SSRI induced Bipolarity "fixed" with Lamictal

Hi everyone!

I'm new to this forum and coming in search of enlightenment

I've been on the classic roller coaster the last couple of years with the climax reaching two months ago when I was unable to leave my bed, just wanting to die. And I'm very confused right now of what is actually happening, and my doctors sure ain't making it better. I was hoping that someone here might shed some light on it.

Short version of my concern:
I'm suspecting that my 7 years on SSRI now has pushed me into the Bipolar spectrum (type II). What is funny is that I was recently put on Lamictal and when I reached the dose of 200, I started to feel awesome, changing from one day to another. Could it be that the real source of my mood switching is actually due to the SSRI and that I'm "fixing" it with Lamictal? If that's the case, it seems ridiculous to solve one drug problem by introducing another instead of just quitting the first one, getting to the source of the problem.

Heavier version;
I've been on SSRI for the last 7 years (starting as a way to handle panic attacks and social anxiety), and the last 3-4 years I've been experiencing episodes of depression and episodes of hypomania. I have a quite stressful job and I have found that when I'm highly stressed, I actually feel better than usual, and when I'm on vacation, I'm often depressed.

The last year this have escalated, starting with a depression that just made me feel totally numb. Because of that I tried to get of my antidepressants, which made me feel even worse until I started again and went into hypomania for a few days. Somewhere around here, I also started drinking on a daily basis. My doctor changed my meds from Celexa to Zoloft and pulled me up to 150mg. It didn't really work, still depressed, still drinking, still going in and out of hypomania. Then I started with Lamictal and only a few days after I got up to 200, I just flipped into an awesome mode and have been staying quite good from that point. I've stopped drinking, feel generally more energized etc.(a bit hypomanic from time to time, but not too extreme).

So now I'm wondering if all this crap is due to the antideprassants, and if it can be solved if I just skip them or lower the dose, or if I have actually developed Bipolarity disorder typ II.

I'm now 28 years old and I have quite a few cases in my family that have been suffering from depression, borderline, eating disorders etc. but I haven't heard of any bipolarity.

Has anyone had any similar experience?

Btw, I'm a Swede so my spelling might not be the best....

hi
antidepressants can trigger a mania in a bipolar person. if you dont already have a disposition for bipolar, it isnt going to create it. lamictal stabilizes bipolar moods so that is why you feel great now because it stabilized you. the antidepressants can be tricky cause it is hard to tell which ones will trigger and which ones dont. like zoloft, within a couple weeks, triggered the worst mania i had. i was hallucinating, not eating or sleeping. it was awful. but i can take wellbutrin no problem. welcome to psych central. you will find we have several forums where you can post about your concerns and receive feedback from other members. you will get a lot of support here. again, welcome

Welcome,,, lexapro sent me ip.. so my pdoc will not let me have any ad..I am not a dr so don't put much stock in what I say but for me antidepressents were a nightmare... best wishes here...I take lamictal and am very happy with it,, but mostly for depression in my case...

Antidepressants trigger mania in me. I don't know if they can actually cause someone to become bipolar. I don't know. Have wondered this myself.

Welcome to PC! I hope your visits with us will be supportive and enjoyable.

I don't know if antidepressants can cause bipolar in someone who is not susceptible but they definitely can mess up someone who is bipolar and on antidepressants without enough mood stabilization.
PsychEducation | Treating the Mood Spectrum has lots of information about this

Your English is perfect. If they made me write in Swedish I'd be in a lot of trouble but you were great.

Beg to differ, there are plenty of people who would NOT be diagnosed bipolar if meds didnt mess them up in the first place. Its a dangerous game but no one seems to realise.

Welcome to PC , You will find a lot of information and support here. Please do keep in mind no one here is a Pdoc and can not diagnose we just offer our own opinions and as you can already see everyone has there own advice and opinions to offer...

When I first found PC I was thrilled to find people who I could get advice and hear their own journey. It can be overwhelming. Pick and choose what applies to you and what you feel fits you the best.

Glad you are here

I'm sorry, I must not have been clear. I did not mean that meds cannot cause bipolar. I just said that I did not KNOW this. I have opinions but not facts. So what I meant to say was that I do not KNOW this for a fact either way but that taking ADs definitely can cause problems if you have are already bipolar anyway.

