Tricyclic Antidepressants

Memery, Depressiom, and Meds

Question:

[posted and emailed] >I can’t move my mood stablizers or take anymore.  What now?  Any thoughts >on gentle antidepressants or results for rapid cyclers or mixed states >BP’s?

serzone may help as an AD (or a tricyclic), and depakote is good for rapid-cyclers…. "Dark Prism" – My personality refracts darkly through the serotonigenic spectrum. Thomas A. Ott — ottthoma (at) pipeline.com – [3 t's in ottthoma!!!] http://www.geocities.com/~ottthoma — main site http://www.geocities.com/~ottthoma/depression/index.html—– depression site http://www.geocities.com/~ottthoma/depression/sjw.html —— st. john’s wort stuff FCC Regulations provide up to 500 dollars in damages PER INCIDENT for Unsolicited Commercial E-Mail.  Go ahead.  Make my day.

Response:

My doctor thinks I’m a Rapid Cycler, too, and he wants to up my dose of Depakote again. I’m at 1500 mg now and have been for 1-1/2 weeks (1000 before that). I’m recently diagnosed but I’ve been taking Depakote for 2.5 years for seizures. My doctor doesn’t want to give me anti-depressants right now unless I get suicidal (and then he’ll put me in a hospital which I can’t handle) because he thinks that will hurt my seizure threshold. I have to see the neurologist first (and that’ll take weeks!). In the mean time, I’m cycling every 5 to 8 days between hypomania and depressions, and both swings are getter higher or deeper each time. This time he decided to bring me down from the high end by giving me a fat dose of something like Valium (lorazepam, I think). Less than a day later (after I slept for most of it), it had kicked me lower than ever and now I’m really depressed. My husband broke down for the second time this week because he doesn’t know what to do and I don’t know either anymore. My insurance hardly covers this kind of health care at all and I don’t want to go doctor jumping so quick. After all, what if the next one is just as bad?? I don’t know what to do. I can’t think straight anymore. And little things keep getting by me. I was home all day and this evening I kept thinking I had gone in to work!  :( Can anyone help? -Susan – Hide quoted text — Show quoted text ->I know the frustration you are feeling.  When I was taking a higher dose of > Depakote, I couldn’t remember my name.  I still have trouble with writing and > coordination, but they are minor compared to the mood swings. >I’m on Tegretol, verapamil, and lamotrigin.  I can’t take Paxil bacause it >makes me rapid cycle, have mixed states, and suicidal.  Wellbutrin didn’t >do any good, effexor was bad, now what.  My pdoc says that I shouldn’t >have antidepressants because of the rapid cycling, but I hate the >depression and I REALLY hate the memory problems.  I look like an idiot. >I can’t think staright, talk, spell, or even remember the smallest thing. >I can’t stand that feeling.  It’s  so embarrassing and upsetting.  I also >can’t stand spending the middle of my day at home, depressed and sad, >sometimes crying.  My night time meds help a little, but not enough.  The >morning meds are the same way.   >Can you talk to your pdoc about what you are experiencing?  Sometimes it takes > a while to find the right combo, and if he/she isn’t willing to help you find > it, perhaps it is time to move on.

Michael and Susan

Response:

> I understand that people have problems with their memory when they are > depressed and/ or when they are on meds.  I just can’t figure out which > one is my problem.  

I never had memory problems before I started taking meds. Now it’s so bad that today, for example, my husband asked me to call his work and give them a message. 5 minutes after he left, I remembered to call, but didn’t remember what the message was. I have to write notes about the most mundane things. It’s devastating to me, and embarrassing. I want to stop taking my meds so that I can have a > clear head for just a while.  I know that would be foolish, but in > academia it’s so important to be able to think clearly.

Julie, I understand so well this thinking. But as for me, I’m so afraid to stop taking meds, because the alternative is so worse. I’ve just learned to keep my mouth shut and my speeches short. That way people will just think I’m quiet maybe. I’ve made a fool of myself too many times. > I can’t think staright, talk, spell, or even remember the smallest thing. > I can’t stand that feeling.  It’s  so embarrassing and upsetting.

This is me, Julie. Again, I just cover for myself as much as I can. I only take Lithium. I know that a combination of different drugs might be better for me, but I’m afraid to experiment and bring back the madness. For now, I can just cope, and hope that I’ll get used to it.

