Problem with antidepressants causing cycling or mania

Under the Psychiatric Medication Forum I posted about my current dilemma over taking an antidepressant.

Normally I would not take an antidepressant medication because of past problems of cycling and mania caused by antidepressant meds, all classes SSRI
SNRI,tricyclics,MAOI's, ect.

It took me, my PDOC and a consultation from a well known bipolar PDOC at John Hopkins to figure out antidepressants make cycling worse for me and tend to push me into a mixed or manic state.

I wanted to ask the question to my fellow members with bipolar disorder if they have had problems with antidepressant medication. That is with increased cycling or mixed/hypomanic/manic states.

With the death of my son,along with the grief an episode of depression I was already experiencing has become much worse.

On the other forum I listed all the non-antidepressant meds, but with antidepressant effects, I have already taken in the past. These meds did not work or had side effects severe enough that I had to stop.

Lamictal,Lithium,Depakote,Abilify,Zyprexa,Geodon,Memantine,Requip,Rilutek,
Trileptal, 50 ECT treatments. Most recently 11 Ketamine infusions which took the depression away in hours, but I ran out of money to do more to sustain the affect. There are others but I can't think of them right now.

Well today with concern from my PDOC I start Effexor. I am currently on 400 mg of Seroquel, and tegretol. We are hoping the Seroquel and tegretol will protect me from rapid cycling and a switch into mania.

I need to be able to get out to see the grief counselor. At this point I am so depressed I can barely move and even with a mega dose of Ativan daily the idea of walking out the front door sends me into extreme panic.

Again I was just wonder how other people with bipolar have handled SSRI's or SNIR's. If you have had issues with rapid cycling or Mania on them was there something you took to counter act these problems ??

...to begin with....I'm still very sensitive to your situation and have exactly nothing to compare it to right now..I've lost people too like your Jason...but not a son....

just shaking my head and rubbing my eyes here because it's so difficult to express with a keyboard.

okay!

anti depressants are full throttle medications...they are designed to counteract the natural and very powerful impulse of the brain to descend into even more powerful grief!

to counteract depression!....now thats a big ask...and the true impact is quite incredible....

and the effects differ significantly depending on the 'mind'..

the bipolar mind is imbalanced and brilliant and yet?... very vulnerable perhaps moreso to the introduction of powerful chemicals.

I am medically allergic to all of them I have been on most of them...they send me into some kind of psychotic orbit that I cannot grasp.

...there was no cycling...it was permanent warped and frightening mania on a continuous cycle and resulted in hospitalisation too many times.

I drank heavily too counteract the effects...because it was something I understood...but I don't recommend that.

I cannot quite describe with words the effects of antidepressants on my bipolar mind...just that I had to stop them or I would lose it (my mind)...
completely.

not everyone is this way
I wish I never took any....cos I now have memories that make no sense and my feelings are all over the place

Yes dubblemonkey,
I am afraid to take that first Effexor. But, I feel I have no choice, I am not functioning at all right now. I could end up in the hospital either way. It really is a crap shot !!!

HELP HELP what should I do ?

ok...

first...you can call me james.

the mind is a maze...a-mazing!

(I sure didn't mean to dis-hearten you)

lets face it ....you are already on a seriously difficult 'ride'
compared to before this event in your life there were perhaps concerns but they are tiny imperceptible

the mind is amazing...if you drift into medicine with hopeful expectation then it can work for you.....at least it's an option yeah!...

...cycling and bipolar swings...episodes have little to compare to whats going on inside your heart!...

not even the craziest mind can touch that....

so?...perhaps it's worth a go.

my guess is you still want to function?...and thats a crazy beautiful thing...
and thats all antidepressants are able to do as long as thats all is expected...they don't necessarily make 'you'...'me' ...happy.

they are an instrument...discompassionate...but effective...
and if thats what it takes to get you through this painfull time?...to function?

then it's better than the alternative ...and thats ok...

Well said James,

Yes I still want to function and that is amazing under the circumstances.
I have a grief counselor set up and a art therapist. I am no stranger to both physical and psychic pain. Although this isn't even in the same league.

