Psycho-Babble Medication Thread 1105833

Shown: posts 1 to 15 of 15. This is the beginning of the thread.

 

Do Antidepressants worked for bipolar 2?

Posted by rovers95 on August 21, 2019, at 6:28:33

So I fit the criteria for bipolar 2. In fact it seems all I've been doing since 2005 is chasing hypomania...and this has finally caught up with me.

Anyway, all of light box, sleep deprivation, and amitriptyline have made me unstable. But otherwise I am depressed, and I'll do anything to avoid that. I took a small dose of abilify (1mg) last night and I feel like I used to pre 2005..but I only slept 4 hours so most probably heading towards hypomania.

If I start to take a mood stabiliser ie lamotrigine, will I then be able to handle an AD (thinking wellbutrin and or abilify)? I really don't want to come crashing down after all this.

 

Re: Do Antidepressants worked for bipolar 2?

Posted by rovers95 on August 21, 2019, at 6:38:58

In reply to Do Antidepressants worked for bipolar 2?, posted by rovers95 on August 21, 2019, at 6:28:33

> So I fit the criteria for bipolar 2. In fact it seems all I've been doing since 2005 is chasing hypomania...and this has finally caught up with me.
>
> Anyway, all of light box, sleep deprivation, and amitriptyline have made me unstable. But otherwise I am depressed, and I'll do anything to avoid that. I took a small dose of abilify (1mg) last night and I feel like I used to pre 2005..but I only slept 4 hours so most probably heading towards hypomania.
>
> If I start to take a mood stabiliser ie lamotrigine, will I then be able to handle an AD (thinking wellbutrin and or abilify)? I really don't want to come crashing down after all this.


Should have added at the end.. Has anyone with bipolar 2 been able to handle antidepressants with a mood stabiliser when they couldn't do so beforehand?

 

Re: Do Antidepressants worked for bipolar 2?

Posted by Christ_empowered on August 21, 2019, at 9:13:48

In reply to Re: Do Antidepressants worked for bipolar 2?, posted by rovers95 on August 21, 2019, at 6:38:58

i think its a common maneuver, if lamictal isn't sufficient. i had a psych who claimed that stimulants were OK in bipolar disorders, but she wasn't a big fan of antidepressants. based on that, I'd say...

psychiatry is -not- a hard science. so, its (sadly...) kind of a guessing game. i'd avoid tca drugs, not just because of potential mood switches, but because they're generally rough and toxic in OD, plus drug-drug interactions. and so...

instead of asking "how am I going to treat my depression?," try to break it down, as in..

"how do I deal with my insomnia?" or "how do I get a bit of relief from my lethargy?" or maybe "how do I deal with intense anxiety and low mood?"

that should help you narrow down your potential drug list a bit. and keep in mind...

not all "depression" is treated with "antidepressants." mirapex is an option, provigil, ritalin or the amphetamines, a low to moderate dose 'atypical' neuroleptic, some supplements...

blah blah blah. hope this help. :-)

 

Re: Do Antidepressants worked for bipolar 2?

Posted by linkadge on August 21, 2019, at 12:10:25

In reply to Re: Do Antidepressants worked for bipolar 2?, posted by Christ_empowered on August 21, 2019, at 9:13:48

Short answer is yes, but not for all individuals. Some people with bipolar II do well on antidepressants alone. Some do well on antidepressants + mood stabilizers and some need all mood stabilizer.

I (may) have bipolar II. I currently take effexor 37.5mg, Remeron 7.5mg and lithium 300mg. For me, sleep is the key. If I can sleep for 9 hours a day, then I mostly operate on a mildly depressed, but stable level. I can handle mild depression with portioned levels of coffee.

Abilify is an effective mood stabilizer, but it can cause insomnia (perhaps more as a start-up effect). You may need to take it earlier in the day, and/or reduce the dose for now. If the insomnia continues, I would switch to something like Seroquel.

I find too, that DHA helps stabilize me.

Linkadge


 

Re: Do Antidepressants worked for bipolar 2? rovers95

Posted by beckett2 on August 21, 2019, at 14:04:49

In reply to Re: Do Antidepressants worked for bipolar 2?, posted by rovers95 on August 21, 2019, at 6:38:58

>Should have added at the end.. Has anyone with bipolar 2 been able to handle antidepressants with a mood stabiliser when they couldn't do so beforehand?

Hello Rover, in my case, yes. After lamotrigine was onboard for sometime, I began Lexapro. It was a hallelujah! event. My BPll treatment seems to require an AD.

