle, because this may well have been about the time the zoloft/sam-e were wreaking some mischief anyway.
Dropping the zoloft on holiday, I stuck to sam-e alone, and still suffered the anger/mood swings and (controllable) feelings of rage.I dampened these with gallons of icy cold cider!!
Anyway, It's time to start again from scratch, and I've now dropped the sam-e too, just in case.I may try it again in future, when and if I'm able to 'normalize'.
I'll keep you posted.Its strange to be (virtually) med free after two very drugged up years- I think I'll wait a bit, then if I crash again, push for the lithium.Take care,
Col.
Posted by colin wallace on July 24, 2002, at 12:09:54
In reply to Re: Depakote tantrums... » colin wallace , posted by Ritch on July 23, 2002, at 21:00:07
>
>> I have been on lithium monotherapy in the past and it worked reasonably well. I pulled myself out a major depression with lithium once (by itself) at just 600mg/day after a couple of weeks. Just because you "only" take 600mg/day, doesn't mean it would not work-that's baloney!
-----------------------------------------Mitch,
'Baloney' was a similar line of thinking to mine on this issue.It's not that I'm against valproate per se- just that I know full well that it doesn't possess AD properties, which I need in addition to the mood stabilization.Hence my request for lithium.
My guess is that this psych. either just has a plain preference for depakote, or else he thinks he'll entice me back onto AD's when I'm a little more...receptive!!
Another curiosity;I mentioned lamotragine, and the guy was aghast, citing awful and common side effects of psychosis (?), and its being a weapon of ultimate last resort for the most refractory of bipolars.
I just sighed and gave up at this point.
He who writes the script pulls the strings.Col.
Posted by colin wallace on July 24, 2002, at 12:20:23
In reply to Re: Depakote tantrums... » colin wallace , posted by colin wallace on July 24, 2002, at 12:09:54
Posted by colin wallace on July 24, 2002, at 12:30:53
In reply to Re: Depakote tantrums... » colin wallace , posted by judy1 on July 23, 2002, at 17:43:54
Thanks Judy,
Was supposed to be ditching the benzo's this year...I started out with benzo's when I first became ill, and only became suicidally ill following AD treatment.Thanks to AD's, I've wasted two and a half years of my life spiralling in and out of suicidal depressions.I honestly wish I'd never even heard of antidepressants, and stuck to benzo. monotherapy in the first place.At least back then, all I was suffering from was anxiety!!
Whinging Col.
Posted by judy1 on July 24, 2002, at 22:22:19
In reply to Re: Depakote tantrums... » judy, posted by colin wallace on July 24, 2002, at 12:30:53
My pdoc (who specializes in anxiety/panic disorders) says he hears that all the time. Whinging :-)- are you English or Canadian?- judy
Posted by colin wallace on July 25, 2002, at 3:50:06
In reply to Re: Depakote tantrums... » colin wallace , posted by judy1 on July 24, 2002, at 22:22:19
> My pdoc (who specializes in anxiety/panic disorders) says he hears that all the time. Whinging :-)- are you English or Canadian?- judy
Neither.I'm a thoroughbred Celt. Foul-mouthed, uncouth, uncultured, and madder than an onion bhajee.
I like the sound of your Pdoc. though!Col.
Posted by johnj on July 25, 2002, at 19:10:20
In reply to Re: Depakote tantrums... » Judy1, posted by colin wallace on July 25, 2002, at 3:50:06
Hey Guys,
Sorry to hear of the troubles and I have had some similiar thoughts and troubles the last month. Frist, I tried sam-e one last time and became excited, it sure did affect my anxiety. I have had problems with a flash temper that has scared me. The solution was to increase my benzo and things have stabled decently, but I am tired quite a bit with low motivation. However, I am able to get around 6 hours of sleep.
What is so hard, and maybe you both have some understanding of it, is that it is hard for me to make a clear distinction between the anxiety and depression. I honestly believe that if I would have had some benzo's a few nights before my panic attack that lead to all of this I probably would not have fallen so far.
Monotherapy: I would love to ditch everything, but a good benzo that works on depression. I have heard good things about xanax and klonopin. Ativan???
The lithobid seems to help, but i am not sure as to how?? I have cut my dose in half at times, but always start to feel a little funky(withdrawl?)
AD's: Colin, your take is particularly interesting to me since I have often thought that at this time in my life the nortryptline may be doing more harm than good. And if I could excercise, things would improve.
