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Re: drugs and manic switches judy1

Posted by wendy b. on June 11, 2002, at 1:33:10

In reply to Re: drugs and manic switches, posted by judy1 on June 10, 2002, at 14:33:22

> So in a case like Wendy's, for example, when she was on Zoloft for awhile and was then diagnosed with
> bipolar? In your opinion, does that mean Zoloft had a manic switch, and maybe it was caused by the drug? I
> really thought it was hereditary and that you sort of had it all your life--it didn't just show up one day. (That's only
> because the folks I know who had it had parents with it.)
>
> I totally agree with you that there is a genetic base, (and I don't know Wendy's history, sorry). When I first entered the STEP-BD program, that was one of the first questions asked- any parents/siblings diagnosed bipolar? So, yes, if one is genetically predisposed and is triggered by a med then you can be pretty certain that person has bipolar disorder. But, until that person has a hypomanic or manic episode without a medication trigger (prednisone is another big culprit in triggering mania), they CANNOT be officially diagnosed with bipolar disorder. So if that was my story, I would not take mood stabilizers or anti-psychotics in anticipation of another episode. I would prefer to be spared all those nasty side-effects and what about decisions like having a child or even the stigma of such a label? Sorry for going on.... Take care, Judy
> P.S. Usually when there is a manic reaction to an AD it happens in the first few days (if there is no mood stabilizer in place). For example, I took 20 mg of prozac for 2 days then spent the next week in a psych ward trying to get a psychotic manic episode stabilized)


Hi there,

Since my case is being spoken about, and it crosses over with Judy's post on Social re: the seeming over-diagnosis of BP disorder in the last decade or so, thought I'd just explain a little more about my history and diagnosis.

I was never dx'd for a mood disorder when I was prescribed Zoloft by my GYN. He prescribed it for my irritability and anger, which were causing major problems in my home and work lives. We had tried various OCs and progestin suppositories (which I couldn't stand!), and those treatments didn't work.

As I mentioned in another post on this thread, the Zoloft lifted some of the daily anxiety I had experienced since childhood, but hadn't known was there because I had never remembered anything else EXCEPT the fact that the ground was always moving under my feet, as it were, and that security was a thing for other people, mostly princesses and movie queens, but not me. (Beardy, I know my grammar sucks at this point, but I will continue anyway...) So the Zoloft was enlightening in that way. It didn't instigate a manic or hypomanic incident for several years. It's possible that in about the 3rd year, I may have pushed over the tolerance level, because I became hypomanic at a dose of 200 mg a day. I had increased the dose with my GYN's approval, since I felt the Zoloft wasn't doing anything for me anymore. I was going through an awful time at work, and was referred to the present pdoc, who took the full history. She dx'd the bipolar based on my history more than anything else, such as the reaction to the Zoloft (although she did take me off it right away), and a father bipolar with comorbid alcoholism, mother with depression. I have responded well to Neurontin as the mood-stabilizer, and Wellbutrin as the AD, a combination unlikely to push me into hypomania. Though there are times (such as now) when I feel the hypomania creeping in, as long as I am diligent with the Neurontin, I am ok.

My tendency is to the lower end of the bipolar sin wave, i.e. depression. I can get hypomanic, but my biggest swings have tended to be downward ones, you know, periods of crying every night at bedtime, waking up crying, etc.

Don't know if that clarified anything, Beardy, but that's it in a nutshell.

best,

Wendy


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