Sorry for being confusing.

AD's are unpredictable, they can actually work for some, for others have adverse effects and ridiculous side effects. About the only AD I can tolerate is wellbutrin which is not your typical AD at all. Unfortunately it does nothing for my depression and increases my anxiety. I still take it only because it does help relieve some of my fatigue from other meds. I thought I found a winner with Zoloft, the first time I tried it and after I got use to it's terrible side effects it at least helped my anxiety but also did nothing for my depression. The last time I tried zoloft it was like a acid trip and not a good one either!

I just started taking Lamictal, only up to 50mg so far, while it does seem to help in stabolizing my moods, it too does very little for my depression! Before Lamictal I was on Seroquel, which was about the same as Lamictal but gave me extreme dry mouth and weight gain and the hang over effect. That's why we switch to Lamictal which has very little side effects, slight dry mouth and tired a little. I'm waiting for Abilify to go generic as that was the best I've tried so far. The hardest for me is my depression and anxiety. About the only possible advantage I have if you want to call it that, is my depression is atypical and or mixed, so I'm not depressed 24/7, I get some breaks but it's always never far off.

Good Luck!

With a mood stabilizer and careful balancing I think ADs have a good role in managing bipolar. I think I was off them for 3-4 years after I was diagnosed and then when I started them it was watched carefully and my mood stabilizers were changed as needed.

6 years ago I went on Emsam, which is an MAOI. They are really stimulating so while I was in the hospital getting started on it they doubled my Seroquel from 300 to 600 and that was for about 2 years my magic potion. I went to sleep at 11 every night and woke refreshed, not manic, at 4 AM every day. I had time for hobbies and to pack a lunch. Emsam has been amazing. I still am capable of getting much more depressed on the mixed side but it's not the same as it was before.

SSRIs for me sent me all over the place, I was cycling up very quickly just to be dropped back down further than before and was down longer and longer. That is what eventually led me to changing pdocs because my current one didn't question any of that (also I had a lot of weight gain from the SSRI and I wanted to change that). The new pdoc had me coming off the SSRI and starting an anti-psychotic the first day with her.

Welcome, jstedt!

The thing that is (to me) most curious of your experience is the timeline. Usually if someone is undiagnosed bipolar and given SSRIs, it's quickly obvious. How long it takes for a given anti-depressant to flip someone into mania(or hypomania) will differ from person to person of course, but 3-4 years certainly does seem like something besides a simple "unmasking" of one's bipolar. So it does seem a bit more complex than that. -- It does make you wonder.

I really don't know. It does seem reasonable to consider a cause and effect like you are. Especially in light of the timeframe.

My personal experience, for what it's worth, was that SSRIs wreaked havoc on me. My Ex had seen many ups and downs over the years, but there was a particularly long severe depression when he had to insist I go see someone. First, I was prescribed Lexapro (by a GP). Within 2 days, I went from utterly, horridly depressed to bouncing off the walls. Wow! This is GREAT! I didn't know any better so didn't question it. (Unfortunately, neither did the GP.) But then all hell broke loose. Up bad. Down bad. I questioned it then for sure! Fortunately, I did see a Pdoc who diagnosed me properly (bipolar). There had been a pattern of big spans of wide extremes for many years (20+!). She put me on Lamictal. I've since had times of being on Wellbutrin but only in addition to the Lamictal. I have a different psych provider now, but they both agree --No SSRIs for you! Lol.

So anyway... The anti-depressants didn't create a bipolar situation, they only threw a harsh spotlight on the already long-standing symptoms. That's my experience. Oh, and yes, a fair bit of family evidence. (Undiagnosed -- to my knowledge, which isn't much-- as they're very "old school". Hush- hush and under the rug with everything.)

Thank you all for that awesome welcome!

As Innerzone wrote, I also think the delayed effect is a bit fishy. I recall that just prior to I started taking SSRI, I had a period where I felt good and worked like 70 hours a week; totally goal oriented, almost a bit OCDish when it came to being productive. I had to be productive at all time and had a hard time just to relax for the sake of relaxing. But it is so long ago so I don't know if it was hypomania. I have had depressive periods on and off probably the last 6 years, but it isn't until the recent 3 years that I am certain that I have experienced hypomania and it's just the last 2 years that it has really gone out of control.