Response:

: I understand that people have problems with their memory when they are : depressed and/ or when they are on meds.  I just can’t figure out which : one is my problem.  I want to stop taking my meds so that I can have a : clear head for just a while.  I know that would be foolish, but in : academia it’s so important to be able to think clearly.  I have been : really depressed lately though.  I think it’s the shorter days.  I sit in : front of my light box and just become a mummy.  It helps, but only for the : time that I’m using it. : I’m on Tegretol, verapamil, and lamotrigin.  I can’t take Paxil bacause it : makes me rapid cycle, have mixed states, and suicidal.  Wellbutrin didn’t : do any good, effexor was bad, now what.  My pdoc says that I shouldn’t : have antidepressants because of the rapid cycling, but I hate the : depression and I REALLY hate the memory problems.  I look like an idiot. : I can’t think staright, talk, spell, or even remember the smallest thing. : I can’t stand that feeling.  It’s  so embarrassing and upsetting.  I also : can’t stand spending the middle of my day at home, depressed and sad, : sometimes crying.  My night time meds help a little, but not enough.  The : morning meds are the same way.   : I can’t move my mood stablizers or take anymore.  What now?  Any thoughts : on gentle antidepressants or results for rapid cyclers or mixed states : BP’s? : Thanks : Julie Ermm… I take tegretol and verapamil as well. I was in a fog, sliding into mediocrity as i slowly lost my vocabulary, my memories, my past, my ability to recall things quickly, phone numbers were lost completely, and i was in a devil of a stew for months. Then, as the depression got worse, i added Effexor. Ta-Da!! My mental capacity is back to normal, except for when i sleep 2 hours all night (zzzzzzz) and i feel good about myself. Im energetic enuff to run with our Golden retriever puppy, im happy, i feel like living, and i love my fiance more and more each day. Too bad i cant orgasm Oh btw im not bp but my fiance is. Thats why i always check this ng in case there’s something out there i dont know yet. — ‘There should have been another way.’  -The Doctor, 1983                                           _Doctor Who_ http://shell.webbernet.net/~jewade01/davison.html

Response:

>: I understand that people have problems with their memory when they are >: depressed and/ or when they are on meds.  I just can’t figure out which >: one is my problem.  I want to stop taking my meds so that I can have a >: clear head for just a while.  I know that would be foolish, but in >: academia it’s so important to be able to think clearly.

Having been in a similar situation in a couple of universities, I can readily understand and sympathize! I vaguely recall trying to pass an oral exam when my memory was so shot that I probably couldn’t have told the committee my middle name. <G> >: I have been >: really depressed lately though.  I think it’s the shorter days.  I sit in >: front of my light box and just become a mummy.  It helps, but only for the >: time that I’m using it.

I would like to see some statistics on how many of us with BP also have SAD. Several of my corresponds have both. Approximately 1/3 of those having FMS/MPS also have a significant cognitive dysfunction commonly known as "Fibro Fog". You can receive further information from this NG: alt.med.fibromyalgia >: I’m on Tegretol, Verapamil, and Lamotrigine. I can’t take Paxil because it >: makes me rapid cycle, have mixed states, and suicidal.  Wellbutrin didn’t >: do any good, Effexor was bad, now what?  My pdoc says that I shouldn’t >: have antidepressants because of the rapid cycling, but I hate the >: depression and I REALLY hate the memory problems.  I look like an idiot.

One thing that significantly helped me was to take my daily prescribed AD dose and divide it into 4 equal portions — taken approximately every 6 hours. That eliminated my ultra rapid cycling (several times per day). Now I "only" rapid cycle. <G>  (FYI I haven’t been able to find a mood stabilizer that is both effective and one that has side effects that I can tolerate.) My HYPOTHESIS is that taking a big dose of AD once (or twice) a day really "slugs" your system with too much AD. That is what initiates the upswing. The downswing comes about as the AD effect "peters out" before taking the next dose. There are a couple of factors that I believe may well come into play. The shorter the AD’s biological half life in YOUR system, the more rapid and the greater the amplitude of your mood swings will be. Also a person’s metabolic speed will affect the biochemical kinetic process. Those with "fast" metabolisms IMO should be more susceptible to very rapid mood swings from the AD influence. A DDR (Divided Dose Regimen) (a minimum of 4 times daily) helps to keep the level of the AD in your system at a closer to steady state level. Those who are very sensitive to an AD should IMO consider further subdividing their total daily dose into 6-8 portions. A pill "chopper" and a multi-compartment pill container will greatly facilitate this process. Both should be available at any large pharmacy for a total cost well under $10 (US). I use a container with 28 compartments which holds a week’s supply of my Rxs. I have another for my OTC vitamins and pain killers. When I go traveling, I carry a mini pharmacy with me! <G> Check it out with your health care professional. But don’t be too surprised if they don’t appreciate the advantages of a DDR — since only a few people (percentage wise) seem to require it to minimize daily mood swings. You might want to consider trying your meds on a DDR. Why not give it a shot? What have you got to lose? Except possibly some ultra rapid swinging. It’s a bit of a hassle admittedly — but to me it is more than worth the extra inconvenience. >: I can’t think straight, talk, spell, or even remember the smallest thing. >: I can’t stand that feeling.  It’s so embarrassing and upsetting.  I also >: can’t stand spending the middle of my day at home, depressed and sad, >: sometimes crying.  My night time meds help a little, but not enough.  The >: morning meds are the same way.   >: I can’t move my mood stabilizers or take anymore.  What now?  Any thoughts >: on gentle antidepressants or results for rapid cyclers or mixed states >: BP’s?

