I am so sick

[SunshineOutside]

I'm trying to go up on Trileptil because it is the only thing I know for sure has help me with my mood.

[Sulu]

Gee Rhonda, that is quite the cocktail!  It must be so difficult to know what is doing what and what is causing what. You asked if you just have Bipolar is all that you need a mood stabilizer, then in the next paragraph you mention the severity of your depression so I am kinda confused.  The antidepressants if they are working should enable you to get up off the couch and the mood stabilizers are supposed to even out the ups and downs. For some that means between mania and depression, some between hypomania and mildly depressed, etc.  Many different combinations.  I definitely would have a heart to heart with your pdoc and see if you could find a suitable cocktail without having to take 1 to counteract this and 2 to counteract that etc.  IMHO you definitely need an antidepressant to fight your serious depression.  But what do I know, I am crazy and still haven't found my correct cocktail.  Hang in there and let us know how you are.  Sulu

[SunshineOutside]

Sulu,

Thank you for responding.  Maybe you're confused because I am about my diagnosis.  For the most part I have delt with disabling depression.  A few of the anti depressants I tried caused me to have hypomania.  I think that is something like BiPolar IV.

But I experienced an overnight mood elevation with Trileptyl....

I don't know......

Rhonda

[Echo]

Rhonda,

First, I hope you start to feel better soon! I've read some of your other posts and know that you have been through a lot as a result of this depression. Lets hope that soon you can get a grip on it, rather than it constantly gripping at you.

Now, your diagnosis is a hard one. You know that and I'm sure your pdoc knows that. They are hesitant to take you off the AD because you might crash and burn, right? Well, in my opinion, if what you're taking now isn't doing the trick (or even coming close) which it quite certainly is not (since you can't get up off the couch and are so very nauseaus (sp?) I definitely think a change is in order. What kind of change? Well....

The heart to heart is your top priority. You've got so many meds going on that you can't possibly determine what's doing what! What's working, what's not, what's helping, what's making things worse?

Unfortunately I have no advice as to what should be tweaked. I think pdoc would know best as they are the one who put you on the laundry list of meds! But what I do know is that something definitely needs to change, and very soon.

That probably wasn't as helpful as you were hoping for. I started off with more to say but as I began to type I realized just how confused your situation is. At the very least please know that I understand where you are coming from and am feeling for you! I really hope this gets worked out.

Keep us posted.

Echo

[gretl]

Yep, that's a lot of meds!  Are you tapering off any as you go up on the Trileptal?

Theoretically, If I just have Bipolar, I just need a mood stabilizer, right?

Sorry, that seldom seems to be the case. Like Sulu said, the MS should stabilize the mood swings, and will often give you a little antidepressant benefit, but most people seem to need a couple different types of medication to do the job.  Not usually as many as YOU listed, LOL, but rarely just the one.

I'm BP2 with mostly depressive episodes, and I take Trileptal between 1200 and 1500mg, plus Lexapro 10mg, and Ativan PRN (usually ends up being 1mg a day; looks like you have a higher tolerance than I do.  The Trileptal/Lexapro combination has helped my anxiety a lot).  I also take natural thyroid for subclinical hypothyroidism.  It works well but if I've had any mood benefits from it, it's been subtle.  I would like to try an ADD med, but pdoc wants me to try behavioral things first.  Aaargh!  (She's got a good point, but you know ... it's hard to commit the effort with so much else going on.)

[Guest Guest]

I wouldn't take a mood stabilizer for bipolar II. Mood stabilizers are very very heavy duty drugs. I think a little hypomania  is best handled with a small dosage of say Risperdal if absolutely required. So what if one is a bit hypomanic. Better a little hyomanic that a lot of drug side-effects. In fact I think there is no reason to treat hypomania.

[SunshineOutside]

I wouldn't take a mood stabilizer for bipolar II. Mood stabilizers are very very heavy duty drugs. I think a little hypomania

[Guest Guest]

The Adderall is another possiblity. I tried Ritalin and I developed tolerance to  Ritalin very quickly and then there was a crash unless I took more. But I saw the writing on the wall.  Adderall for hypomania seems like a very poor choice of drug. You are taking Adderall which causes hypomania when it works and also mood stabilizers to prevent hypomania.