One question for you Colin, and I apologize if I am asking this again, what was the reason you dropped the zoloft? I am thinking of lexapro when it comes out. My doc said it works well at lower doses so 10mg may equal 40 of Celexa. I am leary of a ssri, but not sure what else to do. The pdoc also said my problem is finding something that works at a low enough dose to keep the side effects down since I react so bad.
Ron: FE study is going slow, test is in October. Not so sure I want to stay an engineer at this point. Maybe cutting lawns would be easier since my boss is an ass. But, he may be getting his in the near future from his higher ups.
Finally, on lithium: I was told NOT to decrease my salt since it would make my lithium levels increase and I do feel better getting more salt. Placebo or real I am not sure, but if I sweat I feel worse and it is pretty much the same feeling as when I raise my lithium past 600 mg's.
I am not much help, but appreciate both your posts since we have some similiarities.
Cheers
Johnj
Posted by colin wallace on July 27, 2002, at 15:56:20
In reply to Ron Hill and Colin Wallace, posted by johnj on July 25, 2002, at 19:10:20
Hi there John,
Yeah, our predicaments and symptoms do appear to have a great deal in common.I don't know if this has ever been suggested to you, but much that you report is very suggestive of bipolarism
(type 11 maybe?)I'm wondering if your doc. has had some inkling of this, as you seem to have been placed on lithium (albeit at a very low dose)at an early stage in your illness.Iknow the given rationale was to 'boost your AD effectiveness', but in the UK at least, one typically has to run the gamut of many AD's before this is tried for AD boosting purposes.
Docs balk at the mere thought of polytherapy here too.
I have to say that I've sometimes groaned when reading the assured pronouncements of a (very) few in pinning diagnostic labels on others without real knowledge or training, so I'll be the first to admit that my theory may be way off the mark.I may be talking out of my ass, as I'm out of my depth.
That said, I'll post this link which has been so helpful to me (I don't remember who posted it , and made the same suggestion to me some time ago, but it has been a real revelation I can tell you.)
http://www.psycheducation.org/depression/index.htm
I now understand why I have reacted so badly to AD's in the past, and have simply been exacerbating my depression/anxiety by taking them, even when they appeared to help initially.
As far as zoloft goes, I discontinued because, although it worked superbly (once the first few weeks of worsened anxiety passed), I then suddenly grew extremely angry, restless and agitated on it- even at a mere 25mg.If you read one of my (erratic and unstable!) posts below, you'll see that this enraged mind- state could have cost me (and any another hapless motorist nearby)my life.
I don't blame the med in any sense at all.I think it's one of the best, believe it or not.
But not for a bipolar type depression.
As for myself, I took the plunge and took my depakote yesterday, and my now calm mindstate and clear(ing) head for the first time in two years has made me determined NEVER to touch another AD again.
My plan is to stay on this low dose (200mg, possibly up to 400mg) for a couple of months, and then tentatively add some lamotragine for an AD benefit.Lithium remains to be tried too, if needs be.
Right, have to dash, not least because I fell off my mountain bike today, and am now sporting a left tesicle the size of a well proportioned water-mellon.Was a little weak and uncoordinated fron the dep., but at least I'm not running around in a blind AD induced fury!
Check out that site and let me know what you think.Col.
Posted by colin wallace on July 27, 2002, at 16:02:47
In reply to Re: john J, posted by colin wallace on July 27, 2002, at 15:56:20
How goes it, Ronald ?!
Posted by Ron Hill on July 27, 2002, at 20:07:14
In reply to Re: john J, posted by colin wallace on July 27, 2002, at 15:56:20
Hi Colin,
> As far as zoloft goes, I discontinued because, although it worked superbly (once the first few weeks of worsened anxiety passed), I then suddenly grew extremely angry, restless and agitated on it- even at a mere 25mg.
Are you absolutely positive that the AD was inducing the rage and not the SAM-e? The reason I ask is that, as I have said before, SAM-e was the mega rage enhancer in my case (after 5 months of excellent results with SAM-e). Were you taking SAM-e during the time of the rage episodes? Are you currently taking SAM-e? Don't get me wrong, I hold the same position as you regarding bipolar patients taking an AD's.
>If you read one of my (erratic and unstable!) posts below, you'll see that this enraged mind- state could have cost me (and any another hapless motorist nearby)my life.
Careful with that road rage, Colin! In the US some motorists carry loaded weapons and it can get outta hand very quickly.
