More Bipolar Meds Posts

Nick (Oct 3, 2002): I have have mental illness for 6 years. The first three I was diagnosed with agitated depression with obsession. I was give Seroxat and Trazadone (antidepressants). These I think made me worse.
After three years I was hospitalized and ended up having ECT, upon discharge I went into the same state as before within 3 months. I then went to see a doctor privately (I live in the UK and was being treated on the National Health service). he changed my diagnosis to manic depression, and because of the level of agitation put me on chlorpromazine (an antipsychotic), sodium valproate and clomimpramine (SSRI antidepressant)

Since that time i have had several major depressive episodes, with up (i call them ups as the symptoms do not seem to be real manic (at least not psychosis). The mood stabilizers I have tried are
1) sodium valproate (Depakote).....seemed to work a bit, but made me physically ill in high doses
2) carbamazapine .....had to stop after 3 weeks due to headaches / vomitting
3) gabapentin.......stoppped when i became very depressed while in the US (where the consensus is that it is not an effective mood stabilizer)
4) Lithuim.....while very depressed..after 3 months it had had no effect + side effects were very bad so stopped it...shaking, vomiting
5) Lamotragine (lamictal)

I would generally describe my state as agitated.....both when depressed and high. However the last depressed episode I would call 'classic', I am now agitated again after a period of 'winding up' ...racing thoughts but also depressed.

I presently take chlorpromazine (50mg) at night to knock me out ....cant sleep naturally, lamotragine (300mg.....being upped to ? dose), and clonazepam (2mg per day (spread out).

I have just come off my last antidepressant after 6 years of being on one as there is the possibility that it might be inducing rapid cycling (i seem to be having 2 highs + 2 lows per year at present.

The question is WHAT NEXT!?

having been through all the mood stabilizers, what combinations should i try (given that i seem to be intolerant to some. should i try a more moden antipsychotic?

what are your thoughts on Clonazapam....its a benzo....so i might become tolerant to it? would it be better to use an antipsychotic during the day.....but would need one that slows me down not knocks me out.

my psychiatrist has come to the edge of his treatment knowledge and I am at times close to the edge of my tolerance for this existence. Any thoughts would be great.

McMan (Oct 20): Hi, Nick. Since you posted this, I have significantly updated the bipolar meds articles and added two concerning what the experts regard as best practice. I'm not a doctor, so I'm not about to give specific advice on meds, but a lot of your questions will be answered in the articles.

Leslie (Oct 20, 2002): well, just got out of 10 days in my first mental hospital and then a fun month in various jails as i am federally plea bargaining to a count of embezzling from social security and violated my pre-trial probation by growing pot and GETTING set up and BUSTED! how bi-polar!!!]i have only recently been diagnosed as bi-p and am definitely on the manic end of things. was struck by the symptom of the constant legal troubles, as that has been the baffling bane of my last several years, lost my license, this pot charge, little things but am now TERRIFIED of police. whatever, have a lot to learn. am still decompressing from jail, been very hyped, stayed up all night a couple of times, probably just euphoria of a natural type, jail is a big pain, but i survived. tomorrow i go to my new therapist, who i met by accident and who casually said to me in april that he thought i was BP, then next day to a prescribing dr.in the hospital, they gave me Seroquel, not much to say, made me little sleepy {100 mgs daily] and constipated and a wee bit horny, no problemo with that. but this new therapist seemed underwhelmed by the Seroquel as did another shrink I know who said it was "nasty stuff" I am nervous because the Seroquel is so side-effect minimal and my biggest fear is the guinea pig nature of the prescribing aspect of treatment. I don't want to get fat sleepy lazy and dull and any of the other 10,000 other egregious side effects I read in the PDR. Seroquel is neutral for me does that mean it doesn't work, does the medication have to screw you up in obvious ways before you know it works, like bp in general, does one's life have to be a house on fife before one can say for sure, yes, i am manic-depressive? yes that is ME on fire there, guess that explains the madness/sanity of my life? just asking!one cool thing is that i have begun writing a novel,i wrote quite a lot in jail, here is one way in which my racing thoughts and muti-faceted ways of thinking are an asset, not just exhausting. so, Seroquel?? any one else try this .i couldn't wait to get back online after this past 6 weeks of semi-hell

Ron (Oct 21, 2002): I take Depakote and have taken it for at least five years. I experienced all of the side effects described in your article. I gained weight 50 lbs.I experienced tremors noticeable in my hands. I have hair loss and it affected my memory to the extent that I could no longer work. It has stopped my rapid cycling but it carries a load of side effects. Thanks

Mary (Oct 23, 2002): I have been having a very hard time tolerating any of the medications prescribed by my doctor. Most recently I have been put on Trileptal and I think it might be having a positive effect on my mood. However, after a few weeks I have found myself eating almost continuously. I am very frightened by this. I have reported this to the doctor and he said it was a trade off. I have been gaining weight at a very fast weight and I have always had problems with weight to begin with. Any positive effect the Trileptal has given me is being taken away by the feeling of my uncontrollable hunger and the feeling that I can't tell my doctor the way I feel about this, as if I am ungrateful for finally finding a medication that helps since he has been working with me for so long and nothing has been helping my depression. I worry about him losing patience with me. I'm thinking about going to a new doctor and starting over. Thanks, just wanted to get that out to someone.

