[kkrrhh]

Hi! Sorry, I feel like I've come to PC to ask about meds a million times. I've just been going through med trials for months without getting anywhere, and I feel like I'm losing myself and the little bit of stability I thought I'd built up and I'm just desperate. My pdoc is just about zero help, literally starting to feel like I'm trying to manage and treat myself on my own while he just sits there and waits for me to tell him what script to write because he has no helpful input. This was nice when I had different meds in mind I'd want to try, but not so much when I'm this lost.

Because of depression being the big problem for me (along with anxiety), I've rejected worrying about trying mood stabilizers first because I've just been desperate to get out of the depression and figured focusing on antidepressants first was the way to go. I was reading something the other day though and from my understanding of it, it was saying that even if someone isn't super worried about mania at the moment, mood stabilizers can help bring people out of depression, too. I feel so ignorant, because...is this true? I kind of always assumed the only reason to start with mood stabilizers when trying to treat depression would be to decrease the risk of mania. If I'm in a depression, and worrying about the manic side isn't really the priority (I've only had mild hypomanias and the depression is such a bigger problem, I'm just trying to focus on it first), could a mood stabilizer (other than lithium or lamictal) actually help to get out of the depression? I mean I knew about lithium and lamictal, but I always see most mood stabilizers described as "anti-manics" or "for the treatment of bipolar mania," or maybe some APs slightly helpful for depression as an add on.

I guess basically, I've been trialing through antidepressants but am considering maybe just focusing on starting a mood stabilizer now... I try to avoid starting multiple meds at once, so I'd probably just start that for now if I did. I have realized that, whatever the reason, it just seems most antidepressants don't go well for me. Still, I really don't want to "waste" time starting up a mood stabilizer if it's not likely to help the depression, rather than trying other depression meds.

I know of course meds vary for everyone, but I also wanted to see if you guys had any input on what mood stabilizer I should try first, whenever I do start another. I've been on Lamictal about a year, currently 200 mg down from 250 mg so it's not doing much. I am hoping to get off of it for various reasons, but staying at this dose until I've got other things more stable. I've also been on 150 mg Wellbutrin XL for almost 4 weeks, but it's looking like I might quit it at my next psych appointment. Like I mentioned, I've only had mild hypomanias, and though my diagnosis is uncertain I'm pretty sure I'm bipolar 2. Lamictal seemed to actually also help with my anxiety a lot, and it helped with the problem I've always had of extreme emotional sensitivity. It helped quiet my mind a lot, and really seemed to help with derealization/depersonalization, either directly or just by helping my anxiety and depression. I'm hoping another med will help with that. If it's worth mentioning, the meds that have helped me significantly out of a ton I've tried were Nardil and Lamictal, and Prozac helped a little years ago and Ativan's ok.

I haven't really had the focus to research much but the list I'm considering so far is Geodon, Trileptal, Tegretol, or valproic acid. I need something that isn't likely to cause weight gain. I'm also definitely looking to avoid harsh side effects or a rough start up as much as possible, but that's probably a given. I've always preferred to avoid APs, but I may give in if it's worth it, especially if other AEDs are likely to give me skin problems like lamictal which would be a vote against them. The other med that's sorta stuck out to me for some reason is Latuda, but really I haven't seen any good accounts of it outside of bipolar 1 so probably not. Abilify and Seroquel, plus any big weight gainers, are out.

Sorry if this all sounds dumb or crazy, I overthink things a lot. :P I've tried googling, but I'm just overwhelmed and hearing any personal experiences is always helpful. Thanks guys

[MobiusPsyche]

Yes, a mod stabilizer did help my depression. It sounds like the Lamictal is working for you so that's great! That's really the "go to" drug for BP2.

If you don't mind the blood tests, tegretol is a good option. Trileptal is okay but not as good a mod stabilizer as tegretol. I've been on both, currently on Trileptal and it works well enough that I put up with the side effects for now. I hope you find a cocktail that works for you.

Abilify helped lift my depression but it was mainly, I think, through reducing my anxiety so that I could open up more on therapy and focus better.

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[gina_re]

Originally Posted by MobiusPsyche

If you don't mind the blood tests, tegretol is a good option. Trileptal is okay but not as good a mod stabilizer as tegretol. I've been on both, currently on Trileptal and it works well enough that I put up with the side effects for now. I hope you find a cocktail that works for you.

I know each drug works different for everyone. But I'm just curious as to what side effects you get from Trileptal? I don't hear about too many people being on it, and I am interested on how it affects others.

