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Re: atypical depression: Annie

Posted by Elizabeth on November 9, 1999, at 7:11:09

In reply to Re: atypical depression -how typical?, posted by Annie on November 8, 1999, at 9:44:01

Annie, you sound so sad...I wish there was something I could do to help. I hope that you can pull together the energy to get a second opinion -- it seems pretty obvious that you know something isn't going right with the guy you're seeing now.

I think that docs who diagnose anyone with mood-reactive or atypical depression as bipolar II (and I seem to keep hearing of instances of this) are probably doing more harm than good. Atypical depression has been well documented, and the proper treatment for it is antidepressants (strong evidence for MAOIs, moderate support for SSRIs), not mood stabilizers. Until there is specific evidence that many patients diagnosed as atypical depressive respond to mood stabilizers (as opposed to meeting the [fuzzy] criteria for bipolar II), this should be a treatment reserved for those who do not improve or who worsen on antidepressants.

I don't recall off the top of my head what antidepressants you've tried (if you even mentioned it), but for what it's worth, MAOIs are supposed to be great for irritability. Another thing that sometimes works for people with atypical presentations is stimulants -- amphetamine, Ritalin, etc.




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