See above for my suggestions. >: Thanks >: Julie >Ermm… I take Tegretol and Verapamil as well. I was in a fog, sliding >into mediocrity as i slowly lost my vocabulary, my memories, my past, my >ability to recall things quickly, phone numbers were lost completely, and >i was in a devil of a stew for months. Then, as the depression got worse, >i added Effexor. Ta-Da!! My mental capacity is back to normal, except for >when i sleep 2 hours all night (zzzzzzz) and i feel good about myself.

Glad Effexor has worked so well for you! Of the half dozen or so ADs I have tried, Effexor has been by FAR the most effective for me also. It is unfortunate that some people can not/will not take it because of the extremely powerful effects that it has upon them. IMO a DDR might well be the answer. I would appreciate any feedback on this issue. >I’m energetic enuff to run with our Golden Retriever puppy, i’m happy, i >feel like living, and i love my fiance more and more each day. Too bad i >can’t orgasm

You might want to consider subscribing to the following Newsgroup: alt.support.impotence >Oh btw i’m not bp but my fiance is. That’s why i always check >this ng in case there’s something out there i don’t know yet.

Wishing better mental health to all from, James PS I am currently in the process of creating the data base of subscribers to the "Bipolar Anonymous Newsletter" (BAN). If you are interested in subscribing to the mail list in time to get the first issue, please send me your correct email address and indicate which Newsletter you wish. Please forgive me if you have already subscribed and you have not yet received an acknowledgment. You should be getting one in the next couple of days — assuming that I continue to be reasonably stable of course. BTW I also sporadically publish another newsletter which targets beginning-to-intermediate users (abusers?) of the Internet and computer software (predominantly Windows oriented). This is called "Chaos Manor Newsletter" (CMN). Should anyone desire to sign up for either (or both) of these FREE NLs, the easiest way is to send me an email with the following in the text: body: "Subscribe BAN"    and/or "Subscribe CMN" Please ONLY sign yourself up — and no one else. TIA! If you should no longer care to subscribe to a NL, please send me: "Unsubscribe BAN"   and/or "Unsubscribe CMN" That’s all there is to it! Suggested topics for either newsletter are most welcome! Have a good day!

Response:

Julie, I know the frustration you are feeling.  When I was taking a higher dose of  Depakote, I couldn’t remember my name.  I still have trouble with writing and  coordination, but they are minor compared to the mood swings. >  I want to stop taking my meds so that I can have a >clear head for just a while.  I know that would be foolish, but in >academia it’s so important to be able to think clearly.

I take Zoloft in the AM, Depakote, and nortryptyline at night, and so far so  good.  My head is clear, my energy is good (most of teh time), and my cycles  are greatly muted. >I’m on Tegretol, verapamil, and lamotrigin.  I can’t take Paxil bacause it >makes me rapid cycle, have mixed states, and suicidal.  Wellbutrin didn’t >do any good, effexor was bad, now what.  My pdoc says that I shouldn’t >have antidepressants because of the rapid cycling, but I hate the >depression and I REALLY hate the memory problems.  I look like an idiot. >I can’t think staright, talk, spell, or even remember the smallest thing. >I can’t stand that feeling.  It’s  so embarrassing and upsetting.  I also >can’t stand spending the middle of my day at home, depressed and sad, >sometimes crying.  My night time meds help a little, but not enough.  The >morning meds are the same way.  

Can you talk to your pdoc about what you are experiencing?  Sometimes it takes  a while to find the right combo, and if he/she isn’t willing to help you find  it, perhaps it is time to move on. >I can’t move my mood stablizers or take anymore.  What now?  Any thoughts >on gentle antidepressants or results for rapid cyclers or mixed states?>

I do hope you feel better.   Cathy

Response:

I understand that people have problems with their memory when they are depressed and/ or when they are on meds.  I just can’t figure out which one is my problem.  I want to stop taking my meds so that I can have a clear head for just a while.  I know that would be foolish, but in academia it’s so important to be able to think clearly.  I have been really depressed lately though.  I think it’s the shorter days.  I sit in front of my light box and just become a mummy.  It helps, but only for the time that I’m using it. I’m on Tegretol, verapamil, and lamotrigin.  I can’t take Paxil bacause it makes me rapid cycle, have mixed states, and suicidal.  Wellbutrin didn’t do any good, effexor was bad, now what.  My pdoc says that I shouldn’t have antidepressants because of the rapid cycling, but I hate the depression and I REALLY hate the memory problems.  I look like an idiot. I can’t think staright, talk, spell, or even remember the smallest thing. I can’t stand that feeling.  It’s  so embarrassing and upsetting.  I also can’t stand spending the middle of my day at home, depressed and sad, sometimes crying.  My night time meds help a little, but not enough.  The morning meds are the same way.   I can’t move my mood stablizers or take anymore.  What now?  Any thoughts on gentle antidepressants or results for rapid cyclers or mixed states BP’s? Thanks Julie

Response:

Filed under: Tricyclic Antidepress