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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Jesse on February 18, 2000, at 23:38:03
I'm diagnosed with Bipolar II.(In the past I've also been diagnosed with ,OCD and ADHD. Finally I Curerntly I'm taking Effexor and have just began Lamictal. I also take Trazadone for sleep and Klonopin PRN-mostly at night. Hopeffully when lamictal kicks in I will not depend on klonopin and trazadone as much.
How long does it usually take for lamictal to have a mood stabilizing effect? Do these meds seem like an effective regime for managing bipolar II? I am also a serious runner. Should I be concerned about side effects of Lamictal interfering with this and impair my performance?(I know my mental health is more importaant but running has helped more tha nany drug)
Prior to my most recent depressive episode and then becoming hypomanic, I had success with Wellbutrin and Prozac. Wellbutrin helped my concentration which was severely impaired at times. Have you had or heard of success with wellbutrin and Lamictal combo for Bipolar II? I have serious Obsessive/Compulsive behaviors (which can be quite debilitating) as a result of coping mechanisms over long period os time to deal with bipolarIIsx's. Would Luvox instead of effexor make much of a difference to help with OCD stuff? My doctor is hesitant about using more than one antidepressant. Would the addition of wellbutrin at a low dose to my current regime help my concentration (which is a serious problem at times) It had helped in the past (although I was stabilized when I was taking it before).
Any input would be extremely helpful.
Thank You
Posted by Cam W. on February 19, 2000, at 10:56:27
In reply to Lamictal for BipolarII/Mixed Type Depressio, posted by Jesse on February 18, 2000, at 23:38:03
> I'm diagnosed with Bipolar II.(In the past I've also been diagnosed with ,OCD and ADHD. Finally I Curerntly I'm taking Effexor and have just began Lamictal. I also take Trazadone for sleep and Klonopin PRN-mostly at night. Hopeffully when lamictal kicks in I will not depend on klonopin and trazadone as much.
> How long does it usually take for lamictal to have a mood stabilizing effect? Do these meds seem like an effective regime for managing bipolar II? I am also a serious runner. Should I be concerned about side effects of Lamictal interfering with this and impair my performance?(I know my mental health is more importaant but running has helped more tha nany drug)
> Prior to my most recent depressive episode and then becoming hypomanic, I had success with Wellbutrin and Prozac. Wellbutrin helped my concentration which was severely impaired at times. Have you had or heard of success with wellbutrin and Lamictal combo for Bipolar II? I have serious Obsessive/Compulsive behaviors (which can be quite debilitating) as a result of coping mechanisms over long period os time to deal with bipolarIIsx's. Would Luvox instead of effexor make much of a difference to help with OCD stuff? My doctor is hesitant about using more than one antidepressant. Would the addition of wellbutrin at a low dose to my current regime help my concentration (which is a serious problem at times) It had helped in the past (although I was stabilized when I was taking it before).
> Any input would be extremely helpful.
> Thank YouJesse - The Lamictal dose must be raised slowly to minimized the side effects (like the cognitive one's you mention) which occur at the beginning of therapy. It can take up to 2 months to acheive full effect from the Lamictal. Hang in there, Lamictal has antidepressant activities, as well as mood stabilizing effects and seems to be a good trial candidate, with the Effexor, for your symptoms. Raising the dose of Lamictal too fast can result in a rash (10% incidence) that looks like a sunburn. If this happens, stop taking the drug and call your doctor. Sometimes (0.1%) the rash can progress to a poison ivy-like rash if the drug is not stopped upon first signs of a rash. The doctor may restart you on a lower dose again, maybe not, but call him/her, as the rash (which happens very infrequently if the dose of Lamictal is raised slowly) can become very uncomfortable and may require medical treatment. Lamictal is a fairly safe and efficacious medication.
As for switching to Luvox from Effexor, don't bother. Even though it is not indicated on the label, all SSRI and SSRI-like drugs have some degree of anti-OCD activity. The manic switch rate (the incidence of AD-induced mania) is about 5 times higher with Luvox than with Effexor. Wellbutrin has been used with Lamictal but I haven't seen it personally, so really cannot comment. Give your drug regimen a shot and don't get impatient with the time it takes to work. Disney World wasn't built in a day. Good luck - Cam W.
