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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by crazybeautiful on June 5, 2008, at 19:18:12
Hi guys. I'm new to the board & have spent the entire day reading threads that seemed relevant to me. It's nice to find so much first hand experience & knowledge on these drugs in one place. Anyhow, here's my situation:
I have been diagnosed, but I don't know if anything that any docs have told me are correct. One said I was suffering from major depression or possibly a major depressive episode. That was 10 yrs. ago. I didn't see anyone else about these issues until about 5 yrs. ago. I don't have insurance so it's costly to seek treatment for these problems.
I finally sought outpatient help at my local mental health clinic that provided low cost care & treatment. I had a horrible experience there & really don't want to go back. A p-doc was downright rude to me when I asked her about various meds I had researched. I guess she felt insulted that I had some knowledge on meds, therapy, & what might be going on with me (I do since I'm planning on majoring in Psychology & have taken some classes). She put me on Geodon & Effexor XL right away at the same time. I don't remember how many mgs. I had really bad side effects that I couldn't handle. I tried my best to give them a chance, because I knew that a lot of these meds have side effects that lessen or go away after time. Unfortunately, I couldn't even make it past a week. I don't remember which pill was which, but I would take one of the meds in the morning & one in the evening. One med made me tense & gave me bad muscle spasms, & insomnia. Based on what others have said, I'm guessing this was the Effexor XL. Assuming that, the Geodon made me sleep about 12-14 hrs. & made me confused & disoriented. It was awful!!
Anyhow, I got switched to a different p-doc & got off those meds. He was better, but I think he thought nothing was really wrong with me. I'm a good speaker & pretty articulate & at times people think I'm just fine & that the reason I don't work is that I'm lazy, which is completely not true. At that time I was almost convinced I was suffering from Borderline Personality Disorder & Social Phobia because I certainly identified with the requirements in the DSM-IV. After doing blood work & having me cut down on caffeine, he finally decided that maybe there was truth to what I was saying. He diagnosed me with having Dysthymia with Borderline Personality tendencies. I disagree. He put me on Paxil (forgot the mgs) & I was on that for about 6 months. That just made me into a sexless zombie who didn't care about anything. I couldn't even cry. It did make me quit smoking though, which was odd (started back after getting off it). I was also seeing a counselor, but she always seemed really confused every time I talked to her. She didn't help much, as I had already tried most of the techniques she suggested. Eventually, she said that because of all of my knowledge of psychology, I was "too smart" for counseling to work for me. This is what I figured would happen. Her suggestion? Hypnosis. She said my brain needed to be re-conditioned. I thought this was funny, but I'm open to whatever. I never found a hypnotist, so eventually I just gave up & tried to cope with my symptoms.
Then came another 4 yrs. of hell. My temper was out of control. The smallest thing would set me off. It could start out as a simple argument with my boyfriend about leaving dirty dishes in our bedroom & eventually blow up into all out rage. I would scream & slam doors & physically abuse him. I'd get so mad that I couldn't breathe & would forget what I was mad about in the first place. Then I'd collapse in exhaustion, tears streaming down my face, & holding onto my boyfriend saying "I'm sorry." I hated being like this. I kept thinking that all of my boyfriends were just incompatible. Maybe they were, but with time I realized that my anger & sensitivity were the majority of the problem.
Now I look back & realize that I've been like this my whole life. Even when I was a child, I'd get so mad at my mother, screaming & yelling at her. My father did the same thing to her so I imagine some of what I have is hereditary. Mom is very loving, understanding, & laid back. Dad is just the opposite--raging temper, insomniac, slightly OCD, controlling. His mother was bipolar, but we don't know all the details. So with all of this, how could I not be manic depressive or something of the sort?
I finally decided to seek help again this year. This time I decided that I was not going to make the mistake that I had before. With the other docs, I told them I was depressed, but angry. I appeared hopeless & distraught because this "cycle" of normal, angry, sad/ashamed, had been going on so long. Immediately they think "Oh, she's just depressed. This is easy." But my depression was obviously stemming from a bigger problem which needed to be addressed. So I went to my GP. I had not seen her very much since I only visit when I'm sick, but I decided to give her a try. I explained that I was angry & irritable all the time & this was causing me to be depressed & also that I had no energy & I had social/performance anxiety. I was pleasantly suprised, she was nice & willing to help as much as she could. I had heard great things about Lexapro, & she agreed & put me on 10 mg a day.
