Posted by Keith Talent on January 11, 2004, at 22:57:53
In reply to Re: I Need Suggestions--crazyukchick, posted by Tom G on January 11, 2004, at 20:39:40
I was diagnosed with Bipolar II Disorder, but after a few years, I think it's too soft a phenomenon to be meaningful. I've found it's more useful to conceive of my problem as Major Depressive Disorder. Hell, I hardly ever was high, and even then it was all too fleeting!
Five days on lithium at 1200 mg a day is not an adequate trial. More like six months at 1.0 mEq/L. In PubMed there are a couple of studies from the seventies and early eighties that found that dextroamphetamine produced some improvement acutely in manic episodes. There's a lot that we don't know! Interestingly, tranylcypromine (Parnate) is structurally similar to the amphetamines and has a short-term stimulating effect separate to its long-term antidepressant effect.
I would go on tranylcypromine. People have posted here that they've needed up to 160 mg a day, so don't accept failure at 60. If you still aren't happy with the hypomanic/manic control, go on lithium for six months. Then if it disagreed with you, divalproex, then oxcarbazepine, then lamotrigine.
poster:Keith Talent
thread:299090
URL: http://www.dr-bob.org/babble/20040109/msgs/299635.html