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RE: Problems with new Bi-polar meds.... - 4/6/2007 7:26:17 PM

untndedrosegardn

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Zindy.....
I came in on this late so I'll ask a few questions. Did they do the balance switch? Meaning did they add in the Lamictal gradually while lowering another medication? If so, by chance was it Valoporic acid(Depakote). If sio that explains a great deal. The two dont work well together and neither is a fast start/stop medication. Also Lamictal doesnt play nice with many AD's.... it more often works well with more axxiety geared drugs. Might sound odd but sometimes BP is a little like ADD/ADHD in the way it accepts meds. Sometimes what seems to work is the oposite of what you think it would be.

Patience is the key. And being in tune with your own body. My Dr suggested a journal during medication changes to monitor mood changes. It was a blessing. I hope all smooths out for you.

(in reply to zindyslave)

RE: Problems with new Bi-polar meds.... - 4/6/2007 8:44:14 PM

Aswad

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quote:

ORIGINAL: zindyslave

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.

Drug dependency can be a real problem for some people, but a good pdoc can deal with the risks involved. And in most cases where the doctors prescribe drugs that have the potential for that, the benefits far outweigh the risks.

Being aware of the risk helps, and your Dom should be able to control this if he/she is willing. I can understand your reluctance to consider such options, though.

quote:

I used to take Prozac but it made me have no feelings so I know an SSRI will help

I'm guessing you meant "will not help", since emotional flattening is generally undesireble for most of us. This has been my experience with serotonergic drugs too, along with "brain fog" and memory issues.

quote:

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.

Ah, yes. The MAOIs do have a lot of potential interactions.

Some of them aren't really a problem, as long as the doc knows how to deal with them, while others are absolute contraindications. You might want to consider moclobemide or l-deprenyl/selegiline, though, as these are fairly selective, and thus have fewer interactions.

Of course, your pdoc will know whether this is an option for you. I can certainly understand passing on them.

quote:

I know Lamictal is tricky with the dose but I know what adverse effects I have to watch out for.

Mostly, I was trying to explain the mood swings you are experiencing, as it will take a lot of time for the Lamictal to work the way it is supposed to because of this issue.

quote:

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.

I agree. Most people I know that have taken SSRIs have gained a lot of weight. There are some medications that are weight-negative or weight-neutral, though.

You might want to consider tianeptine (Stablon). It has a significantly lower chance of causing mania or hypomania than the SSRIs, and far fewer side effects. Amineptine (Survector) may also be an option, although that reintroduces the potential for abuse. If you are living with your dom, however, it should be trivial for him/her to manage that risk.

quote:

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 ...

Yeah, I can relate to that. Like you said, it's something to be considered if it gets really bad.

quote:

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.

If you're talking about the SPECT, that's a fairly controversial topic. Most pdocs don't feel that there is sufficient evidence that it is viable for clinical use, and the cost is fairly high as I recall. I'm just going by feedback from other bipolars with regards to Amen Clinics, although I do suspect that SPECT analysis can be helpful in some cases.

quote:

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.

If it works for you, then that's great.

Best wishes,
Aswad.

(in reply to zindyslave)

RE: Problems with new Bi-polar meds.... - 4/6/2007 8:54:22 PM

Aswad

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quote:

ORIGINAL: untndedrosegardn

Might sound odd but sometimes BP is a little like ADD/ADHD in the way it accepts meds. Sometimes what seems to work is the oposite of what you think it would be.

Definitely. People with bipolar spectrum disorders generally have less dense prefrontal cortices than neurotypical ("normal") people, which leads to certain similarities with ADD.

This is why some doctors have advocated using drugs with a more dopaminergic and/or noradrenergic profile. For instance, cabergoline, amineptine, d-amphetamine, ritalin or reboxetine.

In people with BPD, these drugs often end up having a calming, rather than stimulating, effect, just like with people in the ADD-spectrum. Similarly, certain drugs that would normally be calming can have the reverse effect.

That said, atypical reactions to drugs isn't exactly uncommon. I've seen a guy get so violent from antipsychotics that he had to throw everyone out and lock the door to avoid posing a risk to them, and then proceded to bang his fist into the wall for a few hours. Fortunately, after only four more antipsychotics causing the same effect, the docs realized that it wouldn't be responsible to keep trying them on him in an outpatient setting. Unfortunately, they switched setting, rather than drug class, so now he's banging the walls in the hospital until after easter when I can get someone to switch his meds.