> As for myself, I took the plunge and took my depakote yesterday, and my now calm mindstate and clear(ing) head for the first time in two years has made me determined NEVER to touch another AD again. My plan is to stay on this low dose (200mg, possibly up to 400mg) for a couple of months, and then tentatively add some lamotragine for an AD benefit.Lithium remains to be tried too, if needs be.
I'm happy to hear about the good preliminary results with Depakote. Several years ago I did a trial of Lamictal. I really liked how it felt in my brain but it gave me a severe rash (not Stevens Johnson Syndrome though). The pdoc switched me to Depakote and the rash decreased from severe to just bad. The rash continued until I quite taking Depakote. I forgot to list the rash in my side effect list that I posted to you a week or two ago. The rash and the Depakote induced depression were the main reasons I stopped using it. Lamictal, on the other hand, actually helped my depression significantly as well as providing excellent mood stabilization. If it hadn't caused that nasty rash I'd more than likely still be on it. I think it is a great med. YMMV.
> Right, have to dash, not least because I fell off my mountain bike today, and am now sporting a left testicle the size of a well proportioned water-mellon.
I grimiest in pain just reading about it. Hey, if Lance Armstrong can come back from testicular cancer and become a four time winner of the Tour de France, you can come back from this injury. The same thing applies to coming back from your brain chemistry issues. You are going to win this battle!
Armstrong is an inspiration!!
-- Ron
Posted by johnj on July 28, 2002, at 11:18:47
In reply to Re: Was it the SAM-e or AD that induced rage? » colin wallace , posted by Ron Hill on July 27, 2002, at 20:07:14
Hi Ron,
How is it going for you? The observations you both(Colin) have given me the desire to push my pdoc in getting at an accurate diagnosis. He has been pretty insistent on getting me to try lexapro when it comes out, but I do feel my current AD DOES contribute to my depression a bit. I don't know much about lamactil, but if it has AD properties it might be a good choice for me. Changing the cocktail is so scary. Lately, I have had low energy and concentration is not so great hence my FE studying has ground to a halt. The trick is to get an accurate diagnosis!!
Hope things are going well...
Johnj
Posted by johnj on July 28, 2002, at 11:31:17
In reply to Re: john J, posted by colin wallace on July 27, 2002, at 15:56:20
Colin,
WOW, thanks for the link. It sure has A LOT of similiarites with my condition. Even if I am not BP II, I still wonder if getting off the nortrptyline would be best since it hinders my excercise. The doc hasn't bought that argument, but if maybe it would be better to get on mood stabilizers with AD properties, and, just like the website says, excercise can be extremely beneficial.
The overlap with depression/anxiety/agitation and sleep disturbances just have to be sorted out somehow. My pdoc should read that sight. They have got to come up with a way of diagnosing things better! I know my doc is ready to try lexapro when it comes out, but I wonder what would happen if we just tapered down the AD altogether? And switching me to the benzo's that have AD properties might be better too.
Lamactil is very intriguing, but I am not sure if he would prescribe it with lithium. I agree with Ron in the aspect that is it possible the sam-e is responsible for the rages? I am going to post a note about AD's and bipolars and see what I get.
Take care of that swollen jewel!!
Take care
JOhnj
Posted by Ron Hill on July 28, 2002, at 16:41:29
In reply to Ron Hill and Colin Wallace, posted by johnj on July 25, 2002, at 19:10:20
Hi John,
> Ron: FE study is going slow, test is in October.
October will be here before you know it, so get after it! Are there any study guides and/or short courses available locally or on-line for FE preparation? Do you have any friends studying for the test this October? If so, could you form a study group?
>Not so sure I want to stay an engineer at this point. Maybe cutting lawns would be easier since my boss is an ass. But, he may be getting his in the near future from his higher ups.
Last time I checked lawn mowers are not in the same income bracket as engineers nor are the two career fields equal in intellectual satisfaction. There's nothing wrong with mowing lawns for a living if that is what one is called to do, but we did not send you to college just so you can cut the grass.
You made it through engineering school and you'll be successful as a professional engineer. You just need to figure out the correct med cocktail, vitamin supplements, and life style choices (i.e. exercise, interpersonal relations, etc) required to keep your brain chemistry balanced. You'll figure it out, just do your homework and don't depend solely on your pdoc to come up with all the best answers for your particular condition. No one is capable of that in the very brief fifteen minute appointments once every month or so. You are ultimately the responsible party for maintaining your physical and mental health. Do your researches, print the relevant information and studies, and give them to your pdoc. If he/she won't listen to you, find one that will.