Roberta (Oct 24, 2002): As a friend to a bipolar man, I have watched him struggle with other problems, obsession with sugar products being one. I don't think lithium alone has been enough to help him. I don't believe he has had enough help with his thought processes, either. He needs something to help him with his cognitive ability along with the lithium.
Thank you for the enlightenment.

Mauri (Oct 25, 2002): Soon after the mania I was placed on lithium...it was awful. If this was the way to get well, I was going to stay sick. My doctor kept on until I made it through that dreadful time after being manic. I've been on lithium for seventeen years or so and all is well.

An excellent doctor at St Simons Island GA, where I went to get well, put me on desyrl (sic). I loved it! A sleep aid at night...I felt like a human being again...My doctor in North Carolina continued the desyrl as did my doc in Birmingham...got to Greenville, Mississippi, and here we go with Wellbutrin....I was not a happy camper. It's OK...I'm on Risperdal and have no idea what it's doing for me...but I keep the faith...and of course, always lithium...

One thing I want to say: on one occasion I went to a GP for six months or so thinking I did not need a psychiatrist. Wrong. That was a painful and expensive mistake...The combination of medications for any patient is difficult for the super pro...forget being treated by anyone other than a psychiatrist. Go to a mental health complex if you have to....but get to a psychiatrist.

Abby (Oct 28, 2002): My name is Abby. I can be reached at Abby@riverrats.net. I have severe Bipolar Mixed rapid cycling. I have been treated since l988. Hospitalized twice. I have been on Lithium since l989. My psychiatrist tried to take me off it last year and put me on Topamax, b/c Lithium makes me gain a lot of weight. In three days........I was so out of control, my whole world flipped upside down. I was getting kicked out of stores for being inappropriate, iwas hanging out in the park with homeless people for days on end ( and I had a husband and home) although, I don't anymore!! I was skinny...but crazy as a loon!!! I have now resolved to taking my lithium, but I am also on Topamax, as well as Paxil, Klonopin, Deseyrl. I only eat for survival and I take vitamins. I sleep a lot. 10 hrs @ night and a 3 hr. nap in the afternoon to quiet my head and split my day in half. I haven't worked since 1994, and I am on disability, so my stress is under my control. I do pretty good most of the time, but when I don't I call my psychiatrist. I see her once a month, but I can call her when I need to. I have a small, but supportive group of friends that I can talk to that really helps. Even "normal" people are wacky.

I KNOW this disease is tough!!! It's not fun, not even my mania is fun... it's terrifying!! But, there's always HOPE!! There's one thing and one thing only that helps me... but it's not a legal substance yet, but if they ever legalize hemp, Manic Depressives rejoice! This is MY story.

Jen (Jan 15, 2003): Thanks for your information on medication. My son made a remarkable turnaround after being placed on Zyprexa which has saved both his life as well as my own. His doctor recently told me she does not intend to keep him on Zyprexa due to long-term side effects and started him on Trileptal just two weeks ago. Her plan was to wean him off of the Zyprexa. However, as strange as this is ....it seems everything that my son struggled with is coming back. He has been stable for eight months. I would assume that it has to be directly related to the new medicine but how is that possible. He is still taking the same dosage of Zyprexa. I would appreciate your insight. Thanks!

McMan (Jan 15): Hi, Jen. Owing to the risk of tardive dyskensia, the APA's new treatment guideline recommends gradually weaning off the antipsychotic some months after stability has been achieved. With kids, however, the atypical antipsychotics work particularly well, so you may want to get a second opinion. Re the Trileptal, one person's miracle cure is another's nightmare. This is a real wild guess, as since we don't know exactly how these meds work we don't really know, but one possibility is that the combination could have overstimulated a neurotransmitter system or signaling pathway in the brain, knocking out the modulating effect of the Zyprexa and bringing on the original symptoms, but I emphasize this is a very wild guess. We know so little about these meds and next to nothing how they work in kids.

Squiggles (Jan 16, 2003): I have been concerned for some time with the
idea of developing a portable lithium gadget; much like a blood pressure or diabetes meter. I know that the photospectometry or other sophisticated means used for measuring makes this difficult, but I would like some ideas
of how and whom to approach for this.

