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A resounding YES! All I take are 2 mood stabilizers: lithium and lamictal. And, my lith blood level is .94, at the high end for maintenance, low end for acute mania---but I'm not at all flat emotionally. So, I'd say not everyone gets robotic on lithium. No side effects either. (omg, did that sound like a lith plug? i don't work for gsk, i swear..)

(I only use a smidgeon of seroquel for sleep as needed. and the inderal for anxiety once in a while.)

And yes, very successful.

best of luck,

7

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Hi Jill:

I think that you will find a lot of success stories of Bipolar folks being treated without the use of antipsychotics. There are a lot of options, a lot of combinations, and a lot of different dosages within those options and combinations that can be utilized.

I am a Bipolar NOS success story in progress. I take Lamictal, along with small doses of Keppra, Klonopin, and Topamax. The Lamictal works for depression, the Klonopin works for anxiety, the Keppra and Topamax work for irritability and agitation, and the whole mix keeps me mostly stable.

I, too, was originally misdiagnosed. Over the past year, things have slowly gotten better. It will be different for everyone; it will be different for you, but all you can do is to find a good pdoc and work together to try to best treat your situation.

You seem to be in a really difficult place right now, and I wish you nothing but the best. To answer your question directly, yes, other folks can control Bipolar symptoms without an antipsychotic on board.

Todd.

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Another lithium and Lamictal guy here.

I've tried 3 different APs and all seem to give me too much trouble. Just quit Seroquel a month or so ago after a six month go at it. Thank goodness. I guess they are good for mania if nothing else works but who wants to sleep 12 hours a day?

My pdoc's #1 priority is to keep me well enough to work. APs cause me to sleep too much and put me in a fog. Hard to be productive (and happy) when you have to fight that feeling though they did wonders for my anxiety. I cut my benzo down to a baby dose and I could probably drop it now that I am quite stable.

Still get a little agitated every now and then. Especially with people who break time.

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I don't know if I count, but I'm on lamictal with an AD.  My pdoc and I hope to get me off the wellbutrin eventually.  But he won't try lithium; he knows nothing and rejects the idea that a maintenance dose will help my stability and keep me out of depression so I'm safe without the AD.  I think he's very wrong, seeing how many people here are doing so well on it.  I will probably switch pdocs just for that reason.

No antipsychotics except for zyprexa for a few weeks when I began treatment and was really psychotic and flipping out.  I'm a lucky girl in that the ACs have been good to me (except tegretol, which was the devil's pill)

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Why would somebody with a bipolar or depressive mood disorder want to use antipsychotics?

I have Bipolar NOS, Ultra-Rapid/Ultradian Cycling, OCD, Social Phobia, Possible Aspergers.

I've taken Anti-Psychotics before, and I've had nothing but bad reactions from them and worsening of symptoms at all doses. It was because, I didn't need them.

This has been my experience over time.

Seroquel, though, isn't bad at very low doses of 25-50 mg for sleep. It's pretty much an anti-histamine at that dose.

I respond best to anti-convulsants and SSRI's.

Antipsychotics are ONLY for psychotic disorders; not mood, depressive, or anxiety disorders. When extreme mood states have psychotic features, they could be used very briefly. That's the only time AP's should be used. Even then, Klonopin would be better 'cos GABA clamps down on xcess dopamine. Then true mood stabilizers should be used as longterm meds.

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Why would somebody with a bipolar or depressive mood disorder want to use antipsychotics?

<{POST_SNAPBACK}>

Because for some people, they work well.

Antipsychotics are ONLY for psychotic disorders; not mood, depressive, or anxiety disorders. When extreme mood states have psychotic features, they could be used very briefly. That's the only time AP's should be used. Even then, Klonopin would be better 'cos GABA clamps down on xcess dopamine. Then true mood stabilizers should be used as longterm meds.

<{POST_SNAPBACK}>

I have to disagree with you here. Abilify, Geodon, Risperdal, Seroquel, and Zyprexa (both alone and as part of Symbyax) have FDA approval for various flavors of Bipolar Disorder, along with the studies to support the approvals (links available at the CrazyMeds website). In addition, while not first line treatment options, antipsychotics typically have a place in treatment algorithms for Bipolar Disorder (e.g., TIMA). Klonopin, which I take and love, not so much.

I respond best to anti-convulsants and SSRI's.

<{POST_SNAPBACK}>

It's great that you found something that works well for you.

Todd.

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Why would somebody with a bipolar or depressive mood disorder want to use antipsychotics?

Because it's the hot, new item in the psych field. Read here about the BOLDER study-

http://www.medicalnewstoday.com/medicalnews.php?newsid=27107

APs for monotherapy, brought to you by the drug companies themselves. They have to justify their work or they'd be out of business. Right?

