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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by PeterMartin on May 5, 2016, at 20:57:20
Marplan 60mg
Lamictal ER 200 (up from 100mg 5 days ago)
Lithium 600mg (up from 300 2 days ago)
Seroquel 25mg mainly for sleepCould the increase in Li or Lamictal really knock me down for a few days? Im optimistic it will pass as I am bipolar and do cycle but it's extremely frustrating. At the moment I don't feel like the Marplan is doing anything but I know if I came down off it Id be much worse....
Anyway really just needed to vent. Hopefully I'm just adjusting to the Lamictal and Li increases. I've been in 600 and 900 of Li w.in the last year and don't remember it ever causing a mood drop like this one. I just don't want to get out of bed...."j hard myself" kind of thoughts.....
Hopefully something will kick in properly...
Posted by SLS on May 5, 2016, at 22:45:00
In reply to On this combo and major depression the past week, posted by PeterMartin on May 5, 2016, at 20:57:20
For me, any dosage of lithium over 300 mg/day makes me feel like crap. For several years, I was an ultra-rapid cycler before I was treated. My cycling stopped with the introduction of high dosages of lithium. Unfortunately, it left me in a state of chronic severe depression without respite.
I would consider reducing the lithium back to 300 mg/day and then work with the Lamictal. You might do well at 200-300 mg/day. After establishing the best dosage of Lamictal, you can then work with the lithium. Of course, if the previous reduction in the dosage of lithium produced an improvement in your mood, you will have found your answer.
- Scott
Posted by PeterMartin on May 6, 2016, at 0:54:11
In reply to Re: On this combo and major depression the past week » PeterMartin, posted by SLS on May 5, 2016, at 22:45:00
> For me, any dosage of lithium over 300 mg/day makes me feel like crap. For several years, I was an ultra-rapid cycler before I was treated. My cycling stopped with the introduction of high dosages of lithium. Unfortunately, it left me in a state of chronic severe depression without respite.
>
> I would consider reducing the lithium back to 300 mg/day and then work with the Lamictal. You might do well at 200-300 mg/day. After establishing the best dosage of Lamictal, you can then work with the lithium. Of course, if the previous reduction in the dosage of lithium produced an improvement in your mood, you will have found your answer.
>
>
> - ScottThanks for the reply Scott.
I do think I probably do better on 300mg of Lithium but I just recently told my doctor I would try 600 after tell him I'd reduced it on my own from 900mg which was causing bad abdominal/chest pains.
So he has me getting a level next week so I told myself I'd at least give 600 another try and get a level. The Lamictal ER (or perhaps it's just the different generic maker) has alleviated most of the abdomial pain....so at least physically I can tolerate it now.
I'm feeling better now a few hrs later so maybe the depression is starting to break. it's been a rough 3 days though. And it has been frustrating w/ the good days/bad days/etc.... Hopefully that'll settle down once I'm farther along on 200mg....
Thanks again for the thoughts and letting me ramble a bit about it....
Posted by phidippus on May 6, 2016, at 6:57:36
In reply to Re: On this combo and major depression the past week, posted by PeterMartin on May 6, 2016, at 0:54:11
I dont like your combo at all. Why Marplan? Have you tried everything else? You're a rapid cycler, perhaps Depakote would work better.
Eric
Posted by PeterMartin on May 6, 2016, at 14:01:41
In reply to Re: On this combo and major depression the past week » PeterMartin, posted by phidippus on May 6, 2016, at 6:57:36
> I dont like your combo at all. Why Marplan? Have you tried everything else? You're a rapid cycler, perhaps Depakote would work better.
>
> EricUgh on Depakote no way. Took that in 2000 and gained a ton of weight / felt meh.
Marplan definitely helps my depression - gets me out of bed at 6am w/ my GF instead of 10am. I actually think I might be taking too much of it or perhaps it's not working as well after 5yrs. But that's the only med (aside from lamictal) that I've been on for more than a year or two.
I've asked about Trileptal but so far we haven't gone there. My doc keeps suggesting an atypical but I really don't want to pack on my pounds and I tend to get akathesia pretty badly. We'll see though....
But yea I need an AD - I don't want to feel like crap. And the SSRIs don't do it.....If I Nardil didn't cause weight gain I'd probably give that another go....
Much better today btw but still very uninterested in doing much and constantly thinking about what's next.....wanting the day to end sort of thing. I'm trying to be optimistic I just need to let the 200mg of Lamictal settle in...it's only been about a week.....
Posted by PeterMartin on May 6, 2016, at 14:03:56
In reply to Re: On this combo and major depression the past week » PeterMartin, posted by phidippus on May 6, 2016, at 6:57:36
Also I'm not usually a rapid cycler....which is what's kinda odd. It has to be related to the Lamictal (and Extended lamictal generic Dr. Reddy). Hopefully I'll even out....
Posted by phidippus on May 6, 2016, at 15:54:37
In reply to Re: On this combo and major depression the past week, posted by PeterMartin on May 6, 2016, at 14:01:41
>But yea I need an AD
Have you tried clomipramine or mirtazapine?
>still very uninterested in doing much and constantly thinking about what's next.....wanting the day to end sort of thing. I'm trying to be optimistic
Do you ever practice mindfulness techniques?
Eric
Posted by PeterMartin on May 6, 2016, at 17:46:18
In reply to Re: On this combo and major depression the past week, posted by phidippus on May 6, 2016, at 15:54:37
> >But yea I need an AD
>
> Have you tried clomipramine or mirtazapine?
>
> >still very uninterested in doing much and constantly thinking about what's next.....wanting the day to end sort of thing. I'm trying to be optimistic
>
> Do you ever practice mindfulness techniques?
>
> EricI did take mirtazapine once in 2008 or 2009. I got all the way up to 45 but it was still extremely sedating + the appetite effect.
I've been on tofranil but never clomipramine. I'd definitley be ok w/ trying another tricyclic but my current doctor (of about a year due to a move) is pretty stuck on the idea that they're the most likely kind of AD to switch someone to mania. I've gone completely manic (psychotic hospital etc) but it's never happened w/o some chemical catalyst but he seems to think a tricyclic is a risk.
I may try going lower on the Marplan. I used to do exceptionally well on only 20/30mg of Marplan now on the max amount (although people here go above). I'm still remembering dreams which for MAOI I think is supposed to not happen.....perhaps less would be better (Libido/fatigue-energy maybe)....
This is the end of the thread.
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