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Dr. Bob is Robert Hsiung, MD,
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Posted by linkadge on April 11, 2007, at 19:48:34
In reply to Re: If I am bipolar why do bipolar meds make thing, posted by metalblade on April 11, 2007, at 19:22:29
Fish oil helps me too, but most other bipolar drugs make things a lot worse.
Lithium and depakote eventually led to intollerable apathy and depression. Similar with most other anticonvulsants.
The AP's led to intollerable apathy, as well as intense amotivational problems. I don't understand who can tollerate these drugs? They make me feel like I weight 1000 pounds, and they totally kill any interest or motivation to do anything.
It doesn't really matter if used for long or short periods of time. They seem to lock me into a permanant low.
I would just tend to think that if a patient were really bipolar, that they would end up feeling better on bipolar meds.
Linkadge
Posted by Bob on April 11, 2007, at 21:36:27
In reply to Re: If I am bipolar why do bipolar meds make thing, posted by linkadge on April 11, 2007, at 19:48:34
The current medications are just woefully flawed and inadequate for many people. The medical/pharmacological establishment doesn't like to talk about it too much, but it's true for too many. I can't tell you how many meds I tried that made things much, much worse. Some literally almost led to my death through suicide. Of course the "experts" would claim that people who are depressed are at risk for suicide anyway, as if all the patients who end up offing themselves soon after med changes is an enormous coincidence.
It is what it is.
Posted by chiron on April 11, 2007, at 21:42:28
In reply to If I am bipolar why do bipolar meds make things wo, posted by linkadge on April 11, 2007, at 18:29:47
I'm not a classic BP, but kind-of on the BPII side with some cycling between major & minor depression and agitation (as my form of mania). So far everything that is suppose to help stabilize me has made me worse: lithium, depakote, lamictal, trileptal, and even topamax made me more agitated. The antipsychotics are even worse: Abilify, Seroquel, Zyprexa, and especially Geodon.
For example, my first week on Geodon I improved, 2nd week: major akathisia & anxiety, 3rd week: f'n down & crazy; 4th week needed ECT.
So I feel pretty unlucky to not only have a mood disorder, but then to have the drugs that are suppose to help mood disorders actually make me worse - that feels like a double-whammy.
I feel your pain. But it's nice to know I'm not the only "doubly odd" one :)
Posted by Phillipa on April 11, 2007, at 21:58:19
In reply to Re: If I am bipolar why do bipolar meds make things wo, posted by chiron on April 11, 2007, at 21:42:28
Seriously I thought bipolar was one of the easiest conditions to medicate. Boy what I don't know learning though. And good luck to you all. Link is fish oil good for plain old depresion/anxiety? Love Phillipa
Posted by chiron on April 11, 2007, at 22:05:18
In reply to Re: If I am bipolar why do bipolar meds make thing » linkadge, posted by Bob on April 11, 2007, at 21:36:27
have you found anything that helps?
what are your BP symptoms?
what have your reactions been?
Posted by polarbear206 on April 12, 2007, at 6:54:34
In reply to If I am bipolar why do bipolar meds make things wo, posted by linkadge on April 11, 2007, at 18:29:47
> So my doctor is convinced I am bipolar. I don't know why. Anyhow, he keeps adding on all these bipolar meds (which I am finally giving a try), but they make things worse in general.
>
> Do most bipolars actually feel better with bipolar medications. Is it common for meds to make a patient feel worse overall?
>
> Thanks
>
> Linkadge
Link,Have you tried Lamictal?
Posted by linkadge on April 12, 2007, at 8:46:33
In reply to Re: If I am bipolar why do bipolar meds make things wo, posted by polarbear206 on April 12, 2007, at 6:54:34
Currently on it. A lot of agitation. Not much else.
Linkadge
Posted by polarbear206 on April 12, 2007, at 9:02:09
In reply to Re: If I am bipolar why do bipolar meds make things wo » polarbear206, posted by linkadge on April 12, 2007, at 8:46:33
> Currently on it. A lot of agitation. Not much else.
>
>
> Linkadge
What do you take with it?
Posted by nellie7 on April 12, 2007, at 10:08:24
In reply to If I am bipolar why do bipolar meds make things wo, posted by linkadge on April 11, 2007, at 18:29:47
Hi Linkadge,
As someone who suffers from psychosis but gets worse on APs, I can understand your frustration.
