Posted by McPac on June 6, 2003, at 23:17:34
In reply to Re: Antidepressants and Bipolar Disorder? » katia, posted by Ron Hill on June 4, 2003, at 1:44:56
>>>>>>>Ron, is it very common that if a bipolar were to be put on ONLY an anti-depressant (MONOtherapy) that the bipolar would have a very bad reaction---such as SEVERE anger/irritability/agitation?
Is that a "tip-off" to a shrink, that if someone who did NOT know whether they were unipolar OR bipolar, took ONLY an anti-dep., and then reacted TERRIBLY to it with terrible anger/agitation/irritability---would that be a "tip-off" that that person was bipolar and not just unipolar?
Finally, WHY is it that an anti-dep. in monotherapy makes many bipolars completely "lose it" and become much worse? (I understand why they would get the euphoric 'high' but why do anti-dep's in monotherapy cause incredible rage/anger/worsening of symptoms?"Further, some bipolar folks can’t tolerate an SSRI or TCA add-on"
>>>>>>>> So, are you aying that EVEN WHILE ON a mood stabilizer that some bipolars get anger/temper/irrit./agitation when adding on an SSRI or TCA?
I'd heard that some or many bipolars had trouble with SSRI's but didn't know that they had trouble with an ssri while also being on a mood stabilizer.
I didn't know that the TCA's bothered some bipolars, I thought it was just an SSRI thing.
"I’ll try not to bore you with my life story, but let me tell you a little because it illustrates the risks associated with a bipolar patient taking ADs without a moodstabilizer. In 1996, I was enjoying my well established career as an engineer but I was having trouble staying focused on my work (even more than usual) after a heart wrenching break-up with an ex-girlfriend. So I went to a pdoc to discuss my distractibility. The pdoc misdiagnosised me as ADHD and sent me home with a script for Ritalin.
For the first few weeks the Ritalin was phenomenal! Almost euphoric. And I could focus like never in the past. However, after about ten weeks, I started having wide mood swings with severe irritability".>>>>>>>>Very interesting that AT FIRST you felt fine and that only after a while did the bipolar symptoms (severe irrit.) surface (similar to an experience of mine).
"To make a long story short, the pstim, and especially the SSRI, pushed me into a full blown mania, I lost my job, and generally speaking, I acted really weird".
>>>>>>>>>Ron, when you say "pushed you into a full blown mania", do you mostly mean symptoms like rage/anger/irrit./agitation? You don't mean euphorically happy, do you?
"The wrong medicine can end up being much worse than no medicine".
>>>>>>>Damn that's true!
?However, the other side of that same coin is that the correct medicine can make life much richer, fuller, and more productive".
>>>>>>Also very true!
"The lithium controls my hypomania very well"
>>>>>>>re: your hypomania, is your hypomania more the anger/irrit/agitation kind Ron...rather than the "extra-happy, super-joy" feeling?
"but it does little or nothing for my depressive side".
>>>>>>>I wonder if perhaps a higher dose might?
"In case you are wondering, I currently take 600 mg/day of Lithobid for my hypomania.......
and 250 mg/day of niacin (vitamin B3) to control my dysphoric mood states (irritability to the tenth power)".>>>>>>>>Ron, again, might a higher dose of lithium control your hypomania and irritability?
"In addition to doing a great job on my irritability, niacin has antidepressant qualities. I’m told that niacinamide (another form of vitamin B3) is even better than niacin for irritability. Therefore, I may conduct a trial of niacinamide (either with or without niacin)".
>>>>>>>>>Bummer for me...can't take niacin/niacinamide....long story.
I know your post wasn't intended for me Ron but it sure did help me too!
poster:McPac
thread:102831
URL: http://www.dr-bob.org/babble/20030604/msgs/232052.html