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I need a mood stabilizer


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I feel absolutely defeated and tired.  My personality has left me.  I feel like my brain is stuck in neutral. 

I see my Pdoc for the 2nd time this month Thursday.  I've been struggling through a depression while recovering from back surgery and going off 5 months of taking narcotics.  My Pdoc will not prescribe me any anti-depressants, they have caused mixed states in the past.

Seroquel has my main med for a while.  It's not stabilizing my mood like it used to.  I used to take lithium, which I swear made me emotionless, generally depressed + lethargic and was non-compliant on it.  I just tried lamictal, and stopped it for (I'm so bummed I can't take it) the 2nd time: my face and chest became very red and itchy.  So that's not an option.  10 years ago I tried Tegratol and had discontinue because of a low white blood count.  Has anyone had good results with any other mood stabilizers? 

Have they helped with depression?  It seems like lamictal and lithium are the only mood stabilizers that help with depression.

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You speak of depression.

Archetypally I'd suggest Lamictal.  I'm sad you can't take it. =(

That said, Zyprexa has been shown to really fight depression (and fight many of the side effects of narcotics W/D).  Though, since you complain of a sapping of your personality, perhaps you should avoid it.  It made me a zombie who slept 12-16 hours a day, and sapped my own personality (what little that was there to begin with =D).  Personally, I hate the big Z like the Devil, since it gave me akasthisia so horrendous that I had to leave a promising job in a place with nice weather and similar living costs to where I live now. =P

Perhaps Abilify is the right AP (and perhaps M/S) for you.  The overall profile that's been reported is that half the patients are activated whereas half are made somewhat sleepy.  It's not uncommon for it to be given to bipolars, though it's only officially FDA-approved for <6 month episodes of acute mania.  It's also the worst offender for akasthisia; my pdoc tried putting me on it and it gave me 10x the akasthisia symptoms the big Z gave me, and I went off it permanently.  Talk to your pdoc about it......

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You speak of depression.

Archetypally I'd suggest Lamictal.  I'm sad you can't take it. =(

That said, Zyprexa has been shown to really fight depression (and fight many of the side effects of narcotics W/D).  Though, since you complain of a sapping of your personality, perhaps you should avoid it.  Personally, I hate it like the Devil, since it gave me akasthisia so horrendous that I had to leave a promising job in a place with nice weather and similar living costs to where I live now. =P

Perhaps Abilify is the right AP (and perhaps M/S) for you.  The overall profile that's been reported is that half the patients are activated whereas half are made somewhat sleepy.  It's not uncommon for it to be given to bipolars, though it's only officially FDA-approved for <6 month episodes of acute mania.  It's also the worst offender for akasthisia; my pdoc tried putting me on it and it gave me 10x the akasthisia symptoms the big Z gave me, and I went off it permanently.  Talk to your pdoc about it......

<{POST_SNAPBACK}>

Thanks!  I'm looking for ideas to ask my pdoc! 

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Thanks!  I'm looking for ideas to ask my pdoc!

<{POST_SNAPBACK}>

spaz, I'm super-duper glad you found my suggestions useful.  Not just for my own ego-boosting ;-), but perhaps to do yourself some good, too. 

Please, please, though, keep in mind, if you've had any akasthisia issues (variable by patient; most experience a bit of restlessness and compulsive eating, compounding the metabolic issues that especially Zyprexa and Seroquel give, and in others, amazingly irrascible impatience with the restlessness, where patients can't seem to wait between 10:30:45 AM and 10:30:45+500 milliseconds AM.  The latter made me leave my nice job and do a W/D from the big Z.)

The W/D, after my 4 month 'addiction' to Z, went well until I completely went off from 2.5mg to zero dose; this lead to a hyperactive (and rather fun; thought I could leave home then) state for 2 weeks, followed by a stuporous, catatonic depression, where I only got up from bed to shower and perform bodily functions; I had to take meals in bed; God bless my parents for helping out with that, despite me being a college graduate who lay lamely at his parents' home.

I couldn't even leave home in Indiana until the combination of Cymbalta and Trazodone rendered me hypomanic (well, that, and after I was assured that despite high cortisol levels found in March '05, that I didn't have a major tumor!).