Do you suffer from other conditions, physical or psychiatric, which can affect your response to mood stabilizers? Are you on other meds?
Another possibility is that something else is causing your bipolar symptoms - this can be anything from a latent endocrine imbalance to a deficiency in something...
Just a few thoughts... it really is confusing.
Take care,
Nellie.
Posted by linkadge on April 12, 2007, at 12:39:11
In reply to Re: If I am bipolar why do bipolar meds make things wo, posted by polarbear206 on April 12, 2007, at 9:02:09
lamictal, seroquel, clonazepam (PRN), inderal (PRN)
Linkadge
Posted by TheMeanReds on April 12, 2007, at 12:52:35
In reply to Re: If I am bipolar why do bipolar meds make things wo, posted by linkadge on April 12, 2007, at 12:39:11
Linkage, I'm on Lamictal, seroquel, and a benzo as well.
Lamictal causes panic so I need the benzo. Also Lamictal causes insomnia so I need Seroquel.
I just started my BPII therapy, after being off meds for a week and a half.
I thought I felt better not being on lamictal, but yesterday something set my depression off badly. So I crawled back to it. And now my depression is in the back of mind. No longer feel like I'm sinking.
How many mg lamictal do you take?
Posted by linkadge on April 12, 2007, at 13:02:14
In reply to Re: If I am bipolar why do bipolar meds make things wo, posted by TheMeanReds on April 12, 2007, at 12:52:35
200mg, but I can take less if it keeps me up at night. Its just not a feeling I like. It makes me feel really wierd and wired.
Linkadge
Posted by polarbear206 on April 12, 2007, at 13:11:58
In reply to Re: If I am bipolar why do bipolar meds make things wo, posted by linkadge on April 12, 2007, at 13:02:14
> 200mg, but I can take less if it keeps me up at night. Its just not a feeling I like. It makes me feel really wierd and wired.
>
> LinkadgeLink,
Have you tried a LOW dose of a ssri or snri?
Posted by Bob on April 12, 2007, at 13:27:37
In reply to Bob, what are you on?, posted by chiron on April 11, 2007, at 22:05:18
> have you found anything that helps?
> what are your BP symptoms?
> what have your reactions been?
There have been things in my long ordeal of treatments that have helped temporarily, but rarely without side-effects and the benefit was always short lived. I was much more tolerant of these meds (or at least it seems that way) in the beginning, but now after 30-35 different meds and combinations of meds, as well as 20+ ECT treatments, the game as changed significantly. I never responded well to meds to begin with and always had very limited tolerability, but now I can hardly stand them at all. I am literally taking sub-pediatric doses: about 62.5mg Lithium ER, and 10mg Citalopram daily. I'm not getting much help, but honestly, even the slightest change in dosages (especially down) throws me way out of balance, with increases in depression, anxiety, and sometimes even suicidality.I'm not and have never been Bipolar I. If anything, I might be BP II, but I'm not sure that my doc's latest official DSM diagnoses reflects that. I don't really recall a sustainable, or even classical hypomania before the meds, and if such a thing did exist, it was definitely not a textbook type, but rather irritable, and somewhat obsessive. Some med responses could, I suppose looking back, be construed as pushing me in to hypomania, such as the anger from Venlaflaxine, or the hyperactive and more pleasure seeking behavior induced by Buproprion, but again, that was mainly a response to medication, and not a natural state, really. Can a person be bipolar if the supposed hypomanic states are only clear on certain meds? I guess the theory is that the meds are making it more obvious?
I had a very bad response to Topomax, which sent me to the hospital for kidney stones, and caused a general breakdown with almost unremitting suicidality for weeks to months. There was an initial an promising response where I had some focus, energy, and a physical relaxation and calm that was a welcome relief from the oppresive autonomic dysfunction I had been living under from years of grueling SSRI experimentation. (This was important because one of the most disconcerting problems with SSRI treatment had become the odd physical muscle pressure/discomfort I had developed to any sort of significant physical activity. A physical reacition that was extremely distressing. Near therapeutic doses of SSRIs to this day still seem to cause this.) Then it quickly collapses into a full blown mental/emotional breakdown. I was glad manage to not have that episode kill me and swore I'd be more careful with treatments, but eventually the necessity arises to seek more treatment because, after all, I have a health problem that isn't going away just because the treatments aren't working.
