Where do I go from here?

I am currently on geodon for bipolar II and it does a good job with the hypomania but not the depression. I tried abilify but it makes me really sick. Anybody have any suggestions? I can't do lithium because I have hypothyroidism. I see my pdoc Thursday and he told me to brainstorm about where I want to go from here. I have no idea but what I do know is that I can't keep taking geodon. Thanks.

Have you tried Lamictal? I was put on it to help control my bipolar depression and have had a lot of luck with it? Is it also possible to at least add in an anti-depressant to the geodon mix or do they cause mania for you?

I'm on Cymbalta for the depression. My pdoc put me on Zyprexa eventhough I mentoned wanting lamictal. I will try the zyprexa but if it doesn't work, I will ask to try lamictal again. Thank you.

My med combo was Lamictal and Cymbalta, but due to insurance it is now Lamictal and Effexor. I tried Zyprexa and gained a lot of weight. I also tried Symbyax which is also Olanzapine like Zyprexa, but also contains Fluoxetine aka Prozac. I blew up like a balloon. Something like 20 lbs in just a few days.

I'm looking for an answer for the depression as well. Since my last episode my wellbutrin was bumped up from 300mg to 450. From (half attempted) journal keeping, it looks like begin to go into a deep depression around February and March. ... We'll see what the 450 does when it comes around. I couldn't take the Lamictal because of the rash (

But, I take Geodon as well and wouldn't trade it for anything. For me it definitely keeps, at least the angry side, of hypo away.

I'm curious as to why you don't like the geodon, if I may ask.

It's not that I don't like Geodon, it just isn't helping with my depression and isn't as effective as I had hoped it would be.

There are a few different routes you can take:

Lamictal: anticonvulsant/mood stabilizer - I find this to be a great med and it really helped to keep my moods level and the "pressure" out of my mind. There are side effects at first such as drowsiness and concentration problems, but they wore off in 2 weeks for me. No weight gain!

I too have hypothyroidism, and I take Synthroid to keep my levels in range. I am also on Lithium for my mania. When I check my blood for the Li levels we also check for the thyroid levels as well... and so far everything has been in the proper ranges. However, I have noticed the Li has a "lowering" effect for me, which is great if you are manic or BP I, but I would not advise this be a first step for you since you are BP II.

Antidepressant: I would greatly recommend one of these for your depression, in *combination* with the Lamictal or another mood stabilizer as the antidepressant alone bears the risk of inducing mania.

There are two types of commonly prescribed antidepressants, SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin and norepinepherin reuptake inhibitors).

Prozac and Zoloft (SSRI): Tried and true antidepressants. When I am in my depressive cycle, I add Prozac to my Lamictal/lithium mix and it works *great*. My younger sister is on Zoloft (she suffers from PTSD) and it helps with her aggression and acute rage.

Wellbutrin and Effexor (SNRI): treatment for depression and anxiety disorders: generalized anxiety disorder, panic disorder, and social anxiety disorder. Some theories of depression and anxiety believe both serotonin *and* norepinepherin imbalances play a part in depression. If you are not having luck with SSRIs, I would suggest looking into switching to a SNRI as it works differently in your brain. Wellbutrin is usually the first in the line of SNRIs used for bipolar disorder.

Rispperdal: anti-psychotic, used for bipolar mania, schizophrenia, and autism. I have not tried this one, but I have been on Abilify and that was *awful* for me. I felt like poop all day long. If it isn't working for you, kick it to the curb!!!

Long story short, I recommend you talk to your doctor about beginning a combination of Lamictal and a low does of antidepressant.

I hope this helps

Thank you. I am going to call my pdoc tomorrow and ask to be put on lamictal. I already have an antidepressant called Cymbalta that seems to help a bit. Maybe they'll work well together. Thanks for the input!

you're more than welcome Cymbalta is an SNRI the same as Effexor, and I am glad to hear it is working for you. In the future, if it does not work so well, you could always ask about Wellburtrin, which affects the dopamine in your brain (as well as the noepinepherin) at higher levels. All of which will work well with Lamictal.

I hope your appointment goes well and best of luck!!!