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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Chloe on June 27, 2002, at 19:26:04
Generally speaking I feel OK to a little depressed most of the time. Then every three weeks, I start feeling so great and ambitious. And I don't think it's linked to periods, as I am taking the BCP continuously which has stop my periods (and pms).
This go around, I was going to go back to school, start another career, cancel therapy sessions, go on an extended vacation, get involved with local organizations, etc. Then when I realize I can't do it all, I get into this agitated fury where I am screaming frofanities and hate words to the people I love and need. Also, during these agitated times, that last about 36-48 hours, I am highly suicidal, raging and beyond reason(and I often don't remember much of these episodes, or I have terrible remorse). AND I can't take AP's because I have TD from taking mellaril for years and years.
Does anyone have any thoughts on taking extra Depakote or lithium just during these times? Or is the fact that I am cycling at all a sign that I am not on enough mood stabilizer? I am quite petite, and get hit very hard with side effects, so my pdoc has me on many meds at low doses to avoid painful side effects. However, during the times I am not foaming and screaming, I am quite reasonable and rational.
FYI, I take
250 mgs depakote
225 mgs Li ER
600 mgs Neurontin
10 mgs diazapam
1.4 mgs Celexa
25 mgs Doxepin (for lithium induced scalp pain)Thanks
Chloe
Posted by jay on June 29, 2002, at 1:38:27
In reply to Cycling-depakote/Li prn????, posted by Chloe on June 27, 2002, at 19:26:04
Hi Chloe:
I am sorry to hear you are having such a rough time, and especially when you have a 'moment' when all heck breaks loose.
I have heard of docs both up'ing Depakote and Lithium, as your doses do seem a bit low (Esp the Depakote). I wouldn't advise doing it on your own, though, as you know with all of the meds you are on, you may have to have your blood levels of the medications taken. Plus, you also want to get on a 'theraputic' (helpful) level of medications.
Also, did you say 1.4 mg's of Celexa? How do you get that dose? Just curious...and also has your doctor ever tried another antidepressant besides Celexa?
Hope and prayers are with you...please take good care of yourself.
Jay
> Generally speaking I feel OK to a little depressed most of the time. Then every three weeks, I start feeling so great and ambitious. And I don't think it's linked to periods, as I am taking the BCP continuously which has stop my periods (and pms).
>
> This go around, I was going to go back to school, start another career, cancel therapy sessions, go on an extended vacation, get involved with local organizations, etc. Then when I realize I can't do it all, I get into this agitated fury where I am screaming frofanities and hate words to the people I love and need. Also, during these agitated times, that last about 36-48 hours, I am highly suicidal, raging and beyond reason(and I often don't remember much of these episodes, or I have terrible remorse). AND I can't take AP's because I have TD from taking mellaril for years and years.
>
> Does anyone have any thoughts on taking extra Depakote or lithium just during these times? Or is the fact that I am cycling at all a sign that I am not on enough mood stabilizer? I am quite petite, and get hit very hard with side effects, so my pdoc has me on many meds at low doses to avoid painful side effects. However, during the times I am not foaming and screaming, I am quite reasonable and rational.
>
> FYI, I take
> 250 mgs depakote
> 225 mgs Li ER
> 600 mgs Neurontin
> 10 mgs diazapam
> 1.4 mgs Celexa
> 25 mgs Doxepin (for lithium induced scalp pain)
>
> Thanks
> Chloe
Posted by Chloe on June 29, 2002, at 15:34:12
In reply to Re: Cycling-depakote/Li prn???? » Chloe, posted by jay on June 29, 2002, at 1:38:27
> Hi Chloe:
>
> I am sorry to hear you are having such a rough time, and especially when you have a 'moment' when all heck breaks loose.Thanks for responding. The cycles just seem to be taking over lately...But i can't remember a time in my life without them, on meds or off. But, during these episodes, I can never remember feeling "well" and functional. But then when I get back on my feet again, I can't believe I have times of such pain, dissociation and psychosis.
