Here We Go Again

[Zephyr]

As of yesterday my doctor has decided to team up my Seroquel (a mood stabilizer) with Paxil (an antidepressant) since the stabilizer was only taking care of the mania.

If this doesn't work, he may change my medication all together.

I like how my doctor put it though,
"I don't treat illnesses, I treat symptoms."

So if all goes well,
Which I'm 60% sure it will,
This might work.

He said it'd take a week or two to kick in properly,
So we'll see :)

[Atonement]

Welcome to the Seroquel club. I now know of 4 VT members on it. lol. Anyway, I hope it works for you.

[Zephyr]

Hunny, I've been in the Seroquel club for 2 and a half years, lol.

[Atonement]

Well shit...

anyway, hope it works. Your doctor's quote was spot on. SO true.

[Aηdy]

Fingers crossed it works for you hun :)

[Sapphire]

I hope that this new mixture of medications works well for you!
I like how my doctor put it though,
"I don't treat illnesses, I treat symptoms."
This perfectly sums up psychiatry tbh! lol

[byee]

Your psychiatrist might treat just symptoms, which reminds me why I want to be a psychologist.

However, there's a need for those who just do the meds, so maybe your guy is onto something. Hopefully, this new cocktail will work, Steph.

I'll bake you some extra chocolate chocolate chippers, OK?

[INFERNO]

I was on Seroquel before (also works as an anti-psychotic which is why I was on it) and didn't quite like it as I kept getting very very tired. Being so tired during lectures and such isn't good so I went off of it. The tiredness is said to wear off, although I wasn't ready to wait a few weeks for that.

[tempestofnight]

I assume you're being treated for bipolar...

Anti-psychotics and anti-depressants used together are ineffective in treating bipolar disorder. Seroquel is not a mood stabilizer per se, but rather an anti-psychotic.

Oh, before I should continue, I should explain a few things so it doesn't look like I'm copy pasting wikipedia or something similarly stupid. I'll be 17 this April. I've been diagnosed with bipolar disorder and ADHD. It took various doctors years to figure me out. I've been misdiagnosed with (not at the same time) OCD, ODD, depression, and more. When I was younger, I tried playing guinea pig. Counting meds I'm not currently taking and also ones that I AM currently taking, I've been on; zoloft, prozac, concerta, lexapro, risperdol, adderal, lamictal, seroquel, and probably more that I've forgotten by now. Within the last 2 years, we've finally (in my opinion) figured things out. I'm currently on 350 mg of seroquel, 200 mg of lamictal, 20 mg of Adderal XR, and 5 mg of lexapro (which we're debating just cutting out).

I've been given, and used, the label "high-functioning." As in, my psychiatric problems do not impair my cognitive and academic abilities. I'm an A/B student at an elite private school in Philadelphia, and I recently found out I got a 195 on the PSATs (equivalent to about 1950 on the SATs), which is in the 97% percentile. My need for deep involvement in my own treatment has caused what once was a curiosity about psychiatry to turn into a passion and frankly, an obsession. I thoroughly research everything I ever get curious about. I read any medical literature I can get my hands on. I have my own copy of a FULL (2008) PDR, as well as a DSM IV-TR. I've memorized DSM criteria for bipolar 1 and 2, cyclothymia, bipolar NOS, schizophrenia, MPD (also borderline), AD(H)D, and MDD. I read the entire PDR entries for each of the medications I spoke of earlier, as well as all other common SSRIs from wellbutrin to paxil, mood stabilizers from lithium to lamictal, atypical anti-psychotics stretching back to the days of haldol, and more. I get APA publications and whatever else I can find. Today, I work collaboratively with a therapist and a psychiatrist, the ladder often (subjectively) concurring with proposals and/or ideas of mine for med maintenance and such. I fully plan to become a forensic or clinical psychiatrist, and have already planned out (jumping the gun) which med schools I'll apply to.

Alas, I digress. Back to your post. (Not that) new research shows that antidepressants being used with anti-psychotics provide no substantial benefit for bipolar disorder compared to anti-psychotics alone. SSRIs are activating and can cause mania for those like you and I who suffer from bipolar disorder. Combining an anti psychotic (like our fabulous friend seroquel) with a mood stabilizer, is almost always a more effective treatment. I recommend lamictal, based off of personal experience AND studies published in APA literature that I've read. Lithium is a more conventional medicine, but lamictal's efficacy is well documented.

I recommend you discuss this with your doctor ASAP. He or she may not be aware of the research that's been done. I read it in paper, as in not from the web, so I can't cite specific research. However, a simple google search yielded quite a few articles, including one from NIMH, that detail what I suggested. You and/or your doctor should read them.

http://content.nejm.org/cgi/content/full/NEJMoa064135
http://www.bpso.org/ads.htm
http://www.nimh.nih.gov/science-news/2007/study-sheds-light-on-medication-treatment-options-for-bipolar-disorder.shtml

Welcome to the Seroquel club. I now know of 4 VT members on it. lol. Anyway, I hope it works for you.

make that 5





Oh, feel free to use me as a moderator in the psyc section. I'm new, but I know my stuff, and could be helpful. I also have extensive experience with forums including moderating experience.

[Sapphire]

If you care to read this thread properly, she said that her mania was being controlled by her meds while her depression wasn't. I doubt that her psychiatrist is giving her medication she shouldn't be taking. In this instance it seems that if her depression can be controlled with one drug and her mania controlled by another then there is little danger to her.
I also doubt that he doesn't read articles in journals relating to his profession. Especially since it is often a requirement for them to show that they are on top of things every 6 months (or at least in the UK they do).

And btw, BPD (borderline personality disorder) is not the same as MPD/DID (multiple personality disorder/dissociative identity disorder). Which you should already know if you truly have memorised the criteria for them.

[tempestofnight]

I'm well aware of that. You didn't read MY post. I was talking about treating mania, not depression. Had I misread the post and thought that depression was what was being treated, I wouldn't be recommending against anti-depressants, would I?

There aren't two disorders here. If you have bipolar, you don't treat "depression" and "mania." Depressive episodes are part of bipolar, and they can masquerade as symptoms of depression causing a misdiagnosis. I assume that didn't happen, since the poster said bipolar. Manic episodes are another part of bipolar disorder. Mania is a symptom, or state, not a condition. Manic depression was replaced with bipolar disorder.

You again failed to read my post. I UNDERSTAND that depressive symptoms of bipolar can be treated with one medication and another medication used for other purposes. After all, THAT'S WHAT I SUGGESTED. But two medicines does not mean two disorders. The POINT OF MY ENTIRE POST was that anti-depressants can agitate bipolar patients and activate a manic episode.

"With little danger," and "I doubt her psychiatrist is giving her medication she shouldn't be taking" are both completely invalid points. So is your claim that the original poster's doctor reads articles. You were careful to again use "I doubt." You doubt, but you have no idea. You're assuming. My opinion, being that the doctor has not seen this research, is not 100% assumption as yours is. If the doctor has seen the research, he/she would be treating bipolar with an SSRI. If there was a reason for it, then that's fine. But I was going off of what's known. I also said that the poster should talk to his/her doctor about this option. As in, even if the doctor already knows, the patient should always stay informed and active in their own treatment.

Show me where I implied that MPD is the same as BPD (or the outdated term "DID"). See the word "ALSO"? I wrote "...MPD (also borderline)..." You honestly can't infer, when reading that, that by "also borderline" I meant "also borderline personality disorder"? Seriously? I mean sure, I wasn't specific, but can't you use some basic inference skills? Use some common sense.

You spelled memorizing wrong.

Anything else?

[Sapphire]

I'm well aware of that. You didn't read MY post. I was talking about treating mania, not depression. Had I misread the post and thought that depression was what was being treated, I wouldn't be recommending against anti-depressants, would I?

There aren't two disorders here. If you have bipolar, you don't treat "depression" and "mania." Depressive episodes are part of bipolar, and they can masquerade as symptoms of depression causing a misdiagnosis. I assume that didn't happen, since the poster said bipolar. Manic episodes are another part of bipolar disorder. Mania is a symptom, or state, not a condition. Manic depression was replaced with bipolar disorder.I know all of that and never did I state that she had two disorders. Stop talking to me like I'm an idiot. For a while now, the medication that the OP has been on has only been addressing her maina. She has experienced a lot of depression lately and so the psychiatrist has prescribed her an anti-depressant to address this.

"With little danger," and "I doubt her psychiatrist is giving her medication she shouldn't be taking" are both completely invalid points. So is your claim that the original poster's doctor reads articles. You were careful to again use "I doubt." You doubt, but you have no idea. You're assuming. My opinion, being that the doctor has not seen this research, is not 100% assumption as yours is. If the doctor has seen the research, he/she would be treating bipolar with an SSRI. If there was a reason for it, then that's fine.I'm not assuming, I know that psychologists and psychiatrists (here in the UK) have to prove about every 12 months that they are on top of their profession and the literature relevant to it. Things in the US are not going to be drastically different.

Show me where I implied that MPD is the same as BPD (or the outdated term "DID"). See the word "ALSO"? I wrote "...MPD (also borderline)..." You honestly can't infer, when reading that, that by "also borderline" I meant "also borderline personality disorder"? Seriously? I mean sure, I wasn't specific, but can't you use some basic inference skills? Use some common sense. Well, if you weren't talking about BPD, what were you talking about? And, btw, MPD is the outdated term - it has been replaced with DID. But of course after having memorised the DSM criteria you would know that.

You spelled memorizing wrong.I'm from the UK, we spell it differently from you.

EDIT
http://www.bipolaraware.co.uk/medications.html#moodstabil
The above link states quite clearly that anti-depressants can be prescribed for bipolar disorder as long as it is alongside a mood stabiliser. It also states that some atypical anti-psychotics (like Seroquel) have mood stabilising qualities.

It is supported by the following websites
http://linkinghub.elsevier.com/retrieve/pii/S0165032705000108
http://www.rethink.org/about_mental_illness/mental_illnesses_and_disorders/bipolar_disorder/treatment_for.html (http://www.rethink.org/about_mental_illness/mental_illnesses_and_disorders/bipolar_disorder/treatment_for.html;)
http://bipolar.about.com/cs/menu_meds/l/bl_medsAZ.htm (http://bipolar.about.com/cs/menu_meds/l/bl_medsAZ.htm;)
http://www.nhs.uk/Conditions/Bipolar-disorder/Pages/Treatment.aspx?url=Pages/what-is-it.aspx

Seeing as you are oh-so knowledgeable on this topic, you should already have known that.

[Atonement]

Right, so to end this all, I'll just say that individual medications treat (often) individual symptoms, not diagnoses. Furthermore, different medications work differently for different people, so to presume that one will be ineffective is a shot in the dark without trying the medication first. Now, shall we resume on specific post, not on a debate of mood stabilizers and anti-depressants usage together. Its a doctor that prescribed it, we are not doctors. If she wants a second opinion, she's more than welcome to get one, but he's t he professional and I'll trust in his decision to experiment with those medications.

[Zephyr]

Ooookay people...
Why can't we all just get along?

1) Thank you for the support everybody, and Samuel for the cookies xD
2) It's only up to a professional to make judgment, as stated.
3) Thank you for clearing things up Addi but...
4) To prevent further fighting, I'm locking it.