(in reply to untndedrosegardn)

RE: Problems with new Bi-polar meds.... - 4/6/2007 8:57:28 PM

SirDiscipliner69

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I had the unfortunate experience of a couple of exsubbies being bipolar....

The results were sad yet they still denied there was anything to be concerned about.

Ross
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(in reply to zindyslave)

RE: Problems with new Bi-polar meds.... - 4/6/2007 9:10:24 PM

Aswad

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quote:

ORIGINAL: Celeste43

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.

The use of antipsychotics in children is rather controversial in some circles. It has this unfortunate tendency to increase suicidality and decrease life expectancy when used in the long term. And the extrapyramidal side effects can be permanent, which can be a real hassle later on.

If it works, however, that's great.

quote:

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.

This kind of shows in the statistics for ADHD, for instance. People have cited the higher likelyhood of substance abuse with stimulant treatment (about 30-35% prevalence), but what they often forget is that without such treatment, the prevalence becomes about 75% or so, meaning that stimulant treatment isn't ideal, but it's a lot better than the baseline.

quote:

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.

Early treatment, if done with an eye to how happy the child is with the meds, as opposed to exclusively considering how happy the parents and teachers are with them, is almost universally positive.

My gripe has been with cases where the docs essentially medicate the child to treat the parent. Having a child with special needs, whether physical or mental, can take a great toll on parents and teachers sometimes. And the child may need medicine to function. But many docs mix up these issues, often due to parent pressure, meaning that they end up treating the parent by proxy so the child gets suboptimal care in order to effectively "treat" the parents' stress.

Note that I'm in no way suggesting this is the case with you and your daughter.

quote:

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.

Many docs have pretty narrow ideas about how an illness should present itself, and end up puzzled or, worse, overlooking the real problem because its symptoms aren't quite what they expect.

There's a saying in Norwegian that is similar to the "even the devil may quote scripture" saying in English, which more or less directly translates as "reading (it) as the devil reads the scriptures". It kind of applies to how some doctors read the diagnostic criterion for mental illness.

I'm not criticizing the doctors in general here, I know some highly skilled ones. Just pointing out that there are bad apples there like everywhere else, and that those bad apples can affect a lot of people.

(in reply to Celeste43)

RE: Problems with new Bi-polar meds.... - 4/6/2007 9:15:54 PM

Aswad

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quote:

ORIGINAL: SirDiscipliner69

I had the unfortunate experience of a couple of exsubbies being bipolar....

The results were sad yet they still denied there was anything to be concerned about.

Denial is a common response in a society that stigmatizes mental disorders. And during the manic phase of bipolar, it can be hard to accept that one needs to come back down to earth, even if the mania is destructive to interpersonal relationships.

Properly treated, bipolar doesn't have to be anything to be concerned about, and a Dom can provide a bit of a safety net that is hard for others to provide, especially since the sub will generally put a lot of trust in the Dom. But everyone has their own limits with regards to what problems they can live with in their partners, and a Dom is not a therapist.

The OP seems to be doing fairly well so far, however, and I hope things work out even better for her soon.

(in reply to SirDiscipliner69)

RE: Problems with new Bi-polar meds.... - 4/6/2007 10:16:33 PM

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Celeste43 they found the anger puzzling when I was 13 because they hadn't as of then to diagnose me with bi-polar they were just treating me for clinical depression that was the reason I went there then I found out an ancestor had what at the time they called manic depression and then they put two and two together and realized that is what I had. I am glad to hear that Seroquel doesn't cause the sleepiness in everyone. Thank you for the advise. They still won't give me any medicine for my nerve problems because most people with bi-polar will get majorly addicted to them because of the mania they feel when on them.But that is how they treat me anyway.

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RE: Problems with new Bi-polar meds.... - 4/6/2007 10:20:45 PM

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untndedrosegardn They started me out on Celexa and Lamictal together at the same time. My husband (Master) is the one they had on Depakote. I am replying individually to these replies so I can answer all the questions the thing with the anxiety meds are in the previous post. I have tried keeping track of my mood swings but lately since I have stopped the Celexa they aren't as strong as before and hard to notice really. But I go back to the doctor on the 16th and I hope he can fix all of this mess.

