PMDD & Bipolar 2

[moalfons]

I have Bipolar 2 and PMDD.  I switched from Geodon to Lamictal in December 2010.  Since that point, my depression has greatly improved and I feel like my old self.  But, ever since I began Lamictal, the Lexapro that controlled the PMDD issue for years, stopped working.  I'm now having severe PMDD issues every month.  My doctor switched me from Lexapro to Viibryd a week ago.  I am experiencing increased appetite, gastrointestinal distress, and can't sleep.  I'm at a loss for what to do.  Birth control pills aren't an option because I have hypertension and am at increased risk for breast cancer.  I'm 39 and can't continue to lose 1 week out of every month to PMDD.  The lamictal has been the best mood stabilizer I've tried and I've tried several so I hate to give it up.  I've read that Viibryd wasn't associated with weight gain in clinical trials but neither was Geodon and I gained over 100 lbs in 2 years so I'm leary.  Any advice would be appreciated.  

[looloo141]

Hi there, first of all I want to offer my sincere sympathy for both you and krustybrocolli. I totally understand what you are going through..
I have had mental health issues since age 11, I believe my problems started with puberty, as soon as the hormones kicked in..ever since, every episode or mental health crisis has involved hormones, such as having my children, mood stabilisers stopping periods etc.
After being on and off meds for 14 years, a few years ago age 28/29 I started to have peri menopausal symptoms, I thought I was going crazy, every doctor I saw said it was all in my head or a symptom of Bipolar..I am Bipolar 1. They didn't seem to care that BP doesn't cause swollen breasts or hot flushes, or the severe pain..all they cared about was the rage and sudden psychotic depression, which was of course just my BP, they told me to carry on with the ZYPREXA and sent me on my way...
About a year later I had an ultrasound scan and they discovered that I had ovarian cysts.
I was also given vitamin B6 in a really high dose, which helped, a bit like evening primrose does. It really got me down ( and the whole family ) that I was so ill for 2 weeks every month.
About a year ago I got a different pdoc, I had been manic as I refused to take the Zyprexa, because a) it wasn't working and b) because I'd gained so much weight!
My new Pdoc suggested I try something else and after a few tweaks I am now on Depakote and Seroquel XR. I have reduced my Depakote because once again the weight was piling on..but I really like the Seroquel, it has stopped the crazy lady stuff, I was so violent and scary with the PMDD, I'm sure you know what I mean, but it has stopped all that for me, I don't know how it works for everyone else but it works for me. I can't stress enough that the extended release Seroquel is the best, normal Seroquel knocks me out and the weight gain is just as bad as all the others, but the XR is really good, it guarantees that I sleep, every night.

I guess I'm trying to say that there is hope out there! I know thats hard to believe..if you are not happy with your meds keep going back to the pdoc until you get the help you need.
My pdoc suggested Sertraline (zoloft) for the PMDD but it sent me manic.
You ought to have some bloods taken aswell, as there could be an imbalance of Oestrogen and Progesterone, or a problem with your Thyroid, although you've probably had these checked.

I have managed to alleviate the psychological symptoms but I still have heavy, irregular periods, and next week I am having the Mirena coil fitted ( arrrrggghhh ) so we'll see how that works out!
I have the breast cancer risks in the family as well..

I really hope this is some help to you!!

Hugs x

[KrustyBroccoli]

I'm in a similar place as you. I have Bipolar1 with my PMDD though. I'm not able to take any antidepressants for my PMDD as I'm ultra-rapid cycling and they put me into orbit. One Dr recommended taking vitamin B6 for the symptoms and it actually made a huge difference. I also use OTC PMS medications such as Pamprin PMS. My husband calls them my happy pills. Check with your Dr if these are suitable for you.

Geodon DOES cause weight gain. I looked it up on drugs.com, which is my usual med info site. I was able to do some research a few years ago and found some great information regarding antipsychotics and weight gain. Here is a link I recently uncovered.
http://www.hopkinsmedicine.org/news/media/releases/Hopkins_Scientists_Uncover_Cause_Of_Antipsychotic_Drug_Weight_Gain

From my own experience with antipsychotics and weight gain, I've been able to figure out how to describe this in simple terms. The meds quadruple the AMPK enzyme that helps with regulating hunger and appetite, (in mice, but I have felt this in my own body so I would put money on the fact that it's the same in humans.) This makes us feel 4x as hungry as before. If we don't eat every time we are hungry, up to 12 times a day, our body thinks it's starving, it shuts down our metabolism and we hang on to every calorie we take in, because it doesn't know when it is going to eat again.

Most antipsychotics cause weight gain, but I have found that there aren't many drug companies that put that out as a big problem. I gained 60 lbs in one year, a friend has gained over 100lbs in one year. The added weight wreaks havoc with our menstrual cycle.

I take lamictal as well, and it is the best of the mood stabilizers for me the same as you. It's nice when we at least know some meds that make our lives better.

If you are looking for birth control, for the sake of birth control then I'd recommend asking your Dr about an IUD.

The trial and error part of psychiatry really bites. I've always said psychiatry isn't a science, it's an art.

Best wishes.