massmania Posted October 21, 2005 Share Posted October 21, 2005 Does anyone have any experiences vis-a-vis Dpeakote vs. Lithium? I'd be interested to know how people feel. I'm thinking of switching meds - for (Bp1) Link to comment Share on other sites More sharing options...
Lisa_K Posted October 21, 2005 Share Posted October 21, 2005 Does anyone have any experiences vis-a-vis Dpeakote vs. Lithium? Link to comment Share on other sites More sharing options...
seven Posted October 22, 2005 Share Posted October 22, 2005 And to speak for the Lithium camp, I have to admit I really like it. I am eerily stable, just plain pleasant with a full array of swooning emotions and all the galloping thoughts a functioning bp could desire. (ok, I'm also a bit of a ditz, only an itty bit of that is the Li.) While ramping up on it, I had stretches of irritability & depression Link to comment Share on other sites More sharing options...
scatty Posted October 22, 2005 Share Posted October 22, 2005 It's my understanding that lithium is better for euphoric highs and depakote is better for dsyphoric mania. Both didn't work well for me but I am med resistant. Good luck whatever you decide. Link to comment Share on other sites More sharing options...
richarn Posted October 23, 2005 Share Posted October 23, 2005 I was one Depakote for 8 months. Link to comment Share on other sites More sharing options...
WendigoEater Posted October 23, 2005 Share Posted October 23, 2005 I took Lithium for about eight weeks just over a year ago. I have nothing good to say about it. When I didn't feel like a numb zombie just teetering on the brink of massive depression I was having extreme mixed states and ultraidian cycling. I get those anyway but this was horribly out of control - screaming, crying, laughing, bloody episodes. I began to self-injure after taking lithium and I hadn't done that in over 12 years. I have glorious fat scars on my arms now. I suppose I could have continued taking it and messing with it, but I have taken enough meds to know that if I feel even more psychotic after eight weeks I am not going to tolerate it. Lithium is very picky too, with all the blood tests and whatnot. After Lithium I took Epival and that worked quite well, dropped my mania at the time in a week. Even less maybe. But all drugs affect everyone differently. I know people who swear by Lithium. I am just not one of them. Ultimately the choice is yours, so do some research and make an informed decision. If you dislike the meds you can ween off and find something else. The best part of mental illness is the pharmaceutical buffet! WHeeee. Link to comment Share on other sites More sharing options...
NARS Posted October 23, 2005 Share Posted October 23, 2005 I've only experienced Depakote. Depakote was great for my mixed states/dysphoric manias. However it did absolutely nothing for my BP depression, and in fact was sedating enough to make me feel worse. I had to take 300 mg Wellbutrin with it or I would slip into the old black hole. On that combination I still had some anxiety and insomnia, but was basically stable. I've heard that lithium helps some with BP depression, though not as much as lamictal (supposedly a combination of the two rocks for some BPs). I've also heard that lithium is better for euphoric mania, or that it's better for BPI. But the research actually looks like it can work well for mixed states and is quite effective for BPII. If I'd known all this to start with, I'd probably have asked for lithium at first instead of Depakote. The side effect profile is similar, and lithium probably wouldn't have worsened my polycystic ovarian syndrome. So I think it's more of a YMMV thing. Even if something statistically works better for one condition than another, you may be in the 30% or 40% that it will still work for. Side effects will vary, too. So check crazymeds and talk with your pdoc to see which one seems most likely. Link to comment Share on other sites More sharing options...
sun_zoom_spark Posted October 23, 2005 Share Posted October 23, 2005 I was one Depakote for 8 months. Link to comment Share on other sites More sharing options...
massmania Posted October 23, 2005 Author Share Posted October 23, 2005 Some of the meds I've been on: Depakote, risperdal, lamictal, seroquel, lexapro, ativan, klonopin, ... it seems that the depression i've experienced for over two years now is not abaiting. i have had some luck on depakote quelling manic psychosis, but that seems to be the main function of it. i never feel terribly manic any longer. Which is why I'm conmsidering switching. I want some energy again, to work, to play, etc, etc. I'm tired of being exhausted and depressed. I take UDO's healthy oils as of recently, but haven't noticed much difference, mabee a bit of a "bounce". Anyway, what i'm looking for is my happy side. The lamictal I take, could that possibly be taken alone? Depakote (six years) doesn't seem to be making the grade, but I don't want to lose the progress I have made. Link to comment Share on other sites More sharing options...
sun_zoom_spark Posted October 23, 2005 Share Posted October 23, 2005 The lamictal I take, could that possibly be taken alone? Link to comment Share on other sites More sharing options...
Lisa_K Posted October 23, 2005 Share Posted October 23, 2005 Some of the meds I've been on: Link to comment Share on other sites More sharing options...
