Posted by jrbecker on May 1, 2003, at 12:20:50
In reply to bipolar, but misdiagnosed as unipolar?, posted by jralphc on May 1, 2003, at 11:52:00
Many people get hypomanic/irritable on ADs, especially wellbutrin for that matter. But that doesn't necessarily mean you're bipolar. Theoretically, the concept of unipolar and bipolar as separate illnesses or whether they belong on opposite poles of a mood spectrum continuim is a constantly debated topic in the expert arena.
Many postulate that atypical depression (seemingly what you're suffering from) is a soft form of bipolarity, atlthough, once again, this is debated. I would suggest going to the tips section: http://www.dr-bob.org/tips and type "possible indications of bipolarity" in the search engine to find a page that might help you get an idea of whether you might fall into the bipolar II spectrum. If any of the symptoms discussed resonates with you, then you might want to print it out and mention it to your doc. Whether it actually has any implications for treatment consideration (e.g. adding a mood stabilizer or limiting your AD therapy), well, that's a whole other consideration entirely.
Yes, there's other alternatives to Lithium, such as depakote, lamictal, topomax, tegretol, antipsychotics, and others. The choices depend not only on your symptoms but also on what AD you'll be comboing with it. As for the weight gain, not all people gain weight on them. Many say this is dosage dependent. For instance, I've read that depakote has a window where efficacy and lack of weight gain is possible for most people. The more experienced BPs on the board will be better able to answer these questions though.
Maybe the best place to start is to try to write a social history including instances of possible hypomania (which includes sleep disturbances, irritability, agitation, anger, concentration problems) and try to see if they intersect with what you're taking at the time. Show this to your doc and mention the pervasiveness of your atypical symptoms and ask him what he thinks.
Hope this at least points you in the right direction.
JB
poster:jrbecker
thread:223635
URL: http://www.dr-bob.org/babble/20030429/msgs/223639.html