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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by woolav on May 13, 2005, at 16:57:21
I thought these 2 drugs were similiar?? I have been on zyprexa and depoke before w/ lithium and hated both of them!! so i will not take them again. But ive been on lamictal for a while already and its been ok, but it seems i need something more to prevent mood issues or bp2..
Thanks
S
Posted by woolav on May 13, 2005, at 16:58:33
In reply to OH, so i can take a lithium lamictal???, posted by woolav on May 13, 2005, at 16:57:21
Posted by med_empowered on May 14, 2005, at 4:20:19
In reply to OH, so i can take a lithium lamictal???, posted by woolav on May 13, 2005, at 16:57:21
hey! Yes, you can take lithium and lamictal together...in fact, this combination might be much better than taking either one alone. Lithium is great as an anti-manic agent, and it also has anti-depressant properties (it seems to reduce the risk of suicide in bipolar disorder). Lamictal is an **excellent** drug for depression-heavy bipolar disorder, but it sometimes induces hypomanic symptoms, and it doesn't seem to be as effective as lithium at treating and/or preventing manic episodes. Theoretically, combining the two gives you the best of both worlds, and should allow for lower doses of each, which might minimize side effects. Good luck!
Posted by woolav on May 14, 2005, at 6:36:34
In reply to Re: OH, so i can take a lithium lamictal???, posted by med_empowered on May 14, 2005, at 4:20:19
Thanks for the info. I will suggest that to my pdoc. I am guessing that taking prozac right now is not helping with my bp2 symptoms, could it counter-act with my lamictal? Because It my moods are not better even on lamictal. It may have helped slightly* but now, its doing nothing. I feel like Im on no meds at all.
S
Posted by med_empowered on May 14, 2005, at 7:43:24
In reply to Re: OH, so i can take a lithium-med_empowered, posted by woolav on May 14, 2005, at 6:36:34
hey! What form of Bipolar disorder do you have? Is there rapid cycling involved? The tricky thing about bipolar is that it often requires a combination of a number of meds--often 4 or more--to get everything (depression, anxiety, mania, etc.) under control. Prozac would **not** be my first anti-depressant or even SSRI to pick for anyone who has even a hint of bipolar....it has a bad rep for inducing mania and it has a freakishly long half-life. Its also a relatively mild anti-depressant, side-effects aside; you get more oomph out of Paxil and Zoloft. Wellbutrin and Effexor are common favorites for bipolar disorder...Wellbutrin doesn't seem to induce mania too often, and Effexor is strong enough to handle resistant depression. Cymbalta is emerging as a fav. med, too. If you're heavy on depression, the problem may be getting the lamictal dose just right (your doc should increase it very slowly) and also adjusting the other meds. If you've never been full-fledged manic or had psychosis or attempted suicide, switching from Lithium--which prevents suicide but tends to be more effective against mania than against depression--to something else, like Depkote, Tegretol, or Trileptal (maybe even Keppra) might be helpful. Another thought: Symbyax came out recently. Its a zyprexa-prozac combo...the zyprexa prevents mania and helps with the depression. If you have diabetes, a weight problem, or have had problems with anti-psychotics, it probably isn't the way to go. Based on my own experience, I'd think replacing the lithium with Abilify (low risk of diabetes/weight gain, relatively low EPS risk and unique profile are its selling points) would help. The standard starting dosage ranges from 10-15mgs, but lower dosages can be useful, especially if you're not currently psychotic. Anyway, assuming that went well, the next step would be to *sses how your depression responds: if positively, you could probably keep everything and then wait a while. If not so positively, the next step would be to replace or augment the Prozac (my thought: zoloft+wellbutrin), adjust the lamictal as needed, and see what happens. Atypical anti-psychotics seem to have anti-depressant effects (especially Abilify and Zyprexa)...these effects seem to be more pronounced when used in conjunction with an anti-depressant. If desired, the Abilify could be withdrawn after the depressive episode stops, and another mood-stabilizer (my vote: trileptal, with increases in the lamictal) could be used to replace it. Anyway, good luck!
Posted by woolav on May 14, 2005, at 23:31:21
In reply to Re: OH, so i can take a lithium-med_empowered, posted by med_empowered on May 14, 2005, at 7:43:24
Hey, from my symptoms, i appear to have bp2. I dont know much about ablify, (i'll do some reasearch) My main problem right now seems to be hypomania and depression. My anxiety is being controlled by klonopin. But, i am easily irritated and easliy depressed. I went off of a hypomania episode about a month ago. Then, went into depression, where i wanted to kill myself, and now seem* stable. I just want to feel evened out. Like i dont want to have mood swings, and I dont want to have hypomania episodes along with major depression. I was hoping that adding lithium to my lamictal and klonpin would do the trick. And perhaps slowly stopping my prozac. (sorry if this sounds messed up) I have been drinking tonight. (i know,not a good idea) but sometimes its the only way that i feel normal).....
S
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