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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by allisonfly on May 31, 2010, at 7:39:38
Just wondering if you all had thoughts on this? I am bipolar, 10 + years. I have been most stable on Abilify, lithium, and Lexapro. Went off the Lexapro in fall 2009 b/c it was making me sleepy while driving. That is much better now. I had some rocky periods, but got off the Lexapro ok. Just recently tried to go off Abilify b/c my sugar was going up. Not so successful--now I am rapid cycling, mixed states, and all that goes with that. I am in a partial program right now.
But I notice that my mind seems to get stuck on certain anxiety provoking things and then I go downhill from there. I just can't seem to let go of these things despite trying to talk to myself, etc. I did put in a call to my pdoc but am wondering if I really do need an SSRI. Has anyone had this kind of problem and did an SSRI help?
Thanks in advance!
Posted by mellow on May 31, 2010, at 8:01:15
In reply to Do I need an SSRI?, posted by allisonfly on May 31, 2010, at 7:39:38
> Just wondering if you all had thoughts on this? I am bipolar, 10 + years. I have been most stable on Abilify, lithium, and Lexapro. Went off the Lexapro in fall 2009 b/c it was making me sleepy while driving. That is much better now. I had some rocky periods, but got off the Lexapro ok. Just recently tried to go off Abilify b/c my sugar was going up. Not so successful--now I am rapid cycling, mixed states, and all that goes with that. I am in a partial program right now.
>
> But I notice that my mind seems to get stuck on certain
anxiety provoking things and then I go downhill from there. I just can't seem to let go of these things despite trying to talk
to myself, etc. I did put in a call to my pdoc but am wondering if I really do need an SSRI. Has anyone had this kind of problem and did an SSRI help?
>
> Thanks in advance
>I have similar problems. My pdocs vision is that I can maintain my remission with just mood stabiizers. But each time I try and taper my citalopram I get very Nxious and neurotic. I get so obsessed with certain thoughts I drive my self crazy. So ssri's really help my anxiety and obsessiveness. But as long as they are in the picture I need an antipsychotic in my cocktail to keep me out of ssri induced mainia. All said and done I'm kind of stuck in a larger cocktail of 4 meds and my doc thinks the ssri could be causing some of the instability in the first place. But I just can seem to get a good taper and maintain a remission without neurotic obsessive depression without my ssri. Sorry for the long post, but I can surely relate as I ask if my citalopram is helping me or hurting me all the time. I wish you well.
Posted by manic666 on May 31, 2010, at 12:06:49
In reply to Re: Do I need an SSRI?, posted by mellow on May 31, 2010, at 8:01:15
triggers// are a fact of life for us//its anxiety at its cruelest//thats what you are experienceing
Posted by Phillipa on May 31, 2010, at 12:52:08
In reply to Re: Do I need an SSRI?, posted by manic666 on May 31, 2010, at 12:06:49
Hoping your pdoc has called by now. Mood stabalizer if rapid cycling seems reasonable. I am not bipolar so my advise isn't from personal experience. Phillipa
Posted by bleauberry on May 31, 2010, at 17:18:45
In reply to Do I need an SSRI?, posted by allisonfly on May 31, 2010, at 7:39:38
I think after someone has been on an ssri for some time, longterm significant changes did happen in the nervous system. Sometimes returning to an ssri can restore the stability they had when on the ssri, but sometimes they discover things are more unstable than ever, and that the ssri is totally unlike before and totally intolerable compared to the first. It's almost as if the withdrawal of the ssri created new changes that are bizarre, and unable to reverse by simply restoring the ssri.
Just my opinions.
I think it makes sense to try the ssri again and see what happens. That is the first logical step. If it provided stability previously, it might again.
While many pdocs claim ssris are not good for bipolar, others say they are in fact good mood stabilizers. I believe they are good mood stabilizers, though they can destabilize things during the initial first days or weeks.
If it had not worked respectably for you previously, I would say no. But since it did, then yes.
Posted by allisonfly on June 1, 2010, at 20:33:47
In reply to Re: Do I need an SSRI?, posted by bleauberry on May 31, 2010, at 17:18:45
Thank you everyone who wrote to me. I do agree that triggers are just part of the deal that we all have been dealt...and that mood stabilizers are probably the best for rapid cycling. I did talk to my pdoc yesterday evening and he suggested going up on my Abilify for right now. I did bring up the idea of an SSRI or AD and he said, let's cross that bridge...if the increased Abilify doesn't work. I didn't realize that, bleauberry, about how SSRIs can change your brain so that if they previously worked, they can not always work the next time. Sigh. I will keep that in mind and maybe go with a SNRI or something next time if need be. Mellow--I'm sorry to hear about your cocktail of 4 drugs. I hear you--it is completely frustrating that someone, somewhere doesn't have this better figured out.
Thank you again, everyone.
Posted by manic666 on June 2, 2010, at 5:17:03
In reply to Re: Do I need an SSRI?, posted by manic666 on May 31, 2010, at 12:06:49
it is right you may not be able to go back to an ssri that helped you the first time round//ie prozac with me//but i should not have stopped prozac as it worked //i thought wrongly i was curred//i may still have be still on it after all these years ,like one poster has//there the friendly of meds an are easy to tapper one to another with no washing out no start up sh*t//i have just gone back on sertraline from citalopram was on sertraline before and am ok // to me the snri,s are a little more harsh with terrible withdrawls that go on an on//you have 6 ssris to keep trying so do write the off //there he pdocs front line an they dont mind you experimenting on ssris as much as other meds//my oppinion only
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