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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 10 to 34 of 34. Go back in thread:
Posted by cyban on April 23, 2011, at 22:04:49
In reply to Re: Nothing Works, posted by Cyban on April 23, 2011, at 9:32:55
anhedonia is one of my symptoms as well, I forget because my wife is more the one to remind me.
I have also tried Topomax, Cojentin, and Prozac in the past
Posted by Ben on April 24, 2011, at 2:03:06
In reply to Re: Nothing Works » cyban, posted by Phillipa on April 23, 2011, at 0:09:46
1) What about Seroquel/Quetiapine. It should help against mania and depression - so its probably also a mood stabilizer.
2) Did you tried the MAOI Parnate/Tranylcypromine?
good luck
Posted by Cyban on April 24, 2011, at 6:30:33
In reply to Re: Nothing Works, posted by Ben on April 24, 2011, at 2:03:06
> 1) What about Seroquel/Quetiapine. It should help against mania and depression - so its probably also a mood stabilizer.
>
> 2) Did you tried the MAOI Parnate/Tranylcypromine?
>
> good luckI didnt find any gemeric name for Tranylcypromine that I have taken.
I will write them down and talk to my Pdoc about them, thank you.
Posted by Ben on April 24, 2011, at 8:54:06
In reply to Re: Nothing Works, posted by Cyban on April 24, 2011, at 6:30:33
Hi Cyban
Seroquel is the brand name for the drug quetiapine an atypical antipsychotic. Tranylcypromine is an antidepressant which inhibits the monoaminooxidase enzyme in the brain. Brand names are Parnate or Jatrosom.
Posted by Hombre on April 24, 2011, at 11:21:05
In reply to Nothing Works, posted by cyban on April 22, 2011, at 21:10:34
Seroquel might let you get off Ativan and Ambien. You can just take it at the same time every night and you'll be out like clockwork. It really can help with racing thoughts and anxiety all day long, too. You may need a high enough dose, and it might take a few weeks to get over the heavy sedation, but it is workable.
Posted by Ben on April 24, 2011, at 12:00:12
In reply to Re: Nothing Works, posted by Hombre on April 24, 2011, at 11:21:05
I took Seroquel at night and my sleep was fine. Most of all feel a hangover effect the next day and during the day what concerns the sedation. In my case I didnt feel tired the next day but it may depend of the dose.
Posted by desolationrower on April 30, 2011, at 4:47:11
In reply to Re: Nothing Works » linkadge, posted by SLS on April 23, 2011, at 9:28:34
> I will be adding fish oil to my treatment regime. Can you describe what your experience with it was?
>
> Thanks.
>
> I have already added phosphatidylserine, a substance that is supposed to work with fish oil to help support neurotrophism.
>
>
> - ScottSomeone already mentioned taurine as well, which is also abundant in seafood. If possible, i would suggest eating fish as opposed/addition to fish oil, as it contains the w-3 oil, taurine, as well as other things. Of course, a fish oil pill is better than nothing, and high dose w-3 might be useful, at least to try. There is less evidence that i've seen for dose for mental health, but for other aspects the benefits taper off quickly after about .5g/day of EPA/DHA (which is still more than the standard american diet provides), and i think for most people some fish, and avoiding 'vegetable oil' is enough for proper metabolism re:polyunsaturated fats & their metabolites. THere might be interesting interactions with COX inhibitors (aspirin/ibuprofen) which are beneficial for mental health - cox turns long-chain w-3 and w-6 fatty acids into signaling molecules. So it might either antagonise or synergise with high dose fish oil, which may or may not be better than the normal amount. some stuff to think about or try, i guess. w-3s have effects beyond just the eicoisinoids. (for both scott and cyban, actually)
for the OP, that is a long list of things to take, some stuff looks like its working at odds. And i agree about diet etc, perhaps yours it good, but are you generally in good health and is there anything that changed when you changed to bp again? also, i would recommend (actually, i'd rec it for everyone) to go to http://cronometer.com/ and put in your usual meals and see if you are getting enough of everything. CSA veggies are great, but there still could be something missing or that you are out on the far edge of the bell curve as far as how much you need. All kinds of crazy genetic weirdnesses are possible.
MAOI: I would suggest phenelzine aka nardil as the much better choice for someone with prominent mania, agitation, etc.
