Any Rapid Cyclers With Good Valproate Experiences

[DBS]

Hoping to get a little feedback from others with rapid cycle bipolar disorder.

A little about me. I quite clearly rapid cycle. Typically one or two cycles daily. I'm 49, and have been dealing with this for at least ten years (although only diagnosed bipolar 3 years ago).

My mood swings would be described as moderate compared to many. So, I am quite functional. But I am aware of this condition every hour of every day, and I have great regret that I am not the person that I know I can be. Still, I have a wonderful family and a very good job, and I am able to do most of the things that I want to do (albeit with some anxiety, and some decreased enjoyment).

My med experiences have not been positive to date. Started with many SSRI drugs (when they still thought this was depression). Of course, they caused mania. Since the bipolar diagnosis, I have tried lamictal, seroquel, carbamazepine and lithium. All slowed down my thought process to a point of concern (short term memory and vocabulary issues). I am a self-employed professional, working in a demanding field, so those side effects were very alarming for me. I've got a lot of balls in the air, with my business and the financial demands of my family, and so I am not in much of a position to tolerate cognitive side effects.

It has been a year since I stopped the last of the four drugs mentioned. I "survive" by manipulating my cycles -- with exercise, caffeine, alcohol, sinus Advil (pseudoephedrine), and the occasional Ativan. Not an ideal situation, but, again, manageable.

My research suggests that valproate is probably the one drug, used by many for rapid cycle bipolar, that I have not tried. I am on the fence as to whether I have it in me to try another drug, given my bad experiences to date.

Wondering if there are any rapid cyclers out there, with valproate experience, who might offer a word of insight or advice?

Thanks so much.

[AJ]

Welcome to the forums DBS. I am not a rapid cycler but have been on Divalproate (Epival). I didn't tolerate it well. It made me a zombie at the dose needed to control my symptoms. I'm sure there are rapid cyclers who have been on it that will jump in.

It sounds like in spite of your rapid cycling you are highly functional. I was when I worked too, for quite some time. Having your own business must be especially stressful on top of managing your illness.

It can be frustrating trying to find the right combination of drugs. Hang in there. It took me many trials of many different meds before I got a combination that worked. Even now I do have to make adjustments from time to time.

[paul m]

Hello DBS and welcome to the forum. I rapid cycle as well, although not as rapidly as you do. Valproate works exceedingly well for me, unfortunately I get a fairly rare side effect from it(edema) . I've tried it twice and it worked well both times, but each time the edema came back within 6 mths. Nothing immediately life threatening, but it meant that I had to stop the meds. The doctor had me try it a second time because of the good mental results and to see if it was really the medication that was causing the problem.

A website called crazymeds.us has an offbeat , but informative look at psych meds. The author does a reasonable job of advising of the potential of sides effects, while measured against the need for some people to take medication.

http://www.crazymeds.us/pmwiki/pmwiki.php/Meds/Depakote

Just as a personal note and not a criticism, as everybodies experience is different, when I took pseudoephedrine for allergies it made my rapid cycling worse. I will add that pseudoephedrine did not affect my illness except when I was taking fairly large doses during allergy seasons for a month or so. I still take it every once in a while for a couple of days when my allergy alternative isn't strong enough. Take Care. paul m

[markm]

Hi DBS.
I'm a rapid cycler and I can relate to much of your story - many similar experiences. I function highly too, and it was always disheartening to suffer cognitive impairment from the various meds I tried. Many years of frustration and heartache for both myself and my family. In the early years, I was even treated for depression and given antidepressants which put me through the roof in mania cycles.

