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Re: Cyclothymia mood stabilizers/Listohep

Posted by polarbear206 on May 22, 2002, at 8:57:00

In reply to Re: Cyclothymia mood stabilizers Listohep, posted by JonW on May 22, 2002, at 0:59:15

> Hi Listohep,
>
> When you say mood "regulator" do you mean anti-depressant or mood stabilizer. I assume you mean mood stabilizer. Bipolar NOS is often confused with SAD. You've eluded to this by suggesting cyclothymia. Bipolar disorder is a progressive disorder and you may be more sensitive to destablizing agents (i.e. anti-depressants) than you were before. This may explain the "manic periods of irrational irritability" and rapid cycling on Celexa. If you are currently seeing a psychiatrist, you should ask them to recommend someone who specializes in bipolar disorder and go to them for a consultation. If you are not seeing a psydoc, you might try calling a major research university to see if they see people with bipolar disorder (or at least for a consultation) or refer you to someone who does. I don't want to scare you, after all, maybe you and Celexa just don't get along but if you do have a bipolar disorder the sooner you are treated the better. This is a link to an archive of questions an answers sent to a reputable bipolar doc -- you might want to check this out and see if you identify with any of the posts:
>
> http://www.bipolarworld.net/Phelps/topicarchive.htm
> (if it doesn't work, go to www.bipolarworld.net and navigate from there)
> http://www.psycheducation.org
> (another good link)
>
> I'm not familiar with Propulsid but none of the mood stabilizers are TCAs as far as I know -- actually, TCAs are very destabilizing. If they took this drug off the market aren't you going to have to stop taking it eventually? Or is it still on the market in other countries? In any case, you should be under the care of an expert doc and you might want to ask about trying Lamictal (lamotrigine). It's a mood stabilizer with marked anti-depressant qualities, and if you have a soft bipolar disorder you will benefit greatly from a mood stabilizer. You doctor might add the Lamictal and then slowly pull away the Celexa or you may need the Celexa and be able to tolerate it with the Lamictal on board. Lamictal inhibits the reuptake of serotonin (though not as potently as the SSRIs) and this may explain how it exerts its anti-depressant effect.
>
> Good luck,
> Jon
>
> > Greetings all! Have a question for you, but first some history... After five years of therapy and 10 years of self medicating with AD's (originally Zoloft and now Celexa)for SAD, I think we have come upon a diagnosis of cyclothymia.
> >
> > Usually this time of year I am in my seasonal upswing and don't take any AD, but this year, I have symptoms outside of my normal cycle. My AD medication seems to be inducing what seems to be manic periods of irrational irritability, but if I stay off I am cycling into a low period of sleeping all the time and low functioning. This is wreaking havoc on my job since I have a heavy workload I have to balance and obviously my personal life as well.
> >
> > Here is the catch-I am afraid of adding a new med to my current cocktail because I take Propulsid (approved in pharm study since they pulled it of market) because its the only med that treats my low esophageal pressure(I feel like a walking pharmacy some days and find all meds annoying although necessary.) This means life threatening results if I take tricyclics or don't watch what I am taking very carefully.
> >
> > My question(s) are this-of the mood regulators-are any of them trycyclic? or does anyone have any insight why the Celexa isn't regulating like it normally does? Thanks-


Listohep,

I have the exact same problems as you do. The Celexa used alone with "soft bipolar" will exacerbate your mood cycling. You need to concentrate on introducing a mood stabilizer first. If an antidepressant is needed, it should be the at lowest effective dose. SSRI's used alone caused me to cycle with low grade hypomania (good energy) and made my atypical depression (oversleeping, eating, confusion and concentration) worse!!! What works for me is a tricyclic antidepressant in combo with Lamictal. Some low grade bipolars can get away with using tricyclics. From my experience with many antidepressants, I prefer the older drugs over the newer ones. I feel more like myself on imipramine.
Sexual side effects are minimal compared to the SSRI'S. I totally agree with John about finding a good pdoc. Good Luck.

Laura.


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