Posted by SLS on June 25, 2013, at 0:01:26
In reply to Re: Bipolar DX based only on SSRI hypomanic response?, posted by creepy on June 24, 2013, at 23:49:59
> 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.Currently, the only AP indicated for bipolar depression as monotherapy is Seroquel (quetiapine). Latuda (lurasidone) will be the second to be approved for this indication if things remain on track. Hopefully, Latuda will be less soporific than Seroquel and produce no weight gain.
- 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:1045773
URL: http://www.dr-bob.org/babble/20130617/msgs/1045832.html