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I have been beaten on with all the ad's and they all just make my already horrid anxiety just go through the roof. Wellbutrin, cymbalta, paxil, effexor, then tried lithium and it calmed me down but left me depressed, sick and unmotivated. I get bad nausea from the meds and am losing serious weight which I know to alot of you pisses you off to no end. It looks like more and more that I am bp2 and wonder what is the best med for that? I saw some posts here for low dose depakote did wonders for anxiety. I tried lamictal but at 50 mg I couldnt eat and my stomach was in big pain and same for trileptal at 100 mg. I have med tolerance problems bigtime, only one I handled was wellbutrin but was sick depressed and agitated and the lithium as I stated before. I can handle weight gain or hair falling out, just more worried with nausea and sickness type stuff, so any ideas out there please share. I also want to know about the sexual issue with depakote or other bp2 type meds because lamictal and lithium made me hornier as hell and finished strong but prozac was hornier even though no ability to cum which sucked. The anxiety last night got me dangerous again so am using ativan temporarily which is very worrisome because of my past with them with this first started. So any ideas, please share...

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Must agree with K that there is no perfect med, and also with the question about whether you were actually taking tegretol and not trileptal - the lowest trileptal dose (in my experience at least) is actually 150mg (which is really a 300mg tab broken in half).  Also, the mood stabilising properties of trileptal only kick in at around 900mg, and you have room to move to up to about 2400mg/day.  I'm bp2 and currently being taken off effexor xr (I was at 225mg/day, now down to 37.5 and it's been a shitty ride) after finally finding a doctor who agreed that continually increasing the effexor dose (last 2 docs wanted to up it to over 300mg) was a BAD IDEA for a bp 2 woman with excessive anxiety issues.

Anyway... having been on over 17 different meds over the past 5 years and being told that I'm "medication resistant", I can honestly say that trileptal is the first med that has actually made a modicum of difference to my hideous rapid cycling issues.  Had blood tests this week that showed that my levels are too low, so the pdoc is upping my dose from 1200mg to 1500mg for starters.  That said, we are not doctors here! But speak to your pdoc, make absolutely sure what med you were on... trileptal actually has a far lower side effect profile than tegretol.  Check out the www.crazymeds.us write-up on it (would look it up for you, but it's 3:45am here and I'm thinking far too slowly).  Good luck!

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Trileptal comes in 150mg, 300mg, and 600mg tablets in the United States.

shrug* probably does here too.  I just had to break the 300 in half b/c for some reason that's what I was given.  Still proves the point that speedy probably wasn't taking it.

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I posted about bp2 and meds and it turned into a rout about what level of trileptal I took because I wrote 100 mg. That is what I thought but after the beating I just took, I went into my bills and saw it was 150, so you are right about that but please stop the beating about that I am a liar or something. I was taking it with wellbutrin and it gave me severe abdominal pain and took away my appetite just like lamictal did when I hit 50 mg. Both made me more agitated as severe psychotic anxiety is the major issue for me. The hypomania is actually the part I have the least trouble with. I read on here that some people with depakote did ok at lower doses and it stopped their anxiety. Since I had terrible problems with all meds as in I am on the extreme of med intolerance scale and it makes me feel even worse, I am just seeking any advice as to what may be helpful for me. Lithium left me nauseated and sick and depressed after 5 months and same for wellbutrin. The ssri's send me to the roof. If depakote had hair loss and weight gain and some diarrhea, that is easy, I'd be thrilled. I also asked if people had sexual problems on depakote as lamictal, lithium and trileptal all increased my appetite for sex as did prozac except that prozac shut my orgasm down. I know side effects are to be expected, I just dont want to be stuck with nausea, the flu and horrible anxiety and depression forever, it is makes me want to check out. So I hope that clarifies it so you can hopefully give me some good feedback on depakote or other meds at low doses to help anxiety for bp2 people to keep me going one more day....thank you...

