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Re: is anger a sign of depression or.....? SLS

Posted by Elizabeth on May 29, 2001, at 18:09:40

In reply to Re: is anger a sign of depression or.....? Elizabeth, posted by SLS on May 27, 2001, at 20:00:31

> > Medically, the most effective treatments for the ADHD-borderline spectrum of disorders are probably antidepressants (e.g., SSRIs, Effexor, MAOIs -- but *not* tricyclics),
>
> Why not tricyclics? Are they counterproductive when there are BPD symptoms?

Yes, that's exactly right. "Borderline-spectrum" patients (i.e., those identified today as having BPD) seldom respond to TCAs and frequently do worse on them. One possible explanation I've heard is that there is some relationship between BPD and bipolar disorder: TCAs are the most likely of all the ADs to induce rapid-cycling and mania, in particular dysphoric mania.

> In the past, tricyclics were considered effective for treating the behavioral aspects of ADHD in adults.

Behvaioural aspects, but not the affective aspects? I have a hard time imagining that, unless it's just because people with ADHD are often hyperactive and tricyclics tend to be sedating.

ADHD and depression do overlap a great deal, so I'm sure that some people diagnosed with "adult ADHD" would respond to TCAs. This particular case didn't sound like "typical" major depression or dysthymia to me, though.

Does that make sense?

-elizabeth


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