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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by hildi on July 27, 2002, at 19:12:15
What med would be least likely to case mania? An SSRI, An MAOI, a tricyclic?
Are bipolars better off on any specific class of a/d's? How about those who aren't bipolar, but feel BP on A/d's?I don't know what my DX is. I may be BPII, or I just may have extremely agitated/anxious depression. My doc doesn't talk about my diagnosis, even when asked, so I've been trying to figure out what I am, and whats best med for me.
My states are such that, without meds I go from extremely disturbed, hyper, anxious beyond belief, out of my mind agitation to uncontrollable crying. Hypersensitive hell.
On SSRI's, all of them, I have Two things that happen: 1. couch potato syndrome-no energy and don't care about anything. Total apathy. Blank mind. 2. Racing thoughts, and agitation of a different kind- mind and body is almost always in motion (even if I am not physically moving, I sort of am inside), a circular, repeating thought. A cycle of thoughts- repeating the same thing over and over. Same song plays over and over in my head- sometimes something stupid like a Barney tune- it drives me nuts. I also get hyper sometimes.
I may have OCD and/or ADD, too.
I just started a new SSRI and I don't think it's
going to be any different. I feel like it's the same thing all over again. All day long today the same stupid dull mind repeating dumb thoughts. I would love to be able to feel and to think again!
Would the heck kind of med should I try??!!
A little while back, someone (I think) suggested Parnate or Nardil?
Any others agree?
Any ideas you can offer me would be greatly appreciated! Any helpful advice to share?
Hildi
Posted by LostBoyinNC1 on July 27, 2002, at 21:38:57
In reply to Least likely med to cause mania? Help!, posted by hildi on July 27, 2002, at 19:12:15
> What med would be least likely to case mania? An SSRI, An MAOI, a tricyclic?
> Are bipolars better off on any specific class of a/d's? How about those who aren't bipolar, but feel BP on A/d's?
>
> I don't know what my DX is. I may be BPII, or I just may have extremely agitated/anxious depression. My doc doesn't talk about my diagnosis, even when asked, so I've been trying to figure out what I am, and whats best med for me.
> My states are such that, without meds I go from extremely disturbed, hyper, anxious beyond belief, out of my mind agitation to uncontrollable crying. Hypersensitive hell.
> On SSRI's, all of them, I have Two things that happen: 1. couch potato syndrome-no energy and don't care about anything. Total apathy. Blank mind. 2. Racing thoughts, and agitation of a different kind- mind and body is almost always in motion (even if I am not physically moving, I sort of am inside), a circular, repeating thought. A cycle of thoughts- repeating the same thing over and over. Same song plays over and over in my head- sometimes something stupid like a Barney tune- it drives me nuts. I also get hyper sometimes.
> I may have OCD and/or ADD, too.
> I just started a new SSRI and I don't think it's
> going to be any different. I feel like it's the same thing all over again. All day long today the same stupid dull mind repeating dumb thoughts. I would love to be able to feel and to think again!
> Would the heck kind of med should I try??!!
> A little while back, someone (I think) suggested Parnate or Nardil?
> Any others agree?
> Any ideas you can offer me would be greatly appreciated! Any helpful advice to share?
> Hildi
People with classic type 1 manic depression are generally advised to try to avoid antidepressants entirely and just stick with mood stabilizers, benzos and if need anti-psychotics. If an antidepressant is needed Wellbutrin SR is the preferred AD for classic manic depression. Also, ECT is very effective for depression in manic depression. ECT is effective for both the mania part and the depression part of manic depression. Ive also read that MAOIs are OK for the depressive phase of manic depression, although I dont know why.For lesser forms of bipolar or "soft" bipolar disorders you have more leeway but still might have trouble tolerating an antidepressant without a mood stabilizer taken at the same time. Wellbutrin SR would still be a good choice. If you use an SSRI, avoid Prozac cause it has an extremely long half life and if it sets you off into mania/hypomania, the stuff takes forever to get out of your system. Instead use antidepresants with short half lives like Paxil, Luvox, etc.