 

Re: Do Antidepressants worked for bipolar 2? beckett2

Posted by rovers95 on August 21, 2019, at 14:21:20

In reply to Re: Do Antidepressants worked for bipolar 2? rovers95, posted by beckett2 on August 21, 2019, at 14:04:49

> >Should have added at the end.. Has anyone with bipolar 2 been able to handle antidepressants with a mood stabiliser when they couldn't do so beforehand?
>
> Hello Rover, in my case, yes. After lamotrigine was onboard for sometime, I began Lexapro. It was a hallelujah! event. My BPll treatment seems to require an AD.
>
>

Thanks, have you struggled with ADs before going on lamotrigine? I think my default now is depressed, I only go hypomanic when drug induced (amitriptyline, phenibut).

 

Re: Do Antidepressants worked for bipolar 2? Christ_empowered

Posted by rovers95 on August 21, 2019, at 14:27:00

In reply to Re: Do Antidepressants worked for bipolar 2?, posted by Christ_empowered on August 21, 2019, at 9:13:48

> i think its a common maneuver, if lamictal isn't sufficient. i had a psych who claimed that stimulants were OK in bipolar disorders, but she wasn't a big fan of antidepressants. based on that, I'd say...
>
> psychiatry is -not- a hard science. so, its (sadly...) kind of a guessing game. i'd avoid tca drugs, not just because of potential mood switches, but because they're generally rough and toxic in OD, plus drug-drug interactions. and so...
>
> instead of asking "how am I going to treat my depression?," try to break it down, as in..
>
> "how do I deal with my insomnia?" or "how do I get a bit of relief from my lethargy?" or maybe "how do I deal with intense anxiety and low mood?"
>
> that should help you narrow down your potential drug list a bit. and keep in mind...
>
> not all "depression" is treated with "antidepressants." mirapex is an option, provigil, ritalin or the amphetamines, a low to moderate dose 'atypical' neuroleptic, some supplements...
>
> blah blah blah. hope this help. :-)

This is great thanks, I think/fear that low dose abilify will poop out in the long run as that seems common. If I can rotate between that, wellbutrin and mirapex (without causing hypomania) then would be great.

 

Re: Do Antidepressants worked for bipolar 2? linkadge

Posted by rovers95 on August 21, 2019, at 14:34:05

In reply to Re: Do Antidepressants worked for bipolar 2?, posted by linkadge on August 21, 2019, at 12:10:25

> Short answer is yes, but not for all individuals. Some people with bipolar II do well on antidepressants alone. Some do well on antidepressants + mood stabilizers and some need all mood stabilizer.
>
> I (may) have bipolar II. I currently take effexor 37.5mg, Remeron 7.5mg and lithium 300mg. For me, sleep is the key. If I can sleep for 9 hours a day, then I mostly operate on a mildly depressed, but stable level. I can handle mild depression with portioned levels of coffee.
>
> Abilify is an effective mood stabilizer, but it can cause insomnia (perhaps more as a start-up effect). You may need to take it earlier in the day, and/or reduce the dose for now. If the insomnia continues, I would switch to something like Seroquel.
>
> I find too, that DHA helps stabilize me.
>
> Linkadge
>
>
>

Yep I agree with the sleep thing. Allow dose abilify has improved my mood instantly, but I'm certainly not hypomanic actually. I think it will poop out over time looking at the experience of others.

My baseline at the moment is depression and I need to pick that up...hoping lamotrigine will help.

I was quite encouraged by this paper on pramipexole (although it is not an easy drug to tolerate).

https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2015.15060788

 

Re: Do Antidepressants worked for bipolar 2? rovers95

Posted by linkadge on August 21, 2019, at 16:17:40

In reply to Re: Do Antidepressants worked for bipolar 2? linkadge, posted by rovers95 on August 21, 2019, at 14:34:05

Yeah, the initial reports of Mirapex for depression seem promising. I'm not sure why it isn't tried more often.

Linkadge

 

Re: Do Antidepressants worked for bipolar 2? rovers95

Posted by beckett2 on August 22, 2019, at 22:16:47

In reply to Re: Do Antidepressants worked for bipolar 2? beckett2, posted by rovers95 on August 21, 2019, at 14:21:20

> >
>
> Thanks, have you struggled with ADs before going on lamotrigine? I think my default now is depressed, I only go hypomanic when drug induced (amitriptyline, phenibut).
>

I did. They were destabilizing, the symptoms expressed as excessive anxiety. A few doctors in a row decided I did not have bipolar because I was only depressed and didn't recognize my anxiety as a BP symptom. I recall stopping Pristiq and I felt very peaceful and quiet inside. Then came the depression ofc.