I am a great fan of lithium but I recognize that its "narrow therapeutic index" may turn a lot of people off. I think such a machine would encourage people to take advantage of the benefits of this miracle drug.

I have already approached some medical instrumentation companies on the net, but they think that as so few people take it, it is not cost-effective; I did not however receive any remarks about the impossibility of creating such a machine.

Doug (Jan 21, 2003): On changing doctors.

April 1996, that’s when I crashed. After living a life full of superman days and frequent bouts with depression someone finally told me I was not a lunatic. I was a raging maniac. Type I rapid cycling prone to mixed episodes. But what had I known? For all those years the highs were great the lows seemed to be a normal reaction to life.

It took over two year to get my meds in sync (Lamictal and Zyprexa). For over a year my psychiatrist considered me to me “in remission”. I hadn’t had an “episode” of any kind for months. Any breakthrough I did have was manageable and acceptable. Then life as I knew it came to a halt. My psychiatrist retired from his practice.

My initial fears were that whoever I picked would instantly want to changes things. Sure enough it happened. I was strongly warned about the devastating effects of TD (from the Zyprexa) and should give strong consideration to moving to a new regime. In fear I agreed. We added Wellbutrin and slowly reduced the Zyprexa. At first I thought that maybe this would make my wife a little happier as I might not be so sedated, what a mistake. Within weeks the mania reared its ugly head. I was out of the lazyboy, fixing this and doing that. Wanting to go here or there. I managed to get the house painted in two days. Then the crash. Into the hospital (my first experience). Three days and two nights and lots of Seroquel, I signed myself out. Now I have to start all over again just to get back to square one.

Moral of the story. f it works, don’t mess with it. If somebody wants to mess with it, find someone else.

Megan (Feb 3, 2003): I had been diagnosed with several clinical depressions dating back to age 8, and had been treated through counseling until the need for meds became overwhelming (high school). I became much more frustrated, however, when I got much worse on the different AD's that I tried. Finally, at age 26, after too many suicide attempts and hospitalizations to count, I was diagnosed with bipolar. I was put on Zyprexa and Effexor and Klonopin, and everything clicked--I had never felt better. After six months, I noticed that I had gained about ten pounds, blamed it on the Zyprexa, and I decided to research other med possibilities. I have since been on Topamax with the Effexor (since April 2002) and did not realize how wonderful Zyprexa really was. I have tried many different AD's and never really had a hard time adjusting, and even the anti-psychotic Zyprexa was an easy-enough transition, but... there is a reason Topamax is nicknamed "Stupimax" by many of its former users. Sure, I lost the ten pounds--and another thirty (too much for me). I can take or leave food, which isn't good enough for me--I love to eat! Worst of all, I had to give up a management position in a company where I had been working for the past six years because I was unfocused, groggy, and slow, both mentally and physically. I cannot reduce my dosage of Topamax, and my Effexor is at the maximum effective level. My pdoc and I are looking at options now. I'm sharing this because I realize a lot of people haven't been on Topamax for long enough and are mesmerized by its weight loss qualities...right now, I'd rather have my mind back and be 40 pounds heavier.

Michelle (Feb 5, 2003): I've been diagnosed with bipolar. I've been hospitalized, I've probably tried every medication on the market. I got tired of trying to "get on" with my therapists and psychiatrists. I felt like the whole world was judging me and laughing at me. My "voices" kept on telling me how weak i was that i took the medication, i became more depressed because the medication made me gain weight. So, one day i went cold turkey and flushed all my medication down the toilet. This is not who i am or is it i keep asking myself. I'm quite an aggressive person now and choose not to have much to do with people especially family. I have distanced myself from people that I'm so alone in my world of fear & failure. My husband has all the patients in the world and has stood by me but i fear one day he will have enough. I choose not to accept who i am, this is not the way life is supposed to be for me. I believe that i can do this without medication, i refuse to pop pills to be "normal" so other people can "get on" with me. I just hope the path I've chosen is not the one less traveled. I'm tired of being the "special" child in the family.

Kristi (March 27, 2003): I know it's very important to stay on medication but at times I feel I don't need it so I stop taking the medicine and keeping up the appointments until I really need the treatment. When I'm in desperate need I can't find doctors due to noncompliance with the treatments. What then?

McMan (March 27): You already know the answer, Kristi - stay on your meds, no matter what. Then, hopefully, the only reason you'd need to see a pdoc is for routine meds checks.

