Posted by linkadge on March 19, 2006, at 19:28:15
In reply to Re: Never thought I'd hear this..... » linkadge, posted by tom_traubert on March 19, 2006, at 18:02:17
>However, I was diagnosed bipolar in 1994 after >experiencing a major manic episode that directly >followed abrupt withdrawal of 275mg Anafranil >and 1.5 mg Klonopin. After a few terrible >months, I was back on the same medications and >was able to finish school, but then in 1998 it >happenend again, another manic episode that >followed the withdrawal. After that, I was put >on Zyprexa to bring me down (did it ever!) as >well as Depakote, Zoloft,and klonopin etc etc >and it made me a zombie, a depressed suicidal >zombie. 2 months later I tapered myself off all >the drugs and stayed off all drugs for over 6 >years. Now, those 6 years were a lot of work, >and the anxiety levels didn't stop, I wrote and >wrote and wrote, fillled the spiral notebooks, >exercised, did everything I could trying to >manage, and I did, to a point. But the whole >time, I was (and am) terrified of another manic >episode. What kept me going was the description >of withdrawal effects in the book "Your Drug May >Be Your Problem" which I'm sure this board is >familiar with. I disagree categorically with the >authors total dismissal of all psychotropic >medications, but it was reassuring to know that >some people experienced manic episodes as a >result of tricyclic (Anafranil) withdrawal.
You raise some very interesting points. I have had a very similar course of illness. My first major "break" came when I abruptly came off celexa 20mg. The accounts you detail are true. Mania has been a doctumented side effect of antidepressant withdrawl. I remember reading acounts of SSRI withdrawl manias that were so strong they were unresponsive to multiple mood stabilizers. They subsided over time.
There are plenty of possible reasons for this. First you're probably going to experience significant rem rebound and cholinergic activation, which can cause psychosis it itself. Secondarily you are going to go through a major realignment of serotonin and dopamine. Coming off clomipramine probaby shot dopamine relase very high for a while, since SSRI's can dam up dopamine release. Thirdly SSRI's, and I believe clomipramine also affect a powerfull gabergic neurosteroid called allopregnalone (sp.) So coming off of them abruptly can lead to a rebound in excitory neurotransmission.
By the way your experience sounds, I am guessing that it was not pleasant. Ie not a euphoric mania, but (if it was anything like mine) a fearfull, dysphoric mania. The fact that you are scared to death of this happening again sends me a message. One psychitrist told me that if you "fear" becoming manic, then it is probably not bipolar.
>Last year, though, it became too much, I thought >I was having another manic episode and the panic >would not relent. (you can refer to my >exasperated posts) I started and am currently on >1 mg of Klonopin/day and hooked up with a >brilliant CBT therapist. The pdoc suggested >Lamictal, but I wanted to see what Klonopin and >CBT alone could do. I didn't take it out of the >equation, but I haven't gone up in dosage on the >Klonopin or taken anything else. So far, pretty >good for almost a year.
Glad you're doing better. I've had some bad panic attacks that involved near psychosis. The fact that you're experiencing this cluster of manic/panic symtpoms also sends a message. Most manic people are out spending a lot of money in kind of a state of fearlessness. Sounds to me more like a "mixed state".
>I am intrigued, to say the least, of this >board's opinion of "Bipolar III" (maybe I should >start a new thread) as my pdoc was the first >person to bring it to my attention. The real >interesting angle, which I never thought of, is >this: which came first, the manic episode, or >the withdrawal? Meaning, I started drinking, >smoking pot, missing dosages, becoming >hypomanic, then going off meds completely and >plunging into a major psychotic manic episode. >It happened the exact same way both times. Did >the antidepressants bring about the hypomanic >behavior that served as a catalyst for >withdrawal that served as a further catalyst for >mania? If I stayed on the meds would I have gone >manic nonetheless?
Good question. It has been my contention this year to simply test it out. If I am bipolar then I will go manic anyway, without drugs. Well, so far no manic episodes no cyling, no nothing, just back to my original problems, dysthemia, insomnia, anxiety etc. I think it is fully possible for a bipolar person to get prescribed AD's and for a whole lot of bad things to result, but I just never "believed" that was me. Its funny you mention some of the other substances. Yes when I was on AD's I was doing a lot of strange things too. Coffee galore, benzo's, some marajuanna, but a lot of that has subsided after discontinuation. I began to think that a lot of this was simply self medication to try and break with the medication's side effects.
I know that SSRI's gave me some really bad apathy, and akathesia, and that perhaps I was trying to counteract these feelings.
>I am still terrified of another manic episode, >it is my number 1 anxiety-causing issue, and I'm >working on it, and I'm making progress. But it >would sure be nice to know that the meds had a >larger part in my mania than anything else. I >just want a clearer reference point.No, the way you describe it, your "experiences" happened directly after sudden changes in medication. I would personally atribute it to that. These meds are very powerfull, and can do many things upon initiation and withdrawl.
If you have to "wrack your brain" for hints of past bipolarity, then I would personally lean away from that diagnosis.
I have another theory that SSRI's may acutally increase the desire to do illegal substances, to try and restore some ballance in to the dopaminergic system.
Just some thoughts, you thoughts ?
Linkadge
poster:linkadge
thread:620137
URL: http://www.dr-bob.org/babble/20060315/msgs/622223.html