[ultramar]

This came up in another thread, and now I'm curious about it.

Why are atypical antipsychotics being prescribed for BP II? Obviously there's no psychosis involved, though I do know that some AP's can have other benefits aside from preventing/stopping mania and psychosis. But I wonder why they are being prescribed and about the risks (side effects, short and long term) vs benefits in the case of type II.

So, for those of you who are BP II and have been prescribed AP's: Were you on a mood stabilizer first, but it wasn't enough? Do you know why you were prescribed the AP, what symptoms it's meant to alleviate? Does anyone know of research on AP's being effective in stabilizing moods in general, not just to prevent/treat full-blown mania?

Also, just occurred to me, do you think the AP was prescribed for a co-morbid disorder, such as BPD (I understand they are being prescribed for this, nowadays), or other disorder/issue/illness?

Thanks.

[unlived]

I'm not bp2 but they can have psychosis in depression and some get depressed a lot so I guess it would help

My diagnosis is Bi Polar 2, GAD and OCD. I am on an AP that my pdoc has told me works as a mood stabiliser also (Zeldox). I have no seperate MS, just the AP, small dose of AD and stimulants. My depression is far worse than my hypos, and when treated with AP I did not go back to that dark place, so for me, they must work at keeping the depression at bay too. I have never had psychosis, and the only full blown manias I have had have been med induced.

I was put on this medication during severe mixed episode. I had been off meds for about 8 months and had never experienced a mixed episode before. I was desperate but so nervous about starting the zeldox. My doctor said it would work within 10 days, and it did, this medication saved my life. Initially I was pretty much knocked out for 3 days when starting it, the anxiety was also higher for a few weeks. I feel that it does make me tired, but not sedated if that makes sense. I dont feel doped up like I did on seroquel, but I am less active and activity does make me very tired. I dont really have any bad side effects from it, luckily.

I have tried all sorts of med combinations over the years. I was on lamictal for a long time, but it got too expensive as it was not approved for BP here at that stage. We combined that with high doses of AD which looking back on, I think was the real reason the lamictal didnt work as well as the zeldox. I was treated with Seroquel for years too, on a dose of 900mg which also did work, but the weight gain got ridiculous, and I was just so absent minded on it, plus a few other side effects. I took myself off it and was hypo for months. I feel the seroquel did act as a mood stabiliser for me, but kept me at a more depressed level than the others I had been on.

I was also treated with olanzapine and rispiridone. I found the olanzapine good for severe depression, I especially liked the wafers for when I felt that bad. The weight gain and dopeyness put me off it. I do feel that it did help me at times of severe distress. I'd take it again PRN but not regularly. Rispiridone again slightly helped with the depression, but I think that may have been because I was too sedated to care. Went off that one too as I was just existing.

I have done research on Zeldox before being used as a MS but I cant remember any of it. I do remember being very nervous to go on it though. I just trust my pdoc when he says it works in that way now. He has not steered me wrong yet.

Sorry this is so long. I hope it is helpful to the discussion.

[dragonfly2]

I also responded to this in the other thread you're referring to just a few minutes ago, so I apologize if this is repeating info.

Some antipsychotics, particularly Abilify and Seroquel, have antidepressant qualities at low doses. They are typically used to augment, or add on to, an existing antidepressant. They are being prescribed not only in Bipolar disorder, but also in people with a pure Major Depression. As you raise the dosages of these meds, the effect goes from antidepressant to more of an antimanic. I'm not sure when the antipsychotic benefits kick in.

Hope this helps.

[SingDanceRunLife]

I've almost always been on an antipsychotic. For me, they are the best mood stabilizers. Anticonvulsants have all had pretty bad side effects for me along with a lower degree of efficacy.

[ultramar]

Originally Posted by unlived

I'm not bp2 but they can have psychosis in depression and some get depressed a lot so I guess it would help

My understanding is that psychosis is not experienced (either in depression or hypomania) in the case of Bipolar II.

[unlived]

It can be experienced during depression - just not during hypo mania. It's presence during hypo mania rules out bp2 and makes it mania.also off topic a bit but I have an uncle with unipolar depression without psychosis who is on seroquel as mono therapy due to its antidepressant qualities. I guess everyone responds differently.

[wotchermuggle]

I'm on Seroquel, an antipsychotic, because my Pdoc says it doubles as a mood stabilizer and I was also having trouble sleeping due to high anxiety.

I was first put on Effexor but that made my anxiety worse, and that was before she diagnosed me with bipolar 2.

Pdoc also said what someone else mentioned , in that it can augment other medications effectiveness.

[Trippin2.0]

Originally Posted by unlived

It can be experienced during depression

Too true, this is why I was on an AP. Not all my depressive episodes present with psychosis though, only the really bad ones, so longterm use again makes no sense in my case.

[BlackPup]

I'm on Abilify which is an AP. I'm BP 2 with no comorbidities. No psychosis but it works as an awesome mood stabiliser. I can't use anti convulsants due to side effects

I guess either the drug companies are evil or this question is similar to the analogy of why are so many people with heart problems taking aspirin? It's primarily a pain medication but its been found to have benefits to the heart as well. I'm not sure about the APs though, if they are over prescribed or really necessary. I'm on abilify now and have never been psychotic that I know of.