Jackie (April 8, 2003): I was diagnosed with bipolar disorder four years ago and have been on SO MUCH medication. They just figured out the right combination of mood stabilizers and anti-depressants for me. The crappy part? Depakote - (my main med) is a weight gainer and I have gained a lot of weight but I can't stop taking it. Each time that I got sick of my prescribed meds, I would stop taking them and go on a cocaine binge. So without them, despite the weight gain, I would most likely be dead.

James (May 10, 2003): I truly hope that they do develop some better medications for Bipolar and Depression that don't have all those side effects. You either have to take the meds to help stabilize your mood and deal with the side effects, or you don't take the meds and end up torturing yourself mentally. For I have personally tired several meds and all of them had some sort of side effect that was uncomfortable. But when the doses is lowered, it causes more problems for me. For right not I take 400mg. of Wellbutrin, 400mg. of Serqueal, 1200mg. of Lithobid and 30mg. of Remeron and day, and I still have some wild swinging moods throughout the week. I use to take Depakote but it made my hands tremor real bad when they increased the doses. Then the switched me to Lithobid and at a low doses it was alright, but as they increased it up to 1200mg. it started to cause hand tremors too. I couldn't even dial my cell phone without laying my hands down of something flat in order to dial my phone.

Robin (May 12, 2003): I have been a bipolar for six years, hospitalized twice because my meds were not working well. They put me on Wellbutrin & Zyprexa, which have worked really well for the last 4 years. I have been learning about the meds & bipolar disorder. I'm so glad I have a family that understands what I'm going through.

Craig (June 3, 2003): I began to restart Mood Stabilizer therapy for bipolar One and it has worked out in my case. I seem to use less anti-psychotic medication and the same levels of Lithium. I rarely get high and rarely get low. So I seem to be working out OK. But I hope to switch to Abilify fro olanzapine in the next few days. I'll try anything that will improve my Mental Health.

Anna (June 16, 2003): I was diagnosed in 1987 and treated with Lithium until 2001 when Lamictal was added. I noticed a lifting and leveling of my mood at that time and ventured out to apply for a job after hiding in my house for many years, caring for my children but also fearing a relapse. I think that the combination of medication and the structure of having a job...a reason to get up and dressed in the morning/ regular social contact helped me to do very well. My mom who was on Lithium for over 20 years was recently found to have kidney failure. I asked my MD if I should be concerned about that. He suggested switching me to Trileptal which worked well in combination with Lamictal for a couple of years. I recently began to experience a deep depression unlike any of the milder dips I've had since being diagnosed and medicated. (I've always been faithful about taking my meds because I lived with a frequently manic mom who denied her diagnosis and fought those meds .Double vision, unsteady gait and depression. Occasional hypomania lasting for several days and then back into the hole. I am looking for hope. Is anyone "under good control" with treatment and functional most or all of the time?

Elaine (July 7, 2003): For years I have been depressed and moody. I am 35 and had my first extremely manic, psychotic episode 2 months ago. Since then, I have been placed on Trileptal and Wellbutrin. I am so depressed and anxious - has anyone else had this problem? I am so completely terrified of another manic episode, that I am willing to risk some depression. I can't function properly, feel like crying all the time and am very anxious. Do the meds just need time to kick in? I also cant sleep at night - does anyone else have these same experiences?

Deb (July 8, 2003): I've been one of the lucky one to have improved tremendously w/ venlafaxine (Effexor). I was first diagnosed as bipolar when I was in college & told I was lucky as most students w/ bipolar disorder/illness are very gifted. I really didn't feel so lucky - my life was chaotic. My only luck came from the fact that my manic periods came usually during finals! Now I've found (some 30+ yrs later) a wonderful psychiatrist who's affiliated w/ a large university medical school. After trying all the usual SSRIs he put me on Effexor which I credit w/ literally saving my life. Now he's added lamotragine (Lamictal) and I'm on day 19 of my dose escalation. Before I felt OK, but now I can tell a big difference. Pray for me that I don't develop a skin rash or God-forbid Steven-Johnsons and have to go off it. Since I also have fibromyalgia, another syndrome that drives MD crazy, I can concentrate on dealing w/ that since my 3/4 depressive episodes + 1/4 manic episodes are better controlled. Even my husband stated 'out of the blue' - "Wow, seems as if your meds are really right now!" God bless those who don't have it but do "get it".

Sparky (July 13, 2003): Several people I've met recently in an online support group are reporting good results for BP with Straterra, which the FDA approved recently for ADD (which I have in addition to BPII).

I'm particularly interested because Straterra isn't a controlled substance, so my doc may be able to get free samples for me (out of work and no insurance, used to take Ritalin, then Adderall, both of which worked but not nearly long enough per dose, I seem to metabolize everything really fast).

What do you know about this drug? Has anyone here tried it? If so, what's your experience with it?

