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11-02-2007, 02:05 AM
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I've been dealing with my seemingly problematic mental health for years now. I was doing ok on Paxil but then we wanted to get pg again so decided to switch to a different drug that had less likelihood of side effects after birth. I say I was doing ok but I've kind of felt for a long time that things haven't been normal - but I'm a good coper and have been able to function. So about 18 months ago I switched to Zoloft. Had ok success with that...again not great but I wasn't suicidal or crying all the time etc so I dealt with it. About 6 months ago I felt like that while I was ok, I wanted to be better and so talked to my doctor. We increased my dosage of Zoloft to 100 mg. Still not ok really. After doing some research online I realized there was a diagnosis that kind of fit...Bipolar II. I have a strong history of bipolar in my family (both sides of my family), have had racing thoughts in my past, anxiety issues, extreme iritability, and big mood swings. Most of the time I would say I'm on the depressed side of the scale...but during the day my moods can vary pretty widely. So I talked to my family doctor and she referred me to a mood disorders clinic. So there is a few months waiting list and then I can only get 1 appointment per month with the psychiatrist. He has me do a daily mood and anxiety log. My anxiety is all over the place - sometimes very low and other days very high. My mood at the end of the day is pretty much stable, always a little depressed. I advise him that I filled these out, as instructed at the end of the day, after kids are in bed and I've been kind of vegging out for an hour or two, but that during the day I feel like my moods are all over the place and that for a better picture I should fill these out once an hour kind of thing. He says that's fine, gets my family history (ie divorced parents etc)...and diagnoses me with Dysthymia. So I'm confused because in the past month or so my mood has slowly been falling and falling and in the last 3 weeks I'm in a depression...very low. Crying a tonne, not going to work, sleeping 12-16 hours per day...it's really bad. He says that he wants to increase the Zoloft to 150mg but possibly go up to 200mg and also add a small dose of a mood stabilizer. The Mood Stabilizer is Seroquel and the dose so far is tiny 25mg (to the point I'm wondering if there is any point of actually being on it at all). Since increasing the Zoloft and adding the Seroquel (about 1.5 weeks ago) things are worse now. I'm still sleeping a tonne, but now my dreams are extremely vivid (to the point where I don't know where I am when I wake up and I'm confused about whether the dream was real or not - and this has been every day). I'm jittery...like I'm nervous all the time - especially when I have to leave the house. I'm becoming more reclusive. I'm irritable. Things are not good. I'm not sure if it's the depression is just getting worse or if it's the change to the medications. Also, since starting the tiny dose of Seroquel - I'm not sure this is the best choice of medication. I've seen ads about class action lawsuits regarding Diabetes. I'm still nursing my 2.5yo and there aren't any studies though the data that is there is that the milk transfer rate is extremely low and that's for doese of 200-400mg - plus I'm only nursing once per day usually. I'm obese (I actually believe that I have an eating disorder - Binge/Compulsive Eating - which ironically is a comorbity of BipolarII) and Seroquel is known to cause diabetes. So, I'm so confused. I'm going back to my family doctor on Tuesday but I just don't know what direction I should head. I love my family doctor but I'm just not sure she's equipped to handle the medication game. The Mood Disorders clinic has discharged me with recommendations to my family doctor. So I have no psychiatrist...and getting another one means likely another wait (I'm in Canada). I just don't know what to do...Does anyone have any experience here with this stuff....
Thanks so much for any insight you can provide.
Mum to Shealyn April 2, 2001
Kalisse February 4, 2005
Brampton Ontario Canada
#2 of 2
11-02-2007, 07:59 AM
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first of all, Seroquel is not a mood stabilizer, it is an atypical anti-psychotic. This class of drugs is being used regularly right now to treat bipolar disorder to act as the mood stabilizer in combo with an anti-depressant. Seroquel is one of the most sedating drugs in this class, but it's also one of the older and more well known of them all, which could be why you're on it given that you're nursing. All of these drugs impact blood sugar and can lead to diabetes. You will not be able to avoid that issue with any of them. Most of them also cause weight gain.
My DH may or may not be bipolar. He so far has tried all but one of the atypical anti-psychotics, and all of them cause severe depressive symptoms for him.
I have a couple of thoughts, you could check these out with your doctor. Lamictal is a med that many people find work amazingly for bipolar. we have a cousin who is on just lamictal, no anti-depressant. It is a true mood stabilizer, but it also increases serotonin levels in the brain, so it can do double duty for some people, others take it in combination with other meds. Not sure if it's safe for nursing or not, but at this point, your child is old enough and your health is important. I would personally consider weaning if the meds I needed were not safe. That's just me, you have to do what is right for you and your baby.
Fish oil is a natural mood stabilizer. To take it for this purpose you need to get 1200mg of EPA daily. EPA is one of the omega-3s in fish oil, and it doesn't relate at all to the amount of fish oil in the capsule. You have to look at the back where it breaks out the nutrients, go down to the section on Omega-3's and calculate how many capsules you need to meet the required amount of EPA. Usually I find it takes 6 of the 1000 - 1200 mg of fish oil capsules. I haven't found a more potent source, and I've looked!
I would call the clinic and tell the you feel WORSE on the seroquel, ask if you can stop taking it between now and your next appointment. There is no issue with going off of it, and you're at such a low dose, so that should not be the objection. However, you are on a significant dose of zoloft and SSRIs can cause manias in bipolar individuals.
Bottom line is that you cannot keep going like this, you are in a bad place and you need some help. A clinic that specializes in these disorders should have a way for you to access help when you need it, even if it is between appointments.