[Artemis630]

I know, everyone loves these threads, lol. Mostly, I want to know: how do I know if the meds are working, and how do I know when they are not? I feel like an idiot when I talk to my psych and he asks me how I'm doing. I don't know if I'm better or not.

I was diagnosed with super rapid cycling BP II in September '11, so about 6 months ago. I cycle with my monthly hormone fluctuations. Pre meds: PMS = super depressed; during and post-period = crazy manic. Every month. It was a roller coaster.

I'm doing slightly better now. My p-doc started me immediately on Lamictal. At first it was working fantastic. The depression, which I felt was my biggest obstacle, was immediately gone. but as my dosage increased, so did my manic periods. I started swinging from manic to hypomanic and I was a ball of anxiety and aggression. I also started having cognitive issues like I can't always remember words and I sometimes have trouble putting sentences together.

So we backed down the Lamictal and added Lithium, which is what I'm currently taking. 300 mg Lamictal and 600 mg Lithium. I started this combo about 6 weeks ago or so. Again, the Lithium started out awesome. My manic state was soothed and I started feeling stable. But now, for the last week, I have been feeling depressive again. Not really full blown depressed, but just lethargic, indecisive, and feeling stuck. I develop a mild agoraphobia when depressed and that has come back again. I didn't get any mood elevation or even normalcy, I just dropped like a rock and stayed there.

I have been taking both meds together at the same times, in the morning and n the afternoon, but today I decided to not take the Lithium in the morning and I feel a ton better. I'm not 100% but I managed to get some work done and feel productive.

So... will the Lithium work better if I start taking it at night? Do I need to wait longer, or should I give up on it and ask for something else?

I'm starting to feel like a constant complainer to my pdoc, It took me 3 months to convince him I needed a mood stabilizer, and I don't want to go and tell him it's not working if the problem is that I'm not waiting long enough.

Thanks for reading this and giving your thoughts, I really appreciate it.

[BuggsBunny]

First, I would start a mood log you can show your pdoc. It doesn't have to be really complicated, just list the date, or times of day-if you rapid cycle during the day- and your mood. You can list your moods on a 1-10 (manic, 3) or a word (very manic).

This will give you some way of answering his "how do you feel" and of showing the lack of success on your current meds.

Also, with the lithium in your system, you can ask your pdoc if it is safe to raise the lamictal back up.

[kaliope]

It sounds like you are off to a great start. Fabulous that you are in tune enough with your body to know what is going to work best when as it does take a lot of experimenting with meds to find the right dosages and times to take meds to get the perfect balance down to tx bipolar. but as for the dose, you already noticed the change in you with the dose you are on, waiting longer isnt likely going to improve things, more likely decrease effectiveness as your body gets used to the drug. if your doc txs bipolar, then he will be used to frequent med changes. it is important for you to realize that you need to advocate for yourself in this. dont settle for less than the perfect cocktail. you dont have to tolerate cognitive deficits for side effects. there are tons of meds out there to try. you dont have to settle for the first ones the doc puts you on. there are a bunch that pack on the pounds, there are others that cause lactation, others that cause weight loss, some lead to tartive dyskenesia, some conck you out, you just keep working till you find something that gives you as normal a life as possible. i was a rapid cycler with major suicidal depressions for over 30 years of life. i havent had a single sign of mania or depression since oct 2009 and i dont tolerate any side effects and currently only on one drug for bipolar and one for anxiety. took 2 1/2 years of constantly changing meds, up to six meds at one time, to find the right med combo to stabilize me though.

good luck to you. feel free to PM me if you have any questions...

[cocoabeans]

You've probably tried this because your mood swings are related to your menstrual cycle but, mine were too. It would be every other month for awhile, depressed, pms so switch to manic, pms switch to depressed...Taking "the pill" continuously helps so, I'll take it for several months straight without a break and that means only a few periods a year which is awesome and way healthier for you than lithium, yuck! It took a few months before I'd stop having some moodiness when it was supposed to be time for my period.

I'm on lamictal, which I don't think does anything, wellbutrin that makes a few days of hypomania here and there easy and seroquel because I can't sleep for ships on wellbutrin. Am I stable? Nope but, I'm fine.

Doctor says, "how are you doing?" I think, "well I don't want to blow my brains out, I'm not drinking excessively on a regular basis I'm not doing drugs, I'm broke as ship but I'm working, enjoying myself when I can, I have friends, good relationship on the home front and probably showered today" and I say, "Fine. Refills?" I think I screwed up last visit because she asked if I was suicidal and I said, "nah, I'm done with suicide, it doesn't work." That was a joke but, now a sooner appointment and few pills. BOTCH!!! She's got to know I wouldn't do it that way anyway and this is making me go out of my way and wasting my time. Maybe she is out to piss me off?

What you're comfortable with is what you aim for. Don't put your blind trust in doctors. You wouldn't in anyone else. Doctors are just people. Most of 'em are bad with a crap sense of humor.

Go in. Get your drugs. Don't like the side effects, demand something else. Too high a dosage? Lower it! Don't make jokes like that one above or when the doc says, "hang in there." Don't come back with, "so you want me to hang myself?" And you'll be fine.

[noneedtoknow]

Originally Posted by cocoabeans

You've probably tried this because your mood swings are related to your menstrual cycle but, mine were too. It would be every other month for awhile, depressed, pms so switch to manic, pms switch to depressed...Taking "the pill" continuously helps so, I'll take it for several months straight without a break and that means only a few periods a year which is awesome and way healthier for you than lithium, yuck! It took a few months before I'd stop having some moodiness when it was supposed to be time for my period.

I'm on lamictal, which I don't think does anything, wellbutrin that makes a few days of hypomania here and there easy and seroquel because I can't sleep for ships on wellbutrin. Am I stable? Nope but, I'm fine.

Doctor says, "how are you doing?" I think, "well I don't want to blow my brains out, I'm not drinking excessively on a regular basis I'm not doing drugs, I'm broke as ship but I'm working, enjoying myself when I can, I have friends, good relationship on the home front and probably showered today" and I say, "Fine. Refills?" I think I screwed up last visit because she asked if I was suicidal and I said, "nah, I'm done with suicide, it doesn't work." That was a joke but, now a sooner appointment and few pills. BOTCH!!! She's got to know I wouldn't do it that way anyway and this is making me go out of my way and wasting my time. Maybe she is out to piss me off?

What you're comfortable with is what you aim for. Don't put your blind trust in doctors. You wouldn't in anyone else. Doctors are just people. Most of 'em are bad with a crap sense of humor.

Go in. Get your drugs. Don't like the side effects, demand something else. Too high a dosage? Lower it! Don't make jokes like that one above or when the doc says, "hang in there." Don't come back with, "so you want me to hang myself?" And you'll be fine.

OMG-LMFAO-thanks for posting!!!!!!

[bipolarmedstudent]

Honestly, I think you are on the wrong drugs. Lamictal does nothing for mania or rapid-cycling. Lithium is great for 'typical' bipolar I disorder (i.e. not rapid-cycling), but not so good with rapid-cycling.

Depakote (divalproex sodium) is better than lithium for 'atypical' bipolar. And topamax (topiramate) is supposed to be good for rapid-cycling.

Then there is also the birth control pill (Yasmin I think is the one approved for PMDD)

I personally think you need to try a depakote-topamax-birth control pill combo.

As for how to get your pdoc to prescribe you this, a mood journal is a good start.