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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Mike on January 10, 2000, at 9:22:31
Someone close to me suffering from severe long-term depression has expressed puzzlement as to why his prescribed medications seem to bring relief sometimes,
while other times the severe depression returns. He has observed that the illness still cycles in spite of the chemicals which his doctors insist stabilize and modify his neurotransmitters.He has been on many different "mixtures". He has also undergone ECT. As he observes, there must be a biological reason as to why he seems to get occasional temporary and or cyclic relief.
Thanks for any insights.
Mike
Posted by JohnL on January 10, 2000, at 16:08:06
In reply to depression "cycling" while on medication?, posted by Mike on January 10, 2000, at 9:22:31
> He has been on many different "mixtures". He has also undergone ECT. As he observes, there must be a biological reason as to why he seems to get occasional temporary and or cyclic relief.
>
> Thanks for any insights.
> MikeI wonder if one or more of his drugs is a mood stabilizer? If he is cycling, he should be on one or two. A lot of times an antidepressant actually aggravates the cycling. It's better sometimes to treat the person with just mood stabilizers, and no antidepressants at all. The mood stabilizers can stop the cycling and treat the depression simultaneously.
I know there are some doctors who absolutely refuse to treat someone with an antidepressant if they show any signs of bipolar (cycling). They will use mood stabilizers instead with good results.
I think I have very mild bipolar cycling. Very mild. But when I was on Serzone it was incredible. Some days I felt so good I was tingling all over and talking to everyone and just feeling on top of the world. The very next day I would be drowning in despair and gloom. The cycling stopped when I stopped the Serzone. Later on Lamictal (mood stabilizer) there was no cycling at all. It sounds to me like he needs to be treated as bipolar, and try some things without antidepressants in the mix. Depakote, Lithium, Lamictal, Neurontin. JohnL
Posted by Peter on January 11, 2000, at 12:04:06
In reply to Re: depression "cycling" while on medication?, posted by JohnL on January 10, 2000, at 16:08:06
> I wonder if one or more of his drugs is a mood stabilizer? If he is cycling, he should be on one or two. A lot of times an antidepressant actually aggravates the cycling. It's better sometimes to treat the person with just mood stabilizers, and no antidepressants at all. The mood stabilizers can stop the cycling and treat the depression simultaneously.
>
> I know there are some doctors who absolutely refuse to treat someone with an antidepressant if they show any signs of bipolar (cycling). They will use mood stabilizers instead with good results.
>
> I think I have very mild bipolar cycling. Very mild. But when I was on Serzone it was incredible. Some days I felt so good I was tingling all over and talking to everyone and just feeling on top of the world. The very next day I would be drowning in despair and gloom. The cycling stopped when I stopped the Serzone. Later on Lamictal (mood stabilizer) there was no cycling at all. It sounds to me like he needs to be treated as bipolar, and try some things without antidepressants in the mix. Depakote, Lithium, Lamictal, Neurontin. JohnL
Hey John L: We sound very similar. I have had the same "cycling" experiences on Prozac, Wellbutrin, Zoloft, Remeron, and Clomiprimine. For one day on Zoloft I felt the best I have ever felt! Lithium and Depakote did not really work as mood stabilizers/anti-depressants. So as per above post I am trying Lamictal. Are you still taking it: dosage? If not, why did you stop? Have you found anything else that has worked for you? Thanks! Peter
Posted by JohnL on January 12, 2000, at 1:52:00
In reply to Re: John L. depression "cycling" , posted by Peter on January 11, 2000, at 12:04:06
> Hey John L: We sound very similar. I have had the same "cycling" experiences on Prozac, Wellbutrin, Zoloft, Remeron, and Clomiprimine. For one day on Zoloft I felt the best I have ever felt! Lithium and Depakote did not really work as mood stabilizers/anti-depressants. So as per above post I am trying Lamictal. Are you still taking it: dosage? If not, why did you stop? Have you found anything else that has worked for you? Thanks! PeterHi Peter. I still take Lamictal, but only 25mg. The highest I've been in dose was 150mg. I was prescribed Lithium a few months ago, but it was too intense. Since then I've learned from Dr Bob's Tips there may seen some negative interaction between Lamictal and Lithium taken together. Now with Lamictal down to 25mg I'm trying 600mg Lithium for a few weeks. It seems rather mild this time. No benefits yet in the first week. I don't have high hopes.
Lamictal didn't do anything for my primary symptoms of apathy/anhedonia. But it did make my days smooth. No worries of doom and gloom days. None of those sporadic euphoric days either. It does work very well as a mood stabilizer for me. Perhaps my dose was never high enough. The side effects were so mild or nonexistent that getting to a higher dose would have been easy. Anyway, glad you're trying Lamictal. I hope your doc has warned you not to increase dose faster than 25mg a week. Other than that, I hope it works out real well for you. JohnL
Posted by Noa on January 12, 2000, at 6:33:21
In reply to Re: Peter - depression "cycling" , posted by JohnL on January 12, 2000, at 1:52:00
Good luck with the lithium. At 600 mg, I didn't really notice any improvement in my mood, but did after a week on 900. Definite difference after 5-6 days at 1200.
This is the end of the thread.
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