[Greg0391]

I’m new here and just trying to see if anyone can relate. My newest psychiatrist was trying to sort out what type of bipolar I might have (maybe something between BP2 and cyclothymia?). Now it she says it is PTSD related bipolar. In the simplest form I can explain is when I try an antidepressant, I usually get hypomanic like symptoms (feeling high but agitated at the same time, very hard to describe). I always deal with depression and bad anxiety while off meds. I have been taking fluvoxamine and Seroquel for a close to a year and at one point and it helped a lot with my anxiety which was great.

Now I don’t feel like it’s doing much and I asked the doctor about going back to the beginning of all the meds I tried, and see how it goes with Seroquel and mood stabilizer. I mentioned trying Depakote and she says that ‘it requires to much blood work’. I was on a high dose of Lamictal but not on a SSRI so, wanted to try that. (That DR said it would have made the ‘high’ go away and the SSRI work like it should) She said no. lol. And this is the part that doesn’t make any sense. Have been taking 200mg of Seroquel for quite a while and was given 150mg XR to start on supposedly to work my way up to 300mg.

Told her I have been on 300mg XR before and she didn’t seem to care. So, I was given 150mg XR (30-day supply, but I guess forgot about the part of where I was supposed to take 1 a day for 7 days then take 2 I guess to equal the 300mg. (She said it had something to due with insurance reasons but idk). So, she could of literally just gave me 300mg XR and things would have been fine.
So much ******** to go through for nothing.

The thing that pisses me off is, even if I don’t have a 100% diagnosis of bipolar 2 or something close to that, why not just try and treat me like that, and see how If I have a positive reaction to it? If it doesn’t work then go off it and try a different combo. This was through tele-medicine as well because of where I live. Maybe Not all psychiatrist truly cares about how you are doing, or just to lazy to manage meds?

So, has anyone here with PTSD or not been told it was the major cause of there bipolar? Are you being treated with meds? I was basically told therapy would solve it and stay on Seroquel. Makes me wonder if the Psych Drs you pay cash up front would make a big difference. Sorry if this came out to a long rant as well.

I don't believe we're supposed to do anything but share our own medication experiences here, but I'm thinking that maybe waiting to see how 300 mg Seroquel XR works might be worth a try, if that is what your doc wants. Seroquel XR can be a monotherapy, and I've read that 300 mg is the recommended dose for bipolar depression maintenance. Look at almost any major site regarding dosing. I have bipolar type 1, but I know that many with other bipolar types benefit a lot from Seroquel. I'm, personally, much fonder of the XR over the regular instant release. For me, Seroquel XR is quite helpful for pretty much every aspect of my bipolar disorder.

I do not have PTSD, though I have had mild traumas in my life. I know many people's bipolar is triggered by stress/trauma.

I'm only sharing my opinion/experience on this, not any expertise, but I hated Depakote. It was very good at controlling my mania, but useless at preventing or easing my depression. In fact, I credit it for even causing the worst depression I ever had in my life (I'm over 40 years old). Almost ditto for my nephew. Of course others may have better experiences. I despised its side effects. I think more than any other medication I ever took, though a couple were almost as rough, but in different ways. Yes, blood tests are involved, though in my case, fewer than when I was on Lithium. Of course if a doctor recommends it, one could be really helped by it. If they don't recommend it, I, personally, wouldn't fight for it.

[Greg0391]

Yeah, I forgot about asking for medicine advice. Sorry. Seroquel XR being used by itself sounds promising. I hope that I will be able to work up to that eventually, again and see how it goes. Damn, I was hoping Depakote wasn't so bad. I started researching who my new 'Psychiatrist' was and it turned out to be a PA (With a Master of Health Sciences degree). So, maybe that explains the lack of wanting to prescribe whatever or having a hard time diagnosing things like bipolar (Or being comfortable with treating it). Idk. I was assuming it was a true Psychiatrist. That gives me hope though once I find another one in the future, maybe I’ll get treated better. ty

[still_crazy]

the cash doctors semi-local to me are more responsive, from what i've heard, than the clinic doctors or the run of the mill outpatient psychiatrists. im having a better time with a psych nurse practitioner...this individual worked together a relatively safe (as psych drugs go) combination that 'gets the job done,' no major ill effects, so far. tele-psychiatry may be necessary, but i dont find it appealing.

im surprised the psych didn't go for depakote. its standard at the clinic i go to. i declined, so i was on trileptal for a while, which...btw, is not perfect, but did calm me down, until i plunged into a deep depression. i know its frustrating to have a trained professional shrug off your problems, but it could be worse...i only take a couple things, but a lot of people at the clinic i go to are routinely medicated to the gills. i don't get it, i don't know what the reasoning is, but...wow. and then, as they get older, the psych cocktail causes physical problems, so more Rx drugs are added on. fun, huh? so, at least you're only lightly medicated.

[Greg0391]

Being over prescribed meds doesn't sound like fun but I would accept a mood stabilizer /anti-depressant/ and Seroquel. It doesn't seem like much to ask for but, the doctors don't seem to listen. Almost like if its' not just simple depression, they don't want to mess with it. funny thing is about 6 years I explained my situation to a new regular MD and was given a Prescription for Depakote. I filled it and there is sat at home because I was too afraid to take it. After being on Seroquel now, I'd be willing to see If I could tolerate Depakote it. True, I wonder about the long term side affects of these drugs. That nurse told me therapy is important part of healing (Which I believe too) but it's tough for it to sink in when your mind is all over the place.

I feel like a lot of people can relate to that feeling on this website. I just want some form of 'stability' from meds and then I know I can figure things out. It's almost like I would have to lie about my diagnosis, just to be treated appropriately. I wish I knew what was going on completely but I don't. Thanks for the replys though.

[~Christina]

Personally I don’t agree that someone should just be put on a AP right off the bat.

When I was first diagnosed I started on a mood stabilizer, lithium first ...then about a month later I started Lamictal as it’s a seizure Med but often works well in the depressive end of Bipolar so it’s referred to as a mood stabilizer now also.

I did eventually need a antipsychotic(AP) Seroquil xr was the first but looking back I wish I had just started straight Seroquil first as there’s much less problems with large weight gain quickly. But this happened while I was IP So I wasn’t well enough to really make medication decisions.

My Pdoc has always been open to me and my researching of possible medications that I feel might work or at least have less side effects. We both discuss a few options and then decide together which will be tried. I can’t imagine just taking any old pill someone decided I need to take it.

I see many people getting put on more than 1 Med at a time. If there’s bad side effects it’s going to be hard to find out what causes what as everyone reacts differently.

I don’t care much about what “ Label” it is .... it’s about treating the symptoms so a person can go about enjoying there life.

[luvyrself]

Lots of red flags here. Most importantly, you are just being diagnosed and bipolar is complicated—dont use an assistant. Second, if you are bipolar, anti depressants can send you into hypomania so the dosage has to be just right or avoid them altogether. Third, your explanation of the ptsd part was confusing. If you have ptsd, they might put you on totally different meds, from what Ive heard , than straight bipolar. If you are bipolar with ptsd as well, you absolutely should not have an assistant in my opinion. Ptsd and bipolar are both complicated.