Posted by SLS on February 6, 2014, at 5:11:39
In reply to Re: It all makes sense, posted by poser938 on February 5, 2014, at 23:37:05
Bipolar? I am not convinced that you are now dealing with a condition that lies along the bipolar spectrum, but it might not hurt to consider the possibility that there is some bipolar stuff going on that was triggered by antidepressants. It would allow you to explore a drug like Trileptal, which often helps people with bipolar disorder who have irritability, agitation, aggression, or impulsivity while in a mixed-state. However, these symptoms occur with major depressive disorder, too, although they are more prevalent during adolescence.
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http://archpsyc.jamanetwork.com/article.aspx?articleid=1737169
Interpretation on Medscape:
* "The most important finding in this paper is that it confirms...that the majority of people with irritability and depression do not have bipolar disorder," Roy H. Perlis, MD, director of the Bipolar Clinical Program at Massachusetts General Hospital and associate professor of psychiatry at Harvard Medical School in Boston, who was not involved in the study..."
"Symptoms of irritability and anger during a major depressive episode (MDE) appear to be clinical markers for a significantly more complex, chronic, and severe form of major depressive disorder, a new study indicates.
Results from the longitudinal observational investigation of patients with unipolar MDEs showed that those with current overt irritability/anger were significantly more likely to have increased depressive severity, longer duration of the index MDE, poorer impulse control, and a more chronic and severe long-term course of illness.
Overt irritability and anger were also associated with higher rates of lifetime comorbid substance abuse and anxiety disorder, more antisocial and personality disorders, greater psychosocial impairment, reduced life satisfaction, and a higher rate of bipolar II disorder in relatives.
The study findings strongly suggest that "concurrent anger/irritability symptoms are important indicators of increased severity, chronicity, and complexity of unipolar major depression," the authors, led by Lewis L. Judd, MD, University of California, San Diego, write. Symptoms of irritability and anger during a major depressive episode (MDE) appear to be clinical markers for a significantly more complex, chronic, and severe form of major depressive disorder, a new study indicates.
Results from the longitudinal observational investigation of patients with unipolar MDEs showed that those with current overt irritability/anger were significantly more likely to have increased depressive severity, longer duration of the index MDE, poorer impulse control, and a more chronic and severe long-term course of illness.
Overt irritability and anger were also associated with higher rates of lifetime comorbid substance abuse and anxiety disorder, more antisocial and personality disorders, greater psychosocial impairment, reduced life satisfaction, and a higher rate of bipolar II disorder in relatives.
The study findings strongly suggest that "concurrent anger/irritability symptoms are important indicators of increased severity, chronicity, and complexity of unipolar major depression," the authors, led by Lewis L. Judd, MD, University of California, San Diego, write."
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The list of drugs I gave you was based upon the criteria you set for treatment using your theory. Some are good tools for depression, but would not really address bipolarity per se. You don't have to display mania to have a bipolar diathesis (underlying predisposition). Lamictal might help with the depression aspect, as might adding low dosages of lithium to Prozac. At this point, polypharmacy is probably what is going to get you better. The permutations of combinations of drugs are virtually endless. It is hard to lose hope when so many treatments are left untried. I chose to take lithium at 300 mg/day indefinitely because it does so many things that protect the brain from further damage by my bipolar depression and stress. It turned out that going to 450 mg/day sparked an improvement in depression. Minocycline is another drug with neuroprotective properties which has the potential to treat bipolar depression.
Would you really prefer to have electrodes routed through a hole drilled into your skull rather than taking a mood stabilizing drug?
Let's say that you do not have any family history of bipolar or schizoid illness, and that you are not truly bipolar. Bipolar drugs might still help when so many antidepressant drugs have not. I would consider using Abilify or Latuda in combination with antidepressants before going with DBS. I would also consider adding minocycline. You might actually avoid traditional antidepressants altogether by combining Abilify, Lamictal, and minocycline. I have seen it work very well.
My mind is open, otherwise I would not have produced that list of drugs in one of my previous posts. I hope your mind is just as open to the idea that your current condition includes bipolar features.
- 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:1060040
URL: http://www.dr-bob.org/babble/20140123/msgs/1060326.html