Then came ECT. There were 21 sessions, I think and for most of that time the benefits of response were dubious, with my doctor and the ECT doctor intermittently conferring about whether or not I should continue. It eventually became clear that it was not worth the trouble anymore and I stopped. The two years since then have been the worst of my life (arguably) and the 6 months to a year immediately following the treatment were marked by the most serious, sustained trouble I've ever had.
The more recent years of my disease and its treatment have had all the mental problems of the beginning years, but have been increasingly marked by physical reactions and problems. Doctors are quick to point out that just about anything can be caused by depression, but my feeling is that it is likely treatments gone awry. My weight gain on every med I ever took, with the exception of Topomax and Lamictal, has always been questioned, but I know it is the meds. In short, the list of meds I've taken and the negative effects they have caused is a little to long to get into right now. I will say however, that unfortunately, there have been short term benefits, particularly in the beginning years, that made drug experimentation a viable option. What other option was there really, for someone who has genuine mental problems that interfere with daily living? Many drugs did calm down irritation, obsession, rumination, and depression, but then left an overweight, physically dysfuntional, severely apathetic patient. Those are the ones that didn't cause akathisia and panic and send me into a crisis.
Posted by TheMeanReds on April 12, 2007, at 13:30:34
In reply to Re: If I am bipolar why do bipolar meds make things wo, posted by linkadge on April 12, 2007, at 13:02:14
I've found I can only tolerate up to 100, otherwise I feel like I'm not myself and I shake.
I told my doc I didnt feel well while on 100, he said go up to 200. I did. And felt crappy. Now I know not to pass 100. And sometimes not 50.
Posted by Sebastian on April 12, 2007, at 15:14:33
In reply to Re: If I am bipolar why do bipolar meds make things wo, posted by linkadge on April 12, 2007, at 13:02:14
I had a hard time with high doses of lamictal, found lower doses much better. Still dosen't replace zyprexa.
Posted by med_empowered on April 12, 2007, at 16:50:57
In reply to Re: If I am bipolar why do bipolar meds make things wo, posted by linkadge on April 12, 2007, at 13:02:14
worse than the "disease" they're treating. That's just how things go.
Plus, 2 of your meds--Seroquel and Inderal--aren't even for bipolar, and they aren't all that great. Seroquel can cause cognitive dulling, akathisia, sedation, weight gain, diabetes and (for some people) dysphoria. Inderal can cause depression--I'm assuming this is for anxiety and/or seroquel side-effects? The Klonopin can also cause depression, although personally I think its much more tolerable than the seroquel.I don't know what to tell you in terms of what to do with meds. I read an article by David Healy once where he pointed out that the evidence for any anti-suicide, life-enhancing effects on long-term meds (even lithium) is pretty weak; some studies show *increased* suicidality in patients maintained on psychiatric meds for bipolar prophylaxis, which I can certainly believe based on personal experiences. I'm not saying "go med free," but I am saying that you have every right and reason to be very, very selective about what med(s) you take and how long you take them.
Psychiatric treatment isn't as clear cut as, say, giving antibiotics for an infection. With bipolar in particular, the evidence for long term treatment really isn't that great. You can treat an acute (hypo)manic episode with pretty much most sedating meds--benzos, neuroleptics, lithium, anticonvulsants, maybe even opiates and barbiturates--so there's nothing really special about any 1 med. Long-term, really all you're looking at are meds that help to *delay* an episode of mania or depression. Shrinks are always talking about the importance of long-term treatment, but really, there isn't that much indication that the drugs do anything wonderful for most people.If I were you, I'd probably get a new shrink. Or quit meds altogether. Or maybe just take the meds you want to take, when you want to take them. Maybe go for a therapist instead. Maybe try orthomolecular therapy, or some other alternative treatment.
Point is--your shrink, any shrink, doesn't have all the answers, or even *enough* of the answers. They certainly can't justify making someone feel like sh*t all the time (for a fee, mind you) to treat some "disease" that can't be diagnosed by brain scan, blood work or any other form of physical examination.
Posted by Bob on April 12, 2007, at 17:01:20
In reply to Sometimes, meds suck..., posted by med_empowered on April 12, 2007, at 16:50:57
> worse than the "disease" they're treating. That's just how things go.
> Plus, 2 of your meds--Seroquel and Inderal--aren't even for bipolar, and they aren't all that great. Seroquel can cause cognitive dulling, akathisia, sedation, weight gain, diabetes and (for some people) dysphoria. Inderal can cause depression--I'm assuming this is for anxiety and/or seroquel side-effects? The Klonopin can also cause depression, although personally I think its much more tolerable than the seroquel.
