Posted by linkadge on August 3, 2011, at 10:29:30
In reply to Re: unsure about dropping eskalith (lithium) » linkadge, posted by SLS on August 3, 2011, at 9:18:11
I wouldn't add valproate for bipolar depression unless there is notable cycling, mania, or some other unresolved bipolar related issues (anxiety, insomnia, drug/alcohol use). I would not use valproate if depression is prominant (unless it is part of a larger cycling pattern).
There are longstanding debates on how to approach bipolar depression. Some advocate the use of antidepressants, others prefer to add more mood stabilizers. There is evidence to support both approaches and I don't know which data is more reliable.
As a crazy theory, perhaps you are getting too much monoamine activity in relation to cholinergic activity. If I take antidepressants too long, I become anhedonic, and the only way to fix that is to reduce the antidepressant for some time.
Linkadge
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URL: http://www.dr-bob.org/babble/20110728/msgs/992689.html