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RE: Problems with new Bi-polar meds.... - 3/28/2007 7:45:00 AM   
KatyLied


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Okay, good.  I was only asking because a lot of people go to their family physicians for mood disorder treatment and I think that is not the best idea or the proper professional.  Also don't get hung up on a medication's main use.  Some of these medications are good for various disorders.  It's more important to find something that works, than to worry about what it's main use if for.  I hope this all works out for you. 

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RE: Problems with new Bi-polar meds.... - 3/28/2007 7:53:15 AM   
zindyslave


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I don't think a family physican can properly treat mental problems, well the medicine I am on can cause seziures that is why I am worried about it, I don't like the idea of taking a medicine that can cause problems that I don't even have right now but I do know that some doctors beleive that the mood swings that bi-polar people have are some sort of seziure so maybe that is why they use anti seziure meds for it. I hope it works out for me too just a little worried I guess.

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RE: Problems with new Bi-polar meds.... - 3/28/2007 10:35:47 AM   
zindyslave


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Well, just to update everyone I didn't take the antidepressant today and I feel alot better so far no mood swings so maybe that was it but I have never had that reaction to an anti depressant so maybe it was just which kind it was.. Thanks for all the advice it was helpful and it helped me through yesterday and I do feel better knowing that I can ask questions about this disorder and have people respond. Thank you all.

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RE: Problems with new Bi-polar meds.... - 3/28/2007 2:16:57 PM   
hereyesruponyou


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Glad you are feeling better. Keep us up to date on how it goes and never be afraid to ask for support!

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RE: Problems with new Bi-polar meds.... - 3/28/2007 5:13:20 PM   
zindyslave


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I will keep you posted on how it is going for me. Thanks for all the help. It really helped me through that unknowing period of time.

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RE: Problems with new Bi-polar meds.... - 3/28/2007 6:11:46 PM   
shaggy82


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yeah lamictal is a real pain in the ass when it comes to trying to treat bi-polar, it took almost 3 weeks for me to notice a major difference. My doctor had a choice between this and lithium but since lithium has such a fine line between a therapeutic dose and a toxic dose he didn't want to risk it. Both have thier side effects, but lamictal was the better choice for me since i had sone so much work to lose weight and weight gain is a side effect of lithium. And  the only thing that i have to do is get my liver functions tested on a yearly basis, no other tests or concerns. Unfortuantley lamictal you start out at a very lose dose and work you way up. I've been on lamictal for almsot 2 years and very rarely do i have any problem, and when i was on anti-depressants it would actually intensify my mood swings, it was so bad that i started to have anxiety attacks. I hope things improve for you.

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RE: Problems with new Bi-polar meds.... - 3/28/2007 6:23:29 PM   
zindyslave


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Well so far I haven't had any mood swings so I am guessing it was the anti-depressant or the combo of the two, I have a question tho I have an iron overload disease that affects my liver will that be a problem with Lamictal? I really hope not or I will have to change meds...again!

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RE: Problems with new Bi-polar meds.... - 3/28/2007 8:06:54 PM   
shaggy82


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Um i'm not sure, if i remember correctly it is becasue lamictal is metabolized in the liver that is why they check your liver functions, but if you give me a day or two i can check in the compendum book at work and give you all the information regarding lamictal. We carry the human drug compendum book at work and i have looked at it before regardign lamictal i just can't remember everything

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RE: Problems with new Bi-polar meds.... - 3/28/2007 8:12:32 PM   
zindyslave


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oh okay thanks I could really use that info. I don't want to make my other condition worse.

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RE: Problems with new Bi-polar meds.... - 3/31/2007 5:44:15 PM   
shaggy82


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Hi, sorry it took so long to get back to you, but i did find the information for you. The most common side efects of Lamictal are skin rashes, dizzinezz, blurred vision. What I could find regarding the liver is
Impaired Liver Faliure : Results from a single dose study indicate that the apparent clearance if lamotrigine decreased in subjects with Grades, A, B, or C hepatic impairment. A reduced dosage should be used  for those patients, and in caution in patients with severe hepatic impairment.
if you are on hepatic enyzme producing drugs such as carbomazepine, phenytoin, phenobarbital or primidone they reduce the elimination half-life by 50% and double the plasma clearance. (you'll have to ask the Dr to explain that)
I hope that helps, it does say that it is safe to use in patients with liver problems but usually at just a lower dose.

