Medication Advice

[m_nuke123]

Getting a diagnosis has been exhausting. In the last year I've had doctors tell me I have/am: PB1, PB2, medicine resistant depression, severe anxiety, severe depression, mood swing disorder, "in the bipolar spectrum." At this point I could care less what they want to label my problems as.

What I do care about however, is finding a medication that will help with my depression. None of the usual antidepressants have worked- Prozac, Zoloft, and so on. I tried Lamictal for several months and was at 200 mg a day and still felt absolutely no effect other than a slight decrease in anxiety. I tried Vivid as well and also felt no change.

My mood swings range from extremely depressed to only very depressed. There are no high highs. Only low lows or lower.

I'm hoping there is someone out there with a recommendation for a different medication. At this point I am willing to try anything with the exception of not being medicated- living like this for the rest of my life is not an option.

[Anonymouse88]

Do you mean BP I and BP II?  If so, what was the rationale they gave?

It's too bad lamictal didn't help.  Have you had a metabolic workup?  Some medical conditions, especially thyroid problems, can mimic mental health issues, and it's important to rule them out.

Have you considered trying abilify or seroquel?  They are atypical antipsychotics that get used as add ons for unipolar depression, and are used for mood stabilization in bipolar.  You could try an SNRI like effexor if you haven't tried that class yet, or maybe wellbutrin (although this could worsen your anxiety).  There's also remeron, which can sometimes help when nothing else seems to.  There's also trazodone (kinda in a class by itself), tricyclic antidepressants like amytriptiline, and even MAOIs, which interact with everything but work better than the newer generation antidepressants (they're less popular because of the side effects and people not being as compliant with them).  Buspar might be good as an add on to anything you try, and it's also good for toning down the anxiety (it works really well for me).  Any pure antidepressant has the chance of sending a bipolar person into mania, but the SSRIs and SNRIs are the worst offenders, and it's not an issue for everyone.  Lithium is another option if they think you're bipolar, and if you're suicidal, it actually has evidence for being specifically anti-suicidal.

On the more natural side, light therapy is something you should definitely look into, as it's used for things like seasonal depression.  Exercise is good too, and there's some evidence for fish oil.  The guy over at psycheducation.org has an article about fish oil and what proportions of DHA and EPA it should have.

I hope this helps.

@Smiley2000

There's no such thing as "hyper-mania".  There's just "hypomania (as in "below mania") and mania.

[hell1971]

I am Bipolar 2 and if I am not denying I would say I am in a mixed state right now, some hypomanic and depressed symptoms all over the place and feeling very fragile! I started on epilim and yes its great for taking away the high but not very good for depression, lamotragine was the best med I took as it has a weight nutral effect which of course epilim doesn't so be careful not to allow the weight gain to get on top of you and add additional problems you don't already have, another good reason to get going on some exercise, hope you are feeling better

[Smiley2000]

Hi there,

I was diagnosed with having Bipolar Disorder, about a month ago, after I had an episode of hyper-mania!  For no apparent reason I just woke up one morning feeling really happy and energetic and could and did run and talk very fast and load and I had enough courage to quit my sucky job and I felt great and did not sleep for 3-4 nights and eventually went to GP to get script for sleeping medication and was told:  oh no, you actually have some kind of depression or Bipolar Disorder and you are currently in hyper-mania!

So I know what you feel like now:  call it whatever you want, just give me meds that makes me feel better!  do I have BP 1 or 2?  does it matter?  no!  cause it still is what it is.

The meds that I was given and that got me from being on a hyper-mania state into an almost depressed state at the moment:  Sodium Valproate/Epilim - as a mood stabilizer and Seroquel as a Sedative agent.

The Psyco Doc explained it to me:  scale runs from 0 - 10.  They want us to be functional between 4 - 6.  I was on 8 during my hyper-phase and now I am on 2-3.  The sedative brought me from a 8 to the lower scale numbers.

Now, unfortunately I am sleepy during the day and feel more depressed than happy and not normal.  The advice the Doc gave me:  adjust the Sedatives.  I still take 1200mg Valpro daily (500mg morning and 700mg at night) but no Seroquel (sedative).

How often do you still get Psychotherapy?  we all need a friend to talk to and just get it out, but these are trained personnel that can give advise and coping skills.

Hope the info helps and keep on talking to us ;)

[hell1971]

Sorry you are going through this, I am not able to recmend meds as I have a history of medication failure but I can suggest something equally powerfull in the mean time to help you feel a little better while you navigate the diagnosis and illness. Try walking in the fresh air everyday, the hardest thing is putting your trainers on. All I can say is that I started off with 10 minute walks I now get up to 2 hours and I know that this has had a massive impact on myself and the ability to cope, I know that without that commitment to exercise my mental health suffers, is it a cure NO but it really really helps more than staying home sedentary. good luck try it for 3 weeks, make that commitment and if in 3 weeks you don't feel its helping then try something else.