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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Starlight on September 10, 2004, at 14:54:26
Hi,
I went to my new Pdoc yesterday and am thinking that she's the wrong one for me. I'm Bipolar III currently take 75 mgs of Effexor, 300 Lamictal and 1800 Trileptal. I've had some hypomania, but my hypomania isn't unmanageable at all. I do have occasional anxiety, but so far no drops into depression. No one in my family has been diagnosed with Bipolar but me, and for me it was kindled by wellbutrin (supposedly).Here's my frustration. I don't want anymore drugs, nada. I sleep fine, work fine, still have creative energy, and good stable relationships with people. I'm aware of my problems and willing to address them head on.
The thing that I'm really wary of is that she seems to want to push the drugs. Now she's pushing abilify for some anxiety. Initially when she was talking about putting me on Effexor she was pushing Provigil as well and telling me that she's found that to be a good combination.
This is the second time that she has said to me, "Do you know how many different drugs that the average bipolar person takes? Seven." She said it in the last two appointments that I've had. It seems like a signal that she's wanting to push the drugs and seems to discount my lack of willingness with the whole stigma argument.
But it's not the stigma, it's the side effects. You start looking deeper at these drugs and the side effect panels, and I want my treatment to be as efficient as possible. I'd rather self medicate with pot which isn't going to make my hair fall out or give me electric shocks if I quit or any of the other side effects that are included in these drug profiles. But being put on another drug that is going to affect my brain long term and have strong withdrawl effects isn't acceptable to me.
Comments? Is she just pushing drugs? Wanting me to take 7 drugs?
Disclaimer: I know that alot of you take multiple drugs and there are many different levels of these illnesses. I would describe mine as being fairly mild.
Thanks,
Starlight
Posted by HappyGirl on September 10, 2004, at 17:06:28
In reply to Average Bipolar Person on 7 different Meds!, posted by Starlight on September 10, 2004, at 14:54:26
Hi:
I have NO idea why your prod. wants you to get so many drugs. Mine is totally opposite, ... he wants me as little as possible. In fact, at the beginning when I started visiting him, I was just two meds. Zyprexa and Lithium that seemed NOT acceptable to my condition, Bp II with rapid cycler. After about three to four months on these two, a depressive side of my Bp got worse, then he FINALLY put one A.D., but this A.D. is one of the weakest group of A.D.s, then at last he put me on one more A.D., in total, four different meds, Lithium, Zyprexa and two A.D.s.
He told me this is 'MAX,' ... no more med. for me unless some 'awful' thing would happen.In my opinion, if you are fairly functionable, then you don't need more med. Rather, to stick with those three meds. However, in my guess, ... the reason why your pdoc. wants you on MORE/additional meds. is probably because she believes/thinks you can get MORE 'normalcy,' ... in other words, 'more pdoctivity.' Then, if you'd agree with her in this respect, you could take this route/her plan. Because, some of BP's prefer more med. in order to get 'HIGH' functionability.
H.G.
Posted by Starlight on September 10, 2004, at 17:40:25
In reply to Re: Average Bipolar Person on 7 different Meds!, posted by HappyGirl on September 10, 2004, at 17:06:28
Thanks for answering, it's a pretty touchy subject with me. I'm very high functioning, so I've got that down pretty well. I think the Effexor, even though it's a low dose has made me a bit more tired, but the thing is, you take this medication to get this effect, and that medication to treat the side effect of the first and so on and so on.
It really bugs me that she goes into the "average BP person takes 7 meds" routine. And what is 'more' normalcy. Everyone I know goes through some ups and downs, so that would seem to be pretty normal. I don't want to be flatlined, but don't want to be crawling up the walls or digging ditches either. So far I think I have a fairly good balance. But I'm definitely opposed to adding Abilify to the mix.
starlight
Posted by HappyGirl on September 10, 2004, at 20:12:43
In reply to Re: Average Bipolar Person on 7 different Meds!, posted by Starlight on September 10, 2004, at 17:40:25
Hi:
Did you say to your pdoc., ... you'r pefectly fine with three meds.? Just a polite explanation must be sufficient in this situation.I, too adamantly opposed 'Abilify, because this med. is one of atypical anti-psychotic meds. UNLESS you have some kind of problem, such as 'dysphoric/rageous form,' 'a bit of psychotic,' and 'rapid/racing thougths,' and any other 'serious' form that normal/oridinaly' mood-stabilizers have no capability to alleviate.
I am, also VERY difficult to understand your pdoc.'s intention/plan about 'SEVEN(7)' different class of mds. Normally, just three, mood-stabilizer, anti-dep. and anti-anxiety that includes 'sleeping-aid.' However, she sounds like a good pdoc., as seeing the stability of your Bp. If it were you, ... I ask her the reason why you need more meds. and explain in detail about your 'good' functinability thanks to 'THRE' meds. Probably, she may have some 'misunderstanding' on your situation. That said, some pdocs. believe 'bread-winners,' even single(male and female) people without any financial support need 'high functionability' to earn steady pay-check, often 'all-household' cover type of pay. In terms of meds., most of pdocs. prefer NOT to over-medicated his/her patients. It seems to me your pdoc. is very unique in this respect. But, if you likes her, try not to conflict with her.
H.G.
Posted by Phamos818 on September 11, 2004, at 3:19:01
In reply to Average Bipolar Person on 7 different Meds!, posted by Starlight on September 10, 2004, at 14:54:26
i've tried to respond to this a few times and my messages keep getting eaten, so i'll keep it short.
NO, the average bipolar patient is NOT on 7 different meds. i'd say a good coctail to aim for is an antidepressant, a mood stabilizer, and (if you're bipolar 1) an atypcal antipsychotic, with either a sleeping pill (like ambien) or an antianxiolytic (like xanax).
you should NOT take abilify for anxiety. that's not what atypicals are for. someone who's bipolar III should not need to take an antipsychotic. and you should be glad of that -- atypicals are serious drugs and they're too new to know what long term side effects they'll have.
if you feel functional on what you're taking, why does your doc want to prescribe so much more?
Posted by starlight on September 11, 2004, at 10:47:34
In reply to Re: Average Bipolar Person on 7 different Meds!, posted by Phamos818 on September 11, 2004, at 3:19:01
Phamos818,
That's exactly what I find disturbing. I take two mood stabilizers and Effexor to combat depression which can be difficult to deal with, but as far as my depression, I think it's in pretty good control since I've had some real butt kickers in life this year and feel good about how I've handled and dealt with these challenges. I think my anxiety is somewhat better, but could be improved (left over PTSD from an abusive childhood). I actually thought that the anxiety might be better treated with a slight increase in the Effexor, since that can have a good impact on its own.I personally find it rather strange that she keeps mentioning that. I function really well, have a good job, a band, teach yoga, etc. So I can't fathom why she seems to be pushing it. At my last appointment when she added the Effexor, she mentioned Provigil as well. And again, I said, no more than these 3. When she mentioned the Abilify, I felt this shift in my body saying 'no way, what's up with her and the meds'. I just find it strange that her response would be to bring up the multiple medication thing. I've never seen anything that said that the average bipolar person took 7 meds. Especially BP2 or 3. I'm considered a 3 due to it being brought on by Wellbutrin, but even then I still have my doubts. I can see an activating effect from the Effexor - but that's what a good antidepressant should do. It's kind of funny, they give you an anti-depressant to help you have more energy and then try to give you something else, when you've got the energy you were seeking. \
It's unfortunate because I had a terrible experience with my last Pdoc, and now I have this one who I like, but I'm questioning her judgement because of her comments about the meds.
Strange,
starlight
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