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RE: Problems with new Bi-polar meds.... - 4/6/2007 10:27:39 PM

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Aswad what I meant with the ssri's is that they do work I just need to find one that will work without making me feel like a zombie so to speak. The thing about the SPECT is that even if my doctor thought it would be useful my insurace most likely wouldn't pay for it because I am on TennCare which is my states medicaid health insurance and they don't like to pay for anything that is too expensive most meds you get for bi-polar have to be preapproved. But my doc doesn't want to put me on Lithium because of the varied side effects even tho he himself pointed out to me that it worked before. My Master is also bi-polar so we are helping each other through this he was just diagnosed like 2 months ago as where I have been diagnosed since I was 15 or so, the biggest mistake I made was going off my meds 2 years ago but I couldn't get to the doctor and really had no choice.

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RE: Problems with new Bi-polar meds.... - 4/6/2007 10:45:49 PM

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I am sorry to hear that about some of your exsubbies SirDisipliner69 it is unfortunate for people to deny what problems they have some of my family still deny that anything is wrong with me basically my brother, which I don't claim much anymore for other reasons, he believes I am just looking for a pill to fix everything he even beleives my mom is on xanax because she wants to get high not because she needs it to help her eat and to keep her stress levels down. Some people can be quiet stupid about such things. My dad before he noticed a difference seemed the same way about my condition until he noticed a difference in my attitude as they found medicine that kept me from being depressed and manic. So, sometimes things will open other peoples eyes and sometimes things won't. But as far as the ADHD meds helping people with bi-polar I can't speak for everyone but for me they made me very angry and easily annoyed when I was coming down from them so they didn't work well for me which the doctor said they probably wouldn't help because ADHD symptoms end up being signs of Bi-polar which is why a lot of children used to be diagnosed with ADHD and they end up being Bi-polar, my husband was diagnosed with ADHD when he was younger later in life a few months ago he finds out his Aunt has bi-polar goes to the doc tells him about his aunt and about his problems and they right off the bat say it sounds like Bi-polar to them, my cousin was diagnosed with ADHD as a child he was mean as you know what on Ritalin and during the summer when they would take him off of it because he wasn't in school he was as nice as could be which he hasn't been diagnosed as bi-polar but I see alot of the symptoms I used to have in him, he is going to the doctor for it. What bothers me alot with the diagnoses of bi-polar is that they usually wait for you to tell them a family member has it before they even look at that as an example. They are now doing studies on children that show signs of ADHD and are actually finding differences between ones with ADHD and ones with Bi-polar strange differences but differences all the same. But I really wonder how many people out there suffer from Bi-polar and go undiagnosed because no one in there family had ever been diagnosed or because no one in their family would seek treatment because of the stigma placed upon mental illness. But hopefully with all the studies being conducted they will eventually come up with some sort of test to see if you have the gene for bi-polar and couple that with your symptoms to diagnose you with it. We can always hope that will be soon.

edited to add...sorry for all the replys but it is hard to keep all those questions and thought is my head to consolidate it into one long post.

< Message edited by zindyslave -- 4/6/2007 10:50:03 PM >

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RE: Problems with new Bi-polar meds.... - 4/6/2007 11:56:24 PM

Aswad

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quote:

ORIGINAL: zindyslave

Aswad what I meant with the ssri's is that they do work I just need to find one that will work without making me feel like a zombie so to speak.

Okay, I misread you then. Although, in all fairness, the SSRIs are generally quite equivalent in how they work.

Presumably, the reason why Celexa didn't have the same effect on you, is that it has a ceiling beyond which no further effect occurs, something that e.g. Prozac doesn't.

Celexa will max out at about 70% reuptake inhibition, which is below what some theories predict as the minimum effective reuptake inhibition (80%). It is fairly unique in this regard, AFAIK.

quote:

The thing about the SPECT is that even if my doctor thought it would be useful my insurace most likely wouldn't pay for it because I am on TennCare which is my states medicaid health insurance and they don't like to pay for anything that is too expensive most meds you get for bi-polar have to be preapproved.

Seems familiar, although we have public medical care here in Norway, which essentially translates into a single, state-run insurance policy for all citizens. We can usually get the various experimental bits approved, but it takes paperwork.

A single SPECT workup might not be too expensive to pay out of pocket, depending on your income, but as previously noted, you'd have to talk to your pdoc to see if he thinks it'll be money well spent.

quote:

But my doc doesn't want to put me on Lithium because of the varied side effects even tho he himself pointed out to me that it worked before.