> I have heard of docs both up'ing Depakote and Lithium, as your doses do seem a bit low (Esp the Depakote). I wouldn't advise doing it on your own, though, as you know with all of the meds you are on, you may have to have your blood levels of the medications taken. Plus, you also want to get on a 'theraputic' (helpful) level of medications.Yes, I should be intouch with the pdoc about this. But during difficult times she can be particularly hard to reach...Over Mother's day I had a really bad episode, and I paged her many times, and she didn't get back to me for 48 hours. And her pager is for emergencies (which it was...)! Thank heavens I was able to stay safe. I guess I need to arrange some kind of plan during emergencies with her...
> Also, did you say 1.4 mg's of Celexa? How do you get that dose? Just curious...and also has your doctor ever tried another antidepressant besides Celexa?Yes, 1.4 mgs in liquid form. SSRI's work for me at very tiny doses. Otherwise I am SO anxious and agitated and feel rushed all the time, like I literally have to run everywhere. More than 1.4 mgs I am too edgy and speedy, any less, and I tend to obsess a little more. I think the AD effect has long pooped out. That happened with prozac and zoloft. I tried and failed with Serzone, Wellbutrin...AD's in general seem to agitate me and make me cycle more. So a little is best. But I do think I am always feeling pretty blue and blah. I work at not getting caught up in negative thinking patterns...Which helps but doesn't take that chronic "ache" away.
> Hope and prayers are with you...please take good care of yourself.
Thanks Jay, I appreciate the sentiment. I am sorry I am not familar with your history, but do you have trouble with cycling and the ol' rollercoaster of moods? Do have any meds you find useful?
Chloe> Jay
>
>
> > Generally speaking I feel OK to a little depressed most of the time. Then every three weeks, I start feeling so great and ambitious. And I don't think it's linked to periods, as I am taking the BCP continuously which has stop my periods (and pms).
> >
> > This go around, I was going to go back to school, start another career, cancel therapy sessions, go on an extended vacation, get involved with local organizations, etc. Then when I realize I can't do it all, I get into this agitated fury where I am screaming frofanities and hate words to the people I love and need. Also, during these agitated times, that last about 36-48 hours, I am highly suicidal, raging and beyond reason(and I often don't remember much of these episodes, or I have terrible remorse). AND I can't take AP's because I have TD from taking mellaril for years and years.
> >
> > Does anyone have any thoughts on taking extra Depakote or lithium just during these times? Or is the fact that I am cycling at all a sign that I am not on enough mood stabilizer? I am quite petite, and get hit very hard with side effects, so my pdoc has me on many meds at low doses to avoid painful side effects. However, during the times I am not foaming and screaming, I am quite reasonable and rational.
> >
> > FYI, I take
> > 250 mgs depakote
> > 225 mgs Li ER
> > 600 mgs Neurontin
> > 10 mgs diazapam
> > 1.4 mgs Celexa
> > 25 mgs Doxepin (for lithium induced scalp pain)
> >
> > Thanks
> > Chloe
Posted by Ritch on July 3, 2002, at 1:06:13
In reply to Cycling-depakote/Li prn????, posted by Chloe on June 27, 2002, at 19:26:04
> Generally speaking I feel OK to a little depressed most of the time. Then every three weeks, I start feeling so great and ambitious. And I don't think it's linked to periods, as I am taking the BCP continuously which has stop my periods (and pms).
>
> This go around, I was going to go back to school, start another career, cancel therapy sessions, go on an extended vacation, get involved with local organizations, etc. Then when I realize I can't do it all, I get into this agitated fury where I am screaming frofanities and hate words to the people I love and need. Also, during these agitated times, that last about 36-48 hours, I am highly suicidal, raging and beyond reason(and I often don't remember much of these episodes, or I have terrible remorse). AND I can't take AP's because I have TD from taking mellaril for years and years.
