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Re: Atypical depression

Posted by Nancy on April 8, 1999, at 13:03:35

In reply to Re: Atypical depression, posted by Elizabeth on December 14, 1998, at 3:29:21

> > Can anyone give me some information on atypical depression? And what is it sucessfully treated with?
> > Thanks in advance.
> Atypical depression is characterized by reactive mood (ability to be cheered up temporarily when good things happen, but also lability that may lead to irritability and "overreacting" to losses and disappointments) and retained ability to enjoy simple pleasures such as food and sex. Atypical depressives may have periodic cravings for food, especially sweets, and may also have cravings for other pleasant experiences such as shopping, sex, and alcohol and may be quite impulsive about indulging these cravings, bingeing on the things that give them pleasure. They tend to gain weight when depressed, as a result. They also may use excessive sleeping as an escape. They often will feel extremely lethargic, heavy, as though they cannot move at all. Frequently the depression seems to occur in response to some kind of loss (such as romantic rejection) but often far out of proportion to this loss.
> Traditionally, MAO inhibitors (Nardil, Parnate) have been the treatment of choice. Lately it appears that SSRIs are also effective. It remains to be seen whether Wellbutrin, Effexor, Serzone, Remeron, and the like will work as well. The SSRIs, Effexor, and especially Wellbutrin have the nice effect that they tend to be less sedating than other antidepressants.
> Many people with atypical depression also experience significant anxiety, mood swings, and chronic course of illness. For these, a mood stabilizer may be in order (these can help to decrease the number of episodes - you need to take them for a longer time, like a year, before the benefits become apparent). Topamax, in particular, is a newer anticonvulsant that helps promote weight gain, although it may lack the antidepressant effects of lithium. Benzodiazepines may also help with anxiety and interpersonal sensitivity.
> Don't bother with tricyclics until you've tried pretty much everything else. They are not very effective in this type of depression.

E, it sounds like you're describing bipolar-2 disorder. BTW, Topomax is known for inducing weight loss. It is also beneficially used in hard to treat bipolar-1 patients (treatment refractive, rapid cycling).




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