Just wondering

[shannon]

he said he did not give antidepressants to bipolar patients. but after I had been on the mood stabilizer for a few weeks he'd add something to the mix. I feel really tired and run down but I can tell my thoughts don't race like they used to and I'm sometimes able to go for short periods of time without thinking them at all. I would not trust myself driving though right now as I kinda trance out a little bit at times and my coordination is off some. So any ideas as to what could be added to the mix? or what is usually added to mood stabilizers for bp?

Thanks

Shannon

[shannon]

he said he did not give antidepressants to bipolar patients. but after I had been on the mood stabilizer for a few weeks he'd add something to the mix. I feel really tired and run down but I can tell my thoughts don't race like they used to and I'm sometimes able to go for short periods of time without thinking them at all. I would not trust myself driving though right now as I kinda trance out a little bit at times and my coordination is off some. So any ideas as to what could be added to the mix? or what is usually added to mood stabilizers for bp?

Thanks

Shannon

[sun_zoom_spark]

What are you taking, how long have you been taking it and @ what dose??

SZS

[shannon]

HI, I'm taking depakote er 1500 mg at bedtime and .5 mg klonopin for anxiety in the morning and at night. I have been doing this for two weeks now. I go back to pdoc on 21st. I usually feel fine until around 1-2 o'clock in the afternoon then I start getting really drowsy, family members have been saying I slur my speech and stumble around , and I get nauseated I may or may not actually throw up if I do I feel imediately better. If I don't I'll just feel bad until about 30 minutes after my next dose. I've left messages twice last week to ask pdoc if this was normal but never got a return call back. I'm not constantly thinking all the time like I was which is good but I do kind of trance out at times.

Thanks for responding

Shannon

[LostSoul]

Hi Shannon,

I'm assuming he's going to add an AD? Have you been on any before? If so, how did you respond? Do you get euphoric when your manic, or dysphoric and agitated? SSRIs might be a good choice, given the anxiety. They can induce cycling in a bipolar, but you're on enough Depakote to keep that at bay probably. Sounds like you need something a little activating. Prozac is the most activating SSRI. Zoloft can aslo be activating, although it sedates some people. Also Effexor or Wellbutrin could be alternate choices - they are both activating. Not sure if you've tried any of these in the past. Just some ideas. I'm on Zoloft with Lamictal and Topamax as my mood stabilizers and doing well. Wishing you the best.

[sun_zoom_spark]

HI, I'm taking depakote er 1500 mg at bedtime and .5 mg klonopin for anxiety in the morning and at night. I have been doing this for two weeks now. I go back to pdoc on 21st. I usually feel fine until around 1-2 o'clock in the afternoon then I start getting really drowsy, family members have been saying I slur my speech and stumble around , and I get nauseated I may or may not actually throw up if I do I feel imediately better. If I don't I'll just feel bad until about 30 minutes after my next dose. I've left messages twice last week to ask pdoc if this was normal but never got a return call back. I'm not constantly thinking all the time like I was which is good but I do kind of trance out at times.

No depression, that's good to hear. I wouldn't think you'd need an AD. My doc doesn't prescribe ADs for BD patients either.

Might need to lower the Depakote a notch but that depends on blood test and doctor's orders.

How's the anxiety?? Maybe doc can cut that back for now. That would help w/ sedation.

Just ideas.

SZS

[LunaRufina]

He might be thinking of adding an antipsychotic but as tired as you say you are and if your thoughts aren't as racy I'm not sure if that is what he is going for.

[AirMarshall]

Two weeks on a new med is NOT enough time to even tell how it is working. A full trial is more like 8 - 12 weeks. Don't be expecting or demanding a magic antidepressant right away.

The priorities in treating bipolar are normally 1. arrest any suicidal state, 2. treat the bipolar, e.g. reduce the mood swings and get reasonably stabilized, 3 consider supplemental meds for depression (maybe).