Yeah, lithium does have a wide range of side effects. But only you can decide whether your are better or worse off with settling for a known quantity or trying for something that might be better.

quote:

My Master is also bi-polar so we are helping each other through this he was just diagnosed like 2 months ago as where I have been diagnosed since I was 15 or so, the biggest mistake I made was going off my meds 2 years ago but I couldn't get to the doctor and really had no choice.

I can relate. I've had to drop meds because of switching doctors in the past. Going to one prof, I got some treatment that is technically speaking experimental, although quite well known. When I had to switch to another prof, he disagreed with the need to use such an experimental treatment, and refused to prescribe even enough for tapering off, although he never did come up with something that worked in the year I spent there.

That was one rather uncomfortable week; I don't think I've ever been in that much sustained physical pain, although as far as peak pain is concerned, having an adult male sitting on the knee of an infected leg by accident was slightly worse for the brief instant I felt it, a hypertensive crisis is about equivalent, and simply accidentally resting your forearm on an incandescant lightbulb is comparatively pleasant. I wonder where one gets the idea that this constitutes responsible treatment...

Later, the original prof instructed my primary physician to start prescribing something that I had used earlier, but which didn't require any more supervision than I can provide myself. That's been a lifesaver, and I'm happy to say it's working.

(in reply to zindyslave)

RE: Problems with new Bi-polar meds.... - 4/9/2007 9:38:17 AM

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Aswad, my experience with bi-polar children, my own and those of the other parents of bi-polars I am in a support group with is that the symptoms are always damaging to themselves and others. Meaning that they will go into fits of rage and attack siblings, playmates, classmates and parents. If you think a child acting like this has friends and a normal social life, and is happy, then that escapes me. There is no way to manage the rage without medications.

About doctors, I wasn't referring to good or bad but to the necessity of finding a specialist in pediatric or adolescent psychiatry or neurology. And adolescent psychiatrists number less than 3,000 in the U.S., all of whom have waiting lists.

It took a regular psychiatrist six weeks observation in an outpatient adolescent psych unit to diagnose her, even then it was through the literature as she'd never seen this variant before. At the time, a year before Lamictal came on the market I was told she would not survive ten years, that no one with this variant had ever graduated high school, lived past age twenty, and that there was no treatment so I should detach and accept it. Six years later, she's the first I know of to finish an intensely academic high school, and has been accepted into a prestigious university as well as competing nationally. She may die earlier than a normal child, but without the medications she would most likely not be alive today. I'll take that risk because the risk of damage down the line is worth trading for the certainty of death today.

I have a friend who's child was treated for nonHodgkin's lymphoma as a toddler. She was told the treatment would cause heart problems in 20 years. But she still had her son treated because this way he will make it to 25 and before he wouldn't. Every year is a gift, every achievement a miracle.

(in reply to Aswad)

RE: Problems with new Bi-polar meds.... - 4/9/2007 1:20:17 PM

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I have to say I am proud of your daughter I might not know her but as bi-polar myself I couldn't stay in school because of all the people making fun of me which is why I ended up in the psych hospital wasn't a pretty day that day to say the least. But to graduate when you are bi-polar and having all the problems bi-polar has is an achievement.
Aswad: I know how well litium works for me and I don't beleive it could get any better I was normal with normal moods and as it stands right now I am not.

If anyone can answer this please do but lately I have been having a lot of nose bleeds and I was wondering if Lamictal can make that happen or not I usually don't have nose bleeds not like this anyway. It kinda has me worried. Thanks for all the support and info I am getting it is really helping.

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RE: Problems with new Bi-polar meds.... - 4/10/2007 11:48:18 AM

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She doesn't get nose bleeds, but yes, the lit says it's a possible less severe side effect. Of course at this time of year it could also be allergies, if you suffer from them.

http://www.healthtouch.com/bin/EContent_HT/dnoteShowLfts.asp?fname=00549&title=LAMOTRIGINE+(Oral)+(Tablet%2C+Tablet%2C+Chewable)+&cid=HTDRUG

(in reply to zindyslave)

RE: Problems with new Bi-polar meds.... - 4/10/2007 3:45:38 PM

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I have never had a nose bleed allergies or not but it isn't severe either, really just bothers me when I am blowing my nose or when I wake up in the morning it seems to be calming down a bit but I will bring it up with my Doc Monday.