>
> Does anyone have any thoughts on taking extra Depakote or lithium just during these times? Or is the fact that I am cycling at all a sign that I am not on enough mood stabilizer? I am quite petite, and get hit very hard with side effects, so my pdoc has me on many meds at low doses to avoid painful side effects. However, during the times I am not foaming and screaming, I am quite reasonable and rational.
>
> FYI, I take
> 250 mgs depakote
> 225 mgs Li ER
> 600 mgs Neurontin
> 10 mgs diazapam
> 1.4 mgs Celexa
> 25 mgs Doxepin (for lithium induced scalp pain)
>
> Thanks
> ChloeHi there! I have been away for a while. My suggestion would be to up the Depakote to 500mg at bedtime or 250mg twice daily. It definitely works better on my temper than anything else.
Mitch
Posted by Chloe on July 3, 2002, at 18:45:24
In reply to Re: Cycling-depakote/Li prn???? » Chloe, posted by Ritch on July 3, 2002, at 1:06:13
> Hi there! I have been away for a while. My suggestion would be to up the Depakote to 500mg at bedtime or 250mg twice daily. It definitely works better on my temper than anything else.
>
> Mitch
Hey Mitch,
I was wondering about you...Hoping you were doing ok and all.
I have been in an agitated rages on and off for days. I have wanted to increase the Depakote. But if I increase a med, like depakote, I have a hell of a time decreasing it. So everytime I bump up a med, it becomes permanent, because I get so irritable trying to decreasing the dose. Depakote is fairly benign interms of side effects, except for the hair loss thing, for me. It's like a hair-be-gone pill for me. I loose so much hair everyday, it's amazing I still look like i have a decent but fine crop.
I also hate the weight gain thing. It increases appetite and with the doxepin+depakote+bcp, i am just starving all the time. I guess it's better than a stark raving lunitic.I HATE it when I cycle. More than anything. On my latest "up", I planned this "vacation" where I intend to drive 600 miles by myself. So I can spend two weeks with my family, i.e parents, brother, sister, nephews. I was so excited about this at the time. I rented a cottage for two weeks, rented a car that could make the trip. I was so high and confident. I thought this was going to be the greatest trip. Well, I have all this money invested in this, and my family is so excited that I am coming, and everyday since my crash about a week ago, I can't stop freaking out about this. I start crying in panic, dissociating or planning my final exit, because I am to embarrassed to cancel and loose all the money and disappoint my family. I am so messed up now, I just don't know what to do. The date is going to come, and I think I am just not going to go. I can't handle it in my agitated depressed state. This trip would be a challenge on a good day!
But who knows I might cycle around into feeling EXTREMELY ambitious, and want to go on this trip. I sure can't imagine it now. My therapist kept saying two weeks is a long time, family always gets you going, yadda, yadda. I scoffed at his attempts to reeling me back in. Oops. Now I am really in a mess. And I don't know if dep. will help. It sure won't help the depression part of this. But might make me more reasonable in the interum.
Sorry for the blab fest. I guess I am really scared this time. Cycling should not be taken lightly. The crash, IMO is too hard to live through time and time again...I wish my pdoc were more help.
I am really glad to hear from you. I missed reading your posts. How are you doing? Any secrets to the perfect med regime? :?)
Chloe
Posted by Ritch on July 3, 2002, at 23:25:14
In reply to Re: Cycling-depakote/Li prn???? » Ritch, posted by Chloe on July 3, 2002, at 18:45:24
> > Hi there! I have been away for a while. My suggestion would be to up the Depakote to 500mg at bedtime or 250mg twice daily. It definitely works better on my temper than anything else.
> >
> > Mitch
>
>
> Hey Mitch,
> I was wondering about you...Hoping you were doing ok and all.
