[darkeyes]

Hi there, how are you? Do you know if there is a mild stimulant that could be a possibility for a bipolar II? I know docs. are reluctant to prescribe any stimulants because of the fear of igniting any manic episodes. I've been with the lithium for almost 6 months and like the results, but I cannot take this lethargy much longer,it is like the typical symptoms of depression but I can honestly say I'm not depressed only starting to get down cause I can no longer stand feeling like this. I see my doc 4/9/02 but till I do I was wondereing if there are any meds I can ask him about that would help get me "moving", I sleep late every day, I try using alarm clocks even have my husband call from work to see if I am awake yet, this is terrible especially with spring coming Any ideas?? Thanks so much Cam for taking my question.
"darkeyes"

[Anne_E_Austen]

Ok, so my name isn't Cam : )

For whatever it's worth (I'm not bipolar), I'd thought I'd add adderall to your list of possibilities.

I'm on 40 mg of Prozac for major depression. that's helped somewhat, but I've still been sleeping WAY too much! No energy. Tired all the time--the whole bit. The doc has started me on Adderall. It's a stimulant; I think it is used in the treatment of narcolepsy! And if I'm not mistaken, it is also used to treat ADD/ADHD--the crazy, but apparently true principle that stimulants slow down the hyper and speed up the sluggish. (I went to school with someone who would always make a pot of coffee for her friend when he got hyper.)

Hopefully you'll get some more feedback. Good luck!

ANNE

[CamW]

Darkeyes - This is a tough one really. Amphetamines like ADDeral™ and Dexedrine™ can counteract the mood stabilizing effects of lithium.

An option would be to use a newer drug that is indicated for narcolepsy, modafinil (Alertec - CDN; Provigil - US). The only problem with is a doctor will probably balk at the idea. Modafinil is too new to most docs and using a drug that they have never used before, especially for an off-label purpose, may make them think twice about using it in a situation where stimulants usually provoke mania.

I am not positive that modafinil will not counteract the lithium, but I have seen it used in a couple of incidents. I do not know any of the long term problems arising from this therapy, or even if the people who were taking the combination are still.

Low dose Ritalin™ (methylphenidate) is also an option, but I have never seen it used with lithium, personally.

Wellbutrin™ (bupropion) may be another option. It is a stimulant with a structure very close to the diet pill Tenuate™ (diethylpropion) and may be what you are looking for. The doc may be more receptive to this drug than to others. There is a very low risk of manic switch with this antidepressant when compared to others.

The only other suggestion is to chew coffee and keep it between you cheek and jaw (although I truly do not endorse this method).

I think that you have to stress the anergia to your doc. Ask what he is going to do about it, and it is an unacceptable side effect of the treatment &/or disorder. Pester him during the appointment until he does something about the situation.

Sorry that I cannot be of more help. - Cam

<font color=orange>"Sometimes you may be shown the light in the strangest of places, if you look at it right"
- Robert Hunter</font color=orange>

[darkeyes]

Cam, I see you mentioned Wellbutrin years ago my family doc gave it to me for depression it did not have any stimulant effect actually made me drowsy and no mania. If the doctors have seen that the various antidepressants they have given to me (way before I was told I was bp) never stimulated me or gave me mania wouldn't that be a possible indication that I am not BP and was just under some heavy stress and not manic?? I know, who knows? Another thing I'll bring up on 4/9/02. Thanks for your info. I've heard about provigil on the nightly news. Hope you are doing well.
Take care,
"darkeyes"

[bptoo]

Camster,

I was wondering what you thought about Adderall XR as a possibility for darkeyes? I recently switched from the regular to the XR. The regular was hitting me like a ton of bricks (getting me wired very quickly and then wearing off too soon) and was also irritating the hell out of my stomach. I've been taking it due to the excessively long hours I've been working over the last several months and my psych has been monitoring me closely, I knew you'd want to know that.

The XR has been much more mellow, comes on more slowly and maintains a more even keel. I also have no stomach irritation from it. My concentration level has really improved as well.

You are the expert and Grand Poobah of the meds here, but I thought I'd throw this out here for you to see and see what you thought?

I await my slap on the hand....

bp

"All in all we're just another brick in the wall"