N acetyl cysteine or riluzole both work on glutamate, and have *some but not great evidence they might help with substance use and mood disorders.
How is your sleep? have you had a sleep test? I would suggest some melatonin, maybe some sleep drugs too. your symptoms sounds like how i feel when i don't sleep...
-d/r
Posted by cyban on April 30, 2011, at 6:19:05
In reply to Re: Nothing Works, posted by desolationrower on April 30, 2011, at 4:47:11
Well I talked to my Pdoc and asked about some of the medications in the replies if not all of them.
He gave me some reasons he didnt want to switch, some of them being they were similar medications to what I am on and said the MAOI was more for anxiety but my Ativan dose is so high he didnt believe those would even help so he increased my meds to:
Trileptol 1,500 MG Day
Ambien 10 MG Day
Ativan 20 MG Day
Celexa 40 MG Day (I have still been having depressed swings even when manic, which really sucks)
Abilify 20MB Day
Lithium Card 1,200 MG DayIt seemed to help a little.
I don't sleep much, 11PM-3AM, but I do get a lot of fish in my diet (I love Sushi) so I am reluctant to try fish oil.
Posted by desolationrower on April 30, 2011, at 18:32:49
In reply to Nothing Works, posted by cyban on April 22, 2011, at 21:10:34
Well, if what you are taking isn't working, and your pdoc doesn't want to change things, you might want to consider a new doctor.
-d/r
Posted by Phillipa on April 30, 2011, at 20:27:20
In reply to Re: Nothing Works, posted by desolationrower on April 30, 2011, at 18:32:49
I agree with d/r 20mg of ativan or was that a typo? Phillipa
Posted by cyban on May 1, 2011, at 8:26:13
In reply to Re: Nothing Works, posted by Phillipa on April 30, 2011, at 20:27:20
> I agree with d/r 20mg of ativan or was that a typo? Phillipa
No, didnt typo - is that high?
Posted by cyban on May 1, 2011, at 8:29:33
In reply to Re: Nothing Works, posted by cyban on May 1, 2011, at 8:26:13
I was wondering, because I dont know any other Bipolar people, do the meds usually bring you back down to stable, or only decrease the mania a little?
Posted by Phillipa on May 1, 2011, at 21:29:01
In reply to Re: Nothing Works, posted by cyban on May 1, 2011, at 8:26:13
I feel 20mg of ativan is extremly high. Your doc is aware of the dose and prescribes it right? Phillipa
Posted by cyban on May 2, 2011, at 7:40:26
In reply to Re: Nothing Works » cyban, posted by Phillipa on May 1, 2011, at 21:29:01
> I feel 20mg of ativan is extremly high. Your doc is aware of the dose and prescribes it right? Phillipa
Sorry, sorry all, that was a typo... I need to stop replying to posts when I wake up (at 3AM)
It's 20mg Abilify
I only take 3mg Ativan maybe twice a day.Too bad there is no way to edit posts.
Posted by cyban on May 2, 2011, at 7:42:11
In reply to Re: Nothing Works, posted by cyban on April 30, 2011, at 6:19:05
> Well I talked to my Pdoc and asked about some of the medications in the replies if not all of them.
> He gave me some reasons he didnt want to switch, some of them being they were similar medications to what I am on and said the MAOI was more for anxiety but my Ativan dose is so high he didnt believe those would even help so he increased my meds to:
> Trileptol 1,500 MG Day
> Ambien 10 MG Day
> Ativan 4 MG Day
> Celexa 40 MG Day (I have still been having depressed swings even when manic, which really sucks)
> Abilify 20MB Day
> Lithium Card 1,200 MG Day
>
> It seemed to help a little.
>
> I don't sleep much, 11PM-3AM, but I do get a lot of fish in my diet (I love Sushi) so I am reluctant to try fish oil.Typo'd Ativan
Posted by desolationrower on May 2, 2011, at 14:12:48
In reply to Re: Nothing Works » cyban, posted by Phillipa on May 1, 2011, at 21:29:01
heh, good catch
-d/r
Posted by Phillipa on May 2, 2011, at 20:26:39
In reply to Re: Nothing Works, posted by cyban on May 2, 2011, at 7:42:11
Cyban that is a relief for sure!!!! Phillipa
Posted by Phillipa on May 2, 2011, at 21:55:06
In reply to Re: Nothing Works, posted by desolationrower on May 2, 2011, at 14:12:48
d/r thanks. Phillipa
Posted by cyban on May 18, 2011, at 20:43:19
In reply to Re: Nothing Works » desolationrower, posted by Phillipa on May 2, 2011, at 21:55:06
... I dont understand...
