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Can nothing aid my Bipolar Depression?


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So I haven't posted in awhile, I apologize for that.  Never really made the transition to the new board.  So I'll re-introduce myself.  I'm 23, I'm finishing up my Master's Degree in Social Work (Mental Health and/ or Substance Abuse are my main interests).  I'm in the field interning at an agency 24 hours a week, take three classes, and spend 10-15 hours of my week working with a radical bookstore.  And . . .

I'm REALLY Bipolar.  I was diagnosed with BP1 When I was 20, I was put on Lithium and Klonopin.  There have been a myriad of other drugs that have come and gone.  Pre-diagnosis I was having trouble staying in college.  I ended up dropping out twice.  The second time after my second (and thankfully last) hospitalization. It's only been in the past two years that I have found any level of stabilization, and about a year that I have felt stable.  However, while my manias are gone, my depressions still come at their usual times (Winter, and Early Summer).  The episodes have actually been getting worse in a lot of ways, it's like every wave of depression I get my will weakens a little more.  I've have to relapses into self-injurous episodes in the past year.  A real bad bout this summer, and one that I think stopped within a day (it happened two weeks ago).

My current cocktail is: 900mg Lithium daily, and 1mg Klonopin daily.  I have Risperdal on hand for emergencies.  I'm experimenting with a 10mg dose of Celexa, but I'll get to that in a few paragraphs.

So. Now I guess it's time for the laundry list of meds I've been on, and why I'm not on them now.  One's with stars I'd consider trying again.

- Zyprexa and Seroquel - both of these made me MORE depressed, as I slowed down to the point of having trouble sleeping.  Became self-injurous and suicidal.

- Depakote - made me really crazy, really crazy it was like a mixed episode from hell inside a week.  Became self-injurous and paranoid to boot.

- Lamictal - Heart palpitations.

- Abilify - got so anxious I had to think everything 5 times before I would say it

* Prozac - was 15, and may have been the cause of my first notable manic episode

* Wellbutrin - made me way to happy in one week, could have been coincidence

* Trileptal - first time it seemed helpful, second time it did nothing

- Neurontin - did nothing for me

- Straterra - made me aggressive and otherwise hypomanic after several weeks

So yeah I'm experiementing with Celexa right now, along with new doctors.  This doc decided to start me on 10mg.  I have no sex drive, headaches, constipation and diarrhea (depends on the day), I'm getting agitated more and more frequently. Though that may have been not having Klonopin, this new doc thought it would be a good idea to stop Klonopin and start Celexa at the same time.  I corrected this mistake a few days ago, and got him to write me a new script for Klonopin.  I've been on the Celexa for a week and a half, and my gut is starting to say not good things, but at this point I'm willing to try anything.

The reason why I talked about what I spend my days doing is that I CANNOT afford to be hypomanic, or agitated in anyway when I'm in the field.  If my behavior becomes an issue, or if my moods for whatever reason cause me to need to leave the field I have to repeat this ENTIRE year.  So the pressure is on for me to make it.

So with that long winded history:

How long should I give the Celexa?  What are the warning signs some of you have experienced when an SSRI hasn't worked out?

What HAS worked for you?  Is it a *'ed med, or one I haven't tried?

In general advice?  Things that were beneficial that didn't come in pill form? 

And in Crazy Med speak I'm talking Whale Shit at the Bottom of the Ocean depressed, though fortunately this winter it hasn't reached that point yet, but this summer it did.

Thank you for reading all this.

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How long should I give the Celexa?  What are the warning signs some of you have experienced when an SSRI hasn't worked out?

What HAS worked for you?  Is it a *'ed med, or one I haven't tried?

<{POST_SNAPBACK}>

Usually the first choice for BP depression would be Lamictal, but you have already tried that.  It might be worth trying it again and seeing if you have better results.  A lot of people here use it in combo with Lithium and I think most are pretty happy with it. 

The other options would be ADs.  Some BPs tolerate them better than others.  Me, not so much.  It was pretty obvious with Lexapro.  48 hrs and I was in mixed state hell.  With Prozac, it was slower.  The first sign was heightened anxiety.  I would freak out over just about anything.  Then it became clear I was experiencing hypomania.  Irritable, racing thoughts, sleeping 4 hrs a night for a week.  What has worked for me is Lamictal.  I still get mild depression, but it is much better than it was.

So that is my experience.  Hope it helps.

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Lore,

Celexa made me hypomanic when I was on it without a mood stabilizer. It took only one week to do so. However, my psychiatrist is willing to start me up on it again (for I too am at the bottom of the ocean) because I'm on two mood stabilizers at the moment. lithium and lamictal. I'm sorry lamictal didn't work for you. i'm not saying it's been a miracle drug for me, but it's early in the game and i still have some hope. is there another mood stabilizer you could try? maybe you should talk to your pdoc about this.

Mechante

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Yeah, if it weren't for the fact it caused heart problems I would do the Lamictal again.  When I find another new doc (the current one is a quack) I might get an EEG and try lamictal again.

Welbutrin, I was on what ever the lowest time release dose is.

Thanks for the support.  Stories help especially since my doc will not "generalize" about how BPs have reacted to SSRIs.

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I've been on the lithium and Klonopin regimen for over a year and I still fought depression until Lamictal was added to the mix. I felt very well until I got to 150 mg. and now I feel very strange. Going to see if I can cut back down a little.

Lamictal can become pretty activating at higher doses, at least it did for me last time I tried it @ 200 mg. Maybe try it at a lower dose w/ lithium? That's what I'm going to try.

