Possible Bi-Polar DX -- Help?

I had been previously diagnosed with MDD, GAD, PTSD several years ago, and was managing on my own for about 10 yrs after all med "cocktails" weren't working or making my life more miserable.

Recently experienced another nervous break a couple months ago, debilitating. I was again initially diagnosed with MDD, GAD, PTSD with possible complex PTSD. I was prescribed Lexapro 10mg. I took it for 24 days. 24 days of living hell with anxiety and agitation with depressive undertones. My emotional / mood states would flip 2 or 3 times a day most days. It really bothered me and had one episode lasting a few hours that made me almost get a speeding ticket and possibly hurt other drivers with reckless driving. It scared the S*** out of me.

I was pulled off the Lexapro cold turkey. Well, guess what. I thought I was going through hell while on the med, but coming off was worse.

I finally squeaked my wheels enough to get a priortity dr appt worked in this week, a couple days ago. My doc thinks I could actually have been misdiagnosed originally due to treatment resistant depression back then, and when she started my on anti-depressant this time, it induced manic mixed episode. She suspects Bi-Polar.

She started me on Neurontin 100mg to manage eth anxiety and insomnia. I dont' feel any positive difference with it, and framkly experienced a full on mania episode yesterday. I am concerned. Was it the Neurontin, or was the Neurontin not part of it, and that since coming of Lexapro was that part of it? The neurontin hasn't helped my moods or anxiety at all. If anything, I have more trouble falling asleep and waking up after just a few hours, feeling like I haven't slept at all.

Suggestions, thoughts?

Neurontin definitely triggers mania for me. It took awhile to figure it out (the Neurontin was meant to help my anxiety), but my mania is now managed more successfully without it. I miss the energy, but I don’t miss the impulsive and embarrassing things I did while on it.

This is so close to my story! I also have had depression and anxiety for years, and recently saw a pdoc and tried Lexapro for MDD and GAD when it got too much to handle. I also had my mood switch multiple times a day, and sometimes even felt happy and agitated/irritable/depressed at the same time. I could barely sit still and wanted to rip off my skin. One of the most confusing experiences of my life. I was on it for four months before we figured it out and it was awful! I cannot imagine going cold turkey because I went off it slowly and still almost ended up in the hospital. I am sorry you went through that, too.

My pdoc said they cannot officially dx me with bipolar since I haven't had an episode that we are aware of of mania/hypomania off the meds, but that he believes it is a spectrum and some people react like that to antidepressants (said I had a mixed episode). Also said I could be dx in the future if it progresses. So, he is trying me on lamictal to stabilize my moods and help with the depression. Still trying to figure this out myself. I really hope you find something that works no matter what your diagnosis!

I was worried the gabapentin tripped off hypomania when I first took it, but it was really a new job plus my pdoc switching up meds to try to control it.

I notice a slight effect with 100mg on reducing anxiety. I need a higher dose for evenings. I do use 100 mg during the day.

I had to get the mood stabilizer figured out, and then the gabapentin effect was apparent as helpful.

Thanks all for your replies. I was hoping I wasn't the only one who has experienced this. Since it's satuday, and can't call the doc, I called my local crisis line as I am deeply concerned about this "hangover" feeling today since the manic episode yesterday. All they could say was to talk to the Pharmacist or call the ER to talk to them about whether the Neurontin caused this or not. So, as I went to pick up a script for my thyroid issue, I inquired of the Lexapro/ Neurontin and whether they have had anything to do with the crap I am dealing with today. She told me, the low dose of Neurontin could not have caused the manic episode, that it was just part of my illness and now I am finding myself very agitated and unintentionally being short with my kids. I am so tired of this flip-flopping around. I have to get this under control, and now extreme anxiety is kicking in. UGH!!!!!!!!!! My husband, bless his heart is doing his best to be encouraging and supportive, but it is wearing on him and he's begininning to think all this stuff is a bunch of hog wash and that the doc's are screwing my head up even worse than it was before. I just want to lay down and disappear...…

Yellow Fleurs, So, how is it going with the Lamictal???

Sorry, I missed this! It is going okay, but still cycling from depressed to irritable to possibly hypomanic while on the 25 mg. Just upped it to 50 mg. Feeling good the past 2 days, but not hopeful it will last. I guess I'll see once I am stable on a higher dose.

Yes, that's a low dose of Lamictal. My pdoc seemed to up it pretty quickly to at least 100 mg twice a day, but I think she had added the Seroquel as well. There are a lot of meds that don't give me much in the way of side effects except for dry mouth, so I'm lucky that way. Though it is annoying that nearly every single psych med gives me dry mouth. Those 2 meds have kept me the most stable as far as bipolar. Antidepressants tended to cause mania in me as well. Cymbalta did OK for awhile, but I'm not sure if that was so much for the depression of bipolar or because I have fibromylagia too and Cymbalta is often prescribed in lower doses to help with fibro pain and less pain could equal less depression. Most SSRIs give me mania if I take them longer than 3 months or so though sometimes my pdoc has prescribed them short term (usually Wellbutrin & Effexor, the 2 I seem to respond to best).

I hope things start normalizing for you soon!

Sorry you're going through this clp. It sucks when this happens on a weekend and you have to wait to talk to the doctor. Was the doctor who diagnosed you with bipolar a psychiatrist? I find it helpful to see a psychiatrist rather than just a pcp, because psychiatrists understand mental issues and psych meds a lot better.

Thanks, hearing from people here and my pdoc that the cycling is part of the illness and should hopefully level out with a higher dose is keeping me somewhat sane while I wait it out. I appreciate the response! Doubt I will go anywhere near an antidepressant again, especially because I was on it and in that episode for at least 4 months and am pretty shaken up by it. Did help with my reactive arthritis pain, though. Glad the Lexapro works for you!

Yes! Neurontin can, and does for me, trigger massive mania - to the point my hypersexuality gets completely out of control.

Yep, that's exactly what happened to me, though my pharmacist did not seem to think that (2) doses of Gabapentin would cause it, just perhaps "trigger" something already in play.

Bottom line, the psych nurse stopped the Gabapentin, and changed the diagnosis to Bipolar last week, based on reactions to the Lexapro first, then the Gabapentin, and after hearing about the reactions I had to the "cocktails" I was on for the original MDD dx in 2006. It makes sense to me...logical, based on my history, just never connected the dots.

Nevertheless, I am struggling with this new dx...not so much the dx, but that so far have not found more than "try this med.….try that med". Nah, it still bothers me.

I am still unpredictably cycling between depression, anxiety, irritability and over-excitement----sometimes all at the same time. I have been started on low dose of Divalproex ER. Been on it for just over a week. I haven't noticed full-blown mania like a couple weeks ago, but most nights I can't fall asleep, and the past couple days all I wish I could do was sleep to turn all the anxiety off. Maybe I just feel so mentally exhausted, and just starting another new job....

Sorry the ramble. I do that a lot. It's not just in talking, apparently.