What meds now?

   I have been labeled as "bipolar" after many years of being diagnosed as severely depressed. My question is on the meds I have taken since. I was seen at Generose - Mayo (where I was first diagnosed b.p.) and there prescribed a very high (in my Psychologist's opinion) dose of Effexor. He thought this was odd. Do you? For the first time in my life I exhibited manic symptoms. My own therapists and family had never seen me act so strangely. After a while I started tolerating the dose better. Since then I was switched eventually to Abilify. Before this I took a series of other mood stabilizing drugs and had the same dislike for them as Abilify - these drugs seem to want to treat my almost nonexistant mania (anxiety more prominant than hysterical joy) and undertreat my heavy depression symptoms. I feel flat lined and listless on Abilify and have since stopped taking it. Is there any drug more pointed towards we of the B.P. community with overriding angst and little of the fun stuff?

[azalea82]

Have you tried Lamictal (lamotrigine)?  It is generally considered 1st line for bipolar depression.  

[LetaB]

  I must say I never had heard of "bipolar depression" before now. If I have I thought it was just reffering to the flip side of mania for an average b.p. Is it a version of standard b.p.  and if so is there a "bipolar mania" diagnosis as well?

[LetaB]

  Also, I forgot to say, for around 10 years I have been on Adderall (adderrall) - 20 mg extended release. I've read on this site that it's a bad idea for those of us afflicted by b.p. to take uppers like this. For me the benefit I get from the stuff is similar to very large, strong, cup of coffee. I recognize that it, in actuality, is making me slightly "manic" but I come from such a very low place to begin with that I appear to be made a little closer to "normal".

[ILADVOCATE]

Bipolar disorder is a combination of mania and depression so a person can go from manic to depressed and there are euthymic (normal) periods in betwen. I guess the term "manic depression" is easier although not used now because its less clinically accurate. "Rapid cycling" is going from manic to depressed in a short time. An "agitated mixed state" is having the aspects of mania that are speeded up while having the depressed outlook of depression so it can appear to be "anger". My mother who has bipolar experiences that all the time. She is seeking a consult with a psychiatrist now but didn't know what it was until now and it was hard for her and me to cope with. Before recovery I experienced all of these states. What I experience now is more the psychosis and depression of Parkinsonism and that is experimentally being treated with rhodiola and Zofran by a research psychiatrist. That is more like what is described in "Awakenings" (read the book it is more clinically accurate than the movie) rather than standard psychosis or mood variances. That's what they are tentatively calling "tardive psychosis" (a study criteria not pinned down yet). However, If the Zofran (I took Clonidine before it) did not serve as a mood stabilizer (in me, its not been researched for that) I would experience standard mania and depression as well. I agree Lamictal is a good mood stabilizer and one psychiatrists often use. Unlike Abilify it has no risk for tardive dyskinesia and diabetes. However, if a person has bipolar with psychotic features, they need an antipsychotic as well. Make sure to find out what your diagnosis is. Otherwise when you get started you should know Lamictal will take months to titrate to an effective dose (it must be raised 25 mg. per week by FDA law) because of the rare risk of Stephen's Johnson Syndrome (the rash). That occurs in 1 in a thousand people. Otherwise it is safe and effective and well worth asking about and trying out.

[klms]

hey Letb, I tried to send you a message. Let me know if it came through! Thanks

[azalea82]

For more information about bipolar disorder (which consists of bipolar depression and bipolar mania), google "Phelps + psych education."

Some mood stabilizer med work from the bottom up; they are best for treating bipolar depression.  

Other mood stabilizer meds work from the top down; they are best for treating bipolar mania.

Depending on whether your mood episode is mania or depression, your doctor should choose an appropriate mood stabilizer.  

[jennifertyree]

I was treated with anti-depressants for 20 years and al they did was make me manic and miserable....I finally met a Dr. that properly diagnosed me as a bipolar 2 with adhd and a little OCD....i now take zyprexa  (a mood stabilizer) and it isn't a cure but it really helps - with sleep, racing thoughts, impulsive behavior....

[cowgirlnerd]

I am on Lamictal and have been for several months.  Even though you do go up gradually in dosage on the Lamictal, you begin to feel some effects over about a week or so - not as much as when you get stabilized, but you do feel some of it.

Previously, I was diagnosed, like you, with severe clinical depression.  I was treated for that for over 15 years, and as i got older it got worse and worse, and my friends would say, "when she's good she's really good - but when she's bad she's reallly bad."  and they would mention to me that the periods of good were not as long and the frequency was getting closer together.  

When I was diagnosed correctly, I was in full manic mode, and had survived a suicide attempt.  It's important, I think to not just go when you are depressed - as I had in the past, but to go in manic episodes, too.  But the mania - it actually feels good sometimes (it isn't good and we all know what that's about) but to be up from the down???  yes, when you are depressed forever and a day - the up is a welcome friend - until you see the aftermath of the tornado.

Luckily, and to make a long story shorter, with Lamictal, I no longer need an antidepressant, and yes, I can still feel the mania, but it's manageable - that's a first for me.  I am "level" and I can actually FEEL things - emotions, etc.   BTW - I had to come off of Adderal XR 20mg right away because it was amplifying my mania and was most likely a contributing factor in my suicide attempt.  (I am a rapid cycler)

SO, after you get on the right meds, you will be amazed.  It's not a cure, but like jennifertyree said, it helps with sleep, racing thoughts, impulsive behavior, etc., and you can feel "normal".  

Let me know how it goes, please.  

[bernie40]

Hi,  I have heard the Lithium is good for treating the depressive side of bipolar.  I did not want lithium and so I am on depakote (valproic acid), it does help level the moods a little but doesn't exactly "lift you", I've tried AD's along side and had disastrous results.

Each of us is different, not just in how our BP presents but in how our bodies react to medications.  It is a case of trying until you find the one that suits you.

Plus - therapy is needed alongside medication and learning as much as you can about BP.  Medication alone is not the answer.

[cowgirlnerd]

Lamictal that I am on is supposed to be good for the down/up side (depression side of the BP.  It stabilizes you.  

[sharonpax]

my daughter has put on alot of weight with depakote and has an appt with her consultant next week, we were thinking of asking about changing her to topamax she also takes abilify.  Anyone else on abilify and topomax (topamax)?? Is it true topamax makes you loose wieght???

[monkeyc]

Taking a medication like Topamax purely in the hopes of experiencing one of the side effects is the wrong way to go about things.

Weight Loss and Appetite Decrease are noted as side effects yes but so are tiredness, pins and needles in the fingers and toes, dizziness, lowered sense of feeling in the skin, difficulty with language, nausea, diarrhea, indigestion, dry mouth, drowsiness, forgetfulness, difficulty with concentration or attention, difficulty in sleeping (insomnia), anxiety, mood swings, depression, changes in taste and vision disorders.

Is the depakote working?  Id really want to discuss this carefully before changing meds just to get one specific side effect which may not even apply to you.