Romy103 Asks…
My 21-year old daughter is diagnosed with Bipolar II. After being on Welbutrin and Lamictal, for awhile and doing well, she thought she was okay and decided to stop her medications. She relapsed, and the meds didn’t work as well when she went back on them. So Prozac and Lamictal were tried I believe, then Cymbalta – neither seemed to help. Now a new psychiatrist is prescribing the extended release form of lithium. So far not getting any results, but not up to therapeutic dose yet. While I understand the good things about lithium, I have a few concerns/questions about it:
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I am just responding to a statement you made when your daughter stopped her medication. You metioned she “relapsed”. Thats funny. I have had Bioplar II for over 10 years now so I know what it is like to either change up meds or what it is like to miss a dosage. You can never relapse because depression, bipolar disorders etc. are a chemical inbalance in your system so you can never relapse. You can never 100% cure yourself of this disease/disorder. Sorry to shock you with this information of your daughter but she will always have this disorder and as long as she sticks to her meds and focuses on what triggers her mania and depression, she can have a normal life.
Who says hypomania is not as bad as depression on BPII. I think what you might mean is that your daughter doesn’t become fully manic with BP II, and not that she doesn’t become badly hypomanic. Hypomania, and especially rapid cycling from hypomania to depression can be plenty bad. BP II is really not the kinder gentler manifestation of bipolar, and there are plenty of pitfalls with it that are just as bad as BP I. But your daughter is 21 and as the doctor suggests, it is really up to her to start working on this with her doctor. Only she can say if meds appear to be working. Hopefully she won’t make the mistake of thinking again that when meds make her feel better she is cured. There is no cure.
To answer your question simply, yes there are less risky alternatives. First, let me just say that Lithium is nephrotoxic, also it can affect the thyroid. Also it often causes hand tremors. It’s often the best treatment course for people with refractory (ie resistent to treatment) bipolar type 1.
Anyway … the answer to your question. A combination of Zoloft (aka Sertraline) and Seroquel XR has shown great promise as an effective treatment of bipolar type 2 sans the ugly Lithium side-effects. March into your doc’s office and tell him you would like to try Zoloft and Seroquel XR together. Best of luck to you.
Lithium is the mood stabilizer with the longest history. Yes, there can be, not must be, bad side effects but this is true of all psychotrophic medications. There are people who have been on lithium for decades without ill effect.
Lamictal is one of the newer mood stabilizers that seems to help with depression more than (hypo)mania. It also comes in generic.
Bipolar is a lifetime disorder. Medication helps to stabilize mood but doesn’t fix bipolar. Yes, you can have a normal life as long as you continue on medications and monitor your mood states as there can be breakthrough depressions and mania. When correctly medicated, they tend to be less intense or shorter duration.
When I read the question and answer I get a different understanding. If meds don’t always work the same way when you return to taking them, why not? Same drug, same disease, should have the same outcome.
The understanding I get is that the drugs may not have done anything the first time they were used.
Spontaneous remission was discovered in the 1700′s when some in madhouses recovered with no treatment. No one knows why spontaneous remission happens.
That means you cannot determine if some one would have recovered with no treatment. There is no way to wind back time and test the same cases again under different methodologies.
The method used for drug trials gives no “testable objective results.” If someone improves the drug is credited. But placebo often beats or comes very close to beating the drug being tested.
Doesn’t that tell you something?
While you are undergoing a course of treatment for a repeating episode investigate your daily activities for the “special circumstances” for Subliminal Distraction exposure. This problem was discovered to cause mental breaks for office workers.
When my wife had the mental event she was diagnosed as seriously mentally ill within a day or so. SD outcomes cannot be distinguished from mental illness. Her doctors refused to believe she had been normal a few days earlier. They invented a scenario and operated on their fictional beliefs about what had happened.
If your mental distress waxes and wanes, or if the drug stops working investigate SD exposure. It will cost nothing and will not interfere with any treatment you have.
If you recover the doctor will claim that treatment caused it. Why should you care if you improve? You will have learned how to avoid the problem in the future. If Subliminal Distraction was the cause of your psychiatric symptoms they will stop when you find and eliminate the source of exposure.
My sister has been diagnosed with bipolar but is not well even on medication and I feel she’s heading for psychotic episode. Refuses help. She suffers from many other health problems. Need some advice.
Hi! I am also BipolarII. It sounds like your daughter and I are very similar. I have been diagnosed for 26 years. I took Lithium for 23 years with no side effects. All of the levels were checked at least every six months. At that point I started getting tremors,also in my tongue and eye. They even sent me to a neurologist. Finally, I went off lithium and in two weeks was back to normal! I also developed Hypothyroid along the way. Now I have another poll to take daily. The hardest thing for me was trying to find the right combination of drugs. I can’t tell you all the drugs I’ve tried. It’s always off one slowly, wait until completely out of your system, then try another,wait until it is in your system, watch for side effects, start all over again. It’s so frustrating, but many people with other diseases go through the same thing. Anyways, I loved my doctor. He was great about this. I am now on 150mg of Effexor XR, and 150mg of Lamictal.It works for me, but when I went on a higher dosage of Effexor, I went into a hypomanic stage from the meds! I stay alert and aware of any changes and see my doctor regularly. Do not stop taking meds without talking to him first!!!!
One more thing….my PMS made this a nightmare once a month. It gets worse and is hard to distinguish.
Is Orthomolecular Psychiatry an effective treatment for bipolar disorders?
Omega-3 has been shown in some studies to make some difference in depression but it is a bit early to make any definitive statement about it. I have not heard of any other orthomolecular treatment for bipolar.
Recently when questioning the escalation of medication for my son, 49, who is autistic and haa lived in care home for twenty five years. I was told the doses of carbamazapien and Olanzapine were to treat bipolar. The fist I’d heard of it and as we have our son at home every weekend and high days and hoidays felt we chould have been consulted/informed before this. However I do question the diagnosis as and feel some of his medication is triggered the care home staff in search of a quiet life. Despite being prescribed by a doctor.Whiel not denying he may b need teh drugs I feel he is overprescribed and becoming dozy and slow in his movements. Has he any rights? Do we as his parents in questioning the medication? I woudl like to get a chance to reduce his medication but feel the care home feels their authority is being threatened
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