Right away I noticed a difference. It was like night & day. I had not felt this good...ever! I was on a high for about 2 weeks. My temper just vanished & that made me so happy that I cried. I only had 2 arguments with my boyfriend that whole month. No crying spells, or temper tantrums at all. I was amazed & delighted. I couldn't orgasm & was slightly frustrated, but who cares?! I was happy! Then after the initial 2 weeks, things leveled out the 3rd week. I went back to report to GP about my progress. I mentioned the sexual side effects & she said we could always add wellbutrin later to take care of that, but to stay with the 10 mg for another month. By the end of the second month, I hit rock bottom. I got soooo depressed, like really depressed for no reason & I was really sensitive. I didn't get angry, just sad over the smallest things.
Back to GP for another progress report, this time she ups me to 20mg of Lexapro & asks if I wanna add the Wellbutrin XL. I told her I'd wait & see what happens first. I took the 20mg of Lexapro for a month. As usual, first 2 weeks I was on a high again. Beginning of the 3rd week I leveled out & by the end of the 3rd week I was so fatigued that I slept 10 hrs. a day & still needed naps.
During this time my GP decides to quit! I freaked! I was hesitant about going to the replacement doc, but I gave it a shot. Luckily, she was even nicer & better than my original GP. She also suggested adding Wellbutrin XL & said it would help the sexual side effects, counteract the fatigue, give me motivation (which I've had a problem with my entire life) & even help me cut down on smoking! So I added the 150mg Wellbutrin XL. I said to myself, uh oh, here we go, I'm getting a cocktail going. I hope this doesn't turn out to be a 6 or 7 ingredient cocktail before this is all over, but I remained optimistic. I took the 150mg of Wellbutrin XL in the mornings & the 20mg of Lexapro in the early evenings.
Wah-lah! Within a week I was back to having great sex. ;) Within 2 weeks I saw some improvement in my fatigue. I didn't notice any improvement in motivation or smoking cessation. In fact, by this time I had noticed that the Lexapro was making me smoke more & drink more, but I didn't care since it was working so well on my rage & social/performance anxiety.
So back to the new GP to report on progress. She decides to up me to 300mg to see if that solves everything. I take my cocktail & wah-lah! Motivation like I've never had before! Wonderful! Then, as time passes, I start getting irritable. Oh no! Not THIS again! I will NOT go back to being like that! I also develop a tic in my jaw & have some random muscle spasms other places like arms & legs. They happen in spurts & last just about every 2-10 minutes. They will go away for a while & come back again for 2-10 minutes or so. VERY annoying. I can be talking & my jaw will move involuntarily so I kind of stutter. Really embarrassing. I even bit my tongue a few times. I had noticed the tic & spasms happening a little on the 150mg towards the end of the month, but I figured they might go away with time or changing the dose.
So back to GP again. I get lowered back down to 150mg, but this time it's Buproprion SR instead of XL. Nurse Practioner (GP was out of town) says to take 75mg in the morning & take my Lexapro 20mg in the evening. If I find that I need more Buproprion take another one before 5pm (or else I won't be able to sleep). Well, it's been about 3 weeks now & here I am, typing to you guys. Why? Because the Buproprion SR is not working. Even at 75mg I am twitching like a rabbit & I just can't stand it. I'm also noticing a bit more fatigue & a little irritability. Based on what I've told you, does anyone have a clue as to what my diagnosis might be? I know you aren't professionals, but I'd still like to hear your opinions. Also, has anyone been on this Lexapro-Wellbutrin cocktail? Do you have any suggestions as to what meds I should try? I've heard some good things about Privigil, & Inderal. Could either of these be a substitute for the Wellbutrin, taken along with the Lexapro? All responses welcomed. My main problems are:
1. Anger/Irritability/Sensitivity
2. Social/Performance Anxiety (anything even related to performance like performing a credit card transaction in front of people, driving a car, etc.)
3. Lack of motivation to do just about anything
Posted by linkadge on June 5, 2008, at 22:34:49
In reply to NEWBIE--My story (long, but please read!), posted by crazybeautiful on June 5, 2008, at 19:18:12
>A p-doc was downright rude to me when I asked >her about various meds I had researched.
Unfortunately, many doctors do not like being suggested which meds to prescribe. In some respects this can be benificial since one persons cure is another's poison. There is really no good way of knowing which patients will respond to which meds. It is generally a game of Russian Roulette.