[MobiusPsyche]

Originally Posted by gina_re

I know each drug works different for everyone. But I'm just curious as to what side effects you get from Trileptal? I don't hear about too many people being on it, and I am interested on how it affects others.

The usual... Bad dizziness when standing up and dry mouth. It does make me drowsy so I take it before bed.

And sometimes...this will sound weird...but sometimes it makes my lips go numb. That happens less frequently as I've taken it longer, and it hardly ever happens now, but I take it with two other meds at night (instead of all by itself).

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[hopeless2015]

I'm on Trileptal now and am not having any side effects, also on latuda and Lamictal...just added Lamictal a week ago

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[gina_re]

Originally Posted by MobiusPsyche

The usual... Bad dizziness when standing up and dry mouth. It does make me drowsy so I take it before bed.

And sometimes...this will sound weird...but sometimes it makes my lips go numb. That happens less frequently as I've taken it longer, and it hardly ever happens now, but I take it with two other meds at night (instead of all by itself).

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Ahh ok, gotcha. And that doesn't sound weird at all. Actually when my tongue starts to get a little 'tingly' and numb, I know it has kicked in and I'm about to pass out. I also get dizzy around that point. I kind of like that feeling.
And I take the whole 1800mg at night.

Sorry kkrrhh, I didn't mean to hijack your thread.

[cincidak]

I take Geodon, and it helped with my depression and mania. I also take 150mg of Lamictal, and 10mg of Paxil. It seemed to help right away, and it's said to be weight neutral. You might consider finding a new psychiatrist if this one is not helping you. My doctor of the last two years got me stable when I had given up hope of being well. Good luck and God bless

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[fairydustgirl]

I've changed up meds (and pdocs) so many times over the last 10 years but it was always mood congruent in that my dr's would change it to match whatever mood episode I was currently experiencing. (such as depakote for mania)
Lamictal is supposed to be the preferred med for the depression side, although lithium is the gold standard. Latuda is a newer med specifically being approved to treat bipolar depression. I personally got terrible nausea from it.
My current meds are lamictal, pristiq, deplin (prescription folic acid) and namenda (no I don't have alzheimers, it is to treat the problems I have with focus and motivation and attention)...I have not needed an AP in a long time but my go to is saphris. Basically I am on a mood stabilizer and antidepressant for the bipolar mood problems. Me on an antidepressant with no mood stabilizer equals sky high mania and LOTS of problems.
Good luck and don't give up!

[kkrrhh]

Thank you all for the replies!

hopeless2015, how do you like the latuda? I hope lamictal works for you, it's pretty great.

gina_re haha, no worries!

I'm really confused about Abilify. I've seen people say that it's weight neutral and supposed to be one of the better drugs in that aspect, and then I remember hearing about it causing bad weight gain, messing with peoples' metabolism, and iirc increasing risk for diabetes. I wanna believe it's weight neutral and consider it, but the other stuff sounds too scary...

[MobiusPsyche]

Abilify can cause increases in cholesterol and blood sugar even if you don't gain weight. I got a script for a glucose monitor when I started it and thankfully it didn't impact my blood sugar levels at all. (I have other risk factors for diabetes so I'm really worried about that.)

I read the entire information sheet for physicians and if you are already pre-diabetic it can push you over into diabetes. If you're not already pre-diabetic it has a low risk of causing diabetes.

Abilify and Geodon are the antipsychotics least likely to cause weight gain. I have not investigated Geodon so for all I know it has other problems.

[kkrrhh]

Ahh ok, that makes sense, thanks! Hmm, I'm iffy because I have possible risk factors...

I was able to get an appointment with my psych for tomorrow, but I'm still not sure what choice to make. :/

[cheshiregrins]

Originally Posted by kkrrhh

Thank you all for the replies!

hopeless2015, how do you like the latuda? I hope lamictal works for you, it's pretty great.

gina_re haha, no worries!

I'm really confused about Abilify. I've seen people say that it's weight neutral and supposed to be one of the better drugs in that aspect, and then I remember hearing about it causing bad weight gain, messing with peoples' metabolism, and iirc increasing risk for diabetes. I wanna believe it's weight neutral and consider it, but the other stuff sounds too scary...

No, I wouldn't call it weight neutral. I think when they first released it they called it that, but then they noticed lots of people gaining weight. It's just a bit better than other AAP for weight. I was on it for years and it did increase my blood sugar. I switched to Latuda and now my blood sugar is much better.