I promised my husband that I will not kill myself and leave him alone. Also, I started a group in Jason's memory it is called HEAR. Heroin Epidemic Action Reform. Through his death I became acutely aware of the Heroin epidemic in our area. Beautiful young adults are dying at an alarming rate. I will be setting the date of our first meeting today. The number of members is growing. In my good moments I have been doing research setting up contacts, like law enforcement.
When I am not in in a ball in the floor moaning, this group is giving me a reason to go on.

But, I need to be able to dress and get out the front door. This is not possible today, hence the Effexor. I downed my first dose. Bottoms up to hope !

God is really throwing some Sh.....it my way.

Thanks for your reply it helps

you are most welcome..

yes you have suddenly been in God's sights!

..and You are an inspiration for keeping eye contact!

and most of all...You are real!

bottoms up...

Hello, Speed. I'm feeling so proud for you for your strength and ability to have been able to do so much since Jason's death in a positive way to help families whose children have been caught in the heroin death trap.

Speed, I had trouble with Lamictal, Lithium, (no problems with Depakote but began to lose my hair--a side effect.) I kept dropping the level of Lamictal until I was at 15 mg and that still prompted hypomanic attacks.

Since that experience I investigated the use of a new food med called Deplin. It is a concentrated form of folate (metabolized from folic acid, Vitamin B 9) which is able to crosss the blood-brain barrier in people who have inherited an inability to metabolize folic acid into folate which is used in brain functions. The only way to
discover that one is missing the enzymes is through genetic testing, but my psyciatrist felt that if it improved feeling tone in three weeks there was no need for genetic testing.

So I began taking 7.5 mg of Deplin once daily. About 1 month ago, my psychiatrist increased it to 15 mg. per day and I haven't felt so content and calm in years. Apparently it is one that I can take and get no side effects whatsoever because it is actually a food medication.

In addition I added the Omega3 fatty acids which I take daily--about 2 grams per day: once in the morning and once at night. The combination of the two is unbeatable for relieving anxiety and being calm.

You might wish to ask your doctor if he thinks it might benefit you.

Along with other changes in diet, I've been able to almost eliminate all but 10 mg. of Prozac once daily. The changes were primarily : elimination of caffeine in any form, alcohol (but never did use that to any degree), reduction of wheat, and am working on eliminating sugar.

Combined, they all work as a powerful strengthening of the kidneys, digestive system and brain function.

I'm so glad you're going in for grief counseling. That will speed up the process for you and give you really good insight into how you will be able to live and work to help others through what you have admirably survived.

Take care.

A very small dose (10 mg) of Celexa seems to do it for me, although it didn't prevent the breakthrough depression I went through in December. My pdoc won't let me take more because it does switch me into hypomania at a 20 mg dose, and he'd rather I not take an AD at all. But I tried withdrawing last summer and that did NOT go well, so back on it I went.

I started out with Prozac, then was on Paxil for years. I switched to Wellbutrin when it stopped working. BIG mistake---that stuff made me totally manic, and it wasn't a fun type of mania either.

Bottom line, a BPer and his/her psychiatrist have to be very careful when considering an antidepressant. Currently, I take Lamictal 250 mg along with the Celexa and 1 mg of Ativan at night, and this is keeping me in pretty good balance right now. Good luck to you!

I was on Deplin for a number of years. The docs at John Hopkins were not that keen on it. I take high potency fish oil, and flaxseed oil. I just started Reiki sessions again. I need to start exercising again but my level of depression is severe.
Thanks for replying

I wish I could take Lamictal. A couple years ago when I was taking it I felt it was working until I developed a rash. My dermatologist consulted with my PDOC and they decided I can't take it.

I have to take the lowest dose of AD and still only 2 AD's have not switched me into psychotic angry mania. Celexa was good until my jaw started locking.

Sounds as if you might be a little medication resistant, Speed3.

Take care.

I can't take any AD's as it flips me right into an ugly mania.

Yes I am and sensitive to meds. THe off label ketamine infusions were amazing but the out of pocket cost is a problem. I understand there is a new med in phase 3 clinical trials based on the research ketamine spurred. They say it will be the biggest breakthrough in psychiatry in 50 years. Having had the ketamine infusions and having a deep suicidal depression lifted in hours, I know this med will truly help so many.
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