>I guess >she felt insulted that I had some >knowledge on meds, therapy, & what might be >going on with me (I do since I'm planning on >majoring in Psychology & have taken some >classes).
Nothing wrong with doing research, but again what you read in psych textbooks is just general serotonin/norepinephrine hypothesis. There are also no tests for neurotransmitter levels, so its kind of a shot in the dark, even the notion that they are restoring low levels of certain monoamines is only a hypothesis that doesn't explain many things. I guess what I am saying is that even with the most detailed training in psychopharmachology it is still mainly a guessing game.
>One med made me tense & gave me bad muscle >spasms, & insomnia. Based on what others have >said, I'm guessing this was the Effexor XL. >Assuming that, the Geodon made me sleep about 12->14 hrs. & made me confused & disoriented. It was >awful!!
Some doctors prescribe antipsychotics (like geodon) for adjunctives in depression. They generally have a lot of side effects and their efficacy in depression is only marginally documented.
>At that time I was almost convinced I was >suffering from Borderline Personality Disorder & >Social Phobia because I certainly identified >with the requirements in the DSM-IV. After doing >blood work & having me cut down on caffeine, he >finally decided that maybe there was truth to >what I was saying. He diagnosed me with having >Dysthymia with Borderline Personality >tendencies. I disagree.
Sorry I don't follow. You said you felt that you identified with BPD.
>He put me on Paxil (forgot the mgs) & I was on >that for about 6 months. That just made me into >a sexless zombie who didn't care about anything. >I couldn't even cry.
Welcome to the wonderful world of antidepressants.
>I would scream & slam doors & physically abuse >him. I'd get so mad that I couldn't breathe & >would forget what I was mad about in the first >place. Then I'd collapse in exhaustion, tears >streaming down my face, & holding onto my >boyfriend saying "I'm sorry." I hated being like >this. I kept thinking that all of my boyfriends >were just incompatible. Maybe they were, but >with time I realized that my anger & sensitivity >were the majority of the problem.
Was this on paxil or off of it? How soon after discontinuing? After coming off SSRI's people can somtimes have a prolonged emotional rebounds. Ie the SSRI blunts all emotions and for a while afterwards the brain is extra sensitive to emotional stimulii.
Have you ever tried omega-3 fatty acids? There are studies suggesting them as adjunctives for depression bipolar and borderline. Studies suggest they reduce the stress induced release of cortisol which may benifit social anxiety (just a side note)
>Now I look back & realize that I've been like >this my whole life. Even when I was a child, I'd >get so mad at my mother, screaming & yelling at >her. My father did the same thing to her so I >imagine some of what I have is hereditary.Behaviors can get passed down in many ways, genes, behavioral modeling and epigenics. I'm sure you're aware.
>Mom is very loving, understanding, & laid back. >Dad is just the opposite--raging temper, >insomniac, slightly OCD, controlling. His mother >was bipolar, but we don't know all the details. >So with all of this, how could I not be manic >depressive or something of the sort?Its possible. The only thing that doesn't really fit though is your responce to paxil. Antidepressants usually worsen cycling in bipolar. They can also produce manic epsiodes especially when unaccompanied by an mood stabilizer. Its also about sevarity of sympoms. Rage and anger can be symptoms of depression.
For classic bipolar you'd be looking for symtpoms like extended periods of euphoria ie elevated mood for days at a time, loss of control over spending, racing thoughts, lack of need for sleep (ie sleeping 3 hours and feeling great) etc. etc.
Bipolar II is also a possibility if you experience hypomania as well as depression.
If symptoms like irritability improved with an antdiepressnat you might lean more towards a depression or dysthymia diagnosis. If the paxil worsened irriability, or caused cycling then this might be more indicative of bipolar.
Is it worsened or associated with PMS (Ie premestral dysphoric disorder)?
What you're going to find is that the DSM guidelines are not concrete devisions or categories. Some suggest the use of a more dynamic scale system where diagnosis is not about having or not having a disorder.
In terms of the DSM many psychiatrists probably think of a diagnosis secondary to a medication which may help the symptoms.
>I told them I was depressed, but angry. I >appeared hopeless & distraught because >this "cycle" of normal, angry, sad/ashamed, had >been going on so long. Immediately they >think "Oh, she's just depressed. This is easy."
Its hard to know. It is possabile that the anger is serving as a coping mechanism to help combat depression. This is fiarly common in depression.
>But my depression was obviously stemming from a >bigger problem which needed to be addressed. So >I went to my GP.