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Speedy, I don't know if this is any help to you because I fall into the depression side of BPII.  But, I am currently taking 500 mg of Depakote at bedtime as a mood leveller and it mostly works for me (if i am also on the correct antidepressant).  This is apparently a low dose for most people but it works for me.  Side effects mostly weight gain, thinning hair and maybe constipation (who knows what drug that might be from!).  When I was only Lithium for a short time my pdoc took me off it as I could hardly get off the couch and was clinging to furniture and walls to get around.  Hope this is a bit of help.  Good luck in your search for a clear answer.  What does your pdoc say about trying depakote?  Sulu

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Speedy,

Please try not to take offense at some people here. Some just come off a little stronger than others. And the fact is, we are all MI. So I want to say I'm sorry if you were offended. Please come back and post whenever you need to.

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Hi Speedy, welcome.

I'm frustrated for you and the others who say they have used so many meds and nothing worked. I haven't asked any others, but perhaps you would indulge my curiosity.

Lithium:  You said you had a 5 month trial but nausea 7 diarhea. That is certainly a very reasonable length and those effects are quite unpleasant over such a prolonged time.

Lamictal: How long?  Did it help?  Why did you quit?

Depakote: Same questions. I am unclear whether you have tried it or not.

Regards, A.M.

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I am running the prozac discontinuation gig and very likely am bp2 although not prototype whatever that is anyways. My big problems with ad's are incredible agitation from them which doc says may mean bp med may be more suitable to me. I have terrible time with nausea that never goes away. Lithium slowed me down but left me real depressed and unmotivated and sick too. I got some of that with ab pain and no appetite when I tried lamictal briefly and maybe same for my brief trileptal trial. I also got food taste perversion with alot of the meds. Of the three I listed which are the short list according to my doc for next appt if buspar doesnt stop the anxiety, what are you experiences on these. I know you are all different but figured I'd toss it out there and see what people's viewpoints are as I cannot take this anxiety and agitation and inability to concentrate and do a simple task. So fire away for I am all ears....

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About depakote, assuming you haven't tried it yet: it worked great for me for years (had to stop because of girly hormone & insulin issues, rare especially for guys). 

Side effects:

sedating (went away after a few months)

weight gain (not incessant but significant)

hair loss (receding temples, didn't go bald)

stomach & digestive irritation was the biggest.  I had to go on maximum dose of Prevacid for ulcers & evil reflux.  But that did work.  Had to take it with food and even then sometimes needed antacids.

But it was all worth it, because for all that time I was pretty damned stable.  Had to take Wellbutrin with it to offset the downer effect, but adjusted to that too. 

If you tried lithium for 5 months at therapeutic levels, well, that sounds like a good trial.  But with the others, remember that many side effects are transient, and you don't know which ones are transient until you stay on a med for several weeks, usually.  Sometimes slow increases will reduce side effects.  Once the transient ones fade, you can decide if the side effects that remain are tolerable.

The first question with a med is whether it worked for your moods.  Then it's whether you tolerate the med.

And "tolerable" is the operative word.  It's not whether you like them, it's whether they're worth being sane and functioning well in the world.  In my book, if I can function well, am not developing new chronic diseases, and am not having to take more than two other meds to offset side effects (or risk taking excessive sick time), the medication is successful.    But on the other hand, I'm one of those people that hate, and I mean hate, my illness, and will stop at nothing to treat it.

Sorry if this sounds curt; I know it sucks to take meds at all, especially because every one of the BP meds has some kind of side effect profile.  Trust me, I hate the handful of pills I pop.  But I really love being more like a human being.

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Hey Speedy, I am BP2 and this is my current med. combo, which seems to be working. I haven't had any bothersome side effects, but that may be because I am a "fast metabolizer". Whatever that means!

am: .5 mg klonopin, 50mg seroquel, 100 mg lamictal

noon: .5mg klonopin, 75 mg seroquel

3-4pm 50 mg seroquel

6pm- 200 mg lamictal, 20mg cymbalta,.5mg klonopin

bedtime- 100mg seroquel

Iwas having major anxiety attacks, GAD, excessive irritabiliyt and agitation, oh- and suicidal, long-lasting depression.

Now, I am energetic, productive, and positive--not all the time, but alot of the time,. I still have my "moments", but nothing like before, when I was  ;) constantly thinking about different ways to off myself- never any plans or intentions. Hope this helps, mel1

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