Zoloft

I'm leaving for a trip and will be asking these questions at the BH center when I return... but I'm wondering more about how Zoloft should be affecting me. I've written about this in my other thread.. but quick history: Diagnosed ADHD about 4 years ago, on Adderall for most of that time with no real improvements in my issues, went on Zoloft/Sertraline (50 mg) about 1.5 months ago when depression hit hard, hospitalized for suicide attempt around three weeks ago, diagnosed with BPII during my stay in the hospital and now I've started Lamotrigine (only 50 mg to start) and am supposedly weaning off the Zoloft.. which just means continuing to take the 50 mg pills until they are gone and then stop (I think). During the second week on the Zoloft I started hitting the worst depression ever.. but then things started to improve.. until the night I melted down.

They took me off the Adderall at the BH following my episode and then I went through a few days of withdrawal. Once I started feeling good again.. all of a sudden I'm VERY good. Too good maybe. In the past my 'mania' has mostly been goal directed with intense obsessions over eccentric projects that distracted me from my real work .. and then depression. I was intense with racing thoughts.... and could easily drive people away with my enthusiasm. I would sleep a lot less during these periods.. but I've never had completely sleepless nights. Mostly just going to bed late and then lots of interruptions and early rising. But the last week or so I'm feeling much more high than this. I found myself driving at ridiculous speeds yesterday, continuously cycling thoughts on my current obsession and wanted to go running last night at around 11 while I was up photographing the night sky.

Anyway.. the Zoloft is only 50 mg... but could this medication be fueling my current state???

It's certainly possible. Call your pdoc just in case.

50 mg can absolutely affect your current state. It has been known to induce hypomania and mania, sometimes even when on Lamotrigine. You are on only 50 mg of Lamotrigine too, and the therapeutic dose typically is 100-200 mg at minimum (I was told), so there may not be enough "protection" from the hypomania/mania at this point since you are not being fully stabilized by Lamotrigine just yet.

I am Bipolar 1, and based on my history of mania and personal experience with these particular meds, I am extremely sensitive to SSRIs/Zoloft. In fact, I had a manic episode and a horrible mixed manic episode on 50 mg of Zoloft and 200 mg Lamotrigine. So it can definitely happen. However, everyone is different. Just trying to answer your question that yes, the medication can very well be causing this. Definitely talk to your pdoc sooner rather than later. Sorry you are going through this.

Okay.. thank you very much.. that helps a lot.

Here is one question I've been wondering about. Can Zoloft cause hypomania in 'normal' folks that aren't in the bipolar spectrum??? This question relates to my obsessive thought train on... am I really bipolar???

My pdoc said even in some people without BP diagnosis, it can cause hypomania as a side effect/medication-induced by being sensitive to the medication. Therefore, it is my understanding that although it is typically a warning sign that someone is on the BP spectrum, it's not always the case. You did mention you have ADHD/obsessive thoughts so maybe that could have complicated things? Definitely something to ask your pdoc about.

Okay... thanks. I'm making notes to take to the doc.

As to ADHD... I have no idea. They thought I was .. but it was a very informal diagnosis. Mostly based on my past history and the depression I was seeking help for. I don't think addressing my issues as ADHD helped even one bit. I can focus like a laser after all and have never been considered hyperactive in behavior... just very intense. As to obsessive thoughts.. I don't know. My impression was that was an aspect of bipolar... at least in terms of how it normally shows itself... furious research into new ideas/projects/connections.

Anyway... Like I've said in my other posts.. this is all new to me and I will spending more time with the doctors very soon.

This is very interesting.... Sounds like I need to be off this antidepressant:

Antidepressant-Induced Mania - Mad In America