>I had not seen her very much since I only visit >when I'm sick, but I decided to give her a try. >I explained that I was angry & irritable all the >time & this was causing me to be depressed & >also that I had no energy & I had >social/performance anxiety. I was pleasantly >suprised, she was nice & willing to help as much >as she could. I had heard great things about >Lexapro, & she agreed & put me on 10 mg a day.
Again, lexapro is an SSRI. Sure its newer and more widely advertiesd these days but really no more effective than older AD's like say paxil.
The fact that lexapro works and paxil didn't is really a crapshoot. I have heard the same story as yours but the other way around (ie lex did nothing but paxil helped) so its really hard to know.>Then after the initial 2 weeks, things leveled >out the 3rd week. I went back to report to GP >about my progress. I mentioned the sexual side >effects & she said we could always add >wellbutrin later to take care of that, but to >stay with the 10 mg for another month. By the >end of the second month, I hit rock bottom. I >got soooo depressed, like really depressed for >no reason & I was really sensitive. I didn't get >angry, just sad over the smallest things.
Again, welcome to the wonderful world of antidepressants! Sometimes they work great and then just poop out. There are a number of theories as to why this happens. It can simply be pharmachological tollerance, i.e. the brain starts to produce more serotonin transporters to compensate for those inhibited by the drug. It could be bipolar, but again, drug induced behavior is exactly that - drug induced behavior. So many people react to these drugs in a similar way.
>Back to GP for another progress report, this >time she ups me to 20mg of Lexapro & asks if I >wanna add the Wellbutrin XL. I told her I'd wait >& see what happens first. I took the 20mg of >Lexapro for a month. As usual, first 2 weeks I >was on a high again. Beginning of the 3rd week I >leveled out & by the end of the 3rd week I was >so fatigued that I slept 10 hrs. a day & still >needed naps.
One theory suggests that proloned SSRI administration squelches out the production/release of dopamine, leaving the user fatigued and apatheic over time.
>During this time my GP decides to quit! I >freaked! I was hesitant about going to the >replacement doc, but I gave it a shot. Luckily, >she was even nicer & better than my original GP. >She also suggested adding Wellbutrin XL & said >it would help the sexual side effects, >counteract the fatigue, give me motivation
>(which I've had a problem with my entire life) & >even help me cut down on smoking! So I added the >150mg Wellbutrin XL. I said to myself, uh oh, >here we go, I'm getting a cocktail going. I hope >this doesn't turn out to be a 6 or 7 ingredient >cocktail before this is all over, but I remained >optimistic. I took the 150mg of Wellbutrin XL in >the mornings & the 20mg of Lexapro in the early >evenings. Wah-lah! Within a week I was back to >having great sex. ;) Within 2 weeks I saw some >improvement in my fatigue. I didn't notice any >improvement in motivation or smoking cessation. >In fact, by this time I had noticed that the >Lexapro was making me smoke more & drink more, >but I didn't care since it was working so well >on my rage & social/performance anxiety.>So back to the new GP to report on progress. She >decides to up me to 300mg to see if that solves >everything. I take my cocktail & wah-lah! >Motivation like I've never had before! >Wonderful! Then, as time passes, I start getting >irritable. Oh no! Not THIS again! I will NOT go >back to being like that! I also develop a tic in >my jaw & have some random muscle spasms other >places like arms & legs. They happen in spurts & >last just about every 2-10 minutes. They will go >away for a while & come back again for 2-10 >minutes or so. VERY annoying. I can be talking & >my jaw will move involuntarily so I kind of >stutter. Really embarrassing. I even bit my >tongue a few times. I had noticed the tic & >spasms happening a little on the 150mg towards >the end of the month, but I figured they might >go away with time or changing the dose.
>So back to GP again. I get lowered back down to >150mg, but this time it's Buproprion SR instead >of XL. Nurse Practioner (GP was out of town) >says to take 75mg in the morning & take my >Lexapro 20mg in the evening. If I find that I >need more Buproprion take another one before 5pm >(or else I won't be able to sleep). Well, it's >been about 3 weeks now & here I am, typing to >you guys. Why? Because the Buproprion SR is not >working. Even at 75mg I am twitching like a >rabbit & I just can't stand it. I'm also >noticing a bit more fatigue & a little >irritability. Based on what I've told you, does >anyone have a clue as to what my diagnosis might >be? I know you aren't professionals, but I'd >still like to hear your opinions. Also, has >anyone been on this Lexapro-Wellbutrin cocktail? >Do you have any suggestions as to what meds I >should try? I've heard some good things about >Privigil, & Inderal.
