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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Nigel on November 14, 2001, at 14:35:06
Hello - At the age of 50, I experienced my first (and hopefully only) manic episode during a period of intense stress in my work and family life.
I had been on Serzone for depression for about four years. I am now on Lithium which makes me feel dull and stupid and which is giving me hand tremors (1500 mg per day).
Is there a reduced likelihood of recurrence of a manic episode given my history of late onset in conjunction with Serzone? What role if any did the Serzone have in contributing to the development of the mania? Do the side effects of Lithium diminish over time?
Any advice or suggestions would be appreciated.
Posted by judy1 on November 14, 2001, at 16:18:54
In reply to Manic after Serzone, posted by Nigel on November 14, 2001, at 14:35:06
I really think you need a second opinion- since this is your only manic episode and it occurred after taking an AD, I would think stopping the AD rather than putting you on a fairly high dose (I don't know what your blood levels are?) of lithium makes more sense. Did they rule out any organic causes- EEG, MRI, etc. Depakote has a much lower side-effect profile than lithium if organic causes are ruled out and a bipolar specialist feels you need to be on a mood stabilizer (which would really shock me). Best of luck- judy
Posted by Nigel on November 16, 2001, at 17:07:06
In reply to Re: Manic after Serzone » Nigel, posted by judy1 on November 14, 2001, at 16:18:54
> I really think you need a second opinion- since this is your only manic episode and it occurred after taking an AD, I would think stopping the AD rather than putting you on a fairly high dose (I don't know what your blood levels are?) of lithium makes more sense. Did they rule out any organic causes- EEG, MRI, etc. Depakote has a much lower side-effect profile than lithium if organic causes are ruled out and a bipolar specialist feels you need to be on a mood stabilizer (which would really shock me). Best of luck- judy
Thanks for responding, Judy. I was taken off the Serzone immediately after the manic status was diagnosed and plunged into depression with Olanzapine. Then after three weeks or so I was started on Lithium. And certainly there has been no recurrence of mania. I felt a lot better almost right away. But then the side effects showed up.
I am seeking a referral to the Mood Disorders Clinic at the Psychiatric Hospital but there is a two year waiting list I am told.
My GP uses Topirimate mostly for bipolar patients. I have seen Depakote mentioned in a lot of the literature and will ask my shrink about it as an alternative.
I am very curious about research which has been done of the role of SSRIs in mania. If the mania that I experienced was medication induced then the treatment required must surely be different than where people have suffered from a bipolar disorder from a relatievely young age, for example.
Nigel
Posted by judy1 on November 17, 2001, at 11:06:45
In reply to Re: Manic after Serzone, posted by Nigel on November 16, 2001, at 17:07:06
Hi Nigel,
First. I wouldn't necessarily blame the Zyprexa on your depression plunge- I plunge into depression 100% of the time after a manic episode no matter what meds I'm on; it really isn't unusual. Supposedly SSRI's are least likely to set off a manic episode (wellbutrin, effexor an SNRI?) then MAOI's then TCA's. Personally I can't take any AD and I've had this disorder since I was a teen (20 years). Because I have been on so many different meds (and their side effects) I get a little worked up if I see someone who may not have to be on them going through side-effects. Manic and depressive episodes are almost always time limited no matter what med; again assuming organic causes were ruled out and considering your age, why not talk to your doc about not using anything and have your family (educated about bipolar disorder) keep an eye on you. Another good way is to keep a daily mood chart 1-10, where 5 is normal and 6-7 hypomanic, etc. Take care, Judy
P.S. Some people have a manic episode after taking prednisone (a steroid) and because this is so common they are not put on a mood stabilizer once the episode subsides.
This is the end of the thread.
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