Abilify,Klonopin and Effexor EX combo. Anyone else done this?

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Ellie 1
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Date Joined Apr 2005
Total Posts : 1291
   Posted 6/1/2005 3:17 PM (GMT -7)   
Dr. added effexor to halt the crash.  Has anyone else taken this combo.  I'm afraid to add the ssnri.

Danarx
Veteran Member


Date Joined Feb 2005
Total Posts : 585
   Posted 6/1/2005 3:45 PM (GMT -7)   
Hi Ellie,

I hope it works for you. It's going to take time to find the right combination of meds :( I know waiting and experimenting sucks. The effexor should help but will take time.

Hang in there sweetheart, I know you're having a really rough time right now.

Dana
 ~ With Love ~ Dana, Pharm. D.
 
~ Diagnosed with Lupus in May of 2004 and Bipolar II in April of 2001. 
 
Disclaimer:  On any medical information I provide, please bring your concerns to your physician.  I have no financial interests in any drug or drug company.  I will try be as objective as possible.  If I am giving my opinion I will state it first. 


kittycat27
Regular Member


Date Joined May 2005
Total Posts : 438
   Posted 6/1/2005 3:46 PM (GMT -7)   
 HI , I have never had that combo. However I recently (like last week) went back to my doc and he added Effexor to my combo. Starting at 37mg for the first week and 75mg on the second week and thereafter. Well the only reason I wanted to post was to tell you that I have to eat a small something with Effexor because it causes me to become extremely nauseated. I was on Effexor XR last year and loved it , and had absolutely no side effects. Anyhow , I haven't been on it long enough to know if it is helping. Well good luck. Sorry I didn't have any helpful info. for ya!

psychnurse
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Date Joined Mar 2005
Total Posts : 807
   Posted 6/4/2005 4:05 PM (GMT -7)   

Hi, Ellie!

The only concern I have is that you are prone to such bad mania, adding an SSRI without a stabilizer (abilify isn't a stabilizer, just an antipsychotic) may send you into another mania.  I forget, are you seeing a psychiatrist that is doing this?  Either way, you need to be on a stabilizer and even then adding SSRIs to mainly manic patients is generally a no no.  Welbutrin or Lamictal is preferred - especially Lamictal, becuase it is also a mood stabilizer, although not to the extent most BPs need.  It will help stop you from crashing as hard, though.


Ellie 1
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Date Joined Apr 2005
Total Posts : 1291
   Posted 6/5/2005 7:24 AM (GMT -7)   
So far so good.  No I'm seeing my GP.  My last experience with Pdocs put me off them forever.  If it came to that I probably wouldn't see anyone.  I've only been on the Effexor xr for a few days but I'm not having any problems with it yet.
my Dr said when she gave it to me that we would try this.  But that if it didn't work for me she would try something else.  Shes also limited by the fact that I refuse to take anything that causes weight gain.

psychnurse
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Date Joined Mar 2005
Total Posts : 807
   Posted 6/5/2005 10:06 AM (GMT -7)   

If you had a bad experience with one, it certainly doesn't mean they are all bad!!!!!!  Your GP doesn't know how to treat this, and it may ultimately cause you more harm than good.  A BP CANNOT go without a mood stabilizer!!!!!!!  Lithium and depakote are not the only things!  Trileptal is very effective and doesn't cause any weight gain.  I wouldn't take anything that made me gain weight, either, I don't blame you!  That would just be a reason to be depressed, haha!

Ellie, please see a specialist.  Would you rather stay where you are or get better?  GPs are not qualified! eyes   I know you like her, but that's not what will make you well!   You can like someone else, too.  I know I am probably pissing you off, but I am telling you the truth, hon.

Just wait until that double dose kicks in.  sad


kittycat27
Regular Member


Date Joined May 2005
Total Posts : 438
   Posted 6/5/2005 2:55 PM (GMT -7)   
 I am not trying to be rude at all here but, I do want to say that not all GP's are bad either. I actually seem to think that my GP, does a great job in treating me.It is more of my Bp that is a problem then who treats it. well at least that is how I feel. I can honestly say when my GP stops giving less then 120% then I will see a pdoc. I constantly read on here about how wonderful pdocs are, but yet some people are still looking for the closeness of stable. I myself, feel like I am still looking to be stable , BUT, I know I have a great Doc helping me. Please note, I do not refuse to see a pdoc, my GP, was going to give me  a referral. I said , when I feel like we are no longer then I must travel on. I just wanted to say that and I hope noone takes any offense, to my personal experience and opinion. Thanks!!!

psychnurse
Veteran Member


Date Joined Mar 2005
Total Posts : 807
   Posted 6/6/2005 6:51 AM (GMT -7)   
First of all you can't "halt" a crash.  When you try to do that, the patient remains manic or hypomanic and they never stabilize.  Crashing is a fact of BP.  If you are not willing to pay the temporary price, you will never get well, it is as simple as that.

I was afraid I would piss somebody off here - truly that is NOT my intension.  People who "struggle" to get well are usually guilty of blindly following whatever the doctor says and just tolerating whatever meds they are given.  I am not saying that's what either of you are doing - but it sure doesn't help when you are being treated by a doc who doesn't understand the complexities and different levels of illness BPs face.   They are NOT up on the latest meds, treatments and discoveries, because it is not their job to study psychiatry.  They are totally overworked and have little time to read up on their own area of medicine - that goes for all docs.  No, not all pdocs are perfect, but there is a way better percentage of people who get better, and much quicker because they see someone who is thoroughly trained and specialized in this field. Did you know that regular doctors outside of psychiatrists spend almost no time on this area in medical school?  They are only introduced to serious illnesses like BP and schitzophrenia and then only touch upon the main characteristics and more traditional treatment, whatever has been popular at the time they were in school, like lithium and haldol.  Sure, they try new ones that they hear of, but that doesn't mean it jis appropriate for that particular patient.  It is also up to the patient to be constantly communicating with the doctor.  They usually end up referring you to a pdoc anyway if they have much trouble.