>
> I have been in an agitated rages on and off for days. I have wanted to increase the Depakote. But if I increase a med, like depakote, I have a hell of a time decreasing it. So everytime I bump up a med, it becomes permanent, because I get so irritable trying to decreasing the dose. Depakote is fairly benign interms of side effects, except for the hair loss thing, for me. It's like a hair-be-gone pill for me. I loose so much hair everyday, it's amazing I still look like i have a decent but fine crop.
> I also hate the weight gain thing. It increases appetite and with the doxepin+depakote+bcp, i am just starving all the time. I guess it's better than a stark raving lunitic.
>
> I HATE it when I cycle. More than anything. On my latest "up", I planned this "vacation" where I intend to drive 600 miles by myself. So I can spend two weeks with my family, i.e parents, brother, sister, nephews. I was so excited about this at the time. I rented a cottage for two weeks, rented a car that could make the trip. I was so high and confident. I thought this was going to be the greatest trip. Well, I have all this money invested in this, and my family is so excited that I am coming, and everyday since my crash about a week ago, I can't stop freaking out about this. I start crying in panic, dissociating or planning my final exit, because I am to embarrassed to cancel and loose all the money and disappoint my family. I am so messed up now, I just don't know what to do. The date is going to come, and I think I am just not going to go. I can't handle it in my agitated depressed state. This trip would be a challenge on a good day!
>
> But who knows I might cycle around into feeling EXTREMELY ambitious, and want to go on this trip. I sure can't imagine it now. My therapist kept saying two weeks is a long time, family always gets you going, yadda, yadda. I scoffed at his attempts to reeling me back in. Oops. Now I am really in a mess. And I don't know if dep. will help. It sure won't help the depression part of this. But might make me more reasonable in the interum.
>
> Sorry for the blab fest. I guess I am really scared this time. Cycling should not be taken lightly. The crash, IMO is too hard to live through time and time again...I wish my pdoc were more help.
>
> I am really glad to hear from you. I missed reading your posts. How are you doing? Any secrets to the perfect med regime? :?)
> Chloe
Hi,The Depakote is probably going to work on your rapid cycling a lot better. I got hungrier too when I restarted it a couple of months ago (after being off for over a year). But, I am taking a little bit of Effexor with it and the Effex. kills my appetite really well, so I have actually *lost* some weight in the last few days. I quit Neurontin, BTW. I was feeling so so sleepy during the day. I know a lot of it was the Dep, but I thought, why not kill the N? I was only taking 300mg/day anyhow. There was a withdrawal, although mild. The first thing that I noticed was a big increase in light-sensitivity. Everything was much brighter. Then I felt a little agitated. That passed after a week or two. But, the big benefit was the reduction of the daytime tiredness associated with it. Also, the noradrenergic activity of the Effexor is activating me during the day and is wearing off by bedtime so I can sleep OK. NO early-morning awakenings now for about a week! So, I am on Depakote 250mg+Klonopin .5mg at bedtime, with Effexor 25mg AM. That's it, plus Flax seed oil/Evening Primrose (just 2 caps each/day). If I can maintain this 6-7hr uninterrupted sleep pattern I can keep serious depression away-fingers crossed! I have to put up with this for another six-eight weeks.
Mitch
Posted by Chloe on July 4, 2002, at 21:44:06
In reply to Re: Cycling-depakote/Li prn???? » Chloe, posted by Ritch on July 3, 2002, at 23:25:14
> Hi,
>
> The Depakote is probably going to work on your rapid cycling a lot better. I got hungrier too when I restarted it a couple of months ago (after being off for over a year). But, I am taking a little bit of Effexor with it and the Effex. kills my appetite really well, so I have actually *lost* some weight in the last few days. I quit Neurontin, BTW. I was feeling so so sleepy during the day. I know a lot of it was the Dep, but I thought, why not kill the N? I was only taking 300mg/day anyhow. There was a withdrawal, although mild. The first thing that I noticed was a big increase in light-sensitivity. Everything was much brighter. Then I felt a little agitated. That passed after a week or two. But, the big benefit was the reduction of the daytime tiredness associated with it. Also, the noradrenergic activity of the Effexor is activating me during the day and is wearing off by bedtime so I can sleep OK. NO early-morning awakenings now for about a week! So, I am on Depakote 250mg+Klonopin .5mg at bedtime, with Effexor 25mg AM. That's it, plus Flax seed oil/Evening Primrose (just 2 caps each/day). If I can maintain this 6-7hr uninterrupted sleep pattern I can keep serious depression away-fingers crossed! I have to put up with this for another six-eight weeks.
