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Re: MAOIs not good for BPII? jedi

Posted by SLS on June 2, 2006, at 11:43:10

In reply to Re: MAOIs not good for BPII? SLS, posted by jedi on June 2, 2006, at 11:18:57

>
> > The problem with this approach is that bipolar depression looks a lot like atypical depression. Usually, it is anergic and produces a reversed vegetative symptomology - over eating and over sleeping. A misdiagnosis here might result in an exacerbation of the illness if mood stabilizers are not employed.
> > - Scott
>
> Hi Scott,
> That makes sence and may be why so many people go years without being properly diagnosed with bipolar. You would think that by now more PDOCs would be able to ask the right questions to diagnose this illness. I am pretty sure that my atypical depression would lie somewhere on the bipolar spectrum. Nardil, while being the only med that has helped my major depression, has also precipitated at least two episodes of hypomania. What do you think of Lamictal to augment my type of atypical depression?
> Thanks,
> Jedi

Lamictal, of course, produces an antidepressant effect of various degrees. Unfortunately, it does not have appreciable antimanic properties. It is not as potent as lithium or Depakote when treating someone who is already manic, and might not prevent an antidepressant induced switch into mania. However, Lamictal is noted to have an anticycling effect. It can help prevent recurrences of depression along with rapid-cycling. This is true of both bipolar and unipolar presentations.

Your question, then, is whether or not Lamictal will prevent a switch into a mania produced by Nardil. Lamictal might not be a bad first choice. Although I question its antimanic potency, it is usually a clean drug that does not cause weight gain. There is a chance that it would work. If it fails to prevent a manic switch, I would then look at Depakote or an atypical antipsychotic to act as an antimanic mood stabilizer. Lithium is not usually effective when treating bipolar II.


- Scott

 

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