Bi-Po's Unite! I need a peer review please!

Hi, I'm a fairly newly diagnosed Bi Polar, and I only know one thing FOR ABSOLUTE SURE so far.....I will be most DEFINITELY re-gifting this b**ch at the Christmas party! If it were transmissible, I'd TRANSMIT ina MINUTE....(of course, only if I can get rid of it myself by giving it to someone else!)

So here's what I've been put on:

Adderall 20mg 3 x per day
(1st med tried, increased focus & energy to a degree, been taking approx 3 years)

Cymbalta 120mg daily
(1st Anti-D added, who knows if it's doing anything! Been taking for over a year)

Lamictal 200mg daily
(Added to the above regimen after a couple of months of very unstable moods, been taking for almost a year)

Wellbutrin 300mg daily
(Just added yesterday b/c of the extremely severe depressive episode I'm dealing with now.)

Ambien 10mg @ bedtime
(Been taking this approx 2 years and it's 'bout run it's course I think, arrrgghh!)

Klonopin 0.5mcg as needed for anxiety
(Just got changed to this from xanax on the rec of my T, damn her!)

So I'm obviously taking pills for breakfast, but would take twice as many if it made some positive change in this depressive state I'm in. I've been treated for plain ole plain ole depression for almost 20 years, but this current depression is the worst I've ever experienced. (Including having those ~ideas~ that shall not be named, for the first time in my LIFE!) this is some scary *****!

Please, anyone with a similar situation, how does my cocktail look? My pdoc isn't very communicative/creative, so I have to ask EVERYTHING that I can think to ask, AND make suggestions myself if I want anything changed. (No lectures, I KNOW I should find a new one ) Anyway, I'd love to hear from my fellow Bi-Po's, esp those of you with MAJOR Depressive episodes that last for weeks and weeks...

What're you taking and how well is it working? What kind of therapy have you tried and LIKED? A recent therapist suggested finding an EA meeting. While I'm absolutely sure the EA folks are just the bestest supportive group, as a kid of a Twelve Step obsessed recovering alcoholic Dad, the EA option will really and truly have to be a last resort.
Sorry for all the rambling and ranting....it's 244am and guess what? I CANT SLEEP

I'm only on Lamictin 100mg/day, and it's doing 0 for me. I either need to up my dosage or toss it. Just cannot get into a pdoc app until a bit down the line.
I also take Klonopin 0.5mg as needed - it has a longer half-life than Xanax but is very similar.
Last time I spoke to my pdoc, she just wanted to test the Lamictin on its own, otherwise was going to add the Wellbutrin - and I think it's about time.
My moods are all over the place; mainly sever depression, and then the odd bit of mixed episodes (When I just don't know what to do with myself!!) I get hypomanic maybe one day every 2 weeks, but nothing sever.
See - I can totally relate about moods being all over the place. It affects your working relationships, as well as personal relationships.

I used Zopiclone to sleep every now and again (I think it's the same as Lunesta in the States), only when the depression is really bad and I want to hide away from the world

If you have any questions about the efectiveness of meds that you have been taking for a while without any noticeable effect, ask your pdoc about the possibility of taking a break from them. It is not a good idea to just pile up in the meds for the sake of piling up on them. It might add the risk of combined effects and side effects that youmight not really want. If she doesn't want to do that, ask for a detailed reason why. You are employing them, it is your body, and you deserve and explanation. Huggs dear. just my thoughts. That way you can see if the meds really are doing nothing, or if they just seem to be doing nothing.

I'm on Lamictal (150) and Wellbutrin (300). Cymbalta and Wellbutrin are both SNRI's..you have to wonder if just one or the other would do the trick...anyway, I was previously on Prozac (big mistake). Being on Lamictal alone brought on the deepest, blackest depressions I've ever had. Adding the Wellbutrin has helped a lot; I still get depressed but not even close to what it was. My doc won't up the Wellbutrin until I deal with some of the situations in my life that are contributing to it; a way to nudge me into therapy, which I have avoided. I will be starting CBT, but have also been doing a DBT skills workbook.

saywhat?;I'm on 200mg of lamictal and 300 mg of wellbutrin. I am prescribed a sleeping pill, but only take it as needed which ends up being approximately 6 times a month when I'm on night shifts.

