Posted by HOK on April 28, 2003, at 10:58:38
Ok, so my doc and I have finally come to the realization that my atypical depression is most likely a variant of bipolar II disorder. He said he wants to ask his colleagues about how to proceed with treatment now that a mood stabilizer might be in order. This news is sort of a double-edged sword. On the one hand it brings with it a lot more treatment options to consider, but on the other, makes me see treatment as a lot more hit or miss from here on out.
Considering my symptoms are depressed and very atypical by nature without the aid of an antidepressant, and my hypomanic states (if they are indeed that) are manifested by showing 1) anxiety 2) irritability/agitation 3) sleep porblems 4) occasional anger, I'd like to hear any and all suggestions on where to start.
I can only assume my doc is going to probably start me on lithium or depakote, probably the latter. He knows that I have tried Lamictal in the past with limited success (it caused some irritability, moderate cognitive dysfunction, and only a mild mood lift). So, my questions to you guys are...
1) Should I go ahead with a trial of Lithium or Depakote? Some of the info I've been reading up on so far seems to indicate Depakote as a better option for Bipolar II. However, on the other hand, I'm aware that only Lithium and Lamictal seemed to provide any antidepressant effect, and considering my natural mood state is almost always atypically depressive in nature, then what options does this lead one to consider? In other words, I'm quite fearful of mood stabilizers that might lead to more lethargy, hypersomnia, and anhedonia than I currently feel in my natural mood state.
2) Should I stick with a low dose of my antipressant [Lexapro] as a maintenance dose, or should I ditch it altogether? I've been reading up on the kindling debate and whether one should augment at all with an AD. The hardest thing for me to guage right now is whether antidepressants are causing me more harm that good (e.g., manifesting mixed states, agitation, increased cycling, etc.). What I do know, however, is that when I tried Lamictal for a few months monotherapeutically, I was not at all satisfied with it as an antidepresant. And frankly, I didn't believe it functioned as a great mood stabilizer as well since it caused a lot of agitation, irritability and anxiety.
Any advice here guys, I'm quite nervous but also optimistic about new treatments to consider, but I just hope that I can find one that helps my depression just as much as it helps stabilizes my mood. Any personal accounts of similar circumstances would be greatly appreciated. Thanks.
HK
poster:HOK
thread:222897
URL: http://www.dr-bob.org/babble/20030423/msgs/222897.html