[Dawn]

Your post title said it all, of course it's the Meds, I am only familiar with Adderal, Ambien, Effexor and Lorezapam.  Just forget the vitamins for now. Toss the Adderal, cut the Ambien to 2.5 mg. every night, don't take the Lorezapam 3 times a day, cut the dosage by one-third and take 4 mg. when you go to bed.  This may enable you to sleep okay, and that is a large part of the battle.  Do you have a kitty to lay in your arms?  That can help, or a dog on the bed, up against you back...

You are taking too many drugs, grrlfriend.  I am not a Doctor, but I have been there.  Good Luck and Love,  Dawn

[SunshineOutside]

Dawn,

I am fortunate enough to have a kitty and a dog that sleeps with me every night.  Thanks for the advice.  Time to have a heart to heart with my Pdoc.

Thanks again,

Rhonda

Your post title said it all, of course it's the Meds, I am only familiar with Adderal, Ambien, Effexor and Lorezapam.

[Velvet Elvis]

I wouldn't take a mood stabilizer for bipolar II. Mood stabilizers are very very heavy duty drugs. I think a little hypomania  is best handled with a small dosage of say Risperdal if absolutely required. So what if one is a bit hypomanic. Better a little hyomanic that a lot of drug side-effects. In fact I think there is no reason to treat hypomania.

Wow.  Wonder what my Pdoc would say to that!  I think i'll find out!  I really really like the idea.  But I never knew it was O.K. to be hypo-manic.  Her theory has been to stop the cycling and gain stability.  Forgive a little sarcasm here?  I can see the expression on her face when I say "Guest from Crazyboards.org says...."

You sound very experienced.......?

Rhonda

The problem is that you don't always stay "just a little hypomanic." There is often a kindling effect to BP, ie it gets worse over time if you don't stop it in its tracks. Mania if can cause brain damage so being depressed is actually less harmful to your body than being manic.  I know mood stabilizers suck, but halting mania of any flavors really does need to be your first priority.

[Velvet Elvis]

Your post title said it all, of course it's the Meds, I am only familiar with Adderal, Ambien, Effexor and Lorezapam.  Just forget the vitamins for now. Toss the Adderal, cut the Ambien to 2.5 mg. every night, don't take the Lorezapam 3 times a day, cut the dosage by one-third and take 4 mg. when you go to bed.  This may enable you to sleep okay, and that is a large part of the battle.  Do you have a kitty to lay in your arms?  That can help, or a dog on the bed, up against you back...

You are taking too many drugs, grrlfriend.  I am not a Doctor, but I have been there.  Good Luck and Love,  Dawn

That's right.  You're not a MD.  Please don't give specific medication instructions in absolute terms. You don't know this person like thier pdoc or does or even like those of use who have been around here for a long time.  In short, you don't know what you're talking about.  Now hush

[null0trooper]

What do you all think?  Anybody else on this many meds?

Dx:  Bipolar II, GAD

Current Meds:  Effexor XR 75mg at nighttime

                    Lithium ER 450mg morning and night

                    Adderall XR 20 MG morning

                    Trileptal 450 MG morning & night

                    Remeron 30 MG at nighttime

                    Cytomel 25MCG morning

                    Lorazepam 2MG three times per day

                    Ambien 10 MG at bedtime

Vitamins:          One a Day for Active Women, Extra Vitamin .

                        E 400 I.U.  PhosphatidylSerine 200MG.Super

                        B Complex  Vitamin C 500 mg  I normally do

                        the fish oils but I'm out.

<{POST_SNAPBACK}>

Contrary to what others might say, I think that most of the vitamins you're taking are a good idea.  It's damned hard to "eat well" when you're depressed, so it can't hurt to cover for what you might be missing. However, Vitamin C - an acid - and Adderall aren't a good combination. Adderall is absorbed much better with a higher stomach pH (more neutral or basic) than lower. If you need the extra C, shift that to the evening.

Does the Remeron really help? You're taking it at night, which would keep many people awake. I assume you don't take it in the day because it makes the anxiety worse. The evening Ambien and the morning Adderall (without ADD) look like you can't get to sleep and can't wake up once you fall asleep. Maybe one of the more sedating TCAs might help out in the evening in place of the Remeron, Ambien, and Adderall?

:sigh:

You definitely need to first write out how the various drugs you've been on have affected you and what the dose and schedule have been.  Be brief and clear. THEN have the heart-to-heart with the doctor.