It *might* be bipolar, but I'd be more inclined to say you responces are typical. lexapro/wellbutrin combination is basically a low grade version of cocaine. Some research shows that the brain adapts to these drugs like it does to drugs of abuse.
You could go on a mood stabilizer but that will do jack for low enegery levels. It will also not give you anywhere near the umph that an AD does. AD's 'poop out' that the unfortunate reality. Psychiatrists don't admit to that but it still happens.
You had a good initial responce to the lexapro. Why not go back to just lexapro. If it makes you tired or apathetic then just lower the dose. Thats my best advice. If you get into a cocktail, things will get complicated, messy, neurotoxic and not necessarily any better. Provigil is an option, but you may want to get off the wellbutrin first.
Do you take vitamins? How is your b12 status? The amino acid tyrosine may be an option.
How is your thyroid? Low thyroid can cause depression, low energy, and irritability.
>Could either of these be a substitute for the >Wellbutrin, taken along with the Lexapro? All >responses welcomed.
Provigil may help energy but its probably not going to do much for social anxiey or performance anxiety. Its really an alertness promoting agent not a motivation enhancing agent.
I'd recomend dropping the wellbutrin, lowering the lexapro to 5 or 10mg. Adding some b12 (say 10-50mg), folic acid (400mg), omega-3 (300epa, 300dha).
These are the building blocks to the neurotransmitters that may be low. The drugs really only work to recycle the available amount of neurotransmitter, sometimes they can exaserbate the depeletion.
Try to limit smoking. Nicotine may exaserbate a catecholamine deficiancy.
Also check thryroid if you have not already.
Linkadge
Posted by Phillipa on June 6, 2008, at 0:44:34
In reply to Re: NEWBIE--My story (long, but please read!), posted by linkadge on June 5, 2008, at 22:34:49
Definitely get a thyroid panel as all my problems started with hasimotos thyroidistis and it's still off and welcome to babble. Phillipa
Posted by blueboy on June 6, 2008, at 11:28:10
In reply to NEWBIE--My story (long, but please read!), posted by crazybeautiful on June 5, 2008, at 19:18:12
I tried every antidepressant in the book, and saw shrinks for decades. Two weeks ago I went to a very high-level clinic that specializes in diagnosis. They said I was definitely bipolar!
And it makes absolute sense. Not one of all the expert psychiatrists I had seen over the previous 30 years even hinted at it.
So, check it out. If you should be Bipolar II, treating with anti-depressants is going to be a long and frustrating process.
My defining symptom, btw, is a tendency to crash and burn in school/jobs every couple of years. If you're a student and see a lot of fluctuation in your grades from time to time, it might be one indication.
But doctors seem to have a lot of trouble diagnosing it. Bipolar I is a lot easier because the manic phase is so clear -- you go nuts, walk down the street naked, try to buy ridiculous things like a 10 million dollar house on a $30,000 salary, etc.
Bipolar II, on the other -- well, hypomania is great and most people who have it think they are simply feeling extremely healthy.
You don't sound to me like you have Borderline PD, but I'm not an expert by any means.
Posted by linkadge on June 6, 2008, at 13:37:51
In reply to Re: NEWBIE--My story (long, but please read!), posted by blueboy on June 6, 2008, at 11:28:10
Just make sure its based on mood rather than lack of responce to antidepressants.
Some doctors think that antidepressant poop out is a symptom of bipolar. I personally think that antidepressants just poop out. Doctors like to have an excuse for why their meds are not all that great. Oh sure we want to believe its a perfect science but its just not.
I think the real reason that bipolar II is avoided is because its very hard to treat. Bipolar II doesn't usually do well on mood stabilizers alone because the predominant symtpoms are depression. Mood stabilizer / AD combinations don't always work well. Lamictal is an option, but there is really no established evidence for its efficacy. Bipolar II individuals tend to be higher functioning and don't like to take mind AP's and mood stabilizers.
Sure, my marks fluctuate greatly, but overall my GPA is much better off antipsychotics and mood stabilizers.
For instance, there is a possability I would fit into a BP diagnosis. Antidepressants poop out and I go through periods of feeling just fine (I wouldn't call it hypomania though). Nevertheless, why on earth would I want to take a mood stabilizer when 9 days out of 10 it is the depression that is most burdonsome.