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Hi all,

I don't know whether I should be posting this on the AP board or this one, but I'm guessing I'm picking the right forum. Okay. One of my medications is Seroquel, but because I've developed akathisia (sp) so many times on different AP's, and as my left eye has started to twitch since I upped the Seroquel, I'd like to know if I can do without an AP. I've been purposely reading as many of your med cocktails as possible, but they're hard to keep track of. So, I suppose my question is the following: Have any of you been successfully treated with mood stabilizers alone? Anxiously awaiting your replies!

<{POST_SNAPBACK}>

Hi there,

  Yeah, I'm just taking anticonvulsant mood stabilizers.  It's a good way to go.  But the APs are mood stabilizers too, and good ones too.  They are indicated for treatment of Bipolar nowadays.  You can take the anticonvulsant mood stabilizers instead of APs like seroquel and be OK if it works out for you!

i share your opinion too that the antipsychotics' side effects suck more.  but they are real good as emergency meds (ie - knock you on your ass hehe)!

the issue though is finding the right anticonvulsants for you, though... and that takes time and a lot of work!

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Hi all,

I don't know whether I should be posting this on the AP board or this one, but I'm guessing I'm picking the right forum. Okay. One of my medications is Seroquel, but because I've developed akathisia (sp) so many times on different AP's, and as my left eye has started to twitch since I upped the Seroquel, I'd like to know if I can do without an AP. I've been purposely reading as many of your med cocktails as possible, but they're hard to keep track of. So, I suppose my question is the following: Have any of you been successfully treated with mood stabilizers alone? Anxiously awaiting your replies!

<{POST_SNAPBACK}>

Thank you to everyone who responded to my question; your input is priceless. Well, after I wrote the above post last night, both eyes began to twitch. The next thing I knew, my tongue was popping out of my mouth and curling up. I was like an alien. When my mouth started dancing, I called the ER, where I received a shot of cogentin. I was yanked off the Seroquel cold turkey, and although I'm experiencing withdrawal, things are going to be okay. My pdoc called today to see how I was doing, and after talking about it, we both decided to give lithium a try. I took my first baby dose (150mg) this morning, and I honestly felt a difference immediately. I'm to take another 150mg tonight, and then 300 at night until I see him next. I'm supposed to call him tomorrow to tell him how I'm doing. I'm also on Lamictal, so I'm hoping I'll also be a Lamictal+Lithium success story!

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"Why would somebody with a bipolar or depressive mood disorder want to use antipsychotics?"

Because mania always leads to psychosis for my husband. The AP's really help him alot. But once a major episode passes, he goes off the AP and uses a mood stabilizer alone (lamictal in his case).

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I have epilepsy, and when my doctor diagnosed my bipolar I was in a dilema...alot of the meds that treat bipolar cause my flavor of epilepsy to go out of wack. I opted not to use any meds except AC's, so as not to risk seizures. I take Depakote ER, Keppra, and Topamax. It works very well for me.

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wifezilla,

I did say, though, that, when mood states lead to psychotic symptoms, AP's could be used briefly. That's the only time they should be used in mood disorders.

Here was my guff about AP's and my experience with each of them:

Zyprexa- Left me in a severely agitated state few hours after each dose. The agitation was worse than what I get in my Mixed States. It felt like Hell.

Geodon- Initially knocked-out feeling and hardcore drug even at very low doses. Made me narcoleptic. While it was initially sedating me, it was doing something else in my brain and later made me Manic As Hell. I did stupid stuff while I took it. My doctor improperly prescribed it once a night. 2xday dosing wasn't much better, though. Basically, I went berserk on Geodon.

While taking it, I got paranoia delusions, mania, severe anxiety, excitation, wound up, and worsened the Mixed State.

Geodon interacted with Lexapro in such a way and sent me to the "Moon".

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APs have their place, even as mono-therapy. Just because one may work alright for monotherapy (think Symbax) doesn't mean it will for everyone.

I was on just zyprexa for a while which worked a bit. Helped calm me down. I haven't had many bad reactions to APs other than standard side effects that come w/ Zyprexa (weight gain, slept all day etc).

Ablify worked well to counteract my Prozac-induced mania. I didn't have any real noticeable side effects except a twitchy foot.

YMMV naturally, and some people do just fine on a mood stabilizer alone, but to each their own.

Good luck.

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Have any of you been successfully treated with mood stabilizers alone? Anxiously awaiting your replies!