Flownamow (July 23, 2003): I would like to comment on one of the greatest treatments for Manic Depressive Illness. I "have it" and my baby died from excessive fetal fluid and an anomaly of the heart valve. She was Stillborn at seven months in utero. It is hard to talk about still but the labels on lithium should be changed from could cause problems in pregnancy to can be fatal to fetuses. Heavy? Yeah, but I lived and she died because a fetus cannot tolerate the same amount of lithium in their system as an adult can. I intend to contact the Surgeon General's office to change the labels for a lot of people's benefit. More later. I want to meet Patty Duke. Lithium helps a lot of people. I have been on it 20 years but now take a new expensive drug because of my medical assistance. Thank God because I might want to get pregnant again someday.

McMan (July 23): Hi, Flownamow. I'm very sorry to hear about what happened to your baby. The place to report your tragedy is the FDA's Medwatch: http://www.fda.gov/medwatch/report/consumer/consumer.htm

Becky (Aug 8, 2003): I have bipolar I....I am glad that there are drugs out there that I have never heard of that I can try if the ones I am own ever quit working. I am currently stable on Topamax, Geodon, Risperdal, Lexapro, and Seroquel. Thanks, McMan, for showing bipolar meds the attention they properly need.

Julie (Aug 22, 2003): My 21 year old son is Bipolar. He was unable to continue taking lithium so he was put on Neurontin. This did help him, but we felt there must be something better as he was still having a lot of depression and was very tired and unable to concentrate a lot of the time.

His doctor talked to us about the success of some of his other Bipolar patients that were taking Lamictal and we decided to give that a try.

My son is doing so much better now that he is on Lamictal. He is not as tired and has much less depression than before. He said that he has not felt this good since he was diagnosed at age 15.

His doctor has told us that Lamictal seems to be really helping Bipolar patients that experience more depression than mania. He is seeing some dramatic improvements in patients that have switched to Lamictal.

Julie (Aug 22, 2003): Thank you for the information about the meds for bipolar. My 13 year old son has it. As does my father. My son had been on Depakote and Prozac for a couple years now, the Depakote was added when he started puberty. He was put on Prozac at the age of 4. We are now in the middle of switching the Depakote to Lamectil because of weight gain and gynocamastia. And hopefully we will eliminate the Prozac down the road.

Sandra (Sept 11, 2003): I have been Bipolar since I was 17 and am now 24. Recently, my therapist and I have been trying to figure out if I really am bipolar or not. It is possible that I may have just had an psychotic episode as a result of my teenage diagnosis of adjustment disorder.

Anyways, I've been on lithium all this time and reached a point where for about 1 year I couldn't lose weight. So I tried Topamax and had a bad experience- I now have more hair on my face, had abnormal eyelash growth, some acne, menstrual irregularities. I know the doctor meant well but I feel that the side effects of anticonvulsants should me stressed for women.
The whole meds game is so hard!

Barb (Nov 21, 2003): I just wanted to introduce myself and thank you for all the work on your website. You are both inspirational, a huge help to me and others with this as well, I'm sure, as well as having saved me countless hours and anxiety (oh yeah, that, oh oops! lol...can't be getting me all anxious now, can we?) trying to sort through what you've already concisely compiled for me to look at, review and consider. It has been extremely calming and it does very much help to know I'm not the only one with this. I've probably been bi-polar most of my life, but started have massive episodes about seven years ago, and of course, they have devastated my life, career, you know the drill I'm sure. Mine were contributed to hormones or menopause, or "isolated incidents" until my life lay pretty much in ruins at my feet.

I am now starting to get treated, awaiting the first round of social security, trying to find and work with social services I never even considered having to look for before, and can't send you a donation for your site, now, but will when things improve some, and they should somewhat soon I think. My finances are bad of course, but I suspect they're do to stabilize at least.

I still have attention problems from this, and can't read too much at a time still, which is probably the most irksome ongoing part of this for me I think, I used to love to read, and now get exhausted reading a page. I'm in a depressive stage following my most recent episode and have finally been diagnosed, or as I call it, taken seriously by doctors.

Your information has been a huge help to me as this has progressed. I, like you and others I suspect, wish to have some control over, literally not having much control, and like most of am finding the world of mental health care is at best, underwhelming. Being able to read about these treatments findings, the drugs and their successes, and shortcomings has made me feel a bit more in control of what happens next.

Again, many thanks, I'll continue to use and recommend your website. and as soon as I possibly can I will send you my donation for your continuance. I've spent far more to get far less.

McMan (Nov 21): Many thanks, Barb.