For what it's worth, it does look like your doctor is trying to keep your mood and sleep cycle  as stable as possible while he works you slowly to a shorter meds list.

[Velvet Elvis]

Does the Remeron really help? You're taking it at night, which would keep many people awake. I assume you don't take it in the day because it makes the anxiety worse. The evening Ambien and the morning Adderall (without ADD) look like you can't get to sleep and can't wake up once you fall asleep. Maybe one of the more sedating TCAs might help out in the evening in place of the Remeron, Ambien, and Adderall?

Are you sure you're talking about Remeron?  Due to its fairly potent effect on histamine receptors most people find it highly sedating, more so than any of the TCAs.  Increased anxiety is fairly rare paradoxical effect.

[null0trooper]

Does the Remeron really help? You're taking it at night, which would keep many people awake. I assume you don't take it in the day because it makes the anxiety worse. The evening Ambien and the morning Adderall (without ADD) look like you can't get to sleep and can't wake up once you fall asleep. Maybe one of the more sedating TCAs might help out in the evening in place of the Remeron, Ambien, and Adderall?

<{POST_SNAPBACK}>

Are you sure you're talking about Remeron?  Due to its fairly potent effect on histamine receptors most people find it highly sedating, more so than any of the TCAs.  Increased anxiety is fairly rare paradoxical effect.

<{POST_SNAPBACK}>

D'oh! I was looking at the SSRI/SNRI effects and didn't scroll down to catch the antihistamine part!

Hm. Remeron _and_ Ambien though? That looks even more like a wrecked sleep cycle (Like I have room

to talk.), but does make more sense.

And THAT is why SunshineOutside needs to talk to a real doctor if the dosing schedule seems to be a problem.

.

[Dawn]

Geez Im sorry, I never said I was a Dr., just responding to another Forum Member who was asking if anyone had similar experiences.  Guess I'll have to be more general and less specific in the future.

But the member that I was speaking to understood where I was coming from.

This seemed like a forum that I could finally participate in, but I'll just Hush Now, thanks alot...sorry to be such a screw up.

[Sulu]

Dawn, please don't "hush now", you are not a screw up. We know that you are not a doctor (or you would have stated that, right?).  This is a great board and when I first got here I did a few things that didn't fly and was told about it.  Being the way too sensitive person that I am, I too thought I should hush.  But once I had been around for awhile I realized what was acceptable and what wasn't.  There aren't too many things that are taboo but if you accidentally screw up, you will be told about it, and not necessarily in a gentle way.  It is a learning process, but way worth it!  Giving advice about meds is a good example.  "we are not doctors...." we just share our ideas.  I think that is all you were trying to do so don't sweat it, okay.  Please keep posting, I know it has helped me a lot.  Stay well, Sulu

[SunshineOutside]

Dear Dawn,

There is no need no apologize.

[number_6]

Moderator Guidelines., Life as a Trusted Minion.

"5)

[SunshineOutside]

We have had to ban members for giving specific DOSAGES before.

AKA playing doctor.

There is a fine line between saying "well, here is my suggestion to bring up with your pdoc" and saying "this is the dose I think you should take of what meds".

I honestly dont have a friggin clue where Rhonda should go from here. When I dont have a clue I keep my mouth shut. Id rather not say anything than be wrong. There are meds I dont know anything about...and I've been on a LOT of meds and just am a geek that way. But I recognize that. *I* dont wanna fuck anyone up. Plus, Rhonda's got an especially complicated brain.

I was just doing my job. It's within my rights to REALLY shoot first apologize later and just ban when I see dosage numbers given out. Bear that in mind. I'm not as much of a bitch as y'all want to think.

Kassiane

<{POST_SNAPBACK}>

[Sulu]

Kass, I think anyone that knows you is aware that your bark is so much bigger sounding than your bite.  You do a great job as a trusted minion and have so much knowledge and insight to share.  As someone who was once a little freaked out about making my own mistakes here, I can only say to newbies, "About Kass, get to know her and understand her style and you will come to value her input as much as the rest of us. Oh and she isn't as bitchy as she sounds, she is a little cutie who sounds tough but she knows her stuff".  Sulu

[SunshineOutside]

I don't think Kass is a bitch.  I don't think I've come across anyone on this board that I would classify as a bitch.

And if I did, the southern girl, I am, I dare would not say it. Usually.