NARS Posted October 24, 2005 Share Posted October 24, 2005 The lamictal I take, could that possibly be taken alone? Sure it can. I switched from Depakote (plus Wellbutrin) to Tegretol (plus Wellbutrin=depression) then to Lamictal (plus Wellbutrin is a little dangerous but am reducing the wellbutrin). I was always slow on Depakote, had many negative side effects, but as I've said elsewhere I was just glad to be stable. It wasn't my choice to go off of it but it's the best thing I've done. On lamictal I have an emotional richness and self-awareness I never could have hoped for on Depakote. Depakote definitely controlled the nasty mania, but I now see my mental state was not that great. Some people don't get adequate mood stabilization from Lamictal. I don't think it's because they have worse manias, I think it just doesn't work for everyone. But when it works, it's great. You get an antidepressant and a mood stabilizer that doesn't shut you down emotionally. But YMMV. Your pdoc may be worried about triggering one of those psychotic manias if you change meds, so listen carefully and do be cautious about changes. Be aware that Depakote doubles the amount of Lamictal in your system, so if you decrease or drop the Depakote, you'll need to increase the Lamictal. The Lamictal prescribing info sheet has a specific dosing schedule for patients either staying on Depakote and adding Lamictal, or patients going from Depakote to Lamictal. And keep lithium in mind. Some people seem to do great on it. Link to comment Share on other sites More sharing options...
Panz Posted October 24, 2005 Share Posted October 24, 2005 I haven't tried Lithium. Depakote is the first thing that has stopped the frenzied self hating manic inward rages that lead to me trying to kill myself or light myself on fire. Between the clonazepam and the depakote, it seems, I've taken the first steps back from the abyss. I am too afraid of the terrible mood cycling, which i have to a much lesser degree now, to stop the Depakote and try anything else, even though it makes me tired and bloated. Link to comment Share on other sites More sharing options...
MellowYellow Posted October 25, 2005 Share Posted October 25, 2005 I got liver damage with Depakote, became diabetic, and gained over 30 lbs with lithium. I'm damned if I do and damned if I don't! Link to comment Share on other sites More sharing options...
massmania Posted October 25, 2005 Author Share Posted October 25, 2005 I got liver damage with Depakote, became diabetic, and gained over 30 lbs with lithium. I'm damned if I do and damned if I don't! <{POST_SNAPBACK}> I've never heard of anyone becoming diabetic from Depakote before. I'm sorry to hear you gained so much weight from Lithium. Link to comment Share on other sites More sharing options...
NARS Posted October 25, 2005 Share Posted October 25, 2005 Depakote can cause metabolic syndrome (thus the complaints about weight gain and increased appetite) and PCOS, both of which increase the risk of diabetes. Much less of a risk than some of the antipsychotics, though. Some people have absolutely no problem with appetite and metabolism. So it's not a reason not to try it, but it's something to watch and make sure you don't slip into it. It doesn't happen to everyone, and some of us just get milder metabolic syndrome and worsened PCOS, but it's there. Link to comment Share on other sites More sharing options...
MiaB Posted November 2, 2005 Share Posted November 2, 2005 Interested to see this thread, since pdoc said to me this week that she's thinking of dropping the trileptal (which I would hate to do; I feel it's the best med I've been on) and replacing it with lithium. When I made "oh-my-god-not-lithium" noises, she said that the alternative was depakote, which according to her has more side effects. I don't know. I'm getting a bit cranky with the meds-go-round, having just experienced the joy of the lamictal rash the minute she upped the dose from 200mg. Thorazine is giving me hot flushes. Trileptal and valium are the only drugs actually doing anything as far as I can see. argh! Let us know what you eventually wind up taking. Link to comment Share on other sites More sharing options...
sun_zoom_spark Posted November 3, 2005 Share Posted November 3, 2005 Interested to see this thread, since pdoc said to me this week that she's thinking of dropping the trileptal (which I would hate to do; I feel it's the best med I've been on) and replacing it with lithium. Link to comment Share on other sites More sharing options...
Jezebel Posted November 3, 2005 Share Posted November 3, 2005 I haven't a good thing to say about Depakote. Gained 34lbs in a month and quit it. On Lithium now mixed with a cocktail. Have lost 24lbs, but my hair is going curlier and whiter quicker. The E2W blood tests suck, but don't really bother me. I don't really have a taste for food, but do feel the need for a TON OF WATER THAT YOU MUST drink when on lithium. The side effects suck until you are stabilized. Take your pick. Honestly? I'd pick Lithium....that's how bad i hated depakote. Link to comment Share on other sites More sharing options...
massmania Posted November 3, 2005 Author Share Posted November 3, 2005 I haven't a good thing to say about Depakote. Link to comment Share on other sites More sharing options...
Glen Posted November 3, 2005 Share Posted November 3, 2005 In every algorithm I have read lithium is always a first line agent. It surprises me that so many BPs have not tried it. It is efficacious for 50-80% of people alone or in combination. It is inexpensive and along with Depakote has a strong neuroprotective effect. Link to comment Share on other sites More sharing options...