I have been on 2 anti-d's before, but it was because the combination of my mood stabilizer (lithium) and atypical anti-psychotic (seroquel) kept me too low. As soon as I was off the seroquel I no longer needed the 2nd anti-d.

Was the adderall prescribed prior to you being diagnosed BP?

For managing my BP 60% is from my meds. The other 40% comes from individual therapy (approx once a month), educating myself on BP, eating healthy (includes taking a multi-vitamin, vitamin C, omega 3, calcium with vitamin D), exercising, I do work shift work, but I ensure I sill get enough of sleep. I also track my mood at http://www.medhelp.org/land/mood-tracker

I take both pristiq and wellbutrin xL, so two antidepressants aren't unheard of. Different drugs work on slightly different receptors on the brain, so that is probably what your pdoc is doing. Have they considered Adderall XL so you don't have to take it three times a day? I know that doesn't always work well for everyone though.

I'm only on 600mg of Seroquel XR. It seem to be working for me....finally.

I've been on everything you can possibly think of and nothing has ever worked for very long. Right now it's Cymbalta and 1 mg of Klonopin as needed.

I told my doc I was only willing to take 3 meds. I'm on 200 mg Lamictal, 30 mg Abilify and Xanax 0.5 daily. The dose of Abilify is high, but I haven't needed an antidepressant since my dosage was increased.I don't expect perfection; I still experience mild moods swings, but I cope with them because I don't want to become a zombie. If your dr isn't working with you, and you don't feel he can justify them all, I would go to a different dr. I have to have someone who allows me to participate in my own care.

I'm on 10 mg of Abilify, 800 mg of Tegretol (400 mg in morning, 400 mg at night), and 500mg of Seroquel. I'm also getting weekly ECT treatments. The medications are working OK for me, but it's the ECT that's really making the difference.

Just my two cents...

As far as you being treated for just "plain ole depression" before you were diagnosed with bipolar, I think the mental health experts made a bad decision when they named depression depression. It's like called a 9 course dinner, just a meal. There is so much more to depression than feeling "depressed". Depression can kill and yes, it is scarey.

About your meds, have you thought about getting rid of the ambian since you said it's about run it's course? Perhaps you can talk to your pdoc about putting you on a low dose of Seroquel...it works much better for me than Ambian.

Use this board a lot for emotional support and information. It makes all the difference in the world.

Welcome to the community. Sending you a big safe hug!

It's up to you to take the responsibility of discussing it with your doctor but in a "peer review" (I like the phrase) we can suggest ideas or principles around which you might choose to structure your thoughts.

There may be a risk that you may find you do less well in some respect or other if one or more of these were to be stopped. I'm a firm believer in a combination of meds rather than only one.

We really are all very different from each other.

At least you sound generally positive about meds, unlike those who have a blanket idea about them and are determined to stop them altogether - those people I nearly always hear later, went through a ruinously bad patch after.

Some doctors forget to communicate and I think you could ask him/her to explain what the goal is of each one, what is the goal of the dosage, and how well you are responding to it in his/her observation.

You are taking five excepting any klonopin on top which you don't always have, so you know what difference klonopin makes. Does taking five make the task of monitoring your own response too complicated? Which four would it be good to choose if it came to only having four? Maybe you need five really.

The other thing that is usually forgotten is dosage. Maybe you just need the dosage of the odd one tweaked either upwards or downwards.

I take 2,100 mg gabapentin (mainly to manage my nerve pain and the absences I was having) and 1 mg risperidone daily. I go to AA and talk to my AA sponsor but not often enough. Without gabapentin I get the "frazzles" (as well as worse nerve pain) and without the risperidone my thinking seems narrower. I have periodic bouts of excessive depression which I used to take the odd rhodiola rosea pill for (it took the edge off it), but I've run out of those.

I think it's interesting that your doctor has you on an upper and a downer. Meaning perhaps you need the ambian at night because the adderall keeps you wired during the day. I had a doctor do that to me before I was diagnosed and yes it treated the symptoms but I was so wired during the day that then I required a tranquilizer at night. It turned out for me that stopping both drugs and treating the underlying cause worked better.

Definitely talk to your doctor. Perhaps by treating the bipolar disorder everything else will sort itself out. Also, I found it easiest to change only one medication at a time because then I knew what effect it had.

