Posted by Ritch on May 1, 2003, at 23:59:33
In reply to Re: bipolar, but misdiagnosed as unipolar? » Ritch, posted by HOK on May 1, 2003, at 14:43:04
I would still go with a "first-line" antimanic agent like lithium that has got a track record for helping depressive symptoms. You might be wondering about what "mood stabilizer" might be the best considering your current symptoms and want to go there directly, but I still think a first off lithium trial would be the best way to approach it. That way you can determine whether you can **tolerate** lithium, and then whether it helps and how and at what dosage. It is a process of elimination, but at least you would know (if you elminated it) whether it would be worthwhile or not.
> Mitch, jralphc's symtoms sound a little bit like mine. Mostly, I'm unmotivated, lethargic, and sometimes grumpy and irritable. I do think that my antidepressants have helped a little bit with this but I also believe that they are exacerbating them as well. From what I've read up on mixed-states induced by antidressants, it sounds a lot like that's what I'm feeling most of the time. Can you tell me, in your best guess, what you recommend trying as my first stabilizer? I'm fairly depressed by nature so I really need something to give me a little bit of control over my mood but something that won't cancel out my antidepressant altogether. Do you have any suggestions?
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> > > After years of unsuccessful AD treatment, and some terrifying recent experiences with what I can only describe as compulsive and self-destructive behavior, I am beginning to wonder: Is it possible that I have some sort of bipolar disorder, and my ADs (Wellbutrin, supplemented with Adderall XR 20 mg) is aggravating a manic phase. Sometimes I have times when I have energy, stay up all night, spend compulsively, and indulge in drugs and sex, to excess. In the past I've attributed this to compulsive behavior, but maybe it is mania?
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> > > Much of the rest of the time I am tired and lethargic, melancholy, irritable and unproductive.
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> > > I haven't mentioned this to my p doc. I really do not want to take lithium and gain weight--I need to lose weight, not gain it, and Wellbutrin is good from that standpoint.
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> > > Do any of you have experience with drug-induced mania? Are there options other than lithium? I am scared, because I fear that I am hurting myself and the people that I love and who love me.
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> > Nearly all antidepressants I have taken aggravate or induce manic symptoms for me (but I can get those symptoms without help though). Wellbutrin wouldn't make me euphoric, but I would be doing a dozen things at once at top speed (spending more, but not recklessly). Stimulants wouldn't make me euphoric either, but I couldn't tolerate them for very long (anxiety). SSRI's definitely make me VERY euphoric (esp. if I am already high). I act like I am smoking grass and have trouble stopping laughing. There are a lot of options other than lithium. There are a half-dozen anticonvulsants you could probably try. You can change the AD's you take (and/or dosages). You can add thyroid hormones, fishoil, there are a lot of options. It would be worth a closer look. You might consider getting an initial appt./interview with a pdoc that specializes in bipolar disorder and air your suspicions/concerns and see what they say.
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poster:Ritch
thread:223635
URL: http://www.dr-bob.org/babble/20030429/msgs/223773.html