Bipolar II /alcoholism treatment with lamictal & seroquel

Hi

This is my first post on this (or actually any) forum.  I am a 48 year old woman who was diagnosed in April of this year as being Bipolar II (or as my psychiatrist says, I am "bipolar-ish", whatever that means).  I was admitted to a psych hopital for 5 days for "dual diagnosis", alcohol and depression which is where I "met" my psychiatrist.  He offered to take me on as a private patient (I have good health insurance!) and has been doing my meds as well as psychotherapy since then.  I see him twice a week for hourly appointments where we chat about my meds and how I am feeling.  He identified my condition as BP II right away, rather than the depression that I'd been treated for (never by a psychiatrist) for years.  I'd been on zoloft for about 10 years, with only partial success.  All other SSRIs had such bad side effect (extremely anxious and jittery) that I couldn't take them.  Right now I am on 150mg of lamictal in the am (fluctuates between 100-200mg, he keeps changing it) and (usually) 50mg of seroquel in the am and 100mg of seroquel before bed, but I can take more during the day, and I do.  I am now completely off of the zoloft (after horrible weaning period) and have not had a drink in 6 months.

I am writing now because I am feeling anxious, depressed and frustrated with this disease that I guess I have.  I have been reading the various posting here and felt compelled to join.  I need to hear about how others are dealing and to deal myself with all of the various issues/symptoms that I now recognize as Bipolar.  My psychiatrist is kind and helpful, but seems to rely alot on the fact that the meds will help me eventually.  Also I experienced an extreme trauma almost exactly 2 years ago which the dr. feels is the root cause of my failure to respond to meds right now (I agree as I was doing better initially than I am now).

I would like to hear other's opinions on my meds (combo of lamictal and seroquel).  The web search that I did on this drug combination is what brought me here in the first place, even though the postings were from 2006.  I am also interested in hearing about other's experiences with alcohol recovery in conjunction with bipolar.  I feel that I am doing fine, no urges to drink (just to eat uncontrollably from the seroquel) and do not go to AA.  I wonder if my general jittery unsettled feelings are due to my meds or to not drinking (or to something else.  Well that's enough for now.

Thanks to all who read and (hopefully) respond.

I am wondering how long it has taken others to become stable on lamictal and at what dosage level?

Hi Yogamom,

I'm BPII also. I've taken Lamictal for almost 4 years and had very good luck with it. It took about 6 weeks to fully kick in, and as you know, you have to titrate up very slowly on it, so try and be patient. I know how hard that is. I'm at 400 mgs now, and it's the "bedrock" of my meds, if you will. We've changed the antidepressant (which is crucial for me) and added other mood stabilizers along the way, but lamictal still works great for me. There's no way, though, of comparing what works for other people with what will work for you. Everyone's chemistry and needs are so individual.

Wouldn't you think, board, that the seroquel should be helping with the jitteriness, though?

Hi Yogamom,

I have never joined a chat before but since we are close in age and I have experiences similar to yours, I decided to respond.  The sentence below is what drew me in the most:

"I am writing now because I am feeling anxious, depressed and frustrated with this disease that I guess I have." - your words

I would like to tell you most of all that "you are responsible for your treatment" and that you have to "do the work".

First, there are good doctors and bad doctors.  It sounds like you have a doctor that cares but some doctors are better qualified and a better fit for "you" so work that out.

Do your homework and find a doctor that may have a new perspective.  I found out that I had bipolar 1 in 2005 but I suffered from addiction and alcoholism for 20 years prior to that.  I was treated for depression and addiction but to no avail.

Once I was diagnosed properly, I was given Limbitrol first.  Not all doctors use that but it is good for people who are coming off of alcohol.  Then I started Cymbalta (antidepressant) and Lamictal.  I loved Cymbalta but it was giving me panic attacks and pushing me toward mania so I can't take antidepressants at all because I tend to swing more toward mania.  My son is more on the depressed and mixed states side but that is another subject.

