[rovers95]

Hi

Antidepressants make me unstable. I'm now taking lamictal 200mg and 2.5mg abilify for bipolar 2.

Should I have a different/calmer reaction to antidepressants this time around, even if it's the same one that has previously made me unstable (sans mood stabiliser)?

Many thanks

[sugahorse1]

I was taking Wellbutrin when I was on a lower dose of my mood stabiliser. When I still wasn't stable and anxiety was going through the roof, my doc really asked me if we could aim to stop the anti-depressant and could get stable on JUST the mood stabiliser, as the anti-depressant really messed with the chemicals in my brain, and the mood stabiliser was having to stabilise this chaos caused by the Wellbutrin.

I eventually stopped Wellbutrin cold turkey. I'm doing OK. Anxiety is better

[sarahsweets]

This is just my opinion and experiences with other BPII people. I am a believer that SSRI's are not a good fit for us. I have no science to back this up. I take and SNRI-cymbalta and it was part of the magic cocktail that got me out of the hospital. Tricyclics seem to be ok but IME and others in my life if an antidepressant is needed the SNRI class works best. IMO the SSRI class is what is responsible for flipping BP II's into mania or depression but again I have no proof, only opinion.

[still_crazy]

hi. there's...a different way of looking at psych treatment...think less of labels/diagnosis, and more of symptoms/problems. what's ailing you, basically...

Bipolar II mostly exists for billing purposes. it kinda sorta helps guide treatment, but....not all the time. if you've been unstable because of an antidepressant, my 1st guess would be: avoid that drug. my 2nd guess would be: identify what problems you have and get to researching. i have looping thoughts and also get somewhat tired, so an 'activating' (my psych's word, not mine) ssri (read: Prozac, standard dosage) is working just fine, although I do kinda feel flat and medicated, at times. :-( happens.

one thing...the more Rx in the mix, the less predictable things get. :-( sad, but true. 2nd thing...got 2 psychiatrists, get 3 opinions. if possible, i think its important to think outside the dsm/icd labels and identify what you need out of treatment, and run that against what the pills can actually provide.

and...sadly, data quality tends to be poor in psych research (thank you, cochrane review). seroquel is classic for moody, anxious bipolar ii people, but my psych now says she uses rexulti with good results and fewer metabolic problems...

but she wants me on vraylar, because it has 'better anti-manic effects' or something. blah. which reminds me...when necessary, politely and tactfully exercise veto power. it is your body, after all. im still on abilify. :-)

[sarahsweets]

Hey @still_crazy what do you mean when you say BPII exists for billing purposes?

Originally Posted by still_crazy

hi. there's...a different way of looking at psych treatment...think less of labels/diagnosis, and more of symptoms/problems. what's ailing you, basically...

Bipolar II mostly exists for billing purposes. it kinda sorta helps guide treatment, but....not all the time. if you've been unstable because of an antidepressant, my 1st guess would be: avoid that drug. my 2nd guess would be: identify what problems you have and get to researching. i have looping thoughts and also get somewhat tired, so an 'activating' (my psych's word, not mine) ssri (read: Prozac, standard dosage) is working just fine, although I do kinda feel flat and medicated, at times. :-( happens.

one thing...the more Rx in the mix, the less predictable things get. :-( sad, but true. 2nd thing...got 2 psychiatrists, get 3 opinions. if possible, i think its important to think outside the dsm/icd labels and identify what you need out of treatment, and run that against what the pills can actually provide.

and...sadly, data quality tends to be poor in psych research (thank you, cochrane review). seroquel is classic for moody, anxious bipolar ii people, but my psych now says she uses rexulti with good results and fewer metabolic problems...

but she wants me on vraylar, because it has 'better anti-manic effects' or something. blah. which reminds me...when necessary, politely and tactfully exercise veto power. it is your body, after all. im still on abilify. :-)

[still_crazy]

i mean...OK, if I went into an outpatient shrink's office and said i have depression, then i get chipper and don't sleep well for a bit...im not functioning as well as i could...now and then i get agitated...antidepressants triggered bad things...

ok. odds are fairly good that the diagnosis will be on the mood disorder area, probably bipolar ii or whatever, but what does that -mean- ? no brain scans, no blood work...

some psych might go for lamictal, seroquel, latuda...others might pull out gabapentin (it happened tome, way back when), or...blah blah blah. treatment isn't exactly standardized, either. even in today's war on drugs environment, some doctors will use controlled substances while others take a harsher approach, and...

if one has probs severe enough to be on the drugs, just try to haggle for humane, OK treatment. that requires some research.