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I went to a new tdoc today. She's also an MD and can prescribe meds. After listening to my symptoms (ADD, depressed. looooow motivation, not eating/sleeping, losing weight from the 90mg/Ritalin I take daily), she suggested this cocktail:

Depakane R (200mg), once/day

Desyrel (trazodone) (50mg), once day

Ritalin (10mg) up to 90mg day, as needed.

I asked why Depakane, since I'm not bipolar and never have had any hypomanic episodes, and she said it would 'even out my moods' which are normal and sluggish right now.

The desyrel seems to be a basic AD, and the Ritalin helps my ADD, so I'm fine with that, but while I hear about the crappy side-effects of Depakane, I can't find any non-bipolar/non-epileptics using it.

She referred to Depakane specifically as valporic acid, btw.

Any thoughts/experiences with this?

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Perhaps she's thinking cyclothymia (cycling moods, "soft" bipolar)?  Or maybe she's had good experiences with that med helping patients with your symptoms.  Personally I find it refreshing to hear of docs willing to try mood stabilizers like this.  Best of luck!

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Lily, I am not a doc but maybe because bipolar is often diagnosed after a person is treated with antidepressants and becomes hypermanic or manic, she wanted you to avoid having to go through that.  I would ask her again to elaborate on the reason for prescribing it again and tell her about your concerns.  Sorry not to be of much help but thought maybe this reply could help ease your mind until you can speak with her.  Keep posting and let us know how things are progressing.  Sulu

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That sounds like it might work.  Give it a try for a few weeks and it might really help.  The desyrel might make you really sleepy at first.  If it does, you might want to talk to your doc about titrating up to that dose.  I found a dose eventually that helped me sleep and didn't leave me with much of a hangover.  Of course YMMV.  I'd recommend taking the depakene with a fair amount of water (16-24 oz)  that's made all the difference with me and depakote. If your stomach gets upset, I've been taking pepcid ac (OTC) 20 mins before the depakote.  Of course, you'd want to check the interactions with your med cocktail. 

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Let us know how it goes, Lily.  Have you been on antidepressants before without good results?  If so, that combined with family history of BP could make her think depakote/depakene could work.  Also, you may have symptoms that don't make you think BP, but are signals to her of BP or cyclothymia.

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This suuuuuuucks!

I took 1 Depakane (200mg) and 1 25mg Desyrel last night. I got just under 4 hours' sleep, since I had to be up for an 8am meeting.

Felt steadily worse all day, finally cancelled all my meetings, and holed up in my company's sickroom, waiting for the nausea to subside so I could make it home. Thank goodness, I made it home in time to hug my own porcelain bowl.

Nars, you're exactly right--Prozac, Strattera, Ludiomil and Wellbutrin didn't do anything. And the fact that I can pop 90mg/day of Ritalin without batting an eyelash suggests-treatment resistant depression/ADD, I guess (or that these meds aren't targeting whatever's wrong w/ me).

My biggest problem is that I DON'T go to bed at night. If I crawled into bed, I'd be asleep in an instant, but instead I surf the net, or watch TV, transfixed like a deer caught in the headlights, until 3-4am. And I keep forgetting to eat, & no appetite.

I want to take meds to fix these things, but because I don't eat or sleep enough, these new meds just knock me over.

I think I'll stop both Depakane and Desyrel for now (will run this by pdoc of course), try to get my strength up (next week I'm off, so I'll just eat and sleep), then start w/ Desryel. Once I can handle that, I'll either try Depakane again, or something else.

Sorry this is so long. It's just that I can't talk to any of my friends here. To them, depression suggests suicide, so they freak. The mere mention of meds also freaks them out and they go nuts w/ worry. And of course I can't mention it at work. So I feel a bit alone and sad (gah).

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No problem with the length; keep it up, it always helps to talk.

Eat, bubbeleh.  You must eat with Depakote, so I assume it's the same with depakene.  Substantial food, too.  Do not take on empty or empty-ish stomach or serious evilness will result.  I also had to take Gaviscom, an industrial-strength antacid, especially with the morning dose.  I had to eat breakfast of some kind for the first few years I was on it; eventually was able to have just coffee for breakfast, so long as I took Gaviscom.  Not that I recommend not eating breakfast; I'm eating disordered, so breakfast = healthy head.  So maybe next week try to get into an eating-and-meds thing to get yourself on track.  For now, at least drink some milk and have crackers when you take the depakene.  It will help.  Bland food is also good at the start.

With the sleep thing, I'm like you; I can surf trashy TV or play Freecell on the computer until the wee hours if I let myself.  I finally realized I'm like a little kid and I have to just put myself to bed with no books or magazines to distract me.  I make myself get into bed by 11:00 and take an Ambien if I'm not sure I'll sleep.  It's called "sleep hygiene."  I very strongly recommend it.

Lack of sleep is a mood trigger, usually causing mania (at least for me).  So if I want to be healthy, even with meds, I must sleep at least 7-8 hours a night.  Otherwise I get nutso.

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I was just dxed with cyclic unipolar depression which I'd never heard of.  I'd always thought that if there is a cycle, it's bi-polar.  I have a slow cycle where I feel fine for 1-2 months and then drop down for 4-6 months.  I was given an tegretal rx, but haven't taken any yet.

