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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by LibbyH on February 24, 2003, at 12:10:47
My husband was just diagnosed with Bipolar Type II dysphoric type this year. He takes Lamicatal, Lithium, Seroquel, Klonopin, and Effexor XR, all except Lithium are at the max. therapeutic level. The problem, of course, is that he can barely function at all and of course has no sex drive. He is practically impotent and when he isn't impotent, sufers from anorgasmia. He sleeps 12-14 hours every day, never gets hungry, and at times cannot manage the physical coordination to feed himself or even talk. He staggers like he is intoxicated a lot of the time. He can barely walk, but insists on driving a ridiculously fast car at high speeds. He is paranoid & grandiose, but is so flat emotionally that nothing touches him except in a bad way. The effect of all this on our marriage is that I now relate to my husband as if he was a child.
His pdoc says this is normal and he could be like this for the rest of his life. Is this really what it's like to be married to a Bipolar man? And if so, then why wasn't it always like this? It seems to have happened so suddenly!
L.
Posted by Mark H. on February 24, 2003, at 20:13:20
In reply to Help? Bipolar hubby - meds sexual side effects, posted by LibbyH on February 24, 2003, at 12:10:47
I am not a physician and have no qualifications whatsoever to diagnose or to recommend changes in treatment, but, as a long-term bipolar II sufferer, my subjective opinion is that your husband is grossly overmedicated, and that he (and you) can and should expect much better than what you describe from his treatment.
If your husband were floridly manic-depressive (type I) and experiencing full-blown mania, then his current regimen of medication would be justified in order to save his life. But the diagnosis of Bipolar II by definition precludes psychotic mania.
I believe that his doctor is wrong. It is not "normal" to stagger, appear intoxicated, and barely be able to walk or feed himself. The goal of treatment -- and of therapy -- is to INCREASE functionality, not further reduce it.
Sexual dysfunction can be managed once your husband and his doctors find a more functional balance of meds and therapy for him. I deal with it myself by timing my dosages of Effexor (I use regular Effexor, not XR) and by using Viagra.
But sexual dysfunction is a minor side-effect compared to the overall condition you describe. I hope you can communicate the seriousness and urgency of your concerns to his present doctor, and failing an acceptable response from him/her, that you will find another doctor who is willing to help your husband gain additional functionality in all aspects of his life.
With kind regards,
Mark H.
Posted by judy1 on February 24, 2003, at 23:54:50
In reply to Help? Bipolar hubby - meds sexual side effects, posted by LibbyH on February 24, 2003, at 12:10:47
OMG, I couldn't agree more with Mark. At one point I was also grossly overmedicated (with a bipolar 1 diagnosis), taking 6 meds and completely nonfunctional. It took another psychiatrist almost a year to taper off 4 of the 6 and surprise!, I was almost symptom free. Unfortunately there are pdocs out there who just layer on meds to treat other medication side-effects and not the original illness. Please help your husband get another opinion from a different pdoc so you both can start living a better life. take care, judy
Posted by justyourlaugh on February 25, 2003, at 18:30:38
In reply to Re: Help? Bipolar hubby - meds sexual side effects » LibbyH, posted by judy1 on February 24, 2003, at 23:54:50
i just wanted to say i have not been dxed.
i take 4 meds?
i dontunderstand why if one didnt work out.,why was another piled on?
i see my pdoc in 2 days and telling him i rather be psychotic ,depressed,angry and sometimes have a good"manic,grandeous"days thrown in the mix.
than be this ....
i hardley leave my bedroom..
jyl
Posted by LibbyH on February 25, 2003, at 22:39:15
In reply to Re: Help? Bipolar hubby - meds sexual side effects, posted by Mark H. on February 24, 2003, at 20:13:20
Mark & Judy, thanks sooo much for the hope! I went with him to his pdoc last time because my hubby asked me to tell the doc how he behaved after he had his meds. The doc got angry & said we could go to another doc is we don't like him. My husband got scared & said no, no! See, this is the fifth pdoc he's tried in about three years. I was starting to think this might be as good as it gets.
L.
Posted by judy1 on February 26, 2003, at 16:15:26
In reply to Re: Help? Bipolar hubby - meds sexual side effects, posted by LibbyH on February 25, 2003, at 22:39:15
I'm glad you are feeling more hopeful- just wanted to add that this is pdoc # 12 or 13 for me- that's how many it took to find one that cared about the quality of my life and not just medicating. The way your husband's pdoc reacted with anger tells me he's feeling defensive and doesn't like to be questioned- not the type of prefessional that I would want to be involved in my recovery. a good pdoc asks for input from his/her patient. take care, judy
Posted by Thomas123 on February 27, 2003, at 0:31:56
In reply to Help? Bipolar hubby - meds sexual side effects, posted by LibbyH on February 24, 2003, at 12:10:47
Mark is absolutely right.
I think you have to take charge of the meds.
There are non-sedating antipsychotics such as Geodon and Abilify. I would switch to one of these.
He is on two mood stabilizers but he is BP II. I would choose the best one and drop the other one.
Say he gets on an a non-sedating AP well APs are usually pretty good for anxiety. Why take Klonopin which is sedating? Klonopin must absolutely be tapered when stopping.
He has sexual problems and has difficulty staying awake. Effexor can can cause sexual problems. Welbutrin is the AD with the fewest sexual side-effects and is stimulating too boot and since your husband is sleeping too much this would seem to be good. Welbutrin also is less likely to cause mania than other ADs.
And last but not least when things are pretty much improved stop. Do not complain of minor side-effects or unresolved problems. You will get a prescription and be right back where you are now.
Psychiatrists often grossly overestimate their ability to fine-tune brain chemistry, this leads to polypharmacy and disaster.
This is the end of the thread.
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