NARS Posted October 18, 2005 Share Posted October 18, 2005 Well, there's hope. But there's trouble in paradise. Hard to say. Pdoc agreed I should go off the tegretol, approved increasing the lamictal to 250, then to 300 if necessary, and agreed to switch to wellbutrin SR, recognizing that once I'm more stable I may need to get off the wellbutrin. Yes, I know, the wellbutrin is destabilizing me, but he's right that removing it now is likely to make me crash. So not now, but hopefully as soon as I start stabilizing. But he nixed seroquel as a sleep aid and gave me lorazepam instead, in spite of how much I don't want to be on a benzo. He's not worried about me getting addicted because I'm so paranoid and careful about it. He absolutely hates the use of seroquel. He said it causes metabolic syndrome at any dose and will make me fatter than depakote did. It's bizarre; he actually said if I want it I'll have to find another pdoc. And then when I mentioned that if nothing works I'd like to try adding a little lithium to the mix he said even though it's an excellent stabilizer he doesn't want to use it, says it will cause weight gain and metabolic syndrome, and said he would rather put me back on depakote. He was particularly insistent that I get it in my head that I may eventually have to go back on Depakote. I told him that means early menopause, worsening PCOS, and indefinite weight gain, but he was very firm about it. I think he's gone nuts. I know that reasonable minds can differ about how to mix and match the meds, but I'm beginning to think he's being way too inflexible. I don't know if he's just pushing back to my pushiness in my emails this past week, if he's worried about my aggressiveness about treatment. He insisted he appreciates my reports when I'm not doing well. But then he balks at new ideas. I'm surprised at how dogmatic he is. Not sure what I'll do if he won't try new therapies. But I'll burn that bridge when I cross it. End of rant. Link to comment Share on other sites More sharing options...
grousemouse Posted October 18, 2005 Share Posted October 18, 2005 hi nars, well i think you should get a second opinion. you can do this with gp's so can't you do it with pdoc's? i don't know most of the drugs you're talking about personally except seroquel which i take as an offlabel AD/AA and also as a knock out drug for nighttime. it hasn't been that bad for me regarding weight gain, but then again i've been pretty active intentionally with that in mind. grouse. Link to comment Share on other sites More sharing options...
seven Posted October 18, 2005 Share Posted October 18, 2005 ...hates the use of seroquel. Link to comment Share on other sites More sharing options...
Lisa_K Posted October 18, 2005 Share Posted October 18, 2005 Well, I for one will always be pro-Depakote...not just because I didnt get the weight gain...didnt have my ovaries shoot out of my nose...but my moods are stable and so are my seizures...I likey my depakotey...Sorry, every now and then I have to pipe up and defend depakote... If you feel like he is not being a cool doc, maybe you should get a second opinion, as Grouse said...I have had doctors actually tell me to take Benadryl for anxiety before. Yes, you heard me correct...I HAVE EPILEPSY...I cannot take antihistamines...I went 3 allergy seasons thru high school hell with seizures not knowing I was doing it to myself because I was taking antihistamines...so sometimes..if you just have a gut feeling that you may want a second opinion...go with it...thats my 2 cents...Lisa Link to comment Share on other sites More sharing options...
NARS Posted October 18, 2005 Author Share Posted October 18, 2005 I went 3 allergy seasons thru high school hell with seizures not knowing I was doing it to myself because I was taking antihistamines Yikes! Kinda like me with the old pdoc leaving on 300 mg wellbutrin while I spun out of control over the course of a few months. Scary! Yep, I'd still like to hear what people have to say, but on Monday I'll ask my tdoc if she has any other reputable BP docs to recommend. She's been impatient with him in the past, and I know she was hoping he'd let me try seroquel, as she has a number of clients using it for sleep. And Lisa, I guess I should always point out that Depakote was bad for me. It kept me pretty stable for over 5 years, and frankly I was willing to deal with the weight issues. It was only when I got diagnosed with PCOS, and had gotten so whacked out hormonally that I couldn't see straight, that I asked to go off of it. Depakote is a great first-line stabilizer for most people, and I highly recommend it. I just can't handle it myself. Link to comment Share on other sites More sharing options...
Lisa_K Posted October 19, 2005 Share Posted October 19, 2005 And Lisa, I guess I should always point out that Depakote was bad for me. Link to comment Share on other sites More sharing options...
NARS Posted October 23, 2005 Author Share Posted October 23, 2005 I'm just reporting that I'm doing much, much better. After my med adjustment on Tuesday, it took until today for the mixture of side effects from increasing lamictal, dropping tegretol, and switching to the SR form of wellbutrin to settle down a bit. I'm still a little foggy but have great energy today. It was interesting that in addition to the usual lamictal-increase side effects I got reverse side effects from dropping the tegretol. When I started taking it I got dizziness, ditziness, klutziness, cognitive blunting, and language problems (what's that word?). I was only taking 200, and you wouldn't have thought I'd get any withdrawal from that low a dose. But I did. Psychmeds are weird. I don't know if this is the end of changes, since pdoc and I agree that the less wellbutrin I'm on the better. I sure hope this is the right combination, though. My last meeting with him kinda weakened my trust in his openmindedness about things. He's supposed to be the expert, but he doesn't seem to be up on innovative treatment of BP. If I flip out again, I'll probably have to find someone else. But if things are fine there's no need for a change, right? Thank you all for your support while I've been wigging out this past few weeks. I don't know what I'd do without these boards. Even my therapist, who's getting quite smart with her BP continuing ed training, can't really understand what it's like. Link to comment Share on other sites More sharing options...
NARS Posted October 23, 2005 Author Share Posted October 23, 2005 I'm just reporting that I'm doing much, much better. After my med adjustment on Tuesday, it took until today for the mixture of side effects from increasing lamictal, dropping tegretol, and switching to the SR form of wellbutrin to settle down a bit. I'm still a little foggy but have great energy today. It was interesting that in addition to the usual lamictal-increase side effects I got reverse side effects from dropping the tegretol. When I started taking it I got dizziness, ditziness, klutziness, cognitive blunting, and language problems (what's that word?). I was only taking 200, and you wouldn't have thought I'd get any withdrawal from that low a dose. But I did. Psychmeds are weird. I don't know if this is the end of changes, since pdoc and I agree that the less wellbutrin I'm on the better. I sure hope this is the right combination, though. My last meeting with him kinda weakened my trust in his openmindedness about things. He's supposed to be the expert, but he doesn't seem to be up on innovative treatment of BP. If I flip out again, I'll probably have to find someone else. But if things are fine there's no need for a change, right? Thank you all for your support while I've been wigging out this past few weeks. I don't know what I'd do without these boards. Even my therapist, who's getting quite smart with her BP continuing ed training, can't really understand what it's like. Link to comment Share on other sites More sharing options...
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