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RE: Problems with new Bi-polar meds.... - 3/31/2007 7:15:15 PM   
zindyslave


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Ok well I don't have liver problems I just have iron overload which damages the liver before anything else so later in life I will have to watch it if this medicine works which I had an outburst tonight so I don't think it is too much. But maybe it will if I just wait and see. Thanks for the info tho.

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RE: Problems with new Bi-polar meds.... - 4/5/2007 7:04:12 AM   
Celeste43


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Lamictal has to be started at a very low dose and very slowly worked up to an effective dosage. Your mood swings are a result of not having enough Lamictal. Effectively your body thinks there is no medication and the swings are not from the meds, but from not having enough. I imagine your loss is pushing the emotional swings as well.

Unfortunately there is nothing to be done other than slowly raise the dosage. And if you get any kind of a rash, call the doctor immediately.

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RE: Problems with new Bi-polar meds.... - 4/5/2007 12:25:23 PM   
masterslaveseekn


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Well, the things is the mood swings were not as frequent or as severe when I wasn't on meds but they have lessened a bit since I quit taking the Celexa and I have already upped the dosage of Lamictal as my doctor told me too but the mood swings are still there but it takes time to work so I am just waiting. I have noticed my memory is better so that is a plus.


oops on my Masters profile.

< Message edited by masterslaveseekn -- 4/5/2007 12:26:55 PM >

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RE: Problems with new Bi-polar meds.... - 4/5/2007 1:19:57 PM   
Celeste43


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Sometimes it helps to add an atypical antipsychotic to the Lamictal but the doctor won't do that until you've reached an appropriate level of the Lamictal.

It took my oldest six months to get a working med combo at the dosages she's on now. But the difference is night and day, well worth the wait.

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RE: Problems with new Bi-polar meds.... - 4/5/2007 3:19:28 PM   
zindyslave


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Well, from what I understand aren't anti psychotics for like hallucinations? I have never really been on any except when I was around 13 before they diagnosed me with bi-polar and they couldn't figure out why I got angry or anything. Well, I guess it would be helpfull to know what other uses they have for anti psychotics just to keep those in mind if you know could you please let me know. Thanks.

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RE: Problems with new Bi-polar meds.... - 4/5/2007 5:46:42 PM   
Celeste43


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Typical antipsychotics yes. The new generation are referred to as atypical, they are commonly used with another med to treat bipolars. They are also superb for treating anxiety since they don't cause euphoria (hypomania like highs) the way such things as Valium do.

Many medications work on more than one problem. Aspirin for example is a nonsteroidal anti-inflamatory, a pain killer, and also has a blood thinning effect so that it is prescribed for heart patients. I'm not aware of the numbers but my guess would be that the atypials such as Risperdal, Zyprexa and Seroquel probably are prescribed more for nonpsychotics than for psychotics. Risperdal causes weight gain as does Zyprexa but not to the same amount. Seroquel seems to cause the least weight gain which is why my adolescent is on that. She started on the Risperdal but no adolescent female wants severe weight gain so she was switched.

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RE: Problems with new Bi-polar meds.... - 4/5/2007 10:42:29 PM   
zindyslave


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Well, I was on Risperdal before and it didn't help. I also was on a few others but I was never put on Zyprexa or Seroquel I have known a few people on Seroquel and well I don't think I would want to take something like that from what I have seen it makes people really sleepy to the point if they don't go to sleep they will passout and you can't wake them up for a few hours. I do know that anti depressants used to help me enough to keep me from being depressed and most of the time stopped my mood swings but sometimes it just sent me to mania and that is why they put me on mood stabilizers then I chose to go off the meds and now I am starting from step one all over again since my bi-polar is mostly characterized by depression they want to put me on an anti depressant so why celexa did this to me I don't know, but as I have mentioned before when I was first put on lithium it did the same thing with my moods because the level wasn't high enough to be theraputic, even tho the anti depressant I was on I had been on for a few months if not longer so I am wondering if it is just the mix of the meds at first or what. But thanks for the info on the anti psychotics gives me something to ask about if these meds don't straighten up soon.

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RE: Problems with new Bi-polar meds.... - 4/5/2007 11:56:02 PM   
Aswad


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Antipsychotics should be a last-line resort, even the atypical ones. The health issues with long-term use are insane, and a professor of psychiatry that I used to see commented that he's taken more schizophrenic patients off them than he's put on them, and those are after all the main patient group for these meds. But, hey, I'm biased after seeing these drugs ruin too many lives.

