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Re: Bipolar DX based only on SSRI hypomanic response?

Posted by creepy on June 24, 2013, at 23:49:59

In reply to Bipolar DX based only on SSRI hypomanic response?, posted by antennastoheaven on June 24, 2013, at 3:51:05

The DSM may not say it, but many docs consider SSRI induced hypomania to be a sign of bipolar.
Lamictal never got to 200mg+, right? below that point its mostly an antidepressant not much of a mood stabilizer. Id bet you went mixed / agitated on it before you got to a stabilizing dosage. Titrating up on lamictal can be very difficult. Anxiety, agitation, etc. Maybe adding a benzo or an AAP during titration might help?
You might also consider the atypical antipsychotics. Antagonizing serotonin receptors might give benefit without triggering hypomania.
unfortunately theres only a couple 'atypical' antidepressants that work like that. Nefazodone, vilazodone, trazodone. some TCAs like amitriptyline do as well.

 

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