Best Med for Bipolar Depression?

So, I rarely have any hypomanic issues. Most of my issue is depression. Lamictal and Wellbutrin have been lifesavers for me. I also take 10mg of Lexapro every day too. I am still having bouts of sadness/unmotivation, etc.

My question is...Is is possible that the Lexapro is contributing to the depression?? What works for you specifically for depression??

I took Lexapro years ago for anxiety, and it did work, but always made me tired.

Thoughts??

Abilify works best for my bipolar depression. I also have a couple friends with MDD who augmented their anti-depressants with it and found it worked wonders.

There's Latuda and Abilify. Latuda is approved for bipolar depression, as is Abilify. You could look into those 2 as a starting point.

I actually find Lexapro very activating, and I'm pretty sure it's the culprit for my rapid cycling.

I know you made a post before about rapid cycling (I briefly skimmed it), and LExapro could be the cause of it if you think that your mood swings are very intense. I mean, I get 1-2 episodes a month nowadays, with depressions lasting 2-3 weeks and mania/mixed lasting 1 week. I never used to be like this. It all started when I started Lexapro. Before then, my episodes would last a few months.

The only thing that works for my depression is emsam, which is an maoi. All the traditional depression meds do nothing for me. Wellbutrin worked for awhile but then stopped. Emsam has been a life changer. No depression for eight months, and I was getting depressed every other month.

Seroquel isn't talked about much for depression but two pdocs have told me that it helps for both mania and depression. My current pdoc increased it when I was in a depressive episode (as well as Lamictal). The side effects (especially sleepiness) can be pretty brutal, but might be worth a try. At least you can ask your pdoc about it and see what he/she thinks.

Hmm. What is Emsam???

Sometimes, it takes a combination of things. I'm on 30mgs of Abilify as my main "don't go nuts" medication. A full dose of any other antipsychotic would cause side effects for me, but Abilify...gets the job done. No twitches, no tremor, no increased depression.

I also take 400mgs Wellbutrin SR (200 AM, 200 PM), and 100mgs Lamictal. Those 3 keep things under control, although I do still take 1200/Trileptal because my doctor insists that it helps with the agitated, (hypo)manic, mixed episode-ish nasty side of things. Can't complain.

But..yeah...Abilify. Good times. Adding remeron might help, especially if sleep is a problem. I think Lamictal can go to 400 or something like that.

Geodon has lifted the worst psychotic depression of my life in a couple of days. It is my understanding that Latuda is related to Geodon and is already approved for depression (Geodon might become approved one day, too); I would start with Latuda. With Latuda and Geodon, it is very important to take them with a complete meal.

Emsam is an MAOI patch. Side effects are minimal for me. I am on the lowest dose, and I put it on every other day instead of every day. This is because I got slightly elevated when taking it every day. The only thing is if you go above 6mg, you have to follow a special low tyramine diet, which is kind of a drag. No wine, beer, aged cheese, soy sauce, etc. this is because it could cause a blood pressure crisis wherein your blood pressure could spike and become dangerously high. But on the low dose you don't need to follow the diet. I've never had a problem with my blood pressure.

The combination of Zyprexa, Lamictal, and Klonopin works good for me. I used to take Prozac aswell, but found it was causing mixed episodes in me. Klonopin really isn't for the depression but helps the anxiety from the OCD that I have aswell.

Latuda worked wonders for me.

Well, it depends on the person. Your doctor is the best resource. Also, you may find that your meds may get tweeked or changed entirely until you reach a stable state.

Obviously, everyone is different. For me, Latuda broke a terrible depression. Then Trileptal helped even more.

I'm trying Wellbutrin again....this time along with an AP I can tollerate....so far it seems to be helping....it's still relatively early though....time will tell.

Saphris works okay for me. Nothing else has touched my depression.