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Re: Bipolar and SSRIs Ponder

Posted by BarbaraCat on September 27, 2003, at 20:57:39

In reply to Bipolar and SSRIs BarbaraCat, posted by Ponder on September 27, 2003, at 17:36:31

> Is it your position that SSRIs should be avoided altogether in bipolar patients, even if there is a stabilizer on board?

***Some people say that, but I think it's on a personal need basis. I was helped alot by Nortriptyline early this year and even tho' it's not an SSRI, it still acts similarly. There are a number of folks on this board who take ADs and mood stabilizers successfully. It's hard to keep track of dx's, but it seems that a good percentage of them are BP. My opinion from what I've read and personally is that one probably should take a mood stabilizer when on an SSRI whether they're BP or not.

I wonder what things would have been like if I'd added lithium to my zoloft all those years ago. My pdoc at the time kept trying to convince me, more for it's augmenting properties to prevent my meds from pooping out than for suspected BP. I recoiled in horror at the mention of lithium - that's for crazy folks and I was just severely depressed! Silly me. I might have gone happily along with the combo as others have done instead of ending up in the psych unit and one mixed state after another followed from there. The lack of mood stabilizer probably destabilized me into a more severe BP condition than I would have had otherwise.

I don't know why a TCA would work so differently from an SSRI-type med, but it does for me. I was taking Remeron for a few months as I was ramping up with lithium and Lamictal. I still felt very mixed statey, on the edge of doom all the time. It wasn't until I jettisoned the Rem that I started feeling OK. This was on the recommendation of another babbler who had gone through a similar experience. I can't take SSRI's any longer, even tho' they worked pretty well for awhile. I also wonder about Wellbutrin since it's not an SSRI.

If you haven't gone to this website, by all means do so. It has tons of information in it and one article goes thoroughly into ADs and bipolar. You may need to navigate to 'Home' to get the intro page:

http://www.psycheducation.org/depression/frameset.html


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poster:BarbaraCat thread:9730
URL: http://www.dr-bob.org/babble/20030923/msgs/263826.html