I know from this, that I can't take ANY dopamine antagonist (including all the AP/AAP family, as well as Reglan for my chronic indigestion/nausea/vomiting) EVER again.  The big Z is supposed to be the mildest for akasthisia; yet it gave me hell there.  And don't get me started on the EPS (Z is actually the worst offender there, with AAPs at least).  I already have an intention-tremor; that is, my hands shake quite a bit when I attempt to perform fine movements to direct (especially my hands) to a certain, very specific point.  The EPS from the big Z made the tremor so bad that it went beyond intention; I couldn't even deposit the 2 Tbsp. of sugar into hot tea that was required to make sweet iced tea (once the hot tea was then poured over generous ice, of course) =P.  The sugar would go all over the kitchen counter; thank God again for my older, more mature roommates in northern California as well as my parents, for cleaning up anything I failed to spot.

The take-home lesson is to be EXTREMELY careful with the APs and AAPs.  They can be extremely bizarre, if not outright dangerous (especially the regular APs!).  If you experience ANY weird symptoms, report to the pdoc IMMEDIATELY.

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Zyprexa.  Love it.  It made me fat, but I had no personality differences and I slept like a baby.  It did wonders for alleviating my depression.  Unfortunately, my metabolism actually started going backwards (I swear) and off my favorite drug I had to go.

I like my Seroquel, but it does seem to be losing its effectiveness, much like your complaint.

Topamax worked well, but I couldn't seem to find my sweet spot on it.  I used it as adjunct therapy, and now use it prn.

Geodon?  Depakote?  Chocolate ice cream?  I just had the latter, and its better than any mood stabilizer.

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Thanks!  I'm looking for ideas to ask my pdoc!

<{POST_SNAPBACK}>

spaz, I'm super-duper glad you found my suggestions useful.  Not just for my own ego-boosting ;-), but perhaps to do yourself some good, too. 

Please, please, though, keep in mind, if you've had any akasthisia issues (variable by patient; most experience a bit of restlessness and compulsive eating, compounding the metabolic issues that especially Zyprexa and Seroquel give, and in others, amazingly irrascible impatience with the restlessness, where patients can't seem to wait between 10:30:45 AM and 10:30:45+500 milliseconds AM.  The latter made me leave my nice job and do a W/D from the big Z.)

<{POST_SNAPBACK}>

herrfous:  I've been having periods of restlessness, not being able to sit still, and it never occurred to me that it might be the seroquel.  Another good question to bring up!

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Zyprexa.  Love it.  It made me fat, but I had no personality differences and I slept like a baby.  It did wonders for alleviating my depression.  Unfortunately, my metabolism actually started going backwards (I swear) and off my favorite drug I had to go.

I like my Seroquel, but it does seem to be losing its effectiveness, much like your complaint.

Topamax worked well, but I couldn't seem to find my sweet spot on it.  I used it as adjunct therapy, and now use it prn.

Geodon?  Depakote?  Chocolate ice cream?  I just had the latter, and its better than any mood stabilizer.

<{POST_SNAPBACK}>

JBella:  Thanks for the ideas.  I could handle chocolate ice cream.

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Hi Skaz,

Sorry to hear that you had trouble with Lamictal.  I too, have depression as my primary issue, and for quite a long time was able to use just Seroquel and Topamax.  I was on 600mg Seroquel, and 600 mg Topamax, and that held my mood to a nice baseline, until the midforties estrogen kindling starting kicking my ass.  Then I had to add lamictal.

Perhaps Topamax is something you might want to look into.  Yes, the side effects can be a bitch at first, but frankly, I found that they settle down, and that the benefits I get on cycling far outweigh the residual minor word finding that I have.

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Just up my alley, folks--I cannot take ANY of the Atypicals (The ugly ESP thing) so the only mood thing I am on is Tegretol, and 2 AD's--wellbutrin and Zoloft.  I am stable as a board, no depression, no cycling--

BUT NO ME!!!  I might as well be a shell, or a lump of coal, or a rock sitting on my couch.

I cannot stand this--I have read back thru old posts of mine, just to remind muself that cycling every 25 seconds and being crazy, while NOT dull, is not what I am seeking.

Isn't there anything--any mood stabalizer, especially--I can take that won't turn me into a stab;le, non-cycling ZOMBIE??  I hate this--I cannot tell you how I hate feeling like this.

Love china, back--not from the dead, but from 10 days on a work training thing, which THIS time I managed to get thru without freaking out. (Having a room to myself and lots of alone time helped)

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I've taken every Atypical and they each gave me a weird side effect. Risperdal even made me lactate (lucky I'm female lol) no kidding!

Every one of them made me feel like a stupid zombie.

But, every time I retry a med, I get a different reaction. Weird, I know. The first time I was on Lithium I lost my hair, and the second time I was so stupid I forgot my name. Really.

Consider giving LI another chance. Get your blood monitored- some pdocs are lazy and don't do this, and I think that's why I had issues. I'm going to give LI another chance due to my financial issues.

