Posted by Ritch on July 29, 2002, at 9:15:41
In reply to Re: Bipolar II's and AD's, posted by cybercafe on July 28, 2002, at 23:34:00
> >one is in late fall early winter. The summertime one tends to be more of a mixed bipolar depression with more anxiety and insomnia--also I feel more alert and OK in the morning with afternoon/evenings becoming lethargic and fatigued with rebound alertness later in the evening with insomnia/broken, reduced sleep. The
>
> hmmm.. the summer depression sounds like it may respond better to a tricyclic than an SSRI, especially if it is not mood reactive
>
>
> >wintertime one is associated with weight gain, carbohydrate cravings, and hypersomnia--sleeping late into the mornings and still not feeling rested. How that fits into "atypical" or not, I am not sure.
>
> ... yeah the winter one (if there is mood reactivity especially) would be classified as atypical, and would respond better to SSRIs than the summer depression... but it would probably respond to an MAOI like Parnate best of all...
>
Hi,The summertime one *has* responded to nortriptyline+Zoloft before. But interestingly, nortripytline by itself didn't work. Also nortripytline is the only tricyclic that has worked worth a damn. The wintertime one thus far has responded the best to stimulants. I took just 5mg of Adderall in the morning for a wintertime episode once and I had NO depression at all. I couldn't stand the anxiety though! The last wintertime one I responded the best to a low-dose combo of Wellbutrin+Nortriptyline+Celexa. MAOI's would probably be the ideal med for me. Pdoc won't go for it, though. I tend to get hypertensive reactions from meds, so I am not going to argue. I was up to just 25mg of Effexor a couple of weeks ago and my BP went from about 130/75 > 160/90! Eeek. It has done that before on Effexor (but not that much), and I get significantly raised BP from Zoloft and Wellbutrin, too.
Mitch
poster:Ritch
thread:114019
URL: http://www.dr-bob.org/babble/20020725/msgs/114143.html