Trish (Jan 26, 2004): I'm currently taking 20mg Paxil, 1200mg Lithium, Klonopin 1mg 4xdaily, and at night 80mg Geodon,
25mg Lamictal, 300mg Seroquel, and 15mg Zyprexa. I'm actually feeling fairly good. In your opinion, do you feel that this is too much medicine?

McMan (Jan 26): Hi, Trish. If you're actually feeling good, then it's not too much medicine. Having said that, you might want to question why your on three antipsychotics (Geodon, Seroquel, and Zyprexa) and two mood stabilizers (lithium and Lamictal). Your pdoc may have very good reasons for this, but you're entitled to an explanation.

Mark (Feb 23, 2004): I am lucky to be in the group where lithium alone is sufficient enough to curb my mood swings. I also use cannabis to calm me down when I feel manic. You were right when you said this disorder is infinitely complex. Please let me know if there are any studies about bipolar disorder that I can participate in or read about.

McMan (Feb 23): Hi, Mark. Centerwatch has all the participation info you'll need, but your cannabis use will exclude you from just about all of them. Clinical trials exclude virtually all "real world" patients, as they are looking for uniform populations with as few as possible variables that might confound their study. To read about studies as they are published, you can sign up for my Newsletter, as I faithfully report on all the major ones.

Kristie (Feb 29, 2004): To Jen (Jan 2003), whose son was recently put on Trileptal. My son is 6 years old, and has been having a horrible time with bpd. He is also ADHD w/depression. I was extremely hopeful about the Trileptal, having read so many positive things about the drug with little to no side effects. However, I believe it triggered a horrible manic episode in my son. He was so uncontrollable that I thought he would have to be hospitalized. I'm doing everything I can to avoid this, since he has terrible rejection response (after his bp father has refused to see him in over a year). I'm afraid he will shut down entirely if I hospitalize him. This resulted in him being put on Risperdal .25 mg. It has helped flatten out the raging anger, aggression, and violence. But he had a terrible headache after taking it. And I still see the relentless underlying anger and agression. My son used to be an outgoing, energetic, personable little boy. Now he is someone I don't know, and am afraid of. Any help would be greatly appreciated.

O'Malley (June 10, 2004): Heyas.. Just found this site while researching Lamictal. Oi. A lot of the meds you all have listed are ones I have tried, to no bloody good. They all seemed to work for me, for a while, then stopped. The bi-polar is only a part of my problem, at this juncture. Apparently, the ADHD and menopause are complicating things. Oh, joy.
My youngest is 16, and also bi-polar/ADD. While we do share some of the same symptoms, we also have some very different ones, as is to be expected. I am also diagnosed with personality disorders and anxiety, i.e: PTSD and agoraphobia. And that's just the stew in my head. The body is another kettle of muck, but not to worry.
At any rate, a lot of the meds I have gone through have had some pretty scary side-effects, but I am still trying. Eventually, I may hit on the right one(s), and then, look out! I will be rolling about after young Irishmen, again!!!!*wink*

Kim (June 17, 2004): I have suffered from severe depression for 17 years now. I was recently diagnosed as Bipolar/Depression. I was put on Effexor XR and, 6 weeks to the day, had uncontrollable muscle movements. Recently I was put on Lamictal, Seroquel and Propranolol. Within a week, I was covered in the worse rash I have ever had. It seems I have only the rarest side-effects but I have also noticed that the side-effects seem to occur with an increase in dosage. (ie. the Lamictal) The medicine seems to work but the side-effects severely affect my life and I have to take time off from work. I work in a fast food store. I just started seeing a new doctor but the appointments are few and far between. (My next one is a month and a half away.)

JJ (June 25, 2004): I think the one thing about all the medications
available for us out there are the horrible side affects. They all have them and none are really any better than the next. I bet if the people designing these med's were taking them there wouldn't be so many......

My depression seems to get worse every time I get off my meds and being able to talk to a doctor is hard. Is there any suggestions out there for me? I would like to get better but I can't seem to be able to find the right help.

James (June 25, 2004): I was recently diagnosed as bipolar II after ten years of SSRI treatment for depression with very mixed results. Looking back, I can see how the new diagnosis makes sense, in view of years of anxiety and very low-grade hypomania. Somewhat explains how my school and work functioning seemed to be improved during years of substance abuse. After several years of clean time and active recovery from addiction, I still felt miserable on 40mg of Paxil daily. I got diagnosibly manic AFTER stopping that medication (despite several respected psychiatrists telling me that was impossible I discovered a substantial literature on the horrors of Paxil withdrawal, going back to suppressed reports of the original normal control subjects in early testing).