I'm NOT saying to ignore what the pdoc says and attempt to self-diagnosis and self-medicate! I'm simply encouraging you to do your homework. Here's a homework assignment for you: The following link connects to a mental heath diagnosis self-test program. It's only a screen tool, so do not place an undue importance on the results. But I think it’s worthwhile. It costs ten bucks (US) for a ten day subscription. It might be worthwhile to first take it by yourself and then take it again with your wife sitting next to you giving you her input on your answer to each question.
http://www.mentalhealth.com/fr71.html
Also, I recommend that you keep a daily journal of the type and quantity of medication you are taking and a rating of how you feel with regard to depression, anxiety, etc. Also, include in your brief daily journal entries the vitamins and supplements you're taking as well as things like type and amount of exercise, quality and quantity of sleep, and other life style activities that you suspect are affecting your brain chemistry.
Instead of a journal you might prefer to use a spreadsheet (with the quantitative information in data fields and the more qualitative and subjective observations in comment fields). The nice thing about a spreadsheet is that you can graph (and otherwise manipulate) the collected data. I think it's best to devise rating scales for as many of the subjective observational categories as possible because this makes data management and data analysis much more user friendly. Once you have the spreadsheet setup, it will probably only take ten or fifteen minutes to accomplish the daily data entry. Periodic data analysis will take a little more time, but that's the fun part because you begin to see correlations between the stuff you put into your body and the resulting affects on your brain chemistry.
Start out simple and only track a few variables in your spreadsheet. Then modify it as you go making your spreadsheet more sophisticated as you deem appropriate. And one final note; my wife is good at giving me an objective evaluation of my mood, level of depression, etc. Perhaps one or more columns in your spreadsheet could track things like, for example, your wife's evaluation of your depressive state for the day on a scale of one-to-ten.
You are an EE, right? Or did you say environmental? What type of company are you working for and what are your specific job responsibilities? Maybe your boss needs some Prozac, Xanax, or something along those lines, ay? Specifically, what is he doing to make your work life difficult? Have you ever attended any workshops discussing techniques for dealing with difficult people? My former employer sent me to a few workshops of this type and I found the courses to be time well spent. John, I hope your work environment improves soon. If not, there are plenty of jobs available for sharp young engineers like you at companies that value their employees.
> Finally, on lithium: I was told NOT to decrease my salt since it would make my lithium levels increase and I do feel better getting more salt.
Me too.
>Placebo or real I am not sure, but if I sweat I feel worse and it is pretty much the same feeling as when I raise my lithium past 600 mg's.
I'm just the opposite. For example, my brain chemistry is benefited by sitting in a sauna and working up a good sweat (or, for the female readers of this post, when I perspire). Could it be your TCA AD causing this reaction to perspiration?
> I am not much help, but appreciate both your posts since we have some similarities.
I disagree. Your are a message board friend who has helped me. Just knowing that there are others out there with med reactions similar to my own is of great help.
Part of this post is medication related and part is social. Hope I don't get nuked by our benevolent Dr. Bob.
-- Ron
Posted by colin wallace on July 30, 2002, at 8:33:38
In reply to Re: Was it the SAM-e or AD that induced rage? » colin wallace , posted by Ron Hill on July 27, 2002, at 20:07:14
Hi Ron,
> Are you absolutely positive that the AD was inducing the rage and not the SAM-e?
Actually Ron, painful experimentation proved that both zoloft and sam-e were, in varying degrees, responsible for activating my manic/rage symptoms.As I mentioned, zoloft, in common with many AD's I have taken seemed to work successfully for a period of months before triggering the manic response (or 'mixed episode',to coin my pdocs. terminoligy).
This occurred without any sam-e on board.After discontinuing zoloft with a slow taper (I only briefly ventured above 25mg anyway), I discovered that sam-e would prompt a similar response; I stopped all meds, with the exception of a tiny dose of diazepam for a few weeks, and then cautiously re-introduced sam-e at 200mg.It sent me way over the edge pretty quickly- a barely containable anger.
Subsequently I have found that I can, with caution,take 200mg of sam-e (ONLY)in conjunction with a further 5MG or so of diazepam, but to my mind this is self-defeating.