All in all I think I've only had major depression and hypomania when I'm on SSRI, but then again I've been on it since I was 20 years old (7 years) and I don't recall the first years to be that dramatic. This is what's confusing.

Also; would Lamictal work if I wasn't Bipolar?

50mg did nothing for me either (just a short hypomania episode when I went from 25 to 50). BUT when I finally got up to 200, I was kicked out of the depression. So perhaps it will work for you like this as well.

I think it could work. I mean, if you're a unipolar and ADs didn't work for you. It is mostly for the depressive end of things. Don't know for sure though. Just speculation.

There is a movement to include patients made manic with AD part of the Bipolar classification.

When I had depression, I'd come out of it feeling really good. I always thought this euphoria was because the body was "making up" for being depressed! Lol

So I'd end up just reporting the depression. I got prescribed Welbutrin, but it didn't help at first, so the GP increased my dose. I started getting out there, but it also made my depression worse, so I'd get another dose increase.

I finally went to a pdoc, and what did he do? Once again my dose got increased. At this point I was taking 300 mg. I was now bouncing hard, sometimes 3-4 switches in an hour, one minute I'd be laughing, the next crying, and then laughing again. All in all, it screwed up 2 years of my life.

I finally said "hey, I'm bipolar" and got put on stabilizers. I stabilized on the depressed side, so we fine tuned the AD to where I feel normal today. I've been here for almost a year now.

But with the discovery of the DID, I'm wondering how much of my mood change isn't bipolar? Any how, it's something that y'all need to work out hun. Good luck!

This question prompted me to do a little reading, as I seemed to remember hearing that it sometimes is used for MDD. Turns out that some do use it for that (as an "off-label" use), but it is not without controversy. Apparently, there isn't really much in the way of properly done research studies, and what little there is of that basically concludes that it's on par with placebo results.

Now, I'm certainly not any kind of expert, just found it interesting to read this.

And then went and read more that was longer, a bit broader of a scope and much denser reading. Same conclusion though. Interesting. Think I'm science geek read-out for the day though.

Oh. So, back to the question. Yes, it could. Or not. But sounds like it wouldn't suggest anything beyond its working. Or not.

Yepp, I've also done a lot of research among publications but didn't really found anything, so it is interesting indeed. I would have preferred not being the guinea pig though

When I think about the possibility of SSRI induced Bipolarity again, you can say that it is NOT because of the SSRI since then it would have shown earlier and not after 1-2 years. It seems to me like most go crazy right away.

I guess I have to find another doctor to consult...

5 or 6 days after I upped my dosage from 25mg to50mg I had to stop. Got me super depressed like never before, suicidal, and felt like crying, these symptoms are very rare for me! Lamictal may work for a lot of people but not for me. I felt like I was on zoloft only worse!

From the wikipedia page about Lamictal: "The drug seems ineffective in the maintenance of current rapid-cycling, acute mania, or acute depression in bipolar disorder; however, it is effective at prevention of or delaying the mania, depressive, or rapid cycle."

That's why all of my pdocs used other drugs to pull me out of my episodes. I take Lamictal as a maintenance drug, but I took other meds to get me out of depression. There's not a lot of evidence that it treats acute episodes.

Edit: There's some evidence that it might help treat severe depression... just not a ton of it yet.

I was in one of the clinical trials for it. Even then they weren't trying to get it to be a stand-alone; the trial was to attempt to treat rapid cycling bipolar with a combination of lithium, depakote and lamictal. The combination was sort of ok for me but I never got to a therapeutic blood level of depakote in the 6 months of the study which made it less effective. My body eats up depakote for some reason and it wasn't until ER came out (right when I needed it) and we went to a really high dose that we could keep my levels where they belonged. By the time we had depakote working well I was off lamictal because it made me vomit every day about 10 AM. (I now kinda think that was birth control pills but it seemed like lamictal for some reason, probably because taking lamictal often made me vomit because there was a taste that I just couldn't handle but didn't have trouble with at all when I tried it again a few years later. Weird.)

Anyway, the role of the lamictal was supposed to be to tamp down depression, acting as an antidepressant without actually being one while depakote kept things level and lithium prevented mania.

Obviously that wasn't the plan for everyone on lamictal but it was a sign that they didn't intend for it to work alone in a lot of people.