I am now on Trileptal 300 BID which does nothing that I can detect. I still get a lot of limbic hyperarousal stuff (floating anxiety and anger, overreactivity to old memories and resentments- making 4th Step inventory work harder I must report), that isn't about excess energy or activity. I found that verapamil (Calan) really helps with this, and is dirt cheap. My psychiatrist is a resident at a university clinic and refuses to prescribe it because he lacks experience with it. (trying to point out that he lacks experience with much of anything seems futile at this point.) I currently get 120mg a day prescribed from my family doctor.

Do you know anything about either medication. I feel like it may be my paranoia talking, but it seems like Trileptal is getting a lot of off label oversell because it is on-patent and profitable, while verapamil is promising but orphaned because nobody will make a buck off of getting FDA approval. After the Neurontin debacle (illegally promoted at countless free lunches but basically worthless- I was initially prescribed that too) i am suspicious. Also, any suggestions on working with doctors who are cautious aboput listening to me, but gullible with the drug reps. I can't fire ALL of them, so improving my communication skills seems a good idea.

McMan (June 25): Hi, James. Go to http://www.ncbi.nlm.nih.gov/ Select "PubMed" from the drop-down menu, then enter "verapamil,bipolar" into the search field. A bunch of findings will come up, in particular a study by Weisner et al. Print it out and any others you may find and show it to your pdoc. Since this is not a mainstream BP med he/she probably won't prescribe it. Even a pdoc who deals with experimental meds is bound to be hesitant, so don't expect one to go along with you. Simply produce the printout and ask him or her to have a think about it for a later date. Be all reason and sweetness. Re Trileptal, it is basically a repackaged Tegretol without a lot of the drug interactions.

Anne (Sept 9, 2004): Being on meds have allowed me to have what I believe is a close to "normal" life. I feel they have also "shut down" parts of me. But it is a choice.

Lyn (Nov 15, 2004): I have been sick all my life due to mental illness. I have tried nearly all the meds listed on this forum. I suffer from bp and must say that the major depressions dominate. Antidepressants stop working after a time, and I am allergic, sensitive or unable to tolerate the side effects of all mood stabilizers except Lamictal. This has made a great improvement to my life and just when I was on the brink of loosing everything, my life within depression and my sanity or life within manias. I just reached 200mg about a week and a half ago when I thought I had stabilized. Now I have entered a deep depression again as though I build up a quick tolerance. This has seemed to be the case with each increment of dose. Is it usual to go higher than 200mg? Do some people build a tolerance rendering it ineffective after a certain duration? I understand it is reasonably knew, does anyone know if you can use it for a lifetime? All I find is that my hands shake badly, small mood swings and lets say that in the past side effects sometimes consisted of anaphylactic shock. I don't know if I can stand on the edge of this cliff any longer.

Csm (Dec 10, 2004): I have a 16 year old daughter who has been diagnosed with BiPolar disorder and the Dr. has put her on Risperdal, Prozac and Lithium. She has been much better since she started these medications, but I am worried about her being on Lithum for a long period of time. She is starting to gain some weight and I have been thinking about telling the Dr. to take her off of Lithium and keep her on Risperdal and Prozac for the time and see how she does with those two. Can you tell me which medication, out of the Lithium, Prozac and Risperdal are most effective. I am very unlearned and need to know what the best treatment for her is. I love her very much and just want her to be happy. Thank you.

McMan (Dec 10): Hi, Csm. Unfortunately, your daughter is unique, so there is no answer for you. I strongly suggest consulting a nutritionist with regard to weight, as weight gain can have a serious impact on your daughter's overall health and feeling of self-worth.

Marie (Dec 22, 2004): I agree that having Bipolar or depression causes people/loved ones to say "snap out of it". I have heard that so many times. Thankfully my husband knows that I might not snap out of it, and if it's bad enough (mania or depression) he'll call my psych NP. People just don't understand. Thankfully I can function in a job every day, but on the chance that I have an "off" day, I don't know what I'd do. I haven't told my colleagues I suffer from Bipolar disorder, I know that there would be repercussions. I am on a slew of meds - Abilfy, Mirapex, Lamictal and Restoril. Is any one else on such an array of meds? I am coming off Cogentin and Depakote.

McMan (Dec 22): Hi, Marie. Is the Pope Catholic? Three or four meds is is par for the course for BP treatment. The ideal is to simplify the cocktail, but because there is no such thing as a perfect BP med, we find ourselves living in the middle of a "how many meds does it take to change a lightbulb" joke.

Dr Rob (Feb 7, 2005): I must comment right now, though, that even the best new antibipolar drugs, like the atypical antipsychotic olanzapine (Zyprexa), happen to be better because they accidentally treat anxiety in the brain! Dr Maarten Van Den Buuse, here in Melbourne, can see these anti-stress effects in rats. I say, why get fat and diabetic and sleepy on Zyprexa, when Inositol will treat anxiety naturally--it's already made in the body, so is totally natural to the brain, as well as being anti-obesity and anti-diabetic and anti-sleepy!