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Hi lore, another familiar face.  Welcome back as well.

Celexa made me hypomanic as well.  More racy, sped up.  Like Mechante, I don't think it took too long to do so but I don't remember exactly how long.  What else was I taking at the same time...gosh, this was a while ago...I think it was Tegretol/Carbamazepine.

As for other meds to suggest, how about Topamax? I <3 my Topamax.

Karen

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On trying Lamictal again, as I said before I'd have to get my heart checked out first, and any sane doc would probably still say no because of the heart problems I had the whole 24 hours I was on it.  I know it's a wonderful med, and is up for sainthood for it's good deeds with bipolar depression but I can't take it.

On Topamax, this is one that has been slipping off my radar and for no good reason.  The Trileptal seemed to be helpful just a little weak.  So another temporal lobe med WOULD probably be a good idea (thanks for the hope).  For those on topamax, and no anti-depressants is it helpful?  Same question goes to those on Tegretol and the other temporal meds.

Thanks again guys.

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Hi there,

Let's see...

1. Lexapro didn't induce any type of mania. It was better than nothing, but because it wasn't strong enough for me, the pdoc moved onto other SSRI's. Bad idea. Very. Bad. Idea.

2. Prozac made me bat-shit crazy. On the second or third day, I felt myself sinking into a deep depression. Within one week, I was experiencing a charming mixed episode.

3. Celexa, within one week, made me feel aggressive. Aggressive to the point of wanting to knock down little old ladies who were in my way. (I still find this weird, as the pdoc kept telling me that Celexa and Lexapro were the same drug.)

4. Zoloft. I just started Zoloft today. I'll keep you posted, but the only thing I'm experiencing from the drug thus far is nausea.

Take care...keep posting!

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For those on topamax, and no anti-depressants is it helpful?

<{POST_SNAPBACK}>

I can't touch any ADs anymore as they make me postively flip out.  I tried Strattera just this past summer and after 13 days I thought I was going to die (plust the physical side effects were too much.)  I'm surprised I made it that long.  And it's an SNRI.  Silly me.  Like I thought that would make a difference! Screw the ADD.  It's manageable without meds anyway, I guess.  Whatever.

A lot of people say that Topamax needs to be augmented with another anticonvulsant, that it won't work effectively on it's own.  I seem to be doing okay on it.  So is another poster on here.  As always YMMV.  But you're on some other stuff so it might play well with the lithium.  Don't know...

I can't remember but didn't you have some seizure activity as well? If so, this might be even more of a good fit? If in fact the seizure activity is happening in the right spot/s.  If not, sorry for confusing you with someone else!

Karen

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There was once a hypothesis that I had TLE, though this was crazy doc, who thought that I had ADHD and my tx plan should be Lithium and Aderall.  Even though she was the one who put me on concerta and landed me in the looney bin.

So TLE status is unknown.  However there are a lot of temporal lobe issues in my family hx.

I would probably go Tegretol before Topamax, but same sentiment.

I was told there was no major difference between Lexapro and Celexa too.  Though everything I'm reading is saying otherwise.  I would be ramming old bag ladies too, had a not been adament about starting back on Klonopin.  Right now my mood is plumenting because the Celexa has nixed my appetite, and I feel constant stomach upset to boot.  When I don't eat I get way too sad or way to happy.  I've only been able to get down one real meal a day, if that, this week.

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Hey lore- I think lexapro is stronger than celexa but I could be wrong.  I am

seriously considering topamax since I am allergic to trileptal.  I hope you can

figure some way to feel better.  I know when I don't eat my moods are all over

the place- I read somewhere that BPs are more sensitive to blood sugar drops, I

don't know how true that is but it seems to be true in my case anyway.  Is there

any way you could at least chug down a slimfast or instant breakfast drink in the

a.m in addition to the meal?

I have to resort to that sometimes when I'm manic and just can't stand to even look at food. 

Well, anyway, I wish you the best!.

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Hi again,

Just want to give you some antidepressant hope. My nausea from the Zoloft has finally abated, and as of press time, I'm not experiencing any type of mania. I'm hoping your Celexa-induced nausea will resolve itself soon. Celexa made me over-the-top nauseous, too. (But for some odd reason, Lexapro gave me no nausea.) For me, Lexapro and Celexa were as different as night and day. As you probably know, an empty stomach usually makes nausea worse. Hmm...Do you think you could munch on some Saltines? Hang in there!

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On exercise:

- In the spring I exercise everyday, in the winter less so.  We're working on a way for me to do my staff practice indoors.  I also walk a ridiculous amount year round.  Exercise IS really important.  Though with this is seems to make little difference, except when I'm agitated.  Swinging a staff around for an hour or so is really good at fixing that.

- I will try the breakfast drinks, I'll buy some this week, they should really help.  I actually hadn't thought of that, and that's why I love this board.  Solid foods are just *ick* to me right now.

- My plan is to go to the doctor on Tuesday and demand Lexapro.  However, my mom may be about to be diagnosed with Thyroid Cancer, and that would mean I would need to go off Lithium.  Thyroid conditions are genetic in my family.  So Tegretol and Topamax, may be the center of my posts in the near future.

For the person on Zoloft, if you read this, please read the crazymed pages on Zoloft it *can* but isn't always a bad mix with BP.  And to give *you* some hope there are tons of SSRIs out there that are nicer if Zoloft turns out to be not so nice.

Thanks for the support everyone.  I hope to go back to providing some back in the near future ;)

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