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Dr. Bob is Robert Hsiung, MD,
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Posted by Christy Sales on October 7, 2000, at 12:18:26
I have suffered from what I believe is manic depression in a bad way for about two years. about a year ago I was diagnosed as bipolar. I have tried different meds. & found celexa and lithium to work well. however, along with the depression I have been unable to concentrate at all really. (racing thoughts, jumping from one thing to another, anxiety sometimes)
I've been seeing a new dr. and recently brought this problem up. so he has prescribed me concerta (ritalin). he also hopes I might be off my other meds because this will work well. now I am starting to realize he believes me to be add? or is just using me as a ginuea pig. I've been told that this is one of the worst drugs you can give to someone who is bipolar & I should find a new dr. I don't know what to do, does anybody know much about this? I can't find much at all online & I'd really appreciate any info. thanks :)
Posted by Darby on October 7, 2000, at 22:48:02
In reply to manic depression and ritalin (concerta)?, posted by Christy Sales on October 7, 2000, at 12:18:26
Christy:
Little if anything regarding these kinds of illnesses is etched in stone. Good and experienced psychiatrists know to listen to their patients for signs and symptoms, to be flexible but careful with possible treatments, and to try various regimens that might work for YOUR particular depressive illness, no matter the official diagnosis. Yes, an element of ADD/AHDH is a possibilty. I'd express my concerns directly to your doctor (as you just did in this forum), have him explain his reasons for selecting this drug, and give it a try. Ask him if you might be better off starting with a small dose of the standard Ritalin (methylphendate) tablet since it is much quicker acting and stays in the body for a shorter period of time. Concerta is a new, extended-release form of Ritalin which slowly releases the drug over the course of the day. If you respond well to the tablets, you could switch to Concerta. Of course, monitor the side effects closely and keep your MD informed.
Pharmacological treatments for most illnesses are trial and error. What works for you (drug & dose) may not work for someone else. I say be bold, try new approaches in close concert with your doctor, and try to take control of your life. If you're still unsure, always get a second professional opinion.
Best,
Darby
Posted by noa on October 8, 2000, at 9:45:56
In reply to Re: manic depression and ritalin (concerta)?, posted by Darby on October 7, 2000, at 22:48:02
Darby gives good advice. Often, it is individual's symptoms, not the dx that leads the decision making with meds, and trial and error is part of it.
With methylphenidate, trial and error is easy because it is so short acting. If it isn't a good fit, you just stop.
As with most meds, start with a low dose and work up.
BTW, it is not that uncommon for ADD and BP to co-occur. Did you have signs of ADD as a young child?
Posted by noa on October 8, 2000, at 9:49:42
In reply to manic depression and ritalin (concerta)?, posted by Christy Sales on October 7, 2000, at 12:18:26
By any chance, did you notice more restlessness/anxiety from the celexa, either when first taking it or after a dose increase? I guess I am wondering this because of the loss of concetration, etc.
For me, too much serotonin has caused a sort of hyperactivity---edginess, fidgiting, restlessness, insomnia, etc. On the other hand, other people find the same meds make them drowsy and sedated. You can see why trial and error works--we each react diferently.
Just wondering....
Posted by pullmarine on October 9, 2000, at 3:44:47
In reply to manic depression and ritalin (concerta)?, posted by Christy Sales on October 7, 2000, at 12:18:26
Ritalin can cause mania, and psychosis, make sure your doctor is monitoring you well while you switch to stop mania or psychosis at its onset. This having been said. stimulants can also be used to combat mania by saturating the neurons (or so my doc in belgium told my, and it's true that during my mania, ritalin did slow me down.
In sum, ritalin can help, or add fuel to the fire, so u better watch out.John
> I have suffered from what I believe is manic depression in a bad way for about two years. about a year ago I was diagnosed as bipolar. I have tried different meds. & found celexa and lithium to work well. however, along with the depression I have been unable to concentrate at all really. (racing thoughts, jumping from one thing to another, anxiety sometimes)
> I've been seeing a new dr. and recently brought this problem up. so he has prescribed me concerta (ritalin). he also hopes I might be off my other meds because this will work well. now I am starting to realize he believes me to be add? or is just using me as a ginuea pig. I've been told that this is one of the worst drugs you can give to someone who is bipolar & I should find a new dr. I don't know what to do, does anybody know much about this? I can't find much at all online & I'd really appreciate any info. thanks :)
Posted by Mark H. on October 10, 2000, at 21:02:07
In reply to manic depression and ritalin (concerta)?, posted by Christy Sales on October 7, 2000, at 12:18:26
Hi Christy,
I'm bipolar and take methylphenidate; in fact, I probably couldn't hold down a responsible job without it. During the two times of year when I'm "up," I just naturally take less of it -- I don't even have to think about it; my need for it just falls off, sometimes to zero. In my system, it's more gentle than caffeine. I had to quit drinking coffee 12 years ago.
For those of us who need it, methylphenidate can be paradoxical in its action, which is an incentive to keep the dosage as low as possible. A small amount stimulates, but a larger amount (past a point that is different with each person), it can make me very tired and put me right to sleep. To remain effective, I have to take a bit less than might feel optimal on a given day. Likewise, I can't use it as a sleep replacement, or it just isn't there for me when I really need it.
My stock advice is to take 1/4 of whatever your doctor prescribes to start, until you know how it will affect you. Among people I've discussed this with, all knew within a day or two whether they were helped or hindered by methylphenidate. If you listen to your body, you'll probably be fine.
Among "normals," abuse potential for methylphenidate is high, but I have not seen that among those who need it. That's one reason why trying it may be the only way to know whether it's appropriate for you to take.
Pullmarine's caution is correct, however. Potentially, a strong stimulant can bring on mania and psychosis. However, starting with a low dose and listening to your body will reduce the danger.
So we all learn something, please let us know how it works for you.
Best wishes,
Mark H.
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