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Q: Provigil, Other Drugs or Early Mental Patient Retirement
[Editor's note (Dr. Phelps): the following question has been edited to decrease
identifiability, at the italics; he may be brave and ready for sacrifice to
decrease stigma, but generally nowadays it's still worth being cautious about
the risk to one's career with disclosing bipolar disorder, so to be safe, I just
made it a bit more generic...]
Greetings. I am in my 3rd year of graduate school. My first 2 years I
experienced mild
but tolerable swings adjusted tolerably by medication.
Now in my 3rd year, I have been through one serious upswing and no down--I am 26
and
I have been on meds for 8 years;
2 questions
1. Provigil was given to me to help get me out of bed; but when it came to
exam
time; nothing could work to get my brain pumping towards any real sense of
success;
in fact I virtually when from honors to honorless--and I have had to scrape by
on
medication.. Does provigil cause brain damage. Or perhaps its a combo of
everything
else. paxil- trattera-lamictal--klonopin; all i know is i secretly went
through a year on no meds kicked ass and now I am suffering for it but the only way I
think
I can finish my degree is by reverting back to no meds and gambling. Pretty
scary huh--
2. At what point to I just say that I took on to big of a burden and just
take a
step back and look into early mental patient retirement. Many have likened
me to a
Ted Turner -- I have made and lost a lot of money; and know I just want
some track
to focus on; whatever...thoughts from the inner sanctum of medical
stagnation
Dear J' --
With apologies for the shortness of my reply, as I just lost about an hour of
work and got that nice little message from Microsoft: "sorry for any
inconvenience"...
Suffice to say that it sounds like you could have cycled
into depression (e.g. the tone of the "inner sanctum of medical
stagnation", the lack of any real sense of success). If that was
true, we should be wondering if the current medications could have contributed
to the cycling (as opposed to wondering about brain damage, of which there are
no reports to my knowledge with that or any of your current medications (except
Paxil if you go for the hyperbole of
Dr.
Glenmullen).
Two stimulants (provigil and strattera), one
antidepressant, and one mood stabilizer (unless you count Klonopin, perhaps a
weak second), where the mood stabilizer is not one of the ones that's clearly
been shown to control cycling induced by antidepressants -- I'd encourage you to
talk with your doctor about getting on a regimen that is focused on supressing
cycling, as opposed to the current focus which seems primary to have targeted
depressive symptoms.
The previously Microsofted away version had a bit more
of a rant about antidepressants and inducing cycling, my usual soapbox you can
find among several of my other answers on this site.
Definitely not time for gambling, "no meds",
or early retirement. Good luck, get on with some changes in your regimen
promptly.
Dr. Phelps
Published July, 2003
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