Somtimes AD's make people feel better than well for a period of time. Nardil is especially known for this. It doesn't last, but I wouldn't take it as a symptom of bipolar.
Antidepressants can do funny things.
Linkadge
Posted by Zyprexa on June 6, 2008, at 15:12:24
In reply to NEWBIE--My story (long, but please read!), posted by crazybeautiful on June 5, 2008, at 19:18:12
How about a mood stabilizer. Lamictal or depakote. Lamictal will give you more energy than depakot, depakot will realy kill the anger, irritability issues.
Posted by star008 on June 6, 2008, at 17:32:14
In reply to NEWBIE--My story (long, but please read!), posted by crazybeautiful on June 5, 2008, at 19:18:12
sorry u have been having such trouble. sometimes it takes a long time to work things out and find out what is going on.. I would suggest finding a therapist who can help u sort out what is up. I can't diagnose anything but it sounds to me like you have depression with some anxiety. wellbutrin can make you jumpy.. i wouldn't try provigil.. it will make u jump out of your skin if you are edgy already
Posted by bleauberry on June 6, 2008, at 18:45:46
In reply to NEWBIE--My story (long, but please read!), posted by crazybeautiful on June 5, 2008, at 19:18:12
Linkadge had a lot of good wisdom. Keep that post and read it several times.
I would add that if a doctor were to give you an antipsychotic, geodon is not a prime choice. The queen of the category is zyprexa, which I was on for many years. It was good for smoothing out the anger irritibility stuff, made my prozac work better, gave me good sleep, reduced the unmotivated stuff, and allowed Adrafinil (similar to Modafinil) to energize me without the jumpiness side effects.
If psychiatry were easy, this board would not exist. As you've seen, the diagnosis can vary from one doctor to the next. It is very subjective. It also doesn't accurately predict what medication will work good. Honestly, the only way to find that out is by trial and error. Sometimes clues from our previous trials can help guide future choices. For example, paxil made you emotionless and so did lexapro, so you know that the ssris in general are going to have that emotionless apathy unmotivated thing as part the deal, which will require something else to reverse it, of which my personal opinion based on anecdotal evidence says wellbutrin is not reliable enough to do.
Try lamictal. Try depakote. Heck, try a low dose of a natural salt called lithium. You could be pleasantly surprised how well you respond to one of them. Or stay with a lowered dose of lexapro and try adding modafinil. As Link said, it is all a guessing game at best. Who knows, you might be someone who does very well with just a low dose of Xanax or Klonopin and nothing else, or you may be one of those who does poorly on most ssris but does great with prozac, or duloxetine. But if you stay confined within just one category of drugs, you limit the potential of discovering which of those categories are best for you.
Posted by tgo on June 8, 2008, at 18:58:37
In reply to Re: NEWBIE--My story (long, but please read!), posted by bleauberry on June 6, 2008, at 18:45:46
Your anger and irritability outbursts sound a lot like bipolar. You can have mixed episodes where anger and irritability erupt. I would suggest trying a mood stabilizer. Wellbutrin also made me irritable.
Posted by blueboy on June 13, 2008, at 9:22:36
In reply to Re: NEWBIE--My story (long, but please read!), posted by linkadge on June 6, 2008, at 13:37:51
> For instance, there is a possability I would fit into a BP diagnosis. Antidepressants poop out and I go through periods of feeling just fine (I wouldn't call it hypomania though). Nevertheless, why on earth would I want to take a mood stabilizer when 9 days out of 10 it is the depression that is most burdonsome.
>I was told that Lamictal would be superior for BP depression than a straight AD, such as an SSRI.
I can't speak to your symptoms, etc. For me, the AD's did not work. Or, more accurately, other than Nardil, the effects were profoundly . . . well, bad. I didn't get less depressed and I did get horrid side effects.
The guy I saw seemed pretty much on top of things. His number one recommendation for me (BP II with depression and plenty of other "axes" like OCD) was Lamictal and possibly Mirapex, due to the strong anti-depressant action in BP patients. If those failed, he listed all the usual BP suspects (Depakote, lithium) as the primary drugs of choice.
> Somtimes AD's make people feel better than well for a period of time. Nardil is especially known for this. It doesn't last, but I wouldn't take it as a symptom of bipolar.
I'm not so sure about that. I feel that, in my case, the Nardil brought on hypomania. And in retrospect, although I was quite happy, it was destructive.
>
> Antidepressants can do funny things.
>
>Ain't that the truth :)
This is the end of the thread.
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