[Moreta]

I went to go see a new psych today, and he said that anti-depressants can make the bipolar worse. I've never heard this before, so I was wondering if anyone else had...

He seemed a lot nicer than my psych, so I'm going to stick with this one. Very to the point, which I like. I go back to see him in a month.

Yes, SSRI's have a warning on them that they may cause mania in bipolar patients. That's why most pdoc's will give them along with a mood stabilizer if they give them at all.

[Yoda]

agree with farmergirl

I was given Paxil for anxiety/depression before I was diagnosed with bipolar and it caused hypomania and then the worst depression I ever had.
I am now taking a mood stabilizer along with the anti-depressant and doing well.

[blueoctober]

Hi Moreta; glad you like your new pdoc. It really depends on your symptoms. For some people with BP especially BPI even with a mood stabilizer or anti-psychotic it still can push them into mania or hypomania.

I have been on anti-depressant since I was diagnosed (wellbutrin not a SSRI), but my initial diagnosis came when a SSRI anti-d I was prescribed put me into a mixed state and I was admitted to a Psychiatric hospital. Now as long as I'm on a mood stabilizer I have no issues with anti-d's.

Originally Posted by Moreta

I went to go see a new psych today, and he said that anti-depressants can make the bipolar worse. I've never heard this before, so I was wondering if anyone else had...

Oh yeah. Definitely a big issue. Thing is, it's ADs used by themselves (as opposed to in conjuction with a mood stabilizer) that is so problematic for people with BP. They can make higher highs, lower lows (just when one thought it were not possible... ugh), increase cycling and, well I hardly know how else to put this: can create a pure hell of chaos. (Personal experience as well as widely documented).

Now, that said... Once a mood stabilizer is introduced, it is a whole new ballgame. That is what is medicinally needed for BP. Once a mood stabilizer is in the picture, opinions diverge. Some (many, actually) have no problem prescribing an AD in conjuction with the mood stabilizer if they feel that will get things balanced to the right place. Others simply will not on the belief that they are never good in use with BP. So that's the long and short of it!

(Glad you're liking your new psych, Moreta!)

Anti-depressants in the past have made me manic, and this is why they're risky in bipolar patients.

It's good to hear that you like your new psych.

[Ryask]

AD have made me manic until i introduced a mood stabilizer.

[sugahorse1]

I've been OK on anti-dep's alone (Was first Dx'd Major Depressive Episode) and then went off my meds cold-turkey. The new pdoc I went to, had a clean slate to work with, and put me on a mood stabiliser. She wanted to test one med at a time, to determine if they were effective. So I've only been on a mood stabiliser for the last 6 or so months. At first I suffered from TERRIBLE depression without an anti-dep, but recently I've fluctuated around the stable point (Mild depression, irritability, slight hypomania..)
I would like to have an anti-dep added though, as I feel I could be doing better. But it's up to the pdoc. I should tolerate it faily well, as I've never had full mania

[Tsunamisurfer]

Some anecdotal input:
15 years ago I was on Citalopram (an SSRI antidepressant) for depression triggered by pneumonia. I was fine on it for 2 years, but felt emotional blunting, and eventually took myself off it. 8 years later I began self medicating with St John's Wort initially to overcome mild depression, but after a while I found it was helping suppress agitation and irritability. But 2 years ago my depression began to rear its ugly head again, and St John's Wort wasn't working so well for me anymore. Gradually it got worse, until 5 months ago I finally got a psychiatrist to prescribe me a stronger antidepressant - Fluoxetine (Prozac).
We already had suspicions at this stage that I was bipolar, but in the absence of hard evidence, the psychiatrist considered it safe enough to prescribe a SSRI with some Xanor as a sedative in case I spun out of control.
Long story short, doc went on leave, the Xanor turned me into a drunken zombie, and the Prozac turned me into a gibbering idiot with manic highs and suicidal lows several times a day. After seeing my p-doc 3 weeks later and stopping Prozac, the mixed ultradian symptoms continued for months.
We tried a different SSRI 1 month after I had been on a mood stabiliser (Sodium Valproate) and I was destabilised instantly again. So no SSRI for me, even on a stabiliser.
Currently we are treating the depression with Amisulpride, (which is not a typical antidepressant), while we focus on stabilising me and getting rid of the manic symptoms.

Hope that helps.

[Moreta]

yeah, i knew that anti-depressants alone could cause mania and what not. i guess i'm just slightly worried about not being on one. he's also taking me off adderall. urgh...i'm gonna be a blob for like a week. (and yes, everything is being tapered down slowly)

but he did add lamictal to the regimen so hopefully that will help with the moods. also said i might want to think about going back on saphris (since there's a new flavored kind..lol). he just didn't want to change everything this time.

[LittleBird]

I can't use anti depressants at all. Things go horribly wrong if I do. Right now I'm in a horrible depression and my pdoc described a very low dosage of something called Abilify. IT'S NOT WORKING!
So not being able to use anti depressants when u are depressed sucks!

[blueoctober]

Hi Moreta; I hope the lamictal works well for you. I find it does for me, but when I was waiting to get to a therapeutic dose I did struggle for about a 6 weeks. Keep us posted.

[wing]

I was able to get off an anti depressant altogether with the addition of Abilify to my Lamictal.

[PT52]

I was on Prozac (original diagnosis depression/anxiety), which eventually triggered a manic phase. I was taken off the Prozac and started on Lamictal (mood stabilizer) which worked well on the manic but caused serious depression phases. Wellbutrin was added to the Lamictal and things are more stable.

The thing to remember is that everyone is different glad you like your new psych.