Posted by SLS on February 28, 2012, at 6:47:32
In reply to Saphris/Lithium - effect on comprehension -, posted by Solstice on February 27, 2012, at 21:07:02
The information given to you about lithium along this thread is accurate, and the advice sound.
As the irritability emerged, your daughter could have entered a mixed-state (dysphoric hypomania) with attendant depressive characteristics, including irritability, but not necessarily depressed mood. My thinking is that the escalation of psychosocial stress added to her conscious experience by having to suffer the depressive state might have made worse the manic component and brought on delusional thinking and thought disorganization. Not only can stress make worse depression, but it can also worsen mania.
It might be necessary to treat the depression/dysphoria with a drug that has antidepressant properties. Lamictal is the drug that I had thought might be good to add if, after optimizing your daughter's current drug regime, there is residual dysphoria. Lamictal can make a good complement to the prophylactic properties of lithium as well as the antidepressant effects that some antipsychotics exert; Abilify, Geodon, and Zyprexa being perhaps the most effective of these drugs at reducing depression.
Lamictal might put on 5 - 10 pounds of body weight, if that. Lamictal can, but not always, produce cognitive and memory impairments at higher dosages. More often, the lower dosages used for depression will not cause these side effects. 200 mg is usually the optimal dosage of Lamictal for treating bipolar depression. Lamictal, unlike standard antidepressants, is unlikely to produce or worsen mania.
Anyway, that's the thought I had just before going to bed last night.
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1011847
URL: http://www.dr-bob.org/babble/20120221/msgs/1011891.html