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(in reply to Celeste43)

RE: Problems with new Bi-polar meds.... - 4/11/2007 4:40:17 AM

Aswad

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quote:

ORIGINAL: Celeste43

Aswad, my experience with bi-polar children, my own and those of the other parents of bi-polars I am in a support group with is that the symptoms are always damaging to themselves and others. Meaning that they will go into fits of rage and attack siblings, playmates, classmates and parents. If you think a child acting like this has friends and a normal social life, and is happy, then that escapes me. There is no way to manage the rage without medications.

I did not say that a child acting like this is necessarily happy, nor that it would be wrong to use medications to manage rage that cannot be controlled otherwise when it is harmful. I've seen kids that needed meds, and kids that were better off without.

quote:

She may die earlier than a normal child, but without the medications she would most likely not be alive today. I'll take that risk because the risk of damage down the line is worth trading for the certainty of death today.

I'm not arguing against this. And my congratulations on her doing so well. At some point it might be useful to see if an alternative to the antipsychotics can be found, however. Just as once she would not have a chance at life, then got one, there are now chances at an even better and longer life. Not saying the status quo is wrong, just that there may be even better options available to you now than when you started out.

I can certainly relate to trading away a future year to gain a tomorrow. From experience.

(in reply to Celeste43)

RE: Problems with new Bi-polar meds.... - 4/11/2007 4:48:23 AM

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I am bipolar as well, and I have had enough issues with the meds they rotated me through that for the past 2 years I have been off them completely. I have managed to control the major swings on my own, but it has beena lot of long hours and very little support. Doctors tend to want you on meds and my parents and friends dont understand what I go through so for them, I "seemed happier" on the meds. It baffles them why I wouldnt want to go through the minor side effects to relieve the problems.
What concerns me is not the children who truly need the meds, but the ones who believe that their condition is an excuse to act however they want and balme it on their condition. Growing up, I have not only seen it, but it was how my behavior was often written off. When I was in a really bad or depressed mood, it was the bipolar disorder. If I was being overly antagonistic to people, it was the bipolar. I never got in trouble, so I could have pretty much done anything I wanted to and everyone around me would give me the "Poor baby, she has bipolar disorder" pat on the head and that would be that. Behavior like that is what gives us the stigmas... those who truly have problems are eclipsed by those who make their own. Its sad, but it happens.

DV

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(in reply to Aswad)

RE: Problems with new Bi-polar meds.... - 4/11/2007 4:52:48 AM

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I'm not sure what you're saying DV. You appear to be saying that if she's suicidal it's her own fault, and not the disease. If she wasn't ill, she wouldn't feel this way. And I'm not into blaming the victim.

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RE: Problems with new Bi-polar meds.... - 4/11/2007 11:51:13 AM

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From what I understood DV was saying that the stigmas us with bi-polar seemed to have are from those people that make bi-polar people seem like they like to cause trouble and blame it on Bi-polar when in fact they are choosing to make trouble and blame it on a disease. But the thing with bi-polar is that there is an impulse control issue that causes people esspecially kids with bi-polar to do things that end up getting them in trouble because they don't have that check and balance system most people do, they act then think. I haven't noticed this in myself but others have and I have noticed it is my husband it doesn't mean that people with bi-polar intentionally cause problems it is that they don't have the check and balances to know how to act reasonable hence the reason so many people with bi-polar end up addicted to drugs or in jail they don't think before they act. It is a common problem. That is the main difference between kids with ADHD and kids with Bi-polar, kids with ADHD don't have impulse control issues kids with bi-polar do.

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RE: Problems with new Bi-polar meds.... - 4/11/2007 11:53:28 AM

Aswad

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quote:

ORIGINAL: Celeste43

I'm not sure what you're saying DV. You appear to be saying that if she's suicidal it's her own fault, and not the disease. If she wasn't ill, she wouldn't feel this way. And I'm not into blaming the victim.

She's probably not thinking about suicidality, as that is usually a sign that they are suffering, but rather that some kids end up learning that anything bad they do will be ascribed to their condition, even if it isn't due to their condition, and learn that they can get away with anything this way, and subsequently do so.

It isn't that their condition cannot cause lots of bad things.

Rather, it is that even sick kids can do bad things intentionally, just like the healthy ones can. And that in some cases, they get off because they are sick, even in those cases when the bad thing is being done for another reason than their illness.

Of course, distinguishing what is the kid, and what is their illness, may be a daunting challenge.

(in reply to Celeste43)

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