If you aren't already, you should be in some sort of talk therapy with either a pdoc, psychologist or counselor as the next best way to treat any depression as well as your bipolar. Study after study shows the importance of doing both therapy and meds.

hope things get better soon.

a.m.

[shannon]

I get dysphoric and agitated when I am manic. I won't sleep but rather stay awake thinking about all the stuff that has ever happened to make me mad. I feel sympathy for those that have had to put up with me I am sleeping better now though and my thoughts are not always on the things that make me feel angry and upset about how my life has gone. Pdoc hoped that the depakote would help my anxiety too and also the migraines. I do a lot of counting and looking for lost things like if I think of something I know I have like a certain book for instance and it is not on the shelf where I think it should be I will tear my house apart looking for it. I will not stop looking some places more than once even though I know it is not there until it is found. Usually some family member ends up joining in on the search because they cannot stand to see me do this stuff. Pdoc said he had never heard of anybody doing that before and was just baffled by that behavior. He said my doing that and having the crying panicky like attacks in public was part of my anxiety. He said the counting and the starting new hobbies and then losing interest in them was related in someway but we would get to that eventually.

That is about it nice to have someone to talk to

Shannon

[Cetkat]

I do a lot of counting and looking for lost things like if I think of something I know I have like a certain book for instance and it is not on the shelf where I think it should be I will tear my house apart looking for it. I will not stop looking some places more than once even though I know it is not there until it is found. Usually some family member ends up joining in on the search because they cannot stand to see me do this stuff. Pdoc said he had never heard of anybody doing that before and was just baffled by that behavior. He said my doing that and having the crying panicky like attacks in public was part of my anxiety. He said the counting and the starting new hobbies and then losing interest in them was related in someway but we would get to that eventually.

I've heard of that behavior before. I don't know why your pdoc would be baffled.. The counting is classic for OCD; and I've heard mention of the whole searching the house thing in relation to that as well. And, since OCD is pretty based in anxiety.. it does relate to panic attacks - which are, of course, also based on anxiety. I'd bring that up and ask specifically about meds that may help with that.

As far as what else may help you.. it really depends on what you're going for. You say you're run-down and without racing thoughts.. but are also anxious. Besides lowing your Depakote to make you less sedated and giving you a calming med like Zoloft, Paxil, Risperdal, Seroquel, or one of the GABA mood stabilizers (perhaps even Lamictal to even you out); I'm not sure what would be best for you. A single med added on really wouldn't do both, IMO.

[dangergirl]

My ex took Klonopin and it zombified him too - he said he just had no thoughts and didn't even feel like himself. I thought he was lovely on it bc his anxiety and freak outs stopped immediately. I do remember him slurring his words too. Everyone has different reactions to meds. Hopefully your doc will call you back soon and let you know if this is a typical experience. For me, since I suffer from extreme paranoia, that's the worst - waiting for the doc to call. Hang in there and read here - I think you'll find it's typical for the BP ride and you'll get some comfort knowing you're not alone.

[Loon-A-TiK]

i just KNOW you're talking about dep. when you say you feel like a zombie. the stuff knocked me on my behind. i couldn't drive (but then again, i usually can't ), couldn't focus at work (worse than usual), and felt in general like my ADD was at least double as bad. it was really weird.

you're hardly taking any klonopin, but it does make some people into a zombie. i had to get used to it at first.

if you're asking about what he might add, my guess would be another mood stabilizer, or a better bet, probably one of the atypicals that won't make you tired.

just on a side note, i don't know why so many pdocs are weird about giving ADs to bp-ers. i'm on enough mood stabilization to halt any mania that might creep up, but like a lot of bp-ers, my downward moods can still get out of hand without my AD (and even with). i get bad downward moods sometimes, like i had for the past few months and now seem to be out of. i don't know what i'd do wtihout my WB! my pdoc has even been discussing the addition of paxil if i get worse. after about 10 years on the high side, the low side is hitting hard.