Posted by linkadge on July 21, 2019, at 12:22:54
In reply to Re: Dx.Bipolar II and OCD - Wise to be taken off SSRI?, posted by HelenBall on July 21, 2019, at 10:12:15
Hi Helen,
You've raised a lot of issues. To answer your primary question, I don't believe that bipolar II can be diagnosed based on one symptom. As mentioned, irritability can be a symptom of depression.
To understand whether this doctor's decision was sound or not you'd need to look at additional symptoms of bipolar II to see if they match.
Questions / thoughts I would have would be:1) Was Prozac the only SSRI you've taken? If the drug worked well for a period of time, then stopped, my initial thought would be to try another antidepressant (or raise the Prozac dose, if it was on the low side) - unless of course, there were clear symptoms of (hypo)mania.
2) Is the irritability ongoing, or does it occur more episodically? If it is episodic, do other symptoms pop up around the same time?
3) Antidepressants stop working all the time, for a variety of reasons. It is not necessarily indicative of bipolar.
4) There are a number of studies that suggest that bipolar II is *not* effectively treated by mood stabilizers alone. Some studies suggest that antidepressants alone can be effective for some individuals with bipolar II. Others studies suggest that a combination of antidepressant and mood stabilizer is optimal.
5) The emotionality you are experiencing could be a sign of SSRI withdrawal. For Prozac, this may start occurring many days / weeks later as it has a longer half life.
6) I would treat the biggest problem first. Think of your cluster of symptoms pre-medication. If the biggest problem is depression / OCD, then yes I would stick with an SSRI.
7) Given your symptoms, you might be better served by an SSRI (perhaps try ones other than Prozac). If hypomania symptoms occur, then think about adding a mood stabilizer. Something like abilify or Seroquel might work well at reducing hypomania symptoms while still allowing you to take the SSRI. A SSRI lamotrigine combination can also work well for some.
Linkadge
poster:linkadge
thread:1105343
URL: http://www.dr-bob.org/babble/20190513/msgs/1105349.html