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Re: Are antidepressants right for someone with Bipolar JohnX2

Posted by Mitch on December 20, 2001, at 0:47:07

In reply to Re: Are antidepressants right for someone with Bipolar, posted by JohnX2 on December 19, 2001, at 19:21:51

> Mitch,
> In what sense are the recommended dosages
> far too high for us bpii's if we are on mood
> stabilizers. I take a moderate dose of topamax
> and lamictal and klonopin and my thinking is that
> these meds normalize electrical conductance more
> to that of a depressed patient's and a depression
> would thus require a similar dose. Am I off here?
> What would happen if the AD dose is too strong?
> -john


I am thinking in terms of someone who is adequately controlled(the highs) with monotherapy on mood stabilizer(s) who then adds an antidepressant and experiences breakthrough hypomania or worse. I just don't buy (my opinion) the idea that if you have control over hyperthymic situations with mood stabilizers, that everything is okeedokee with respect to adding normal "therapeutic" doses of antidepressants for breakthrough depression and to invariably expect a unipolar's response to the addition of the AD, that's all. In other words, if you are bipolar and are controlled adequately with mood stabilizer monotherapy and have a breakthrough depression episode-don't be surprised if you respond with a hypomanic or increased cyclic reaction to the addition of the antidepressant (which a unipolar would most likely not not have). So, in conclusion, I believe you have to be extra careful with *dosages* despite the presence of mood stabilizers (at whatever dosages-level of control) in a biplolar patient.





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