Diazepam, alprazolam, clonazepam and barbiturates can be used to control some types of mania for a while, and dependence isn't really an issue if you don't have drug abuse problems, provided the pdoc knows what he is doing. The risks are lower, and the side-effects far less unpleasant, than the antipsychotics.

As for SSRIs, they are generally not the best choice for people with bipolar spectrum disorders, as they have a tendency to induce mania and lower the seizure threshold. There's tons of stuff out there that doesn't have quite the same issues with mania and seizure thresholds.

The MAOIs, particularly phenelzine (Nardil), are fairly nice in this regard, having the lowest incidence of mania of any commonly used antidepressants, though phenelzine can cause weight gain. Isocarboxazid (Marplan) or moclobemide (Aurorix) might be a better choice in that regard. Tranylcypromine (Parnate) can probably be too activating. L-deprenyl (Emsam; Eldepryl; Selegilin) might be worth trying at subclinical doses (5mg/day) or as a patch (sustained delivery reduced the likelyhood of mania, and users report less stimulating effects). All of these, except moclobemide, come with dietary restrictions, though.

Lamictal is really tricky. When it works, it often works very well. But it's pretty much touch-and-go with regards to the dosage, which is usually started low and titrated slowly. The manufacturer has tried pretty hard to pin down some guidelines for how long it takes to stabilize, but failed to do so.

If you need to stabilize this more quickly, you might want to talk to your pdoc about valproic acid (Depakene; Depakote; etc.) instead, or consider a short time as a voluntary inpatient, or both.

Also, I've heard good things about the Amen Clinics with regards to treating bipolar. They do a SPECT scan of your brain, and use this in determining the kind of med(s) that will do the trick for you.

Hope things work out for you.

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RE: Problems with new Bi-polar meds.... - 4/6/2007 12:08:49 PM   
zindyslave


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Well about the addictive meds many people with bi-polar have addictive personalities so I don't think that would be a good choice for me as my family both sides are addicted to something and I don't want to go down that path. I used to take Prozac but it made me have no feelings so I know an SSRI will help MAOI's are not able to be taken with many other meds and as I have  some problems that require meds that don't work well with MAOI's I have to pass on that. I know Lamictal is tricky with the dose but I know what adverse effects I have to watch out for. Depakote causes weight gain this I do know because my husband was put on 5 a day and gained 30 pounds in two months I don't normally condone people not taking their meds but he needs to lose the weight and being on depakote will not help that and I am losing weight so far so I am not going to take anything that will make me gain weight I can't afford that because of my risk for diabetes. The reason I posted this to begin with is because I am not wanting to be in an inpatient hospital I have been there once and I had no contact with my family until I was released and that is not something that appeals to me even tho I know where I could go it is got real bad which while I was on the Celexa it did get bad but now that I have quit taking it I don't feel like I am going crazy but I am having mood swings much like I did when I was younger more frequent and I haven't done that even without meds for a few years but I notice these and that is a plus. But I have to go back to the doc on the 16th so we will see what he thinks.  I have never heard about anything they could do to help with bi-polar as you mentioned. But if that was available to me I beleive the doctor would have mentioned it or he might do so if he can't find meds that work for me. I am going to suggest Lithium since I know it works for me on the right dosage and doesn't cause me to gain weight.

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RE: Problems with new Bi-polar meds.... - 4/6/2007 7:10:58 PM   
Celeste43


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She doesn't have the sleep problems that Seroquel can cause, she's been on this combo for five years now and it's amazing. Beforehand she was told that Special Olympics would be too tough for her, now she competes with normal kids and some adults in national competitions.

About the addictive personalities, that's a chicken and egg question. Some of these people with mood disorders are self medicating with alcohol and illegal drugs, if that's the case then a med with low side effects that was more efficient in treating the problem would cause less addictions. The problem here is the trial and error period when they try different meds and combinations of, if someone's used to calming his swings with marijuana, he isn't going to be amenable to having major swings for six months while they try to find a workable solution.

And that's one reason why those of us parents who have kids with problems are so insistent on early treatment, because they get used to taking the correct meds in the right doses and don't experiment with street drugs.

Zindy, I don't know why they found anger with bipolar puzzling, it may not be usual with adult onset but it's one of the ways they normally identify it in pediatric and adolescent populations.

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