>
> MitchWow, maybe you have stumble upon something! I am so glad you are able to sleep through the night uninterrupted. I am jealous! I still have early morning waking, even with the doxepin. (FYI, I don't sleep as well with the doxepin. I wake up at dawn and can't fall back to sleep soundly. I just turn and dream alot. But the lighter am sleep is worth it, since my pain is manageable AND my mood is marketedly better. I was so ugly and explosive on ami, it was really awful LOL)
So going off the N wasn't so bad for you? I notice if I miss my dose by an hour! I get very irritable, unfocused, rushed. How nice that you don't miss it and eveb feel better during the day. It's also impressive that the noradrenergic activity of the Effexor is not making you grouchy, like you reported with noradrenergic meds like Ami or Doxepin.I am so you are feeling well for the time being. I will keep my fingers crossed for you, too.
Oh, one question. Do you take all your depakote at night? Do you think it's better to space it out, to have a more constant blood level? Also, have you heard anything about Depakote ER being better for the notorious side effects of hair loss or weight gain? Hum, I guess that was two questions...Thanx
Chloe
Posted by Ritch on July 4, 2002, at 23:43:53
In reply to Re: Cycling-depakote/Li prn???? » Ritch, posted by Chloe on July 4, 2002, at 21:44:06
> Wow, maybe you have stumble upon something! I am so glad you are able to sleep through the night uninterrupted. I am jealous! I still have early morning waking, even with the doxepin. (FYI, I don't sleep as well with the doxepin. I wake up at dawn and can't fall back to sleep soundly. I just turn and dream alot. But the lighter am sleep is worth it, since my pain is manageable AND my mood is marketedly better. I was so ugly and explosive on ami, it was really awful LOL)
> So going off the N wasn't so bad for you? I notice if I miss my dose by an hour! I get very irritable, unfocused, rushed. How nice that you don't miss it and eveb feel better during the day. It's also impressive that the noradrenergic activity of the Effexor is not making you grouchy, like you reported with noradrenergic meds like Ami or Doxepin.
>
> I am so you are feeling well for the time being. I will keep my fingers crossed for you, too.
>
> Oh, one question. Do you take all your depakote at night? Do you think it's better to space it out, to have a more constant blood level? Also, have you heard anything about Depakote ER being better for the notorious side effects of hair loss or weight gain? Hum, I guess that was two questions...Thanx
> Chloe
Chloe,It is unfortunate that antidepressants can mess up your sleep as much as depression can! It seems that the half-lifes make a big difference. Prozac, Zoloft, Imipramine, Wellbutrin, and even higher doses of Celexa would disrupt my sleep. Strangely, psychostimulants didn't mess it up, and the shorter half-life AD's didn't seem to bother things like Paxil or Effexor. It seems that if the AD blood level is crashing by bedtime, I sleep OK, and feel rested the next day.
Depakote-I take it all (250mg) at bedtime. I thought about 125mg bid, (and have done that before), but found that it makes me too hungry in the afternoons after I take it. I am still impressed with its ability to suppress anger and hostility impulsiveness. I am taking the same low-dose Effexor I took years ago (that triggered hostility then), and I am not getting short-fused now. So, it seems to be the *presence* of the Depakote more than the *absence* of Effexor leading to being *not* hostile. I never have tried any ER Depakote. I suspect that it only is helpful for folks with seizures on high doses that need to minimize side-effects (just a guess).
take care,
Mitch
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