Posted by judy on February 19, 2000, at 16:46:16
In reply to Re: Lamictal for BipolarII/Mixed Type Depressio, posted by Cam W. on February 19, 2000, at 10:56:27
Hi Jesse,
Since I was unable to take any AD's (including wellbutrin) because of rapid cycling (and manic switches) my pdoc put me on lamictal in addition to depakote and I think risperdal at the time. He raised me 25mgs every 4 days until about 200 mgs I actually became hypomanic. So I guess it really is a good AD, and according to my pdoc that was the only the second time he saw an "overshoot" on it. Can't help ypu with the OCD stuff, but hope the lamictal info helps. Also, compared to the other meds I have taken, it had a very benign side effect profile. Take care.
Posted by Jesse on February 19, 2000, at 22:36:28
In reply to Re: Lamictal for BipolarII/Mixed Type Depressio, posted by Cam W. on February 19, 2000, at 10:56:27
Cam W.
Thanks for you're response. Any support is extremely helpful right now. I'm 25 and have a long (10year), frustrating history filled with misdiagnoses etc. Anyway I'm finally coming to terms with the fact that I have Bipolar II. But it is at the expense of major impairments in professional and social functioning which I am experiencing currently. I'm very impatient and need to be stabilized fast- Hypomanic, dysphoric periods then I crash. My MD is away for a few days and I'm getting worse. Ok my question -For bipolar II, What can stabilize me faster than lamictal.My M.D. and I agreed on Lamictal because of the low side effect profile.He recommended Zyprexa as well but I held off because of fear of weight gain (I obsessively exercise an was a serious runner-the only thing that saves me when I gets so hyper and agitated) Anyway right now I am getting worse and scared and willing to set aside any worries/obsessions about side effects so I can get better and function and be stable. Another issue with mood stabilizes- I am an aspiring actor and was afraid it would effect my creativity. But now I am not good and don't give a shit I just want my life back in control. WHAT IS THE BEST TREATMET TO GET A BIPOLAR II PATIENT STABLE IN A HURRY-DEPAKOTE? SHOULD I START ZYPREXA? Neurontin? I need help?
Posted by Cam W. on February 19, 2000, at 22:56:11
In reply to Re: Lamictal for BipolarII/Mixed Type Depressio, posted by Jesse on February 19, 2000, at 22:36:28
> Cam W.
> Thanks for you're response. Any support is extremely helpful right now. I'm 25 and have a long (10year), frustrating history filled with misdiagnoses etc. Anyway I'm finally coming to terms with the fact that I have Bipolar II. But it is at the expense of major impairments in professional and social functioning which I am experiencing currently. I'm very impatient and need to be stabilized fast- Hypomanic, dysphoric periods then I crash. My MD is away for a few days and I'm getting worse. Ok my question -For bipolar II, What can stabilize me faster than lamictal.My M.D. and I agreed on Lamictal because of the low side effect profile.He recommended Zyprexa as well but I held off because of fear of weight gain (I obsessively exercise an was a serious runner-the only thing that saves me when I gets so hyper and agitated) Anyway right now I am getting worse and scared and willing to set aside any worries/obsessions about side effects so I can get better and function and be stable. Another issue with mood stabilizes- I am an aspiring actor and was afraid it would effect my creativity. But now I am not good and don't give a shit I just want my life back in control. WHAT IS THE BEST TREATMET TO GET A BIPOLAR II PATIENT STABLE IN A HURRY-DEPAKOTE? SHOULD I START ZYPREXA? Neurontin? I need help?
Jesse - Your doctor has made a good call. The Zyprexa is only going to be used short-term, minimizing the risk of weight gain. It will most likely only be used until the Lamictal is raised to an effective dose. Also, keep up the exercise and eat a healthier diet (fill up on salads) to reduce the risk of weight gain. Zyprexa has some antidepressant activity and also very pronounced anti-manic effects and may help control some of those ruminating thoughts. Give it a shot. Benefits will probably outweight risks in this case. Keep your doctor (and us) posted to you progress. Good luck - Cam W.
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