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What you say (Miguel'smom) makes sense, and I'm actually perplexed by the 'no-AD' thing. My pdoc consulted the head of the Bipolar program here, who's quite well-known in the field, and that's what he said. In my case, Lamictal alone really kicked the depression in the butt, but I really don't know what they do with people with more persistent depression.
Does anyone know if there are other mood stabilizers, apart from Lamictal, that tend to help with depression?
Actually, I just looked it up, now I get it. The hospital where I receive care (and work) was involved in a gigantic research study STEP-BD and these were the results re AD's.
7. What are the results from the STEP-BD acute depression medication trial?
A. Of the 179 participants who received an antidepressant in addition to a mood stabilizer, 24 percent achieved a durable recovery (at least eight weeks with no more than two depressive or two manic symptoms), compared with 27 percent of the 187 participants who took a mood stabilizer plus placebo. Moreover, adding an antidepressant did not increase the risk of a switch to mania or hypomania. The similar rates of durable recovery indicate that the addition of an antidepressant medication to adequate, optimally dosed mood-stabilizing medications does not improve recovery from bipolar depression any more than adding a placebo.
Nonetheless, clearly people have benefitted from AD's. It's just since the hospital conducted this study, they go by the results. I'm actually going to google around and see if I can find more recent research.
Also, you'll see that *some* people did benefit (just not statistically more than those who did not take it), but interestingly, it says AD's (or the one's they prescribed, which were specific and I can't remember which type) did not send people into mania *either*. So maybe, even going on these results, if there isn't much danger of sending someone into mania, then may as well give it a try.
When I took Zyban (aka Wellbutrin) over a decade ago to stop smoking (before being diagnosed) it sent me into a psychotic mania. Though it's possible that this class of AD's was not used in this study.
I know there are plenty of people who have been sent into hypo/mania from AD's, at least anecdotally, I don't know the studies.
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