<{POST_SNAPBACK}>

I wouldn't call it a success yet, but I am on Lamictal only and I am way better than I was before I started treatment.  My personal experience, mood stabilizers are the only thing that I have reacted well to.  Of course, I have only tried the one so my experience is not comprehensive.  Since I have less problems with straight out mania, APs aren't all that helpful for me.  Unless, of course, I have taken an AD.  Mania tends to be a problem at that point.

Just because one may work alright for monotherapy (think Symbax) doesn't mean it will for everyone.

<{POST_SNAPBACK}>

Count me as one that it doesn't work for.  Evil shit, IMHO.

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I did say, though, that, when mood states lead to psychotic symptoms, AP's could be used briefly. That's the only time they should be used in mood disorders.

Here was my guff about AP's and my experience with each of them...

On all of them, I hit jackpots on side effects. EPS, TD-like symptoms, akathisia, tics, other movement problems were somewhat prevalent esp. on higher doses but were evident some even on lower ones.

Well, that's you, and not everybody else.  YMMV, remember?  What sucks ass for you may be great for me.

I just don't need them. I guess it's because I don't have psychotic symptoms with my disorder in the first place.

Yay for you not needing them.  Boo for thinking that APs are ONLY for psychotic symptoms.  I got put on Zyprexa because I went manic awhile ago.  Psychotic symptoms=NONE.  Yet, it sure worked to knock out my manic symptoms.

APs can be used in conjunction with ACs or other meds to combat symptoms that aren't responding to those other meds.  Take Symbyax--an antidepressant, basically for bp's with hard to treat depression.  The Zyprexa boosts the Prozac to really hit the depression.  It's for depression and NOT psychosis.

Thinking any class of meds ought not be used for treating one sympotm or another is patently ridiculousand backwards.  If that kind of thinking were held in general, ALL vp's would have would be lithium and maybe ADs for the depression.  No ACs because hey, folks like me (and I suspect rather a majority of bp's) don't have epilepsy.  Ruling out a whole med class simply restricts treatment options.

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Hi everyone,

This is Jill. I'm on my second day of lithium (only 300mg), and I'm amazed by how much I pee. It's like I have to pee everytime I blink! Anyway, I'm pretty sure that I'm experiencing some nasty withdrawal after being yanked cold turky off Seroquel after the side-effects it caused.

I can't sleep at all, and I'm severely anxious, but not in a bipolar II way. I called the doctor, and he said I could take 25-50 mg of Seroquel for sleep, as that dosage is safe. Well, I took 25 mg this afternoon (I was desperate for sleep), and in addition to knocking me out, within about 15 minutes of taking it, I felt like I wanted to die. I swear it made me worse. I'm not taking any tonight. I'm realizing that while AP's work for some people, I'm just too sensitive for them. I'm actually scared of them now.

I'm just really worried, because I've always suffered from severe anxiety, and I don't know if my present anxiety is from withdrawal, or if it's just my usual hell. Can lithium help control anxiety? Also, I'm concerned because the Pdoc keeps saying that lithium isn't good for helping mixed-states. What do you think about this?

Thanks again for your help!

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Sorry that I implied that AP's were to be used only for psychotic disorders. Many people do have good responses to them for all disorders such as when used as augmentors to other meds.

I was just one of those, though, that didn't respond well to them and reacted adversely to them. So, I kinda gave them a bad rap in general. My mother certainly thinks they have a bad reputation based on my responses to them, and she's BP II as well.

I never have outright full-blown Euphoric or Dysphoric Mania with my disorder, but I have hellish tormenting [mixed state] depressions as part of my ultradian cycling that last as long as 9 hours thru a day. I would cycle thru normal mood then later, down to Hell for hours, then ascend back up to normal mood. As part of ultra-rapid cycling, I have few days in a row where I'm in a flat mood and basically in emotional numb state. I don't feel emotions at all, and I basically appear to have some kind of deficit syndrome. Then I have 2 (maybe 3 days) in a row of Ultradian cycling. Then back to few days in a row of flatness/deficit-syndrome.

When Geodon was added to my cocktail of Topamax and Lexapro 1.5 years ago, I went BERSERK. I had manic attacks from left to right. Five days after addition of Geodon, I got high, then higher.

My family doctor added Geodon just because I had a moderate depressive episode, before Lexapro fully kicked in. I had been taking it only a few weeks, and it took 4+ weeks before it reached full effect. I was also titrating on Topamax as well. He should have given me Klonopin to take temp. PRN instead.

Topamax and Lexapro alone were great, though, after Lexapro took full effect and Topamax titrated fully.

Abilify caused dysphoric mania and Zyprexa worsened the mixed state.

I'm finding that the AP's are what cause mania for me. Not AD's.

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