Quick question

[cadno]

Ok as many of you know I've been having a rough couple of weeks, but my last appointment led me to this question.  The pdoc wanted to look into the idea of adding an anti-depressant to my current meds (Olanzipine and Lithium).  I'm nervous of this because I don't think he realises how this could affect me, I get mania's that scare the living daylights out of me and those around me.  If he is just trying to deal with my current downward spiral what effect could this have on my manias?

I don't have the name of the one he wants to put me on but I'd like to know if anyone else is on a similar setup of meds?

Cadno

[Gemini]

I am on Seroquel XR and two antidepressants.  The reasoning behind it was as my pdoc described. The Seroquel is to deal with the hypomania and the antidepressants are to deal with the depression and he prescribed them to me so we have them both covered (I know that sounds simplistic but he wanted to make sure I understood in plain english).

He said that if for any reason that I started to feel "too good" then I was to stop the anti-depressants but so far that hasn't happened.

Also, while we are making changes with meds, I see him at least once a month so he can monitor how I am doing and he is on call if I need to see him sooner.

Also, from what I understand the dosage of the anti-depressant is different if giving it to a bipolar person together with a mood stabilizer or antipsychotic.  It is not the main drug being relied upon.

Now I am not a doctor so I may be way out to lunch here but this is how I understand it anyway.

Take care

[Phyllis]

generally it is not common practice to give someone with BP1 antidepressants because it can cause mania. There are obviously 2 thoughts of school on this so it depends on your doctor and how many manic episodes you have in any given time. I'm BP2 so it is obvious that I am on an antidepressant  . If they do put you on an antidepressant, ask about a rescue med for if you get manic. I take seroquel to curb my anger in a pinch. But my manias are often triggered by anger. So once I nip that anger in the bud, I'm good to go.

[Paz]

 Dude, if you are BP1 DO NOT take an antidepressant! Before they diagnosed me BP1 they gave me citalopram [antidepressant] and I went out of my fucking mind! It made me SO crazy. I would get a second opinion if you are BP1.  If you are depressed, what about tweaking your mood stabilizer?

[cadno]

Now my problem is I don't know which one I am because I've been given so many different answers.  I get told I'm BP with psychosis, then I'm schitzoaffective, then I'm BP again and once after all these diagnosis I was told I'm just a little depressed.  The problem I'm facing constantly is in the last couple of years I've had at least 7 different diagnosis from various professionals.  Yes there is a point here lol, the point is I don't know where I stand as I tend to blur the edges on days, I rapid cycle sometimes, I get prolounged periods on others and naturally my psychotic symptoms are always there.

I have to say I don't feel comfortable with another med when they've not tweaked the dosage right on the lithium yet.  Its almost as though they want to put me on something until they are sure I'm actually taking my meds.

As for citalopram, had that one too Pax, sent me into hypersexuality orbit and it caused a great strain on my relationship because I was constantly angry and frustrated with myself for feelings as I did.  They even threw me on Fluoxitine (think that's how its spelt) and dioxitine which was just as bad for me. 

Please keep the advice coming though, I need as much info on this so I'm able to challenge and come up with a care plan in regards to meds that works out for my best interests.

Cadno

[Dreamline]

I have BP1 and my pdoc said he would never give me an antidepressant.  I took a supplement called SAMe one time...it helps you make more serotonin, dopamine and norepinephrine...its a precursor to all of those.  I was depressed and read that it takes 2 weeks at the full dose to do anything.  I took one 25mg dose (full dose is at least 200mg) OMG I went fucking nuts with just one dose of that shit.  There was nothing wrong with the pills because my friend took some and it did nothing at all.  Within 2 hours of taking one I was manic as shit.