When I was first diagnosed I went from one med to six and found it excessive so I figured out what I didn't need. I always research everything I'm on and sometimes just compile all the info into a word document for myself.

I prefer Klonopin to Zanax because one is very addictive for me and the other is not. I had every side effect of Ambien except driving (THANK GOODNESS) which got ridiculous, I really hate that drug I was on it for years. I'm taking Lunesta instead now and it's way better.

Whenever I've taken any ADHD medication it has either increased my anxiety a LOT or triggered some minor manic episode, or both.

I've actually had sudden suicidal ideation as a medication side effect (no more Geodon for me). It does seem like a weird cocktail to me and if you are not comfortable with it that is an important issue.

How are things going? Have u changed any meds?

please keep in mind that every med carries some risk of side effects, some of which are permanent... sometimes a med can make suicidal thoughts much worse, stronger and more influential. this is no small consideration, as suicide is a real risk with depression: judgement and impulse control are often affected. Please consider carefully "experimenting" with meds... best wishes,, Gus

LOVE IT!!!!!!! I have a list of people I would LOVE to give the bipolar away to....

The sleep meds are something to get right, no matter what you end up needing. The extra energy flying around in my head gives me insomnia. The lunesta is helping my brain figure out that yes, I really can sleep like I used to before working nights!

I wouldn't wish this on anyone, although the thought of regifting is tempting!
I take 1200mg Lithium, 200mg Seroquel, 600mg Effexor, .5mg Konopin and 200mg Lamictal. I think that's it anyway.
Having a hard time kicking the depression. Bipolar depression is pretty severe and can be more dangerous than unipolar depression in terms of certain urges and thoughts.
I was curious about the Cymbalta for you, I am not a doctor, but those types of antidpressants are known to cause manic episodes. Maybe you should check into that.

I take Lamictal 100mg, Concerta 36mg, Cymbalta 30mg, Abilify 15mg and Ambien 15mg. All my meds were reduced when I started ECT in May a year ago. I had my last (probably) maintenance ECT the first week of October so we will be watching my mood for signs of depression returning. ECT has been great for me.

Two notes on medication. When Abilify was added it seemed to "kick-start" the Cymbalta and helped with my depression. As to Ambien, I just found out that it is a hypnotic so you should go to bed no longer than 15 minutes after you take it. There is a "window" of effectiveness when it is at its peak and if you miss it by being up then it really won't help much in putting you to sleep. I learned this from my pdoc. (Ambien, Lunesta and Sonata are the only hypnotics used for sleep.)

I also take a stimulant (Concerta) in the morning. It runs out long before it is time to go to sleep. Without the Concerta I can't get myself going and tend to just sit through the day. I would not want to stop taking it.

Hi everyone,
I am so appreciative of all the posts, giving me a peek into what is happening with others and their regimens. I really am starting to think I've got too much going on and I've been queasy for the last week, EVERYDAY, and have no idea as to what is causing it....anxiety? Def a possibilty b/c it's been high this week. Reaction to all these different pills floating around in my stomach at the same time? Possibly. I've got some serious reflux going on from all that's involved in my universe right now? Another possibility (I take Prilosec everyday also for reflux). The queasiness is making me eat less, which is absolutely OK with me, but it's kinda miserable otherwise.

Some of you were asking about the adderall....It was prescribed by my very first pdoc for symptoms that he thought could be related to ADHD, I did the little test and he did an evaluation and came up with this diagnosis. I was already taking an Anti-D at the time, I think zoloft, AND already taking Ambien at that time. I have no idea about the upper/downer combination. Honestly it never occurred to me. The adderall definitely gets me wound up to some degree, but I've got a decent tolerance to the "bouncing off the walls" effect. I tend to avoid the third dose to give me a better chance at sleeping.

When I changed pdocs, the new one (my current one) wanted to leave my regimen as is for a couple of months. Since then, she's changed it all around except for adderall and ambien. We've not talked about it too much, she focuses mainly on the Anti-D's/mood stabilizer. It seems I'm going to have to have a serious discussion with her or just find a new one. I'm one of those that avoid difficult conversations, especially with docs in general....they intimidate me! But right now I feel like a science experiment, so time to (wom)an up. Arrrgghh!

You guys are so supportive and informative...I've never been on a forum like this and am truly glad I found you!

Good luck! Let us know how it goes.