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Re: meds for agitated depression? » olysi79

Posted by SLS on February 6, 2005, at 8:35:24

In reply to Re: meds for agitated depression? » SLS, posted by olysi79 on February 6, 2005, at 2:08:52

> I think you are right on this. Spriggy needs to document every single one and also look for a history of hypomania with a psychiatrist.

Spriggy now informs us that both parents are bipolar. Bipolar disorder is highly heritable. This information would extracted if the psychiatrist does his job properly in an interview. I don't know how this would affect the choice of an antidepressant. There is, however, such a thing as psychotic depression for which the delusions and psychosis exist without mania. Like agitated depression, nortriptyline would probably have a better chance of treating this condition effectively. It probably makes sense to have a mood stabilizer in place while evaluating different antidepressants because of the family history.

You, on the other hand, are unequivocally bipolar. SSRIs seem to destabilize you. I'm glad things are OK for you now. You don't want to rock the boat. Perhaps you can reduce the height of the waves by taking Depakote and further stabilize your condition. You might even be able to tolerate higher dosages of SRIs should it be necessary.

If your OCD seems refractory despite SSRI treatment, it might be interesting to try Anafranil with Depakote as a mood stabilizer.

Just to throw this out there, Zyprexa and Risperdal have been known to be helpful in treating OCD. They also act as anti-manic agents, and help treat psychotic depression as well. You may never want to opt to use these drugs, but I believe it is good to have this information to work with.

Keep posting. I'm sure others will propose better ideas. I would like to hear more from you.


- Scott

 

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