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That's 3 birds with 1 stone folks...

I saw the pdoc on Thursday. My trial on Lamictal was a disaster. Pdoc wanted to start me on Lithium. Frankly I'm afraid to take Lithium, I don't have a legitimate reason, but I'm afraid nonetheless. I also discussed the fact that I'm not convinced I am BP III. To make a long story short, I found evidence that Seroquel, although not a firt-line treatment for BP III, does have some antidepressive, anti-manic, and anxiolytic properties. I suggested to him I go back on the Seroquel as a trial. I've taken it before. I will use it as a mood stabilizer, anti-manic, sleep aid, and mild anxiolytic during the day.

I'm eliminating Lunesta for sleep, Valium for anxiety (only 20 mg), and of course the AC , in this case Lamictal. I know I'm running into some other fora here so I'll cut it short. The bottom line is, if this works for me, I lose the Benzos, the sleep aid, and the AC in one shot. He doesn't believe it's a viable solution for me, but with much reservation is willing to let me give it a chance . Time will tell after all.

Any comments, observations, or suggestions?

John

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Hi Jafco.

Sounds reasonable to try the Seroquel.  All the qualities you listed sound correct.  However, seroquel is not strong on any one of them.  It is more of a suppressor. I think that in the long run you will find that it will need a good mood stabilzer for augmentation: Lamictal, Lithium, Depakote, take your pick. 

How was Lamictal a problem?    I found that lower dosages of Lamictal and Lithium simultaneously were effective.  I have no experience with Depakote.

A.M.

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That's 3 birds with 1 stone folks...

I will use it as a mood stabilizer, anti-manic, sleep aid, and mild anxiolytic during the day.

<{POST_SNAPBACK}>

However, seroquel is not strong on any one of them.

i'm going to disagree a touch with AM. the seroquel is used by many bps alone as a stabilizer--i personally don't like the idea but some pdocs/hospitals just do that. and it's fda approved as an anti-manic. and it's the bomb for sleep. however, w/AM i'll agree it's not first line for anxiety. but many threads in the AP board attest to it's usefulness here as well.

as for your fear of lithium, maybe it's the old truism that people only write about it when they're having problems, hence the preponderance of posts about wretched side effects. as a public service, maybe a thread should be started about how unproblematic it is!

I personally had NO side effects, no tremors, no drowsiness (except for the very first dose), no nausea (except once when hopped up on Excedrin), no polyuria, not even excess thirst. i really have to remind myself to drink water. AND, no brain-lock, deadness to the world, lead shoes. Actually, since going up in dose, my brain has come a little more alive. I'm more like the old me. I even can't stop thinking sometimes. I wake up with my mind buzzing.

I too used to fear lithium and cringed every time my pdoc mentioned it. Now I'm on 900mg and don't understand what all the fuss was about. I truly feel for all those who've had a rough time. But I'm relishing the delicious minty feeling of metal running through my veins. (when i get manic, i sometimes feel metallic too, so this sensation is most welcome ;) )

7

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Ok seven,

I broad brushed it.  I agree that Seroquel does help with all those things.  It isn't a first choice as a mood stabilizer, mostly because it has such a heavy effect initially and second because it's mood stabilizing effect isn't as great as the Big 3.  But it is still a good drug.

A.M.

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I'm giving some thought to the Lith, doing my homework. deven- I supose the Inderal is for the hand tremors? I've done the Neurontin thing, I was in a constant state of Zombiness. Along with the Remeron... talk about over medicated! So it's not in the "big 3".

As I said, I question how bp I really am... I'm just trying to keep the meds to a minimum. Half the time I'm stumbling around, forgetful, and generally have no strength, emotionally or physically.

Luckily I'm not working at this time. But I'll never get back to work if I can't find something I can function on. Currently I feel like a shell of my former self. I've lost my soul.

<{POST_SNAPBACK}>

Re: the inderal

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I'm giving some thought to the Lith, doing my homework. deven- I supose the Inderal is for the hand tremors? I've done the Neurontin thing, I was in a constant state of Zombiness. Along with the Remeron... talk about over medicated! So it's not in the "big 3".

As I said, I question how bp I really am... I'm just trying to keep the meds to a minimum. Half the time I'm stumbling around, forgetful, and generally have no strength, emotionally or physically.

Luckily I'm not working at this time. But I'll never get back to work if I can't find something I can function on. Currently I feel like a shell of my former self. I've lost my soul.

<{POST_SNAPBACK}>

Re: the inderal

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Yes, I'm definately depressed. New diagnosis BP III. Atypical drug resistant depression and GAD. I've been fighting this for over a year now.

I'm been on the EFXR 300 mg for 3 months now. It is not doing anything for me, but for now, I'm giving it some more time. I was on Cymbalta 120 mg for 3-4 before that was until I had a hypo manic episode. I've also tried almost all the SSRI's. No, I'm not suicidal. Prozac, Wellbutrin, several AP's, etc etc.

I had read that Inderal was used for hand tremors from Lithium. I actually took it myself for heart palpatations, worked great.

<{POST_SNAPBACK}>

since you're already on an ad, i would say, yes, adding lithium could be a good idea. it's sometimes used to potentiate antidepressants in treatment resistant depression (so is lamictal). you might find your ad will suddenly start working...or that's what i've read. my pdoc won't let me near ad's. there are also maoi's and tricyclics but i suppose you've tried those too.

7

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I would try a low dose of lithium. Perhaps 600mg with the intention of obtaining a serum level of .5-.8mEq/l.

<{POST_SNAPBACK}>

Thanks Glen

When I saw the pdoc this past Thur. I told him I'd make a decision in 2 weeks, my next appt. I'm leaning toward giving it a try. If I go for it I'll ask him to start me on a low dose as you mentioned, 600 mg. I've been doing a lot of investigation, as always and it looks like it may be worth a shot.

Seven

If I do, looks like we'll be on a very similar cocktail, minus the AC for now. I can bounce some questions off you along the way if you don't mind.

I've taken Inderal in the past for pounding heart, palpatations; it worked great. Pdoc mentioned he also uses to quell any possible hand tremors from the Lithium, if I get any. 

John

300mg Effexor, 600mg Lithium to start?, 200mg Seroquel, 15mg Valium, 300mg Axid for GERD, Flonase for severe rhinitus. That's all folks!

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Seven

If I do, looks like we'll be on a very similar cocktail, minus the AC for now. I can bounce some questions off you along the way if you don't mind.

I've taken Inderal in the past for pounding heart, palpatations; it worked great. Pdoc mentioned he also uses to quell any possible hand tremors from the Lithium, if I get any.

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