[Blackberryrocks11]

I am on Geodon (80mgs in AM, 120mgs at night) as I am currently riding out a manic phase Wooohoooo!!!!!!!!!!!!!!
Also on Trileptal (150mgs 2x a day, AM and PM) I think trileptal is making me more manic....

I was taken off Trazodone and Celexa for they were aggravating my insomia. For some reason I was taken off Klonopin too...(good riddance, the memory loss and feeling "stupid" weren't worth the benefits)

Your mileage may vary

[BlackPup]

Originally Posted by h33th3n

I guess either the drug companies are evil or this question is similar to the analogy of why are so many people with heart problems taking aspirin? It's primarily a pain medication but its been found to have benefits to the heart as well. I'm not sure about the APs though, if they are over prescribed or really necessary. I'm on abilify now and have never been psychotic that I know of.

Great post but I don't think it's either/or.
Drug companies are evil AND it's like taking asprin for heart attacks.
Don't ever underestimate the evilness of the drug companies

[venusss]

Anybody who thinks Pharma is not evil is delusional. Or clueless.

I once partied with a guy who did marketing and created commercials for Pharma. When asked "what to take for <insert trouble>" he loudly answered that he never takes Pharma stuff. Telling, ain't it?

[Andysmom]

Originally Posted by VenusHalley

Anybody who thinks Pharma is not evil is delusional. Or clueless.

I once partied with a guy who did marketing and created commercials for Pharma. When asked "what to take for <insert trouble>" he loudly answered that he never takes Pharma stuff. Telling, ain't it?

My husband works for "Pharma" and he is not evil and I am not delusional or clueless!

[MagicsMom]

I take 2 AP's - Seroquel (400 mg) and Risperdal (.75 mg). I'm not sure why but I did recently have a somewhat hypo episode so Risperdal was upped to .75 from .50. I'm not even on the recommended dose so not sure why I'm on that. The Seroquel was to help me sleep and for severe depression. I've never been psychotic. Supposedly

I'm on Lamictal as well so I don't know what is making me feel better - the Lamictal or the Seroquel or both. The Risperdal does keep away the bouts of hysteria.

I have concerns about my current psych and will be switching when I move back home to PA from MD. From everything I read I don't think I'm even on the right meds.

[venusss]

Originally Posted by Andysmom

My husband works for "Pharma" and he is not evil and I am not delusional or clueless!

do you believe Pharma is angelic?

of course not every of their workers is evil, but Pharma is industry is. So is Big Oil, arm industry...

[gayleggg]

I'm on Seroquel, which is an AP for a mood stablizer.

[Andysmom]

Pharma is made up of thousands of people doing their jobs. I don't believe there is some vast conspiracy between drug companies and Pdocs to keep us all drugged up. I trust my Pdoc to do what is right for me. I have no desire to spend the rest of my life in a mental hospital.

[venusss]

Originally Posted by Andysmom

Pharma is made up of thousands of people doing their jobs. I don't believe there is some vast conspiracy between drug companies and Pdocs to keep us all drugged up. I trust my Pdoc to do what is right for me. I have no desire to spend the rest of my life in a mental hospital.

Pharma fakes their studies though, oversells some drugs, and pays the doctors. Sorry, it is so.

And I wish you and others trust themselves before they trust their doctors. Unless your doctor lives with your 24/7 you know yourself better. And "for your own good" rubs on me wrong way. It's really not about letting your doctor do what he deems right for you and being locked up.

[MagicsMom]

I work for a Pharma company and they absolutely do not fake their studies. We are governed by the FDA and could never get away with that. If a company did that there would be sanctions against them. And they can no longer pay their doctors unless they are speakers at conferences.

I'm no fan of Pharma but don't like to see false info out there.

They do oversell their drugs and lots of reps promote off label use.

[SingDanceRunLife]

My pdoc wants me on the least amount of meds possible while keeping me stable. She has never once pushed a med or had me take something I was uncomfortable with. She will ask me what I think about things and if I have any suggestions based on what I know. This is why I love her. She really is trying to do best for me.

[Zabine]

Originally Posted by VenusHalley

do you believe Pharma is angelic?

of course not every of their workers is evil, but Pharma is industry is. So is Big Oil, arm industry...

Your blanket statements are quite offensive, might want genralize less, you may get better reactions from people, just saying.

[venusss]

I will not apologize to Pharma, sorry. (neither will I declare that arm industry is made of good people and that politicians are great people do and do what is best for us. Or say Nestle is really sweet company). I guess I will have to without better reactions from people.

If a company did that there would be sanctions against them.

cause there never ever were lawsuits against Pharma? Pharma indeed doesn't publish some of their stories, the ones that ain't favourable.

[Andysmom]

Originally Posted by VenusHalley

I will not apologize to Pharma, sorry. (neither will I declare that arm industry is made of good people and that politicians are great people do and do what is best for us. Or say Nestle is really sweet company). I guess I will have to without better reactions from people.


cause there never ever were lawsuits against Pharma? Pharma indeed doesn't publish some of their stories, the ones that ain't favourable.

You don't have to apologize for your viewpoints. But don't treat those of us who choose to use medicine to control our symptoms as idiots. We are all struggling to live with this disease and our choices are all valid.