Posted by SLS on April 1, 2002, at 13:11:09
In reply to Re: zyprexa for atypical depression?, posted by OldSchool on March 31, 2002, at 20:18:51
Hi OldSchool.
It looks like we have slightly different opinions regarding the use of neuroleptics in mood-illness.
> Scott...you say you are bipolar.That's what a few doctors have said. Mania has expressed itself only in conjunction with my taking MAO-inhibitors. Some people do not regard this phenomenon as being a defining feature of bipolar disorder. However, because I displayed a striking 11-day ultra rapid cycle (8 days depression followed by 3 days of non-manic euthymia - sometimes called normothymia) for two years prior to drug intervention, I would lean towards bipolarity. Also, that the features of my depression are of the atypical type would be supportive a bipolar depression.
> Im not bipolar. Its common knowledge that antidepressants oftentimes trigger mania and dysphoric feelings in bipolar people.
So? At no time during my dysphoric manic episodes had suicide ever entered my mind. Is suicidality exclusive to manic dysphoria? Of course not.
It is common knowledge that antidepressants can sometimes make unipolar depressives feel worse and think more about suicide. I believe the contention that antidepressants can cause suicide is true. The law suits brought against Eli Lilly regarding Prozac-induced suicide have merit, in my opinion. (I hope Potter and Schmidt aren't reading this). The physicians involved are perhaps more culpable, though.
There are quite a few people on PB describing themselves as unipolar who have reported becoming severely suicidal as a reaction to various drugs. Many had never been suicidal previously. These reactions can be intense, painful, and unique within one's historical experience of depression.
> When I am discussing atypical anti-psychotics on here dude, I am discussing them in reference to UNIPOLAR MAJOR DEPRESSION.
So? Why do you deem bipolar disorder to ineligible or irrelevant in a discussion of drug-induced suicidality? I am confused. OK. Let's talk about unipolar depression.
> I never had an antidepressant that made me think about suicide more.
> However, every atypical <antipsychotic> Ive taken in conjunction with an antidepressant made me more depressed, as well as caused acute EPS symptoms that were a major pain in the ass.
Here is what we know so far:1. Zyprexa + SSRI = suicidality for OldSchool
2. OldSchool is unipolar.
3. OldSchool has never had an antidepressant make him feel worse.
4. Every atypical neuroleptic antipsychotic that OldSchool has thus far taken in conjunction with an antidepressant has caused him to feel more depressed and has produced EPS.So far, so good.
These are a few questions that come to mind. I think they might help to put into some perspective (mine, of course ;-)) the use of antipsychotics in unipolar depression.
Question #1: True or FalseStatement: Neuroleptic antipsychotics are the only drugs that have caused unipolar depressives to think more about suicide.
Question #2: True or FalseStatement: No drug, other than neuroleptic antipsychotics, has ever caused anyone to think more about suicide except for in those people who suffer from mental illness.
Question #3: True or FalseStatement: Every unipolar depressive who has taken a neuroleptic antipsychotic has reacted to that drug by thinking more about suicide.
Question #4: What is the percentage of unipolar depressives who react to neuroleptic antipsychotics by thinking more about suicide?
Question #5: What is the rate of response of treatment-resistant unipolar depressives to the addition of a neuroleptic antipsychotic to their treatment regime?
Question #6: What is the rate of response of treatment-resistant unipolar depressives for each drug tried as an adjunct to their treatment regime?
Question #7: True or FalseStatement: Every unipolar depressive feels more depressed each time they take an atypical neuroleptic.
Question #8: What is the percentage of unipolar depressives taking appropriately low dosages of atypical neuroleptic antipsychotics that experience EPS?
I don't have statistics to offer for any of these questions.
> From now on, whenever you read my posts about atypicals, please remember I am discussing them in regards to UNIPOLAR depression, anxiety, using them for things like insomnia, etc.I will.
Is it your opinion that there are no circumstances for which the use of neuroleptics in unipolar depression is justified? If so, which ones?
> Remember...bipolar and unipolar depression are two totally different things.This is probably true. However, they both suck.
- Scott
poster:SLS
thread:100817
URL: http://www.dr-bob.org/babble/20020327/msgs/101299.html