Last year, I found a Pdoc that got me on valproate (and later added a small bit of seroquel add-on) and he took his time trying to find the right dosage - that was important. I have to say I feel really good on it (if you ignore a few side-effects which I'm learning to manage - those are easier to manage on my own than my cycling). My cycling is still there, but so very much easier to manage because the extremes are minimized. I, like you, had also tried a lot of self-medicating, but I had to be honest with myself with the fact that "surviving" by manipulating my cycles was not allowing me a happy life. So besides the valproate, I make sure I'm always in routine with sleep, hydration, nutrition, exercise, and meditation. The meditation aspect just helps me be mindful of my physical and emotional reactions. I cut any stimulants and depressants which only induce and exaggerate cycling - caffeine, alcohol, drugs (either over-the-counter or homegrown) - and I watch out for other triggers (overworking, emotional stress, social withdrawal, etc.) Basically, I'm not putting all my eggs in one basket - I'm not expecting valproate to be a silver bullet - I'm doing what I can to be holistic. That being said, valproate at the dosage I'm on now was a key ingredient to what I feel is the first time in my life I feel "good" and successfully managing my disorder.

I'm no doctor, but from what I'm reading these days, and what my Pdoc and MD tell me, valproate with and add-on (seroquel, lamotrigine, etc) seems to be a common "go to" for rapid cycling. If you decide to try it, educate yourself on the side-effects and how to counteract them, and contraindications and interactions in general. That helped me mitigate a lot of the bad side of it. Luckily for me, many of the early side-effects are gone once my body adjusted to the drug.

Good luck and be well,

[Fighting back]

No direct experience myself, but plenty of observation.

My son suffers from epilepsy as well as depression. He can and does cycle rapidly and his mood is pretty poor in the morning before his meds kick in. The most effective med appears to be valproic acid, which is the common name for valproate in the epilepsy treatment world. He reports it helps his mood as well as controlling his seizures. He has been seizure free for a number of years now and it was not under control until he was prescribed the valproic acid.

There has been an interesting side effect reported in that those who take valproate develop better musical pitch. Interesting article on it here.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3848041/

[notgettingbetter]

I don't believe I've been on that med. I have bipolar 2....cycle rapidly...2 days of nothing no motivation sleeping alot. Feelings of guilt alot. Am currently on cymbalta, lamotrigine, clonazepam & trazadone. Can't tolerate any antipsychotics....pdoc tried one that knocked the shit out of me then another one that caused jerking in legs. It's tough. Wish I could find the right combo. I want my life back!

[notgettingbetter]

Sorry...meant to say 2 good days then nothing....

[paul m]

Hello Notgettingbetter and welcome. When my moods get out of hand, I tend to rapid cycle too and I can understand how tough that can be. I can't tell you what will make you better I can only say what helped me. Other people will not have the same reaction to medications that I have had and everybodies life is different so our recovery will be different. So what follows is not a criticism of you or any one else.

I hate antipyschotics too. I hate what they do to my mind and they make me gain weight. However whenever my moods get out of control, antipyschotics are the only thing that really work at stopping the rapid cycling and give my mind a chance to rest and recover. Once under control and having had a chance to rest , I found that I could switch to medications that I got along with better. I have found that my mind is like any other part of my body, once it's been affected by illness, injury or disease, it takes a while to recover.

For about 30% of the people with bipolar, antidepressants are known to cause rapid cycling. Until the docs and I discovered that, any antidepressant (and I tried a lot) caused me to rapid cycle even worse than normal. Even today when I relatively stable, if I try taking an antidepressant I know that sooner or later it will start my moods cycling. The on that I can work with the best is wellbutrin, but even that one gives me major problems if I take it for too long.

As I said, I can't say if any of the above would be of any help to you. Please use the forum to ask questions, answer other people's questions and/or use the forum to vent out a few of life's frustrations. Take Care. paul m

[dave]

4 me the only meds that stabalized my (ultridian....or something) super rapid cycling were lamotrigine and seroquel. Before those two in combo i would cycle every few hours or every few days. Exercise and diet and relaxation and deep breathing and visualization help. When the energy is too much then extra seroquel and bye bye racing thoughts it is..also i try not to take on too much or stress myself out

[boris04]

Hello,
I have been on Valproate for a while and the agitation and anxiety went away. I feel better-I do not rapid cycle anymore either......