I take 200 mg of Lamictal and I take Librium.  Librium is a benzodiazapene and I take just a small dose at night but I can take more if I need to.  That is for anxiety.  Most people with bipolar have anxiety and maybe that is what you are missing.  Ask you doctor about it.

Remember, this is the only life you have.  People get sick and unfortunately there is no cure for bipolar but read everything, find out about medicines, get 2nd opinions and believe in yourself.  Your body will tell you when a medicine is not right for you.  Seroquel was not right for me.  I wanted to feel energetic and not groggy.  I flat out told my doctor I wouldn't take it.  If it is making you eat too much, tell your doctor to take you off because packing on the pounds will make you depressed at our age.  Also, menopause may be having some effect on you.

Remember to see a doctor to have bloodwork done to find any other problems like a thyroid or blood sugar problem.  I think every person who was a drinker should go to an endocrinologist and be tested for pre-diabetes.  I have that and I take medicine and control my diet.  Many other things can affect your mood so journal every day from how you feel when you get up til you go to bed.

Trust your intuition and never stop working to get that stability you seek.  I haven't drank since March 2005 and I love it.

You can have bipolar and be happy - it will happen if you don't give up.  Never give up!

Oh, and I don't do AA either.  I do go to church and spirituality is a big part of my life.

God bless you. 

Hi all,

I wrote my first and only post so long ago and was surprised and also happy to be notified that someone had recently responded to it!  Thanks for writing Luvurself.  Since I wrote the  post you responded to I've begun peri-menopause which has caused my moods to become even more erratic.  I'm taking 100mg/day of zoloft during the premenpausal period (can be months long) and 150mg Lamictal/day and seroquel mostly at night to sleep.  My doctor won't give me any anti-anxiety drugs like Librium (or any "benzos") because of my history with alcohol and risks of addiction.  He also wanted me completely off of the zoloft because he thought it was actually making me more anxious and jittery (he's the first doctor who finally realized this, that I was bipolar II so the zoloft wasn't good for me), but I haven't been able to do that succefully.  I've also started taking fish oil and folic acid at his suggestion, as well as making sure I'm getting enough calcium and vitamin D.  I like that he suggests natural as well as pharmaceutical remedies.  I'm "only" seeing him once a week now, but he continue to be quite helpful with the psychotherapy aspect of my treatment.  I'm doing well with my not drinking too and have actually started attending a weekly women only AA meeting, although I have a tendency to slack off if I get busy.  I wouldn't really say I need AA not to drink but I think these women can help to support me in feeling better about myself and less alone, which can only help me stay away from any kind of addictive behavior.  Good for you for staying away from alcohol since 2005!!

Regarding the seroquel too, since I'm only taking it at night most of the time now, my problems with weight gain have ended.  I've also been taking Topamax at night as well-my Dr.'s big on that drug for alcoholics, but I think it helps me with appetite control as well, and with sleep.

I'll try to write again soon.  Good Luck and hope you find lot's of good advice and information here.  I did when I first searched through.

Yogamom

I am also suffering from bi-polar disorder and alcoholism. I have been going to a therapist for awhile now and a psychiatrist. He has me taking 600mg of Seroquel at night and I take Antibuse/Zoloft 100 mg in the morning. Recently, I was pulled over for a DUI, put into a psych unit ( over night ) and most recently a "Sober Living" environment for 72 hours. I am also on probation for the DUI. I have finally come to grips with being "powerless" of alcohol. My Dr. has diagnosed me with bi-polar and alcoholism. Before, I was depressed and dealing with a lot of stress due to the economic hardship with the economy. Oh, I also forgot to mention, I have detoxed three times due to alcoholism and voluntarily admitted into a rehab facility twice.
I am scared I am going to die. I have a two small children at young ages and a husband who is about to leave me. I am willing to try and do anything it takes to get through this difficult time. We have no family in town to help out.
If anyone has any advice or any suggestions for me to challenge, I am all ears.

I go back to see my psychiatrist next week ( after Easter ) and also my alcohol therapist.

PLEASE HELP!!!!