Jezebel Posted November 3, 2005 Share Posted November 3, 2005 I haven't a good thing to say about Depakote. Link to comment Share on other sites More sharing options...
NARS Posted November 3, 2005 Share Posted November 3, 2005 In every algorithm I have read lithium is always a first line agent. I've been very frustrated recently and may need to change pdocs for one who follows the latest tested and proven algorithms. My pdoc inexplicably rejected lithium as an adjunct to lamictal if lamictal didn't stabilize me enough. It makes no sense, unless he buys into the not-very-credible line that folks with BPII don't respond to lithium. Link to comment Share on other sites More sharing options...
Glen Posted November 3, 2005 Share Posted November 3, 2005 Nars, Here is something hot off the press... OBJECTIVE: The authors tested the hypothesis that divalproex would be more effective than lithium in the long-term management of patients with recently stabilized rapid-cycling bipolar disorder. METHOD: A 20-month, double-blind, parallel-group comparison was carried out in recently hypomanic/manic patients who had experienced a persistent bimodal response to combined treatment with lithium and divalproex. Sixty patients were randomly assigned to lithium or divalproex monotherapy in a balanced design after stratification for illness type (bipolar I versus bipolar II disorder). RESULTS: Of the 254 patients enrolled in the open-label acute stabilization phase, 76% discontinued the study prematurely (poor adherence: 28%; nonresponse: 26% [of whom 74% remained depressed and 26% remained in a hypomanic/manic/mixed episode], intolerable side effects: 19%). Of the 60 patients (24%) randomly assigned to double-blind maintenance monotherapy, 53% relapsed (59% into depression and 41% into a hypomanic/manic/mixed episode), 22% completed the study, 10% had intolerable side effects, and 10% were poorly adherent. The rates of relapse into any mood episode for those given lithium versus divalproex were 56% and 50%, respectively; the rates were 34% and 29% for a depressive relapse and 19% and 22% for a hypomania/mania relapse. There were no significant differences in time to relapse. The proportion discontinuing prematurely because of side effects was 16% for lithium and 4% for divalproex. CONCLUSIONS: The hypothesis that divalproex is more effective than lithium in the long-term management of rapid-cycling bipolar disorder is not supported by these data. Preliminary data suggest highly recurrent refractory depression may be the hallmark of rapid-cycling bipolar disorder. Link to comment Share on other sites More sharing options...
massmania Posted November 3, 2005 Author Share Posted November 3, 2005 Nars, Here is something hot off the press... OBJECTIVE: The authors tested the hypothesis that divalproex would be more effective than lithium in the long-term management of patients with recently stabilized rapid-cycling bipolar disorder. METHOD: A 20-month, double-blind, parallel-group comparison was carried out in recently hypomanic/manic patients who had experienced a persistent bimodal response to combined treatment with lithium and divalproex. Sixty patients were randomly assigned to lithium or divalproex monotherapy in a balanced design after stratification for illness type (bipolar I versus bipolar II disorder). RESULTS: Of the 254 patients enrolled in the open-label acute stabilization phase, 76% discontinued the study prematurely (poor adherence: 28%; nonresponse: 26% [of whom 74% remained depressed and 26% remained in a hypomanic/manic/mixed episode], intolerable side effects: 19%). Of the 60 patients (24%) randomly assigned to double-blind maintenance monotherapy, 53% relapsed (59% into depression and 41% into a hypomanic/manic/mixed episode), 22% completed the study, 10% had intolerable side effects, and 10% were poorly adherent. The rates of relapse into any mood episode for those given lithium versus divalproex were 56% and 50%, respectively; the rates were 34% and 29% for a depressive relapse and 19% and 22% for a hypomania/mania relapse. There were no significant differences in time to relapse. The proportion discontinuing prematurely because of side effects was 16% for lithium and 4% for divalproex. CONCLUSIONS: The hypothesis that divalproex is more effective than lithium in the long-term management of rapid-cycling bipolar disorder is not supported by these data. Preliminary data suggest highly recurrent refractory depression may be the hallmark of rapid-cycling bipolar disorder. <{POST_SNAPBACK}> Thanks for posting this. Link to comment Share on other sites More sharing options...
sun_zoom_spark Posted November 3, 2005 Share Posted November 3, 2005 I've been very frustrated recently and may need to change pdocs for one who follows the latest tested and proven algorithms. Link to comment Share on other sites More sharing options...
Glen Posted November 4, 2005 Share Posted November 4, 2005 I've been very frustrated recently and may need to change pdocs for one who follows the latest tested and proven algorithms. Link to comment Share on other sites More sharing options...
sun_zoom_spark Posted November 5, 2005 Share Posted November 5, 2005 Response to medication in turn can shift Link to comment Share on other sites More sharing options...
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