 

Re: Do Antidepressants worked for bipolar 2?

Posted by linkadge on August 23, 2019, at 8:10:04

In reply to Re: Do Antidepressants worked for bipolar 2? rovers95, posted by beckett2 on August 22, 2019, at 22:16:47

>I recall stopping Pristiq and I felt very peaceful
>and quiet inside.

The problem is that, in a sizable portion of patients with just depression or anxiety, antidepressants can make this worse.

In fact, even in animal models, administration of SSRIs can sometimes aggravate anxiety. While this could be an indication of bipolar in some individuals, in others, it is just a fault of the drugs.

To further complicate matters, anticonvulsant mood stabilizers can have anti-anxiety effects independent of their mood stabilizing properties. Valproate, for example, lowers anxiety in normal mice exposed to stressful situations. Same with carbamazepine.

Response to a particular drug, doesn't necessarily mean that one has the disorder for which the drug is approved.

Linakdge

 

Re: Do Antidepressants worked for bipolar 2?

Posted by beckett2 on August 23, 2019, at 15:33:21

In reply to Re: Do Antidepressants worked for bipolar 2?, posted by linkadge on August 23, 2019, at 8:10:04

>To further complicate matters, anticonvulsant mood stabilizers can have anti-anxiety effects independent of their mood stabilizing properties. Valproate, for example, lowers anxiety in normal mice exposed to stressful situations. Same with carbamazepine.

In my experience, Lamotrigine has had an anti-anxiety effect, although not immediately apparent, in addition to an antidepressant effect. I have thought if originally given lamotrigine at the onset of symptoms, I may not have developed BPll and may not have required additional medication. This is personal conjecture.

 

Re: Do Antidepressants worked for bipolar 2? beckett2

Posted by linkadge on August 26, 2019, at 12:03:05

In reply to Re: Do Antidepressants worked for bipolar 2?, posted by beckett2 on August 23, 2019, at 15:33:21

>I have thought if originally given lamotrigine at >the onset of symptoms, I may not have developed >BPll and may not have required additional >medication. This is personal conjecture.

Yeah, I often do the same to myself. Although, I blame SSRIs for sapping my desire for self improvement. I feel like there's no personal growth because I have no interests anymore. I basically wade through the day not really anxious or depressed, but have nothing that excites me, gives me pleasure and nothing I want to pursue. Because this is gone on so long, I've passed up on so many opportunities. I feel trapped.

I think if I'd been on a mood stabilizer (perhaps lamotrigine) and perhaps a ADHD med, I wouldn't have fallen into this well of apathy.

Linkadge

 

Re: Do Antidepressants worked for bipolar 2? linkadge

Posted by beckett2 on August 26, 2019, at 21:48:16

In reply to Re: Do Antidepressants worked for bipolar 2? beckett2, posted by linkadge on August 26, 2019, at 12:03:05

> >I have thought if originally given lamotrigine at >the onset of symptoms, I may not have developed >BPll and may not have required additional >medication. This is personal conjecture.
>
> Yeah, I often do the same to myself. Although, I blame SSRIs for sapping my desire for self improvement. I feel like there's no personal growth because I have no interests anymore. I basically wade through the day not really anxious or depressed, but have nothing that excites me, gives me pleasure and nothing I want to pursue. Because this is gone on so long, I've passed up on so many opportunities. I feel trapped.
>
> I think if I'd been on a mood stabilizer (perhaps lamotrigine) and perhaps a ADHD med, I wouldn't have fallen into this well of apathy.
>
> Linkadge


I've added a little Adderall, and it helps. That with a small cup of coffee and dark chocolate. But I'm in a similar funk.

 

Re: Do Antidepressants worked for bipolar 2?

Posted by bleauberry on October 18, 2019, at 16:17:54

In reply to Do Antidepressants worked for bipolar 2?, posted by rovers95 on August 21, 2019, at 6:28:33

I can find stories of bipolar2 patients who were helped by antidepressants, bipolar2 who were made much worse by antidepressants, and bipolar2 who didn't get much at all.

It is pure experimentation to find out what works for you, if anything. I would just add that I am not a fan of the reuptake inhibitor antidepressants as they tend generally to numb out emotions rather than correct them. If a patient has a profile that really could use some numbing out of emotions, then maybe an antidepressant might be considered.


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