I think we should bear in mind though that sam-e, with its (latent in our cases) capacity for
activating 'mania' after being otherwise taken successfully for a period of months, is no different in causing a bipolar11 type response to any AD medication. Indeed, I view it as a testiment to its AD efficacy; we know it works, but its not what's needed as far as our delicate brain chemistries are concerened!>>The rash and the Depakote induced depression were the main reasons I stopped using it (Lamictal)
That really is a shame, especially after the promising influences lamictal seemed to exert.
Depakote has without doubt managed to quell these awful rage/mixed symptoms in my case-but then again they were caused in the first instance by AD meds- fighting fire with fire maybe??
Sadly, it is almost inevitable that I will relapse into a depression at some point (especially now my father, who brought me through the worst of my own illness, is terminally ill. This has put paid to my desire-and opportunity- to return to work too).
Being very mindful of everything that you and Mitch have said, I have no alternative but to try to forestall this with either lamictal or lithium ,or the addition of one of the two.
Much thought and research will go into this before I take the plunge, rest assured.
As you say, preliminaries with valproate are good, so I think it may be prudent to experience a coupla months of sanity before I go tinkering further with my med regime.
>>if Lance Armstrong can come back from testicular cancer and become a four time winner of the Tour de France, you can come back from this injury. The same thing applies to coming back from your brain chemistry issues. You are going to win this battle!>
> Armstrong is an inspiration!!Thanks for the vote of confidence Ron.
I used to think of Lance Armstrong as an inspirational figure, years ago following his recovery and grit in just getting back on a bike-at that point he was virtually unknown- glad he won the tour again- amazing character.
My swollen testicle is healing nicely too- Beardy said it was looking so much better this morning..... *_-Col.
Posted by colin wallace on July 30, 2002, at 8:40:37
In reply to Re: Was it the SAM-e or AD that induced rage? » colin wallace , posted by Ron Hill on July 27, 2002, at 20:07:14
>>I grimiest in pain just reading about it.
That's 'grimace' Ronald....but you may well be the grimiest too...!!!!
(sorry Ron- temptation was just too much).
Posted by johnj on July 30, 2002, at 19:54:54
In reply to Re: Tracking Medication and More » johnj, posted by Ron Hill on July 28, 2002, at 16:41:29
HI Ron:
On the FE front. I have gone through the subjects that I have taken and since I haven't taken any electrical so I don't think I will even review that section. I hated dynamics too, but I will give it my all. I am an environmental engineer and I have started the afternoon environmental section study as of yesterday. (you are an env too right?) Did you take your PE? My moods really regulate my motivation and retention. I did the thermo review while I remeron so I don't know if I retained anything at all or not!!
My boss has one huge flaw: He is never wrong and has never apologized in his 25 years at work. We are government employees...quite different from my past jobs, and the pay is not so good, but I was thankful to find a job while my wife was finishing up school and I could actually bike to work! The main thing at work is that another young engineer's personality clashes with our boss and I have been dragged into the middle since I am new too. He did it to prove the other guy didn't hear him correctly. Acutally, our boss just makes things difficult and you are right he needs some meds bad!!! At least a benzo!! It is a difficult situation and to make a long story short 3 of us went to his boss and had a talk. But, as you know if it is bad down the ranks it is because somebody up above is too lax. It has gone one step further and on Thursday one more higher up is meeting. I am out of it right now and am able to keep my distance, but, I am not a guy to stand and watch someone get raked over for no real reason that someone wanting to flex their muscle.
You hit the nail on the head about my AD's. They do make me feel rotten if I sweat or work out. I don't think it is the lithium or benzo. My pdoc said that lexapro is more effective at lower doses. like 10 mg lexapro is equal to 40 mg of celexa, that is why the lower side effect. He said we need to find something I can tolerate that doesn't give me such nasty side effects. I agree and if I can at least replace the nortryptline I can excercise and blow off some stress. Also, my benzo is making my mornings really crappy. My sleep is not so good and I start to perk up around late afternoon. The benzo drag is just that, a drag. Wish there was a benzo that didn't make me so tired.
I am really going to push my pdoc about a possible bipolar II. I sometimes wonder if I need another mood stabilizer and just a tad bit of AD. With excercise I can at least help myself.
The tracking is a good idea. I am reading that book by David Burns and I haven't been a very good proponent of therapy, but wonder if I might benefit. Have you tried any Cog Behavior therapy? I think I am going to hit the hay earlier tonight feeling kind of tired.
Thanks for the support I will keep posting on what has worked and what hasn't. I know you take the same amount of lithium as I do (600mg?), but do you ever take any AD's?
Take care my friend
Johnj.
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This is the end of the thread.
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