Posted by 3 Beer Effect on April 26, 2002, at 23:30:48
In reply to 3 Beers - I need your advice, posted by rainbowlight on April 26, 2002, at 1:25:16
I've read that both Zoloft & Prozac have a higher tendency to make Bipolars manic or hypomanic than most other anti-depressants since they are so activating. In the PDR & in the drug prescribing info for both Zoloft & Prozac the percent of patients who experienced an activation of mania/hypomania are artificially low just like the numbers for sexual side effects. Clinical experience in real life has proven those numbers wrong & so good psychiatrists don't give Bipolar patients Zoloft or Prozac not only because of the greater chance for a manic switch, but also because of the insomnia & nervousness/anxiety that is common to those two medications, which are two side effects Bipolars are probably more sensitive to than the rest of the population- If you notice, most of the mood stabilizer meds- Lithium, Depakote, Topomax (with the exception of Lamictal) are very sedating & basically turn you into a Zombie.
Psychiatrists usually use Paxil, Remeron, or Wellbutrin SR in patients with Bipolar since these 3 anti-depressants have the least tendency to cause mania.
Since you have anxiety & don't like the Remeron, taking Paxil instead of Zoloft would probably be a good idea. Everyone always complains about the short half-life & terrible withdrawl of Paxil but they have recently released Paxil CR (Controlled Release). If I were you I would pay the extra money & use this new version of Paxil since it is probably smoother in its onset of action & less likely to cause anxiety & other side effects.
Here is a link to the prescribing info for Paxil CR:
http://www.paxil.com/paxilcr/
poster:3 Beer Effect
thread:104181
URL: http://www.dr-bob.org/babble/20020425/msgs/104255.html