I went to another pdoc and they said that my primary pdoc was doing good and they wouldnt change anything...
I have gone from manic to f*ck*ng depressed in half an hour, so there telling me this is as good as it gets... I dont know if I can do this for much longer, I hear and see things when im manic, and have suicidal impulses when Im depressed. I have such a strong urge to crash into an oncommin car just to feel better its stupid. This ISNT normal, can no one do any f*ck*ng thing about it, are all doctors incompetent, or are there just no medications other than death for this debilitating mental condition?
Posted by jono_in_adelaide on May 28, 2011, at 19:48:48
In reply to Nothing Works, posted by cyban on April 22, 2011, at 21:10:34
You are on enough meds to calm a horse.... you might be able to tinker at the edges, swap trileptal got valporate or abifily for haloperidol, but realy, or add welbutrin, but it realy looks as though they are doing everything they can
Three mood stabalisers
Two tranquilisers, one major, one minor, sleeping pills
The only thing i could suggest was adding welbutrin to your SSRI to try and get a better antidepressant response, and maybe having a sedating antipsyhotic (chlorpromazine for examply) to take when you feel particularly hyper
Posted by cyban on May 29, 2011, at 14:23:38
In reply to Re: Nothing Works » cyban, posted by Phillipa on April 23, 2011, at 0:09:46
Just an update, I detoxed from all meds, changed PDocs, and went on to Seroquel 400 mg day, will be adding Wellbutrin in 2 weeks. So far so good, it seems to be helping and I am sleeping better, and not passing out at random.
Posted by jono_in_adelaide on May 29, 2011, at 17:22:41
In reply to Re: Nothing Works, posted by cyban on May 29, 2011, at 14:23:38
Good work!
I guess we sometimes think that we (and our doctors) forget that we might need less pills rather than more) as the answer to every issue.
Congratulations!
Posted by Phillipa on May 29, 2011, at 21:17:02
In reply to Re: Nothing Works, posted by cyban on May 29, 2011, at 14:23:38
Cyban you accomplished all this in a month just reviewed the meds you were one in first post. How did you do this in a month? Diagnosis the same? I'm amazed. Phillipa
Posted by cyban on May 30, 2011, at 0:24:20
In reply to Re: Nothing Works » cyban, posted by Phillipa on May 29, 2011, at 21:17:02
> Cyban you accomplished all this in a month just reviewed the meds you were one in first post. How did you do this in a month? Diagnosis the same? I'm amazed. Phillipa
My diagnosis has not changed, I am ADHD and Bi-Polar.
I did something my pdocs werent to happy about.
I was having bouts of severe insomnia and mania where I would be up for 48 hours or more, and since every medication I was on I was abruptly taken off at one point... So I stopped all meds, stayed up for 72 hours in case something happened, and was with friends who were awake at all times to try and be safe.
After day 3 I was pretty much detoxed. I changed pdocs the 4th day after some sleep and requested the Seroquel, he agreed but wasnt happy about me going off my meds. He is also putting me on Wellbutrin in 2 weeks after we know how the Seroquel works for me.
So far so good, feeling better, and my mania has decreased along with my stress.
Posted by Phillipa on May 30, 2011, at 0:36:01
In reply to Re: Nothing Works, posted by cyban on May 30, 2011, at 0:24:20
How long? All are fully out of your system? Reminds me of when I was 27 had my third and wanted off all valium, playcidyl and alchohol as the baby we up 24 hours a day gee at the time they didn't know the dangers with babies. I stopped all meds was told I'd have seizures as she was in hospital at two months for hyperness. I felt like I was walking on a rocking ship and lay on the couch for two weeks. Then resumed only 5mg of valium and was fine. Oh what wasn't known. And seriously glad you are okay and have good friends. Think now maybe not bipolar and was the meds or is this a sort of remission? Phillipa
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