which one?

Maybe this belongs better in Bipolar, I dunno, but here it is, for what it's worth.

I have enough money to afford one of the two meds I need refilled. Nobody gives samples anymore because of the big hullabaloo about drug reps influencing prescribing habits.

1) I'm bipolar.
2) I am still slooooowly coming out of an extremely severe depressive episode.

So: Do I spend the money on the antidepressant, or on the mood stabilizer?

A-d's are supposed to be bad for people with bipolar, unless a mood stabilizer is attached, because it can throw them into mania. But I'm so far from manic it's not even funny. In the meantime, I don't get paid for another week and I have to make a choice! Ideas/suggestions/helpful hints?

CB

I thought some mood stabilisers can help with the depressive episodes as well?

If you are already coming out of a depressive episode, you don't want the AD's to speed that up, but then make you go too far ending up with you being manic.

DO NOT TAKE AN ANTI-DEPRESSANT without a mood stabilizer... I would take the mood stabilizer. What is it? The AD may throw you into a mania (which I admit may feel good at first or maybe longer--to you--but not to those around you or to your co-workers, your neighbors, the police, etc. if you are bipolar I).

What kind of insurance or doctor or medical plan forces you to choose this as it is medically unsound? Even the lowest level medically trained person should know better than to give you an either/or decision like that. It is insane (excuse the language) but just asking for a trip to the mental hospital if you end up on a mania. Unbelieveable to me.--Suzy

It's not anybody's fault but my employer's, for not paying me a living wage. I've been on short-term disability for several weeks and don't go back full-time till Monday. 2/3 of "next to nothing" is "even less than next to nothing." I have no credit (thanks, bipolar) and I have no savings (thanks, crappy job). My last check went to my landlady and food and a little gas, and $9 is what's left of it, seriously. And my rent is dirt-cheap.

The meds in question are Depakote and Zoloft.

I think I would call my doc and ask her. I'm on Depakote and wellbutrin I wouldn't know which to choose

look into drug compnay programs as well. i get my lamictal through the maker for free b/c im poor. lol

seriously, look up prescription assistanc programs

I'D TAKE THE DEPAKOTE--NO QUESTION.--Suzy

I'd definitely go with the mood stabilizer, works wonders for me even with the severe depression.

Good luck candy :Good-Luck:

I don't qualify for any of the drug co. assistance programs, because even though I don't make diddly, I make too much for their purposes. And they tend to want tax returns to prove it. Believe me, I've looked.

You may now have an inexpensive, non-prescription option for antidepressant activity......

N-acetyl-cysteine is a sulphur-bearing amino acid that serves as a strong antioxidant in its own right, and is a precursor to an even better one, called glutathione. It's available at some drug stores, but certainly at health food/vitamin stores. A month's supply might cost $10, more or less. Internet suppliers like Iherb certainly have it.

Regards,
Lar

Biol Psychiatry. 2008 Sep 15;64(6):468-75. Epub 2008 Jun 5. Links

N-acetyl cysteine for depressive symptoms in bipolar disorder--a double-blind randomized placebo-controlled trial.

Berk M, Copolov DL, Dean O, Lu K, Jeavons S, Schapkaitz I, Anderson-Hunt M, Bush AI.
The Mental Health Research Institute of Victoria, Victoria, Australia.
BACKGROUND: Treatment-resistant subthreshold depression is a major problem in bipolar disorder. Both depression and bipolar disorder are complicated by glutathione depletion. We hypothesized that treatment with N-acetyl cysteine (NAC), a safe, orally bioavailable precursor of glutathione, may improve the depressive component of bipolar disorder. METHODS: A randomized, double-blind, multicenter, placebo-controlled study of individuals (n = 75) with bipolar disorder in the maintenance phase treated with NAC (1 g twice daily) adjunctive to usual medication over 24 weeks, with a 4-week washout. The two primary outcomes were the Montgomery Asberg Depression Rating Scale (MADRS) and time to a mood episode. Secondary outcomes included the Bipolar Depression Rating Scale and 11 other ratings of clinical status, quality of life, and functioning. RESULTS: NAC treatment caused a significant improvement on the MADRS (least squares mean difference [95% confidence interval]: -8.05 [-13.16, -2.95], p = .002) and most secondary scales at end point. Benefit was evident by 8 weeks on the Global Assessment of Functioning Scale and Social and Occupational Functioning Assessment Scale and at 20 weeks on the MADRS. Improvements were lost after washout. There was no effect of NAC on time to a mood episode (log-rank test: p = .968) and no significant between-group differences in adverse events. Effect sizes at end point were medium to high for improvements in MADRS and 9 of the 12 secondary readouts. CONCLUSIONS: NAC appears a safe and effective augmentation strategy for depressive symptoms in bipolar disorder.

Hey Lar, good to see you.

Trouble with things like that is I have a ton of other health conditions (diabetes and a clotting disorder, to name two). Can I still use this stuff?

Yes, there are no contraindications for it. The very least it will do is help make your liver more resilient. I'm not bipolar, and I started taking some to see if it helps with my treatment-resistant depression and neuropathic pain.

Lar