Kass is right when she says I have an especially interesting brain (or something like that)  My doctors and I continually scratch our heads about what to do next...or nothing at all.

But I'm much much better than I've been in a long time, thanks to Trileptal (sp)  It's so expensive.  We're looking at substituting Tegretol instead but we're scratching our heads about that even.  Don't want to mess up a good thing.

By the way, I've discovered how to get rid of the guys that you're trying to get rid of.  Tell them you have Bipolar II disease.  Adios omigos (sp) :-)  (except for one who loves me inside and out and I'm not attracted to. :-(

I'm rambling.

Take care, mean it!

Rhonda

[LunaRufina]

By the way, I've discovered how to get rid of the guys that you're trying to get rid of.  Tell them you have Bipolar II disease.  Adios omigos (sp) :-)

That does usually work... except for the *really* creepy ones who are

into the 'crazy girl' thing.  They might get more interested. Then you

have to try to out crazy them.  Although,  acting crazy simply to make

someone go away can be a great stress releiver at times- an alternative

form of therapy.

Rhonda-

I know I am probably just echoing a lot of what others said, but...

It sounds like you are starting to work together with your doctor more

now than before.  It'm sorry you feel like shit- on the other hand, you

seem to be more together than when you first came to the boards.  With

so many meds, I don't know how to figure out what is making you sick ,

what is helping you the most, and what may not be doing much at all.  I

hate to hear that you feel physically terrible all the time; I don't know how the meds will help you to be better and functional if they plant you on the couch.

As far as being on as many other medications and having similar

experiences: I take several medications, but the only thing that we have

in common is the fish oil. One of my dxs is Bipolar NOS [for the time being]

But I don't end up incapacitated.  I hope you can talk with

your doctor more, like it seems you have been- you shouldn't be in emotional and psychological pain, that

is a given. But not being able to do anything isn't an acceptable solution.

hmm... do I rant enough?

I hope you can find a way to figure out what is/isn't working. You

definately sound disouraged and it is hard not to if you experience so

much, physically, but still feel like things aren't quite working.  Good

luck, Rhonda. I really wish you well.

~navy~

[Velvet Elvis]

Geez Im sorry, I never said I was a Dr., just responding to another Forum Member who was asking if anyone had similar experiences.  Guess I'll have to be more general and less specific in the future.

But the member that I was speaking to understood where I was coming from.

This seemed like a forum that I could finally participate in, but I'll just Hush Now, thanks alot...sorry to be such a screw up.

Participate away.  Just don't give specific advice without qualifying it with things like "ask you doc about trying" or "you might want to read up on."  or "such and such could be an option."

If you're going to give medical suggestions rather than simply sharing your own experience, please take some time to read old posts by the person you are responding to in order to get an idea of their situation and history.  Once you've stuck around a while you'll get a better feel for these things. 

Any time you join a new online forum of any topic it's a good idea to lurk for a month or so before you start responding to lot of posts just so you can get the feel for the place.  Most of the Internet newbie guides and nettiquite guides agree on this point.  Every online forum has its own culture and way of doing things.  What is fine in one may not be in another.  Asking questions as a newbie is one thing.  Answering a lot of questions before you learn who is who and what is what can get you in trouble.

[Dawn]

Thanks guys, I have been lurking for awhile, but my big trap gets me into trouble almost everywhere, thanks for the kind and helpful words, hope I will be on track from now on...

[SunshineOutside]

None of us are always on track.  I like your effort though.  Many times I say things without thinking about how I will be perceived.  Whatever.  Can't go around being too careful.  Might not say anything at all.  Anyway, that's how I feel this morning.  Haven't had my cup of coffee yet.

Rhonda

[Guest mayilong]

None of us are always on track.

[Guest mayilong]

Dear Kassiane (pardon if I misspelled your name, I can't see your post it now),

it seems to me that -- this isn't any of my business -- that your whole way of responding to Rhonda'

s meds questions is a sort of bipolar response. Rush in and then feel remorse later. That's how I sometimes do things, anyway. Anyway, I have no right to make a comment about you or your behaviour. I just had hypomanic event, attacking my father verbally until after going swimming I realized that I had been hypomanic. Thanks for your tolerance.

Mayilong

[Guest mayilong]

Thanks guys, I have been lurking for awhile, but my big trap gets me into trouble almost everywhere, thanks for the kind and helpful words, hope I will be on track from now on...