>
> I don't know what to tell you in terms of what to do with meds. I read an article by David Healy once where he pointed out that the evidence for any anti-suicide, life-enhancing effects on long-term meds (even lithium) is pretty weak; some studies show *increased* suicidality in patients maintained on psychiatric meds for bipolar prophylaxis, which I can certainly believe based on personal experiences. I'm not saying "go med free," but I am saying that you have every right and reason to be very, very selective about what med(s) you take and how long you take them.
> Psychiatric treatment isn't as clear cut as, say, giving antibiotics for an infection. With bipolar in particular, the evidence for long term treatment really isn't that great. You can treat an acute (hypo)manic episode with pretty much most sedating meds--benzos, neuroleptics, lithium, anticonvulsants, maybe even opiates and barbiturates--so there's nothing really special about any 1 med. Long-term, really all you're looking at are meds that help to *delay* an episode of mania or depression. Shrinks are always talking about the importance of long-term treatment, but really, there isn't that much indication that the drugs do anything wonderful for most people.
>
> If I were you, I'd probably get a new shrink. Or quit meds altogether. Or maybe just take the meds you want to take, when you want to take them. Maybe go for a therapist instead. Maybe try orthomolecular therapy, or some other alternative treatment.
>
> Point is--your shrink, any shrink, doesn't have all the answers, or even *enough* of the answers. They certainly can't justify making someone feel like sh*t all the time (for a fee, mind you) to treat some "disease" that can't be diagnosed by brain scan, blood work or any other form of physical examination.Damn, that was well put!
Posted by chiron on April 12, 2007, at 23:58:40
In reply to Re: Bob, what are you on? » chiron, posted by Bob on April 12, 2007, at 13:27:37
sh*t, I wish we knew more about what is going on in the brain. Why are reactions so individual and variable? I wonder if there is anything that those of us who become worse have in common physiologically. Sorry for your pain.
Today I just found out my uncle has Wilson's disease- which has a high rate of depression. Basically your body doesn't clear out the copper and allows it to accumulate in the liver & brain. I would love it if that was my problem- I would have a concrete explanation and know exactly how to treat it.
I guess at least we are living in a time that science mostly acknowledges there is a problem & has come up with some mixtures. But I wish we knew what was going on instead of playing this painful guessing game of trial and error that for some of us is just continual errors and screws us up even more.
Posted by nellie7 on April 13, 2007, at 7:58:58
In reply to Re: Bob, what are you on? » Bob, posted by chiron on April 12, 2007, at 23:58:40
Very well put!
Posted by Phillipa on April 13, 2007, at 19:04:56
In reply to Re: Bob, what are you on? » Bob, posted by chiron on April 12, 2007, at 23:58:40
Chiron how do they treat it? Chelation theraphy? Love Phillipa
Posted by chiron on April 14, 2007, at 23:30:45
In reply to Re: Bob, what are you on? » chiron, posted by Phillipa on April 13, 2007, at 19:04:56
>Chiron how do they treat it? Chelation theraphy?
The disease is treated with lifelong use of chelating agents such as D-penicillamine or trientine hydrochloride, drugs that help remove copper from tissue. Patients also need to take vitamin B6 and follow a low-copper diet. Taking extra zinc may be helpful in blocking the intestines' absorption of copper.
Posted by Phillipa on April 15, 2007, at 18:28:53
In reply to Re: Bob, what are you on? » Phillipa, posted by chiron on April 14, 2007, at 23:30:45
Thanks had a feeling. Love Phillipa
Posted by tictactoe on April 15, 2007, at 23:08:08
In reply to Re: Bob, what are you on? » Bob, posted by chiron on April 12, 2007, at 23:58:40
chiron--
have you been tested for wilson's disease?
it is genetic (autosomal recessivie i think)
Posted by chiron on April 16, 2007, at 12:27:55
In reply to Re: Bob, what are you on?, posted by tictactoe on April 15, 2007, at 23:08:08
> chiron--
> have you been tested for wilson's disease?
> it is genetic (autosomal recessivie i think)I just set up an appointment for May 1st today. The Mayo Clinic is doing a study on our family. The chance is still small because I would have to get a gene from my mom as well.
Thanks for caring.
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