Even valproate (Depakote) has been found to cause fatty liver in a whopping 60% of patients taking it. Unanticipated major long-term side-effects will be the downfall of bipolar drug treatment and research, especially when the newer drugs are combined, each being only a part-remedy.

There's no future here, and let's not forget that the underlying genes are probably GOOD--so why knock out their pathways thoughtlessly with drugs? It's time to bail out and go natural with diet, and let the genes show their original good side, which is why they evolved in the first place (see Samuel Barondes' book Mood Genes).

And Lithium, as you say, may be natural, like Fishoil and Inositol, but Dr John Cade's quite accidental discovery of its sedative effects in guinea pigs was based on pure speculation about some manic substance in the urine of bipolar patients, not on a scientific or inductive hypothesis based on existing knowledge about bipolar disorder.

In other words, he could not have predicted its chemical effects, which only now we are finding out about, and you can't call serendipity science.

There was, even in Cade's time (1949), enough known about diet in psychosis, about pre-diabetic state and fat bellies in schizophrenia and bipolar, and about co-morbid anxiety in both psychoses, to put together an integrative hypothesis on diet and psychosis. This, Cade admits he never did--a scientific failure that he acknowledged many years later, always insisting his discovery was no more than a lucky accident.

Going back to 1900 or so, the great Emil Kraepelin concluded from his vast psychiatric experience--which did not include taking a dietary or gestational history--that both psychoses were due to a \"hereditary taint\"--a view that later led his Berlin colleague Ernst Rudin to urge the Nazis to sterilize or kill 100,000 mentally ill people, instead of improving their diet. German psychiatric \"pioneers\" were not dietetic pioneers.

Compare this bleak, ignorant therapeutic nihilism with London's warm-hearted Dr Charles Mercer, psychological physician at St Thomas's Hospital, who took a close interest in his patients' diets. He was appalled at their fatty puddings and lack of fresh fruit and vegetables, proceeded to fix the diet in some cases, and claims to have virtually cured some of depression and psychosis. He wrote to The Lancet about his exciting results in 1910, but medicals showed no interest, and John Cade would not have read the report.

I wonder how different psychiatry would have been, had Mercer been in Cade's position in 1949; as Superintendent of the hospital, he might have promoted healthy low-fat diet for the patients, with the whole grains and legumes that happen. luckily, by accident, to be natural sources of Inositol to treat stress. The typical mental hospital diet in those days was poor and fatty. Had Mercer seen good improvements in his bipolar cases, through healthy diet, it would have been a world first to get this published and noticed. Instead we have Cade's Lithium, which is an unreliable partial remedy, whose good and bad effects come from an unnaturally high dose of a natural substance.

So when Psychiatry is put in the cold light of Science, we see a fairly unthinking profession, devoid of nutritional knowledge, surviving on accidental discoveries, and unlikely to be able to invent drugs that can ever compete with nutritional neuroscience's best and most natural offerings--Diet, Inositol and Chocolate-coated Microencapsulated Fishoil Powder!

The crunch will come when clinical trials of Diet, Inositol and Fishoil are done in bipolar: I predict a smashing success, and that this regime will become standard therapy in both psychoses, and will eventually displace drugs, including Lithium. If the efficacy of a nutritional approach can be proved, look at what it offers--a sensible nutritional regime, with natural supplements that are easy to take (Inositol tastes sweet!), and easy to comply with. In the emerging Post-Medical (and Post-Cade) Era, patients are getting unhappy with endless meds, and many--if not most--would prefer a scientific natural therapy, once it was proven and made public. I am actually starting a website this year that will offer such therapy, called www.brain-nutrition.org.au.

Esther 5/2: The best thing that happened to me was to go on Lithium. It stabilized me and Neurontin helped my anxiety. Before I went on these I was a mess. I thought you should not go on pills.

Holly 7/4: I've been diagnosed with bi-polar disorder for about 6 years, but I believe I've had it my entire life. For 8 months I was part of a research study in Jacksonville, FL. I was taking Seroquel (originally used as an anti-psychotic) and Depakote (Valproic Acid). I later added Zoloft to the mix.

Yes, that's a lot of medication, but, I feel the best I can ever remember in my life. It's a great combination, at least for me, and I hope that psychiatrists are aware of it. Many people may not need the addition of Zoloft, but Zoloft really helped my anxiety levels. I'm able to be consistent and productive now- I'm rarely depressed at all and I have almost no manic symptoms. And, this is coming from a person who had five close suicidal episodes just prior to this treatment.

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