If you have bipolar and must use an antidepressant, Wellbutrin SR is generally the one to use.
>
Posted by hildi on July 29, 2002, at 13:52:22
In reply to Re: Least likely med to cause mania? Help!, posted by LostBoyinNC1 on July 27, 2002, at 21:38:57
thanks Lostboy. I would say that if I am bipolar, it is more soft/a lessor form of it. Or maybe I'm bipolar II. I seem to fit that description. . .what I FEEl like is ADD, GAD, severly anxious/agitated, hypomanic, melancolic/retarted, obsessive compusive, . . .Who cares what the 'title' is anymore- I just want to treat my symptoms!
ECT is not an option- I cannot Afford it. Wellbutrin I haven't tried yet- my doc discouraged it because he said it could make me more anxious. However, Prozac, which is activating, too, made me more focused than agitated,, although it did cause some mild mania/racing thoughts.
Have you heard anything about wellbutrin not considered for treatment for those with major anixety d/o's? I'll have to look into this.
Thanks,
Holly
Posted by katekite on July 29, 2002, at 15:54:59
In reply to Least likely med to cause mania? Help!, posted by hildi on July 27, 2002, at 19:12:15
Can you take a family member or friend to the next doc appointment? I've found this helps tremendously with getting a straight answer on whether they know what the diagnosis is or not, and if they think they do, what it is. Sometimes a doc will actually answer them when they say, "what is wrong?".
Sorry you are having such trouble with meds.
kate
Posted by LostBoyinNC1 on July 29, 2002, at 17:39:47
In reply to Re: Least likely med to cause mania? » LostBoyinNC1, posted by hildi on July 29, 2002, at 13:52:22
discouraged it because he said it could make me more anxious. However, Prozac, which is activating, too, made me more focused than agitated,, although it did cause some mild mania/racing thoughts.
Thats common for Prozac in bipolar patients. Thats one of the reasons Pdocs try to avoid using Prozac in bipolars.
> Have you heard anything about wellbutrin not considered for treatment for those with major anixety d/o's?
Oh yes! Its well known that Wellbutrin is one of the poorer medications for anxiety and panic. In fact Wellbutrin can aggravate anxiety. So your doctor is correct on this one if he thinks you have beaucoup anxiety or panic. For anxiety, things like benzos, buspar, anticonvulsants and the more sedating, serotonergic antidepressants like Paxil or Luvox are used. Remeron is also a good choice for bad anxiety, although it might aggravate your bipolar. MAOIs are also good for anxiety, although they are mostly reserved for more refractory med resistant folks.
Posted by littlebaldy29 on July 30, 2002, at 14:39:52
In reply to Least likely med to cause mania? Help!, posted by hildi on July 27, 2002, at 19:12:15
You definitely want to stay away from tri-cyclics!
Posted by fairnymph on July 30, 2002, at 14:54:59
In reply to Re: Least likely med to cause mania? Help!, posted by littlebaldy29 on July 30, 2002, at 14:39:52
My ex bf was BP type II....
He took 100 mg of wellbutrin a day...more and he started rapid cycling. Other than that the wellbutrin seemed to work well.
However, he realized he needed more of an antidepressant., so he went on paxil...he was taking 10 mg/day at first but this induced mania and severe sexual dysfunction...so he went down to 5mg/day (which means you have to split a pill in half) and that seemed perfect.
The two above antidepressants along with 2000 mg depakote and klonopin (1 mg) as needed was the best cocktail of meds he found.
He was seeing a bipolar expert/specialist at the Stanford clinic.
Hope this helps!
Posted by Ed O`Flaherty on July 30, 2002, at 16:30:02
In reply to Re: Least likely med to cause mania? Help!, posted by fairnymph on July 30, 2002, at 14:54:59
Wellbutrin is probably the safest for BP.One other safe option is omega-3 fish oil which is widely discussed on this board.Have a look too at www.omega3.20megsfree.com
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