Geodon is the WORST of the WORST and I recommend everyone to stay away! I think some people do well on it, but it made me literally want to kill people. NOT a good side effect.

Abilify may do it. I took Abilify for awhile and it was ok. It didn't do it for me but it does for others.

Zyprexa is from hell. It will knock you on your ass. This is good if you are in a manic frenzy and they give you an injection in the ER, but not if you plan on fitting into a tent.

Brightest Blessings

OH--------> also there's Depakote. I had a friend who took LI for decades and then had liver issues, so was switched to Depakote. He's been without depression, mixed, or manic states and feels like himself.

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My pdoc put me back on Lithium.  She is really pushing the Seroquel, but I don't know about taking it long term, and I've started only taking 25mg on nights I can't fall asleep. 

I already have the old lithium taste in my mouth. 

I've been wondering about Depakote, it sounds like a good choice, I'll see how the lithobid does over the next month.

I've taken lithium before with mixed results.  I totally hear you chinacat!  Loon-A-TiK thanks.  Anelize, thanks too.  My whole med thing is really ticking me off!  I felt like I had no choice but to go back on LI.  Maybe it's for the best, I'll see.

Everything takes so long to work. 

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So basically it seems EVERY mood stabolizer sucks.  I need one too, but I don't like the sound of any of them.

So, which one do all of you think has the least side effects? 

Gaining even more weight is out of the question for me.  I gained enough on Remeron, still trying to lose it.

Lets take a poll here:

Which mood stabolizer sucks least?

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I've never tried an AP, but there are certainly a lot more ACs you could try.  Is there a particular reason your pdoc is leaning towards APs?  If not I'd say you should suggest trying some conventional mood stabilizers.

I took 1000mg depakote for years.  It was a really good mood stabilizer for me.  I did need an AD with it, so I took 300mg wellbutrin too.  I thought the depakote didn't help the depression, but I now realize that it only seemed that way because depakote initially sedated me quite a bit.

When I switched to tegretol from depakote I got terribly depressed 2-3 days after my last depakote dose.  It was awful, and the wellbutrin seemed to have no effect at all, even when we increased it to 450mg.  Lamictal has been much kinder to me, and I actually had to drop the wellbutrin back down to 300 when I got manic on the combination.  Since then I've been very stable with some mild situational depression now and then, largely because I'm now conscious of how much work I have to do to repair the wreckage.

Anyhow, here's the list of AC/mood stabilizers from crazymeds.us (sorry, gang, still my favorite med resource):

Topamax

Neurontin

Trileptal

Tegretol

Gabatril

And others not-so-commonly used.  Also check out psycheducation.org; Dr. Phelps has very good charts of medications and recommendations for treatment.  A very smart man. 

I know ADs are strongly discouraged for BP disorder.  However, if you don't get enough AD effect from lithium or the other stabilizers, it may be indicated.  Like I said, except for that initial episode with the lamictal-wellbutrin combination, I've doen very well on an AD plus stabilizer for many years.  If you do try it, make sure your pdoc prescribes a mood stabilizer that's proven to be OK for BP.  Wellbutrin is one; I know there are others. 

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What about Tomomax as a mood stabolizer?  Someone on another site told me he LOVES it.  Apparently if anything it causes weighloss instead of gain.  I'm still researching, but it might be less scary than lamictal or lithium or high doses of APs.

Does it suck?

Any thoughts experts?

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Geodon is the WORST of the WORST and I recommend everyone to stay away! I think some people do well on it, but it made me literally want to kill people. NOT a good side effect.

<{POST_SNAPBACK}>

I think this is a perfect YMMV example. I love Geodon.

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If lithium is an effective mood stabilizer for you, after a period of time (2 months?) you may want to ask your doctor about taking your full dose at one time, at night. Supposedly it diminishes the side effects.

<{POST_SNAPBACK}>

Thanks Glen.  I'm taking it that way now.  I had the shakes today, used some propanol.

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NARS,

That link has a chart where you can actually compare for making a decision on mood stabolizers. 

http://www.psycheducation.org/depression/m...stabilizers.htm

Good link.  BTW, I still like crazymeds too.  I'm not involved in the politics.

Thanks,

Dee

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That's a great link!  I was actually checking it out earlier today.  Thanks Nars and Dee.

My Pdoc says that I'm in a bit of a mixed state.  I was wondering if anyone has taken both Depakote and Lithium together?  I was reading about using the two at a low dose, and how that can be very effective.  My nerves are trembling right now on the lithium even though I took a klonopin and some propanol earlier. 

devilla:  Lithium does not suck the least! 

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