[nordicnicki]

maybe you do need something else as well as your lithium and olanzipine but definately not anti depressants of any sort.any doc worth his qualifications would know that one .sometimes it does take a bit of jiggling around with stuff before that happy medium is found....there are no quick fixes to help aid our illness.as many of us have said in the past we are treated in a sense like the doctors guinea pigs seeing what drugs willl do what to us and often the right ones take some time....keep hanging on in there and eventually a calm should be found when they reach the right medication for you.
when i first diagnosed they told me all kinds of things that i had wrong with me  as bipolar is hard to disgnose properly....but i stuck with the  bipolar diagnosis and eventually the doctors agreed 

[Paz]

Cadno,
 I looked up olanzapine, it is also called zyprexa and it is a combo of an antidepressant. Why would your doc want to give you another antidepressant?! 
 Are you on any sort of  straight benzodiazepine[tranquilizer]? Perhaps you may need one. Dude, if you get crazy manias, then I would NOT take any sort of antidepressant. Why don't you ask for a plain benzo [like valium] and also ask why the fuck they have you on a combo med that has fluxoitine [prozac] in it. Olanzipine is a combo of a benzo and an antidepressant. Just speaking from my own experience with severe mania and rapid cycling, My doc wouldn't even THINK about an antidepressant in my treatment. Doc did make sure I has enough tranquilizers, though. And do you take a straight atypical antipsychotic?[seroquel, or geodon] Maybe one of those may help.
 Just my opinion...

[Gemini]

I think that you shouldn't take any sort of antidepressant before finding out which Bipolar you are.  I am BP II so taking an antidepressant is okay for me as I tend to be more on the depressed side of the scale. 

However having said that, my pdoc and I are watching for signs of hypomania that is not good so we can tweak my meds and even come off the antidepressant if necessary.

I have heard that taking an antidepressant for a person who is BP I can definitely cause mania so maybe a second opinion is in order if your pdoc insists.

I hope you get this resolved and can get on the right combo of meds to help you.

Take care

[cadno]

Thanks for all the advice

Paz, the reason for the Olanzipine is for the psychotic symptoms of my condition, trust me when I say without I am something that scares me and those around me.  I know its not typical of BP but I do get voices that will act with my moods.  For example, if I'm low they will compound that low with comments designed to make me feel worse than I am.  But on the Olanzipine these disappear to a certain extent, I'm aware they are there, but its like background noise as opposed to in my face.

But this does raise an interesting question, could the Olanzipines success also be the double edged sword that has led to an increase in my current swings?

I'm going armed with as much information as I can next time I go, which is apparently in a month (I won't hold hope up there).  I know one thing though, I will get through this and get things balanced, I have to focus on something possitive and here its been provided with all the help you guys have put forward and from the various success stories I've read.

Cadno

[Paz]

 I used to hear voices too, Cadno...mostly whispering creepy voices, and I would see dark clouds in corners, and sometimes shadows outside the windows. Antipsychotics stopped that from happening. Are you on a straight antipsychotic? If not, maybe one would help.

[cadno]

I have to be honest, the Olanzipine at its current dose works well for me, the voices are nothing more than whispers that my normal coping skills can deal with.  In typical style though I've sorted one problem to be faced with another.  When I was more extreme in mood the psychosis wasn't so bad, when my psychosis was bad the moods were stable.  Ok in fairness that wasn't always the case but its a pattern I've noticed is more frequent than the rest.  Personally I feel they've not got the lithium dosage right yet and adding more drugs would be pointless until that is explored.

But then I am but a mere mortal in the hands of a doctor who doesn't even know my history, oh the fun I'll have going through all that for like the seventh time

Cadno

[cadno]

I had to post this up as I'm a little confused between my GP and my Pdoc

I was told by the GP that Lithium dosage can not go above 1200mg and yet my Pdoc reckons I might be above that.  I'm a little worried for obvious reasons and was wondering if anyone can shed light on this for me.

Cadno

[nordicnicki]

cadno i found this to be the other way round with me....gp took me over the recommended dosage but pdoc is very by the book........i honestly think that i was the better judge out of them both as to what dosage i should have.....mine went up- slowly and once it started to do its job i knew then that i was on the right dosage
not of much help to i know but that was just my opinion

[cadno]

I'll have a good long chat at the beginning of next month when I see the PDoc

Cadno