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Guest pressmama unlogged

I totally agree with NARS.  I'd like to add a couple of things though:  I was just like you almost three years ago...I was taking a full course load for my senior year of college and I was the editor of a local weekly magazine.  There were some nights I would go totally without sleep, on a good night I'd get 4-5 hours.  Plus I have other reasons for not wanting to go to sleep at night anyway, so I'd find diversions to help me stay awake: a good tv show, an interesting book, the internet...  I tried one med: topamax.  The first three days I got a headache and I was like screw this...I'm too busy!!  For the next three years I had periods of hypomania and moderate depression but I just kept going then in May I crashed.  This whole summer of not being able to work and struggling to get my brain back has really made me wish I had done something sooner, before it got bad. 

You're never too busy to take care of yourself.  I know it's hard, but please don't wait. 

The first two weeks suck (and if it sucks after that try depakote instead of depakene), but after that it gets A LOT better.  Take the depakene with food, with LOTS of water...like a whole half liter (17 oz) bottle and an antacid.  Make a bedtime ritual...it's a struggle for me everynight, but it's helped.  For me, I smoke a cigarette (one of two I smoke everyday), change into my pjs, take my med and GET RIGHT IN BED.  I'll turn the tv on if it takes a little while to fall asleep, but I stay in bed.  That's the important part, get in bed and stay there!!  Good luck!!!

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I just got a little fussy and googled "sleep hygiene" (with quotations) and came up with a bunch of sites describing strategies to regulate your sleep patterns.

What works for me when I get off schedule:

No TV, bright lights (including computer), strenuous exercise, stimulants (I guess a cig is fine if you're a regular smoker) for an hour before bed

No reading in bed (I'm a reading addict)

Pick a time and stick to it for 2 weeks

For me, if I lie awake for more than 1/2 hour I get up, drink some tea or milk and sit in the living room for 10 minutes, then try sleep again.  I guess that's individual; someone told me once it's a problem if you get accustomed to lying awake in bed with your thoughts racing.

The TV thing is individual, too.  I can listen to quiet music to sleep, but if the TV is on I'm awake.  Wide awake.  Even if I'm stone tired.    ;)   So no TV for me in the bedroom.  But whatever works, works.  There's a whole menu of things you can try.

Also, I use a light therapy box I bought at Apollo's website in the winter time.  It's magic.

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Guest luli2545

Just dropping by,

Interesting thread; I'm restarting depakote er(?) new extended release; for a couple years I was on 500 mg of depakote (some old variety, pink 250 mg pills) .... and I'm on effexor 225mg....for a year and a half.

My pdocs said they thought I cycled. ?  Pdoc yesterday who said to go back on depakote said that when people take antidepressants they can start to cycle mildly (?).... so I said, hey, I have dips, is that a cycle? And anxiety....(the dips seem to be anxiety/depression dips) So I don't really get cyclothymic, wheres my mania?

Anyhow when I was on serzone a few years I also did 500 mg depakote; felt sort of normal ups and downs with situational adrenalized HOT anxiety which really did suck.

Used 250 mg depakote for a while; pdoc said it was subtherapeutic dose, so I tried going without a few months and whammo, serious anxiety/depression.  So I wonder if depakote helps with depression? Anxiety? ????

Sort of liked only having to remember the effexor but I guess as the depakote left my system and some yukky things happened I tried to tough it out til I just couldn't stand the anxiety/depression any more.

About ten years ago I used desyrel (trazedone?) for sleeping; really had to time it carefully and I used 1/3 of a tab.....about 1.5 hrs. before bed.... and in the am, I could really feel when it was no longer affecting me...I liked it a lot.

I never had to do food or water much with depakote, no stomach problems. Heard depakote is easier to tolerate than some other forms of depa...whatever.

Thanks for the reminders about sleep hygiene and food anyhow. I really have to plan both parts of my life, as when food or sleep slip I go totally nutso

Thanks,

Luli

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Lily, all I can say is that what's going on in my brain when I'm up past my bedtime is that I'm getting all bratty and refusing to be a good girl and go to sleep.  It's the eight-year-old in me coming out.  I usually have to give myself a talking to.  I don't have to go to bed because my Mom/Dad/therapist tell me to.  I have to go to bed because if I do I feel OK (or better) the next day, and if I don't I get all crappy the next day.  And I don't like feeling crappy or manic or despairing because I haven't slept.  And sleep doesn't cost me anything but a few hours of surfing.  Usually it works.

It's hard.  Just last night I got into bed at 10:30 then spent 3/4 hour paging through some songs I'm trying to learn.  I guess that's half-assed discipline, but I still got to sleep before midnight.

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Why, thank you!

A guy I work with was out walking his dog along the beach when he happened upon this tiny kitten. Someone had (as often happens here) brought some newborn kittens out to the middle of nowhere to leave them. This guy's dog found her as he was running along, and gently carried her in his mouth back to his human. A good thing, since there were some bigass birds circling overhead, apparently. (The guy said he was too scared to go look and see whether the rest of the litter was around.)

Given that this guy already has 4 kids, 2 dogs and a really tired wife, they couldn't keep the kitten, but they did feed and take care of her while we all looked for a new home. Given her gorgeous good looks, she soon found one.

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