The reason I am so passionate on this subject is becuase I have seen it time and time again!!!!!!  7 years in psych, you see a lot!  Why keep f******* around while they guess?  He doesn't even have you, Ellie, on a mood stabilizer.  Duh, that is about the ONLY required med for BP.   There are many to try, not just depakote and lithium.  tegretol, trileptal, Lamictal, combination lamictal/other stabilizer for antidepressant effect, Topomax, Neurontin, Gabitril, the list of combinations is endless.  It is also NOT wise to put a BP with mania as severe as yours on an SSRI, ESPECIALLY without a stabilizer!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!  NO pdoc would do this!!!!  nono It is a catastrophe in the making.  If it doesn't happen, I would be shocked.  And no, it may not happen right away.  A wise doc would take a wait and see approach at best with the 37.5mg dose.  Not plan to double it in a week!  It won't even be at full capacity at 37.5 for at least 2-3 weeks.

He has already proven he doesn't know how to treat your particular form, or even basic BP.  You don't just throw SSRIs at BP depression, it isn't the same as other people's depression!  He didn't even try Lamictal, which works for almost every  BP.  He doesn't know that, because it doesn't work on regular depression, which he sees every day.   He doesn't know that it will probably take a combination of welbutrin with it, to control any manic symtoms the welbutrin may cause, but it isn't nearly as bad as SSRI, and well controlled with lamictal, since it is already an anticonvulsant (stabilizer). 

I know that some people do OK on SSRI, type IIs but they still have to have a stabilizer.  Type I is a different story.  Does he even know what type you are?  GPs really aren't taught how to tell the difference, and they quickly forget out of school since they rarely see it and usually never treat it. 
 
Getting stable takes work and time for every BP, but it's much quicker and easier with a pdoc.
 
I hope no one is pissed; I only want to see people succeed, after all that's why I chose to be psych nurse.  The  other 3 years I spent in Internal Medicine, which sees everything, including depression almost every day, and bipolar on occasion.  Internists are specialists at treating and diagnosing more serious illnesses of every kind, except psychiatric ones. GPs are considered the starting point of any illness.  If it's not an obvious diagnosis, they send to an internist to find out.  Then, depending upon the severity or complexity, the internist MAY refer to a specialist; otherwise they treat, still they refer serious mental illnesses. 
 
I am not slamming GPs or internists at all - some are more up on the latest conditions, but not psychiatry - it's not what they do.
 
I'm sure my little "lecture" probably won't change your mind, but you need to know why I harp  about this.  I am telling you as an insider, you are getting free advice from a medical professional.  At least try a pdoc.  Really talk to them about your hopes and fears - they will understand every word you say, it's their job and they know BP all too well.  Find one you like, you may even like the first one you get.  Perhaps you will be more comfortable with a female, they are oftentimes more sensitive to your feelings.  A younger one of either gender is also good, as they have learned the more recent findings and treatments in school and aren't burnt out yet,hehe.  Call around before you decide.  You are very lucky you have insurance, and thus a choice.  Take advantage of what is available to you.
 
If you had a rickety automobile you couldn't really drive, would you refuse to buy a new car if you had the money?
 
Again, I want to say, I just want to see people succeed, like I have - it's wonderful but you don't know it yet. 
 
I hope you're not mad at me. sad


kittycat27
Regular Member


Date Joined May 2005
Total Posts : 438
   Posted 6/6/2005 10:35 AM (GMT -7)   
 Pyschnurse, PLEASE and I emphasize please, don't think I am hearing your communication and info. to me as just a lecture. For I do know you are in the CORRECT medical profession nd withyrs. of experience to give me advice. I understand your concern! :-) I am not in any way shape or form pissed off. I did not intend for my post to come off that way. I also agree with alot of what you have to say about GP not specializing in BP or other mental illnesses if you will.I also agree that it is up to the pt. to be open and honest with any DR. they have as I , too am in the medical profession just a different kind. ( Surgical Tech. Student/ Plastic Surgery).about the Effexor being raised or doubled in the second week is because1: in the past a small dose on Effexor didn't help 2: I am a really good communicator; my GP asks questions of the severity of my depression and I tell him. Today is June 7, I was to see my GP after being on my 37mg of Effexor for a week so he could see how I was doing. I had to reschedule because the Effexor was making me nauseated so I didn't take properly till I spoke on the phone with him today. He adviced eat with food , keep on the 37 mg for another week if I am not nauseated then come in and see him before I increase the dose. Just as was planned. I should have mentioned that before! Anyways, I will think about seeing a pdoc. I always take things into consideration especially when it comes to my personal well being. I am not mad, glad you are here for great advice.    

Ellie 1
Veteran Member


Date Joined Apr 2005
Total Posts : 1291
   Posted 6/6/2005 1:41 PM (GMT -7)   
Thanks Kitty for posting. It's nice to know I'm not the only one seeing a GP. I as well say that I will stick with her until it no longer works out. I started on Effexor xr 75mg and I haven 't had any problems yet. If I start getting manic again I'm sure I'll be the first to know. While not all Pdocs are bad I also believe not all Gp's are incompetent.

kittycat27
Regular Member


Date Joined May 2005
Total Posts : 438
   Posted 6/6/2005 3:59 PM (GMT -7)   
 Ellie nice to hear from you. Keep us posted. You know we can come to this site and talk about other things as well. We all should! BP is a huge part